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monocle

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  1. What I want to do lots of work with can only be done in large centres (robotics), and it's always been kind of the dream to be faculty in a metropolitan city. I've jumped through all the hoops so far, and I think I've got a step up on most of my peers on terms of academics. Now, if I'm being asked to be a clinical associate my opinion might change. I would be very hesitant to enter that kind of a deal which only realistically grant me a shot, and not a position, at the end of it. It's very discouraging to hear that this kind of craziness is the new normal.
  2. Does this apply to most specialties in Toronto (the whole clinical associate thing)? I've done my fair share of academic slavery, but I wasn't planning on doing any more beyond a fellowship (already have a Masters) to at least have a shot at an academic position. If I'm asked to CA, I don't know what I'd do as I've been working towards this goal for several years now. I think that's very unfair and akin to daylight robbery considering you could be losing anywhere from 150-300K a year while going through it. I don't get off/orgasm over research or teaching at all, but I'm willing to do it if it secures me a spot. This is some real bullsh**, incredibly discouraging!
  3. This is quite concerning considering I've already busted my ass landing a spot in a surgical specialty and my goal is to work in a large center. Welp. When does the grind end?! How do I make myself more competitive from day one? I've already done a post-grad degree and will be doing a fellowship/s.
  4. I would definitely consider spending the $500 on the practice exam this time around. As the MCCQE1 is now a limited attempt exam, you want to just get it out of the way. Really dive into the questions on the practice test, read the explanations - esp. on terms of ethics. It will be the most high yield thing you can do. Explore how the CDM section works. I would recommend UWorld+TNotes+MTB Step 3, but if you want to be extra prepared you should also do the ethics/population etc. questions from CanadaQBank again to have that covered (I feel this is the area a lot of IMGs have trouble with). Good luck, and don't you dare lose hope or sleep over this.
  5. Thank you! As for your question, I wouldn't give up that easily - you were really close. What I would suggest is reading all the CPSO guidelines on their website (mandatory reporting, relationships with industry etc.) and read through high yield sections of the AFMC primer (the TNotes epidemiology section is based on this, just expand on your knowledge using the primer). Make sure you know those CPSO guidelines inside out. Secondly, it's essential that you get a new copy of TNotes. Several ethical things have changed since 2011, most notably medical assistance in dying (MAID). Considering your background as a qualified GP, medicine is the area you'd want to pay the least attention to. Focus on Psych, O&G, Paeds and selective surgery. Try to build a super strong base of the common stuff (Asthma, depression/bipolar, COPD, MIs, common infections, heart failure etc. - the big stuff) and chase unicorns later (i.e. specific glomerular diseases). Ditch CanadaQBank, it's garbage in my opinion. Use USMLEWorld and the practice tests on the MCC website. When you don't know the answer, look it up (esp. ethics).
  6. Hey buddy, I know this must be a really tough day for you but honestly, it's a roll of the dice. You just had a bad day. Do not be too hard on yourself. It doesn't have any bearing whatsoever on how good a doctor you will be. You weren't that far off, just 11 points behind. Just book it again (I think applications are open now) and go for it if you feel confident. Please note that they only allow 4 lifetime attempts of this exam, kill the ethics section next time and you'll be done. If you need any specific help, feel free to ask!
  7. Well, I don't know how, but I managed to pass with a respectable score. Thank god the written section of my MCC journey is over!
  8. Page 6 onwards: https://mcc.ca/media/MCCQE-Part-I_Standard-Setting-Report_July-2015.pdf
  9. Yeah well the term “percentile based” implies that other people’s scores (where the distribution would come from) matters, but it doesn’t. The difficulty is determined by a panel of medical educators who are given stacks of questions and they make subjective assessments of whether it’s an easy, medium or hard question. They use the Bookmark or Angoff method I believe: https://files.eric.ed.gov/fulltext/EJ1027679.pdf. This is the only other variable that affects your score, but it doesn’t provide a positive multiplier unless you get the question right, so if your whole exam was hard, there is no benefit. and yes, I haven’t heard of a board exam which isn’t percentile based either, which is why I am confused by this choice by the MCC.
  10. Where did you get it's "percentile based" from? Could you explain what you mean by each exam is unique in how it's scored? As far as I'm aware, there is no curve or statistical analysis being performed, it is just the raw score you personally get. I'm getting my information from the MCCQE1 website, where they specifically mention it's a criterion referenced exam and how other people perform has zero impact on whether you pass or not, it's just whether you get the passing score. They then go on to say each question is worth a point, and the difficulty of the question somehow factors into it to be worth more or less points. 226/400 = a ~50% score.
  11. Pretty much this. Just know that thousands of people like you have felt the same way, walked down that road and made it home safe in the end. Clinical experience and relating that pre-clinical knowledge to a real living and breathing patient is what solidifies the information in your mind. The reason for this is that your patient's life depends on it, and you have a duty to deliver the best care you can. It isn't just to get through some exam. The motivation to know your algorithms and keep up to date is much more relevant and fun because it allows you to do that.
  12. I would give the practice tests and see how you do. It can definitely be prepared for (kind of), but I personally feel hands on clinical experience is essential to success in this exam. A lot of the answers are based on your gut feeling rather than you knowing it cold. Even then, it may not help you - it's a bit of a lottery.
  13. Yeah, the CDM part was like a fever dream, totally bizarre. I think I did OK on it, but that in itself worries me that I might have overlooked something. I also think the exam wasn't subjectively "hard", they just don't ask the bread and butter stuff you would expect on a clinical exam like this and the answer options quite often give two right answers out of which you have to choose the "best" one (and knowing the "best" one is just a gut feeling usually). No idea how it (or the entire exam) is graded. For example, there are 210 MCQs (180 without pilots) and 60-70 CDM (55 without pilots) questions, the MCC website says all of them are "worth" one point. That gives you a maximum "raw" score of of 235 and leaves 165 points on the table, where do those come from? As far as I'm aware, they use some statistical method to relate the raw scores to question difficulty and then give you a final score.
  14. Hey, I feel exactly the same way if that's any consolation (sat it yesterday). Not confident with it at all. To top it all off, the passing score is now >50% (it was previously ~30% in 2013 and then in the ?40s before this most recent change). Don't let old fail rates fool you, they have and will go up. I don't think it's a very well designed exam. The new changes are also kind of unfair on the new cohort of students (they group the questions now e.g. an abdominal pain can be O&G, paeds, psychiatry, surgery etc. they only balance it so you get an even distribution of different cases, not by specialty like it was before so if you get 60 paeds questions you're SOL). I can recall about 130 MCQs and about 30 of the dubious ones I can't answer even now with the aid of Google and PubMed. You won't find the answers to these questions in a book, and your responses are mainly instinctual/gut feelings. The time is ridiculously short for the MCQ section and I was struggling to complete it. In contrast the CDM section I had two hours to sit and mess around with. Many questions test non-standard concepts (e.g. the most common symptom/most prevalent risk factor etc.) instead of focusing on the pathology, diagnosis and management like the USMLE. The questions aren't thoughtfully designed and include controversial subject matter (e.g. controversial treatment options, off-label drug use). There is far too much emphasis on ethical dilemmas that only a medicolegal practitioner should know.. I'm hoping and praying I pass because I don't want to go through this exam again. Even if you study for it inside out, there's still a chance you will do poorly. It's a throw of the dice on what questions you get.
  15. Like anything, any changes need to be evidence-based, not based on anecdotes. E.g. are there any confounders? Do the children of rich parents also have more opportunities to excel at things like research, networking etc.? Do they have better social skills? Is this actually happening to the level where it skews the entire match in the first place? Regardless, a vast majority of CMGs are matching to positions in Canada. It is very unfortunate that some people do not match and I do understand how this is disastrous. The reasons for this need to be looked at properly and changes implemented as required.
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