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gogogo last won the day on August 5

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  1. I am very interested in FM and definitely recognize its benefits, but it is important to be critical of any specialty so that we can understand what we are getting into. It's important to remember that all specialties will exaggerate their pros and downplay their negatives; it's marketing just like anything else. So, for the sake of being a devil's advocate, let me give a different perspective on the benefits of FM: Jobs It's true, FM has jobs everywhere. But let's be realistic: How many job openings do you actually need? It's not as if you're going to switch your clinic every year. You'll find a clinic you like and stay there, in all likelihood. I also think that the tight job market in at least some of the other specialties might be overplayed. Speaking to people in certain specialties, they seem to be confident about the job market, even in specialties that, from the outside, I'm told have a tight job market. Of course, if you want to work downtown Toronto, then it'll be difficult to get a job. But if you're okay with working in the suburbs/community, it seems there are jobs available. I think it's important to talk to people in the field, especially residents in their final year, to get a different perspective. Lifestyle FM has the best lifestyle, but other specialties have it pretty good as well, like dermatology, ophthalmology, and outpatient IM specialties. I've also been told that you have a lot of control over your hours as a staff even in the more demanding specialties. I also check the hours of FM clinics in my area, and there definitely are FM doctors who are working 50-60 hours a week, including on weekends, and pretty late into the evening. Residency lifestyle seems awful for any specialty and is temporary, so probably not worth thinking about. Income I'm still learning about FM salaries, but it seems AB is an outlier (isn't AB in the news now for trying to unilaterally slash funding?). In ON, it seems reasonable that, on average, you'll make ~200-250k as an FM working 40-50 hours/week. Some are efficient and can do more, but some are not as efficient and work more hours for less (especially when you include the time they spend doing paperwork outside of clinic hours). And being efficient to make more money might not be enjoyable for some people because it requires faster appointments. Of course, 200-250k is a good salary, but your colleagues, who only put in ~3 years more than you, are making 100-200k more (or even 2-3x more in specialties like ophthalmology or dermatology, with an equally good lifestyle). I know this shouldn't matter, but as med students with type A personalities, it's hard not to allow comparison to be thief of joy. And to elaborate, you have to be in the 80th percentile of FM in ON to make 320k after overhead (see here). It's good to be ambitious and be inspired by these numbers, but there is a reason that only 20% of FM in ON are billing that high. We can't just say that 80% of FM in ON are lazy or inefficient doctors. If so, then perhaps be prepared to be like them, because by definition, we can't all be in the top 20%. Scope There are niches in FM, but again, there is probably a reason most don't do them. For example, to be a cosmetic FM, you have to build a clientele and compete against other specialties doing cosmetics, like derm, ENT, and plastics. Splitting your time between regular FM and a niche could also prove to be difficult, because the days you spend doing the niche (e.g., cosmetics) are days that you're not giving time to your regular FM patients. The latter patients will then be angry with you. ER has a rough lifestyle, OB has a rough lifestyle and probably requires that you work outside of the city, etc. I also find it almost self-denial to say you want to go into FM because of the +1 opportunities. It's basically saying that you want to go into FM so that you can *not* do FM. If you are interested in a niche, perhaps it's better to just go into a specialty that does that niche? Matching I agree with this. But there are negatives to everything. Instead of sucking up to staff and residents to get research opportunities, as an FM doctor, you have to "suck up" to patients by putting up with their vague complaints and frustrations with the healthcare system (because you are their primary care provider/their first exposure to healthcare). For example, dealing with a chronic back pain patient who says nothing works for them is a very frustrating experience for everyone involved. Overall, despite everything I said above, based on my limited training thus far, I think FM is great. But I think it's important to critical. FM is not an easy waltz into a 300k salary and requires sacrifices just like any specialty.
  2. I have heard of people using those and they seem to like it. Part of med school nowadays is finding the resources that work for you. I don't use those because I'm satisfied with my resources. First aid has nice quick summaries of topics, but you shouldn't use that until you have the background from sources that go more in-depth (like Merck and Costanzo); First aid can be your "refresher." Pathoma is the same idea, but for diseases. Boards n beyond seems pretty good, but I don't want to pay for it. Not sure about Step 2 ck.
