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shematoma

Ontario's 53 extra residency spots

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Spots at my school were offered in internal med (2) and family med (3). I believe 2 spots in each were filled.

Other programs like ER and psych that were included in the press release were not possible due to lack of training space.

Process was by internal match (independently within each school). One could rank all or some of the available programs/locations. Submission involved all the typical documents, CV, letters, personal statement for generalist medicine. No interview. Admission and spots were determined a few days before grad. This was very fluid with meetings between schools and govt taking place well into May to decide on a process.

In order to participate one must have entered the 2nd iteration by agreeing to the contract. I believe actually applying and ranking programs was not a requirement.

Some decided to continue pursuing a specialty. Most here took the deal.  We lost one student to suicide. I am not sure if all the unmatched people at my school were eligible due to the 2nd round requirement.

2 yr return of service, the same contract as for IMG residents. Some limitations on +1 and fellowships that are permitted. Internal med was required to be GIM or geriatrics. Family allowed rural +1 ER, northern anesthesia +1, and care of the elderly. These have to be approved by MOH in advance.

Overall it worked out but was a miserable experience. The admin freely admitted they did not foresee how tight the match would be, with fewer spots than applicants.

Backup plans were year 5 (risking an even worse match year and roughly another 18k tuition + 7 months of electives fees, travel and accommodation) or the armed forces recruitment surge. I wonder how many the army signed on.

Considered leaving medicine, but this comes with approximately 200k of debt that would have been converted to a 10 year term loan, approx 2k/month in payments, with another 50k in OSAP loans. I was more on the frugal side, and self-funded both undergrad and medical studies. My peers from undergrad have been earning at 70-95k/year salary and graduated with low 5 figure debts.

For any premeds reading this, avoid medicine as it is now a high risk game. If I had worked after undergrad and gambled all my earnings away on bitcoin and weed stocks I still would be ahead, while having flexibility where and what field I work in. Having to seriously consider the rural spots (La Ronge, Fort Mac, Grande Prairie, Nunavut, etc) in the 2nd iteration made me realize how much I had taken job portability for granted.

Closely following the match this year. I fear it will be the same or worse, with no rescue from the govt this time.

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1 hour ago, ontariocarmsthrowaway said:

For any premeds reading this, avoid medicine as it is now a high risk game.

I agree. It's not worth it. Sure some people get lucky, match to what they want and then land a job they like in a location they are happy in. But for every story like that, there is a person who didn't match, scrambled into a specialty they hate or ended up with a job or location they hate (I'm in the last category). 

It's not worth the risk. Get out while/if you can. You can be happy with another career and have way more flexibility and way better co-workers. I wish I had known enough to quit early.

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1 hour ago, ontariocarmsthrowaway said:

Spots at my school were offered in internal med (2) and family med (3). I believe 2 spots in each were filled.

Other programs like ER and psych that were included in the press release were not possible due to lack of training space.

Process was by internal match (independently within each school). One could rank all or some of the available programs/locations. Submission involved all the typical documents, CV, letters, personal statement for generalist medicine. No interview. Admission and spots were determined a few days before grad. This was very fluid with meetings between schools and govt taking place well into May to decide on a process.

In order to participate one must have entered the 2nd iteration by agreeing to the contract. I believe actually applying and ranking programs was not a requirement.

Some decided to continue pursuing a specialty. Most here took the deal.  We lost one student to suicide. I am not sure if all the unmatched people at my school were eligible due to the 2nd round requirement.

2 yr return of service, the same contract as for IMG residents. Some limitations on +1 and fellowships that are permitted. Internal med was required to be GIM or geriatrics. Family allowed rural +1 ER, northern anesthesia +1, and care of the elderly. These have to be approved by MOH in advance.

Overall it worked out but was a miserable experience. The admin freely admitted they did not foresee how tight the match would be, with fewer spots than applicants.

Backup plans were year 5 (risking an even worse match year and roughly another 18k tuition + 7 months of electives fees, travel and accommodation) or the armed forces recruitment surge. I wonder how many the army signed on.

Considered leaving medicine, but this comes with approximately 200k of debt that would have been converted to a 10 year term loan, approx 2k/month in payments, with another 50k in OSAP loans. I was more on the frugal side, and self-funded both undergrad and medical studies. My peers from undergrad have been earning at 70-95k/year salary and graduated with low 5 figure debts.

For any premeds reading this, avoid medicine as it is now a high risk game. If I had worked after undergrad and gambled all my earnings away on bitcoin and weed stocks I still would be ahead, while having flexibility where and what field I work in. Having to seriously consider the rural spots (La Ronge, Fort Mac, Grande Prairie, Nunavut, etc) in the 2nd iteration made me realize how much I had taken job portability for granted.

Closely following the match this year. I fear it will be the same or worse, with no rescue from the govt this time.

I'm sorry to hear that we lost another student to suicide. Was this published at all? I haven't read anything in the news since Robert Chu, but I also completely understand if the family wanted privacy. 

I also wonder how the match will go this year. I don't foresee things getting easier.

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4 hours ago, ontariocarmsthrowaway said:

Spots at my school were offered in internal med (2) and family med (3). I believe 2 spots in each were filled.

Other programs like ER and psych that were included in the press release were not possible due to lack of training space.

Process was by internal match (independently within each school). One could rank all or some of the available programs/locations. Submission involved all the typical documents, CV, letters, personal statement for generalist medicine. No interview. Admission and spots were determined a few days before grad. This was very fluid with meetings between schools and govt taking place well into May to decide on a process.

In order to participate one must have entered the 2nd iteration by agreeing to the contract. I believe actually applying and ranking programs was not a requirement.

Some decided to continue pursuing a specialty. Most here took the deal.  We lost one student to suicide. I am not sure if all the unmatched people at my school were eligible due to the 2nd round requirement.

2 yr return of service, the same contract as for IMG residents. Some limitations on +1 and fellowships that are permitted. Internal med was required to be GIM or geriatrics. Family allowed rural +1 ER, northern anesthesia +1, and care of the elderly. These have to be approved by MOH in advance.

Overall it worked out but was a miserable experience. The admin freely admitted they did not foresee how tight the match would be, with fewer spots than applicants.

Backup plans were year 5 (risking an even worse match year and roughly another 18k tuition + 7 months of electives fees, travel and accommodