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gogogo

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  1. Like
    gogogo reacted to offmychestplease in If you like FM, is there any point in exploring other specialties?   
    Thank you for providing these points. I just want to add, though:
     
    Jobs:
    For some (many people), they want to only work in Toronto/Montreal/Vancouver/Calgary and not rural/smaller centres. Let's not kid ourselves. For many specialties (surgery for example), it is extremely difficult to land a position in these locations without connections + luck + further fellowships etc. Some people are not willing to compromise on location. With FM, this is an non-issue. 
    Lifestyle:
    To get the "cush" lifestyle of optho, you need to go through 6 years (residency + at least one fellowship) of very demanding surgical training in an age when most people are getting married/having kids. I understand that the lifestyle is different after, but for some people who already had to go through so much to get into medical school in the first place, then go through medical school, 6 years is not an insignificant amount of further time to grind to then be able to finally have a "better life." 2 years of FM VS 6 years of surgical training are nowhere near comparable in any way.
    Income:
    I agree with you here. It is hard to argue that many specialties will not make significantly more, on average. But again, the potential is there in FM to make a lot and having years of time to invest money does mitigate some of the difference. 
    Scope:
    I agree with you that there are pros/cons to all these niches but the whole point is that FM is flexible you can bounce around different ones or even have a practice where you do multiple at the same time. Few specialties allow you to do that without being hyper-focused on one area. 
    Matching: 
    You're right. Again, I guess you can't have it all. But I just think from an overall pro/con and cost-benefit analysis especially after the 8-10 years of university education that medical students have under their belt on average after medical school, FM seems to be a great option.
  2. Like
    gogogo got a reaction from MedicineLCS in If you like FM, is there any point in exploring other specialties?   
    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. 
  3. Like
    gogogo got a reaction from MDinCanada in If you like FM, is there any point in exploring other specialties?   
    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. 
  4. Like
    gogogo got a reaction from Nirvanesthesia in If you like FM, is there any point in exploring other specialties?   
    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. 
  5. Like
    gogogo reacted to MDinCanada in If you like FM, is there any point in exploring other specialties?   
    I would argue that a good portion of the FM doctors who are unhappy would also be unhappy in any other specialty. 
    Probably a big portion of the people who chose FM are those who realized that medicine isn't what they expected, they became burnt out towards the end, etc,
    I also noticed that surgeons are happy being surgeons even while being bullied by their seniors, working awful hours, etc., not because they find the job itself fun, but just because they have intrinsic "happy" personalities or it's a cemented defense mechanism to prevent them from having an existential crisis/dropping out of residency.
     
  6. Like
    gogogo got a reaction from frenchpress in Could I please get some advice on how to study in medical school? Or additional resources to use?   
    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.
  7. Like
    gogogo got a reaction from honeymoon in Could I please get some advice on how to study in medical school? Or additional resources to use?   
    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.
  8. Like
    gogogo got a reaction from bruh in Australian Trained GP - salary coming back to Canada   
    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.
  9. Like
    gogogo reacted to ellorie in Australian Trained GP - salary coming back to Canada   
    There can be a big mental health component to chronic pain - and for some people who experience chronic pain or any other chronic physical symptom, it's really difficult/impossible to accept that there may not be a "medical" diagnosis/explanation or cure, so people continue to request demand more tests and more treatments (e.g. opioids) that are not really clinically indicated, and this can be a point of major polarization.
    In many cases, we feel it might be most helpful for people to accept that pain is likely to be part of their life going forward, that there may never be a clear medical diagnosis that can be "fixed" and that it may be important to do things like rehabilitation, engaging in daily activities as best as possible, trying to get back to work, and working on addressing ways of thinking about and interpreting pain, whereas some people may experience that as invalidating and continue to request/demand that a solution be found to the point of being unwilling to engage in any other kind of approach.  Also high comorbidity with various mental illnesses, and many non-psychiatrists don't always enjoy working with people with things like personality disorders or trauma or somatoform disorders or substance use disorder or things like that because it isn't always really imminently fixable and it tends to create difficulties building and maintaining a therapeutic alliance, leading to anger, lots of emotion on both sides, etc.  Many doctors also struggle with treating patients with problems that can't be fixed, because for some people, that doesn't feel as satisfying and can feel pretty frustrating.  Others are ok with it - it's just a personality thing about what we derive value from in our work.