  3. As a med student, I think GP income is quite an enigma and still haven't been able to get an handle on it. Offmychestplease's numbers seem justified for Alberta (based on another post, he'll show you the data to back it up). But, I've spoken to residents who will say that the typical family doctor will gross (i.e., pre-overhead, pre-tax) 300k in FFS and 400k in FHO (I'm speaking about Ontario specifically). FHO positions are very hard to come by in metro areas and usually only open up ~2+ hours outside of the city. If you want another source of data, go here: https://www.cihi.ca/en/national-physician-database-metadata. Download the NPDB data table release and go to the table showing "Gross clinical payment per physician, by specialty, 2017–2018" (Table 3.3). Looking at Ontario, those in the 60th percentile are grossing 335k (roughly 234k after an average 30% overhead) and in the 80th percentile 460k (roughly 322k after overhead). Trimming the data by those who gross at least 100k, we find that the mean in Ontario for FM is 364k (roughly 250k after overhead). So, 250k seems to actually be the average rather than on the low end. But also remember that this is an average of those who work FFS and those who work in a capitation model (e.g., FHO). FHO is likely pulling it up a bit. From my understanding, to beat this average, you can (a) go rural, (b) do high volume/be efficient (e.g., cut out social chat or do walk-ins), (c) some niche (e.g., pain clinic), (d) work longer hours (your 50 hours is above-average, from what I hear), or (e) learning how to maximize billings properly. Some also state that family doctors make extra income from private fees (e.g., workplace forms). But, I'm not sure how prevalent that is. All in all, I think it's safe to assume 200k-250k, but with some creativity, perhaps you can exceed that.
  4. I think you got a good response above. I'll just add two points that have helped me: Anki and other resources First, anki is very important. I recommend doing Zanki step 1 for pre-clerkship (and step 2 closer to clerkship). Step 1 will have some cards that are very nitty-gritty and obviously just for the step 1 exam; I suggest suspending these. But, it's very good for understanding the basic physiology of every system (supplement it with reading the Costanzo textbook for physiology; this textbook is a very good balance between depth and conciseness) and a decent overview of the diseases you'll learn about in pre-clerkship (supplement that with Amboss, Osmosis, Merck Manual, and youtube as needed). Zanki Step 1 will not cover everything your curriculum covers, however. For that, you should make your own cards and add them to fill in the gaps. For every disease and system, I suggest starting with Osmosis for a broad overview (it'll explain things in simple terms for someone who has no background). After that, read Costanzo to solidify the physiology. Then read Amboss or Merck for solidify understanding of the disease (American Family Physician is also good). Lilly is pretty good for cardiology. I don't recommend textbooks for any other system because it'll be overkill. Toronto Notes is good for knowing an approach to presentations, but for someone just starting med school, I think it's too bare bones and you won't really understand anything until you've developed the fundamentals. Change your mindset towards studying and knowledge I also came from an academic background that was not content-heavy and required more problem-solving and applying concepts vs. memorizing facts. For this reason, I've found that posts from engineers about their experience in med school to resonate with me (there are a few if you search google). I started med school trying to understand everything in a broad, conceptual way. I found that this did not work very well, was inefficient, and also made me lag behind peers. I noticed that the most successful students in my class weren't focusing as much on the "why" and more on the "what" and "how." They spent way more time memorizing. So, I changed my mindset. Med school is not like engineering where the emphasis is on understanding broad concepts and applying that knowledge via critical thinking. Of course, you have to understand the basics of physiology and anatomy. But, at least for now, once you know the basics of the physiology, way more time should be spent on memorizing anatomy, pathophysiology, lists of symptoms, indications for tests, names of medications, etc. Those who come from a traditional premed path may find this easy and perhaps even a review of what they already know, but for those without this background, I think it's quite an adjustment. Be prepared to spend long hours memorizing rather than problem-solving.
  5. Another consideration is how much of the kind of work that you don't enjoy as a resident will follow you as staff (e.g., research, administrative roles, etc.). If staff are doing similarly boring tasks as you have to do as a resident in this specialty, then you either (a) have to get used to it or (b) stop considering this specialty. If it's just a hump you have to get over to "pay your dues," then I think it's worth it to achieve what you want in the end.
  6. Someone more knowledgable should chime in, but I believe you're right: the big incentive is that it allows you to practice FHO in a non-high need area. I see job postings from a clinic in downtown Toronto offering this option frequently. Good luck getting an FHO spot in downtown Toronto otherwise. I do occasionally see postings for FHO spots 1-2 hours outside of downtown Toronto (not NGEP, just normal FHO), so if you're willing to move there, I don't see why you would enrol in this program and restrict your income. The compensation of ~180k over 3 years is low, but if you look at the postings here from new FM grads, those working 35-40 clinic hours a week in the GTA are making ~200-220k, so it's not that much lower. From what I hear, FHO can be very lucrative, so perhaps after the 3 years of restricted income, your income could probably double. On the other hand, if you're willing to work hard FFS right out the gate, NGEP would not be a smart choice financially. But NGEP does come with the assurance that you'll have set up your practice after 3 years and can count on that and down the line, probably work fewer hours to make just as much as the hard working FFS family physician.
  7. I feel the same as you. I'm pretty set on FM because I am content with it (I don't mind the "negatives") and have chosen to focus more on other aspects of my life that make me happy. I think it depends on your personality. Personally, I used to be much more ambitious when I was younger. But I saw what pursuing success at all costs leads to and I realized it wasn't worth it to me. I like the rest of my life too much. Case in point: As intellectually satisfying and enjoyable it can be to understand something, I find that whatever pleasure I get from an intellectual pursuit is the same pleasure I get from simpler things, like having free time, being around family, and pursuing my hobbies. If you cannot live life without feeling as if you've reached your maximum career potential, then that's the only reason I'd say you should consider a specialty; but understand that pursuing your maximum career potential means sacrificing other areas of your life. There's much more balance with FM that I think is appealing and only becomes more appealing the older you get. But maybe clear your headspace first to make sure that you're not choosing FM just because it's an escape.
  8. I am not at all trying to dissuade you. Medicine, from a purely career standpoint (pay, respect, impact, stability, autonomy, etc.) is very good and very hard to match in another industry in Canada, as long as you know what you want from life and pursue a specialty that fits that (e.g., if you want money, probably don't go into peds; if you want lifestyle, probably don't go into neurosurgery; if you want a specific location for work, probably don't go into general surgery, etc.). I will point out the many pitfalls in other careers for people who think that the grass is greener in other careers. Most other careers don't enjoy the purely practical benefits that doctors get. And that part is fantastic for doctors. I was specifically responding to your idea that medicine provides a career where you get to practice science every day. If that is what you are looking for, I don't think medicine is the right pick, because I don't consider most medicine that scientific in practice (it is obviously based on scientific research, but most doctors don't want to deal with that). P.S. Some of the issues you pointed out with engineering (low stability, office politics, hours) could end up being issues in medicine too. So, just be careful about which specialty you pick (if you decide on medicine). Specifically, some specialties have less stability (e.g., many surgical specialties have a poor job market); most hospitals have lots of politics; and hours are usually long. But back to my point above, if you know what you want from life and know what you are willing to sacrifice (e.g., I've heard that you have to pick two of the three: money, prestige, and lifestyle), then you can find a specialty in medicine that will provide that.
  9. Congratulations on making the career switch. I did it too and medicine is better than my previous career. I am also "older" than the average med student, though not that much (27). I do not agree with you about how med school and residency won't force you to put life on hold, however. By "on hold," I don't mean life has to stop. You can for sure get married, have a kid, buy a house, etc. if your circumstances allow. So instead, by "on hold," I mean not have as much time for those things as you would want. I am speaking as a med student in a long-term stable relationship and who has older parents in my class. Med school is all-consuming, especially clerkship. Residency is probably the same. Of course you can "make it work" during this time. But I don't think it's ideal. I am putting off kids for after residency because I can't imagine how I'll be a parent while I'm studying all the time. My partner is extremely supportive and understands why I barely have time to spend with her. Even when we do spend time, I am studying 90% of the time. The fathers and mothers in my program are going through the same thing. They don't have much time for their family and it's the partner who is shouldering most of the domestic duties. So of course, you can get through med school and residency while being a parent, but it's a very, very tough ride. Many of the younger students in my class also broke up with their partners pretty soon after med school started. Your experience may be different and I hope you find a way to make it work!
  10. I feel like I could've written your post a year ago. I also first studied in a scientific field with poor job prospects and saw medicine as a perfect solution: it's scientific, has great salary + security, and it allows me to communicate with people--all big plusses to me. Now that I'm in med school, I see it a bit differently. I can only speak about medicine from the perspective of someone in their first year (who is also burnt out from studying all the time), so you may to wait for staff to comment on what I'm saying too. But to reply directly: 1. Economic security is very important. Again, I know how you feel because of my previous field and how after all of my sacrifices, I was faced with an undesirable financial situation and job prospects. But make sure you enjoy medicine because otherwise, no amount of money will compensate for the misery it causes you. This is a very common path to disappointment that many doctors are on. I had heard of people saying "don't go into medicine" before I started and I didn't understand where they were coming from. It seemed like a perfect job to me. But I am starting to understand their feelings now that I'm in the field. Just do you due diligence to figure out if you like medicine for the right reasons. 2. I do not consider medical practice a science. Maybe this changes when you are staff and again, maybe it's different in academic centres where you come across rarer diseases and need to figure it out. But so far, it's a ton of memorization. The students doing really well in my class are not that focused on the "why" of the disease, but rather, just the "what." They can, in a split second, list the common symptoms of any disease, the way to diagnose it, and the first-line medications/management. This is very different from conceptually thinking about a problem to come to a creative and critically-planned solution. When you practice, from my perspective, it seems like almost everything you see in clinic becomes mundane and you just get faster/more efficient at recognizing what the problem is. You follow algorithms. For example, if a patient comes in complaining of fatigue, you are taught to follow an algorithm to rule out the various causes of fatigue and narrow down your diagnosis. There isn't that much thinking in this, especially after you've done it 20x, because you're just following the steps until you have your diagnosis. And then when it comes to medications, you again just look it up to find which medication is the best fit for your patient. If you want more detail on what the practice of clinical medicine is like, just search "[disease x] american family physician" in google and go to the page to see how doctors approach a disease (here's an example). This is just family medicine, but my impression of other specialties so far shows me that it's pretty similar. As for specific examples of engineers going into medicine, here's an example (scroll to the response by HeyNow_HankKingsley, an engineer who didn't enjoy medicine). Here's another thread (look at what elevation and MarsRover have to say). I want to emphasize that I'm just a med student, so please see if staff agree with this assessment or they think medicine is scientific with a lot of critical and creative thinking. 3. Lots of people in tech are also self-taught. Maybe consider that as well. I know the dissatisfaction you feel, but maybe take some time to reflect. Don't make a decision out of disappointment.