    That would be my best guess - I don't work in pain but I do see a bunch of these folks from the other side.
  10. Like
    gogogo got a reaction from procrastinating in Not happy in medicine.. Not sure what to do?   
    I'm only in first year, so perhaps my comment will be naïve (though I'm non-trad, a bit older, and didn't come into med school with rose-coloured glasses). I have days where I wonder why I'm doing this, and days where it feels amazing. I think that's part of the process. The better you get at something, the more you tend to enjoy it. So being incompetent now and feeling bad about that are not how you'll always feel if you keep working hard to get better. It also probably wouldn't be different in any other job. You'd also feel incompetent in another occupation in the beginning.
    It's also worth wondering how much these thoughts stem from you rather than medicine. People who are self-critical will be that way no matter what the setting is. Not saying that's the case for you, but it may be, especially if you're thinking "I would've been happier doing X" (which is usually just a fantasy that people conjure during the worst of times; i.e., grass is greener phenomenon). I was on track for a different career before medicine, and I'll tell you, regret over one's career choice is present in all fields, maybe especially in high-status fields (e.g., law, medicine, finance), because people with ambition usually find ways to be unsatisfied and therefore strive for even more. But it's worth remembering how lucky we are to have been accepted and have access to a job with a level of pay, stability, respect, and impact that many others would love to have.
    More practically, it sounds like you don't like internal medicine or the hospital setting. Maybe things will change during another rotation, such as one in a clinic with more reasonable hours. Medicine is really diverse across many dimensions. It also sounds like you don't like your preceptor. I've been told not to let my opinion sway because of a good preceptor vs. bad preceptor. Your environment and lifestyle can have a huge effect on your wellbeing, so when you find an environment and lifestyle that fit you, I'm guessing you'll feel better and remember why you chose to go into medicine.
    Hope things get better for you!
  11. Like
    gogogo got a reaction from honeymoon in Feeling exhausted... How do I decide on a specialty?   
    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.
  12. Like
    gogogo reacted to McBurneysPoint in Feeling exhausted... How do I decide on a specialty?   
    I was in the same boat during clerkship and decided to pursue FM. I enjoyed the cerebral aspects of IM and really digging deep into patients' issues, however, realized that I am one of those people who work to live, not the other way around. I wanted the flexibility and time to spend it with my significant other and the thought of relocating potentially three to four times up until staff life was not something I wanted. At the end of four years, I just wanted to be 'done' and move on with life, rather than go through another gruelling 5-6 years of stress and uncertainty. 
    I think my happiness stems from time with family, ability to live where I want, and time that I am able to spend on hobbies etc.
  13. Like
    gogogo got a reaction from Lesigh2 in Feeling exhausted... How do I decide on a specialty?   
    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.
  14. Like
    gogogo got a reaction from KawhiMD in Feeling exhausted... How do I decide on a specialty?   
    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.
  15. Like
    gogogo got a reaction from Haribo7173 in Feeling exhausted... How do I decide on a specialty?   
    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.
  16. Like
    gogogo got a reaction from HongHongHong in Debt levels per year?   
    Average seems to be about 100k by the end of med school, but if you have no support and no savings, 150k is common, and 200k isn't unheard of either. If by "aim to reach" you mean what level of debt is reasonable, that also depends on your situation. Schools differ in terms of cost of tuition and cost of living. My advice is to figure out your fixed costs (e.g., tuition, rent) and variable costs (e.g., recreation, food) and find ways to reduce both (e.g., cooking at home vs. eating out, renting a cheaper place, cheaper car, etc.). 
    Although you'll make it all back later, I think some students go overboard with using their line of credit irresponsibly, such as getting a nicer apartment than required. The lower your debt at the end of med school, the more you can use your resident and staff salary for yourself. So, try to find a balance between comfort and frugality during med school.
    Finally, be very persistent about scholarships. I wasn't eligible for many of the ones at my school and had to go through a bunch of administrators and email them reminders over 5 months. In the end, I got ~$7500 from funding that wasn't advertised on the scholarship page of my school. If you're persistent, you can probably find scholarships to offset costs.
  17. Like
    gogogo got a reaction from dh. in 5 year plan for career switch eng to med - seeking constructive criticism   
    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!
  18. Thanks
    gogogo got a reaction from NextChapter in 5 year plan for career switch eng to med - seeking constructive criticism   
    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.
  19. Like
    gogogo reacted to NextChapter in 5 year plan for career switch eng to med - seeking constructive criticism   
    So it sounds like I'm passing the buck but remember we're talking about literal teenagers here. When I was younger I recall that every single person I spoke to from my parents to family friends to guidance counselors, not a single one had any warning at all except 'it might be a tough degree' but otherwise everyone said great choice go for it. Then you speak to people studying at the university who evangelize the program and employees who are basically advertising it for potential students and their parents. Basically every single person I spoke to fell in to two camps. 
    1. Uninformed/dated perception of the modern reality of engineering in Canada (parents, family friends, guidance counselors).
    2. People biased towards supporting the choice (current students, university employees).
    If a bunch of working 22-35 year olds pulled me aside and said listen here's what its really like in terms of pay, available jobs, career progression, etc. I very well may have chosen something else entirely. Though it's tough to say what that would be so many years removed from my naive 18 year old self's decision. Another very worth while exercise would be to mock up an average fresh grads resume and see what browsing indeed and looking at real life jobs is like. I wish I did that when I was 18.
    Of course that's just my personal answer to why there are so many misperceptions about engineering in terms of salary, job prospects, job stability, and nature of the job like you asked. Maybe someone else can chime in if they feel like my answer didn't cover it.
  20. Thanks
    gogogo got a reaction from NextChapter in 5 year plan for career switch eng to med - seeking constructive criticism   
    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. 
  21. Like
    gogogo got a reaction from tallshirts in 5 year plan for career switch eng to med - seeking constructive criticism   
    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!
  22. Like
    gogogo reacted to petitmonstre111 in 5 year plan for career switch eng to med - seeking constructive criticism   
    Unfortunately I also agree that this is an extremely risky plan... I am assuming you are based in Ontario? Have you considered relocating to another province? If you want to get better chances at either Dal or McGill, you may need to consider moving to either provinces.
    While I totally understand the preference for continuing working full-time, I would encourage you to consider doing the opposite: work part-time, school full-time. I would suggest looking into 2 year accelerated nursing, or consider other degrees that could be completed within 2-3 years using some of your engineering degree, and that lead to another profession that you are interested in. Honestly your current plan really doesn’t seem worth it to me.
  23. Like
    gogogo got a reaction from petitmonstre111 in 5 year plan for career switch eng to med - seeking constructive criticism   
    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.
  24. Like
    gogogo reacted to magneto in Ask questions about family medicine here   
    I think it is all about having a positive attitude.
    You can use a similar reasoning for any specialty in medicine and make it look boring.
    Family medicine is about building a relationship with your patients. They come to you for help. They are looking up to you for guidance. I think that is very rewarding experience.
    Let's take diabetes for an example. If you pick up a new diagnosis of diabetes through screening, you have the potential to significantly change a patient's life.
    Let's say no one picked up that this patient had diabetes. It is possible that he/she could present one day to hospital in severe hyperglycemia state with sepsis that could potentially be life threatening. Or he/she can lose vision one day all of a sudden due to diabetic retinopathy. Or he/she can develop chronic kidney disease requiring life long dialysis.
    As a family doctor, you are in a position to screen for morbid diseases like diabetes and then connect patients with the right resources (e.g., optometrist for diabetic eye check up).
    Will you be successful 100% of time? NO. But just because you will fail sometimes that does not mean that it is not worth a try.
  25. Like
    gogogo reacted to magneto in Ask questions about family medicine here   
    It is not only incremental decreases in HbA1c. It is about looking out of your patient.
    A 50 year old male can come to your clinic because he has blood in his stool. You can refer him for colonoscopy and potentially pick up an early cancer.
    Many people don't feel comfortable sharing their embarrassing problems to new people such as a physician at walk-in-clinic or emergency doctor unless they are anxious or super unwell. However, they trust their family doctor because they believe that their family doctor is their quarterback.
    Let's take another example. A patient has a small mole on his skin. He/she is worried that she has cancer. You can do a skin biopsy or small resection under local anesthetic and send it to pathologist for diagnosis. Within a week, you have the ability to potentially diagnose (and even treat) a skin cancer OR give good news that the mole is benign and nothing to worry about. You can possibly pick up an early melanoma and save a patient's life.
    There are not that many things in life where you can play such a crucial role in another person's life.
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