  11. I agree with offmychestplease. Three more points for you to consider: 1. Do you actually think you'd be okay with starting medicine at 30? That's a major life disruption. Basically, you'd have given away your 20s and 30s to academic work. Please consider this seriously. Your life will be on hold until you're ~40. If you decide to marry and have kids during med school or residency, you won't have much time for them (even if you do family medicine, your life during med school and residency will still be nearly all-consuming). I am studying nearly non-stop every day and I started med school at 27. Please make sure that you are willing to sacrifice your 20s and 30s for what, at the end of the day, is just a job. 2. Those who go into medicine from a field requiring more creativity/thinking sometimes struggle/don't enjoy medicine. There are specifically posts from engineers in this forum and in others online where they lament that medicine is just memorization and they miss *thinking* like they did in engineering. I agree with this, too. I came from a field that was more about the big picture and critically thinking about problems. So far, my experience in medicine is that there is almost none of that. You memorize symptoms, indications for tests, etc. and follow guidelines. It feels pretty robotic. So, perhaps reflect a little more deeply about what drives you. It may be that medicine is not in fact the "engaging, challenging and science adjacent career" because, personally, I don't consider clinical medicine akin to practicing science at all. It is basically pattern recognition and you just get faster at that (academic medicine may be different, though the vast majority of doctors are not in academics). I encourage you to read more about engineers who switched into medicine and see if you'd be okay with the transition. Of course, this may be different once you start practicing; I can only speak about med school and my impression of the field. 3. Is there something else closer to engineering that you may enjoy? What about doing a degree in CS and going into software engineering, or doing a masters in data science and pursuing that? These are options that are closer to your field with a good job market/good pay but which would require less sacrifice and would allow you to start working sooner.
  12. No worries. It'll seem daunting at first, but just download the program, download AnKing, and start. You'll learn through doing it. It took me ~1 week to get the hang of it and just make it a habit. Look into basic guides on how to use Anki but don't go overboard.
  13. As far as I know, we don't have one specific for Canadian med schools, but medical knowledge doesn't really change by country . Step 1 and Step 2 will cover such a vast ground that you'll have all the knowledge needed for pre-clerkship (I can't comment for clerkship--not there yet--but I hear that step 2 + UWorld is a good combo). The Step 1 deck will sometimes cover things that are very nitty-gritty and are obviously just for the Step 1 test, so you could always just suspend those cards (i.e., turn them off and not see them again). So, I still highly recommend doing AnKing even it it covers stuff you won't cover or details that seem extraneous (again, just suspend them). AnKing has been developed over years with many contributors and it would take a lot of your time trying to create cards. It'll provide you with a very broad and sufficiently in-depth understanding of pre-clerkship medical knowledge. Don't worry that by following AnKing, you may not be following your school's curriculum. A good compromise would be this: Imagine you've started cardiology at your school. Look through the AnKing Step 1 Cardiology deck and compare it to your school's curriculum. If you find that there is a topic your school really focuses on but AnKing doesn't, then add cards just for that. Like that, you can "fill in the gaps" where needed but also have the assurance that the rest of the deck is covering everything you'd need to know.
  14. Anki is fantastic for learning. Look into the AnKing deck (or make your own, but I recommend the former). In the AnKing deck, Step 1 will cover every system's physiology and pathology. Step 2 will be more clinically oriented and is supposed to be for clerkship (so I recommend AnKing Step 1 to get a foundation). It's a lot of cards (25000+), so start soon and be committed to the reviews (otherwise, you will forget things easily). The biggest "issue" people point out about Anki is that it promotes memorizing little details that would only benefit on a multiple choice test. I agree with this *if* you just use anki as a memorization tool. So to counter that, whenever I do a card, I make sure to do a quick summary of the clinically-relevant/big picture stuff when I answer it. For example, if the card says "[blank] is a risk factor for coronary artery disease," I'll answer the question, but *in addition*, I'll quickly remind myself what coronary artery disease is and how it presents. You also have to constantly be making the big-picture connections between cards, otherwise you'll again just learn small facts without understanding the concepts. So do all the background reading needed and then go back to the cards to solidify that learning. If you do what I say above and do your anki reviews every day, I promise you'll be a top student during med school.
  15. I would say it matters. I may be assuming here, but if you're in your early 20s and just starting med school, you may not care. But once you hit your late 20s/early 30s and are a resident with 100k-200k in debt, and you see that your friends who started working out of high school/undergrad are married, have kids, and a house, you'll really want to rush to get started on your life. If you limit your debt during med school, you can get a down payment faster, then house, etc. Of course, your staff salary will be nice, but it takes time to raise a decent downpayment and catch up to your non-physician friends who have been working for ~10 years already.
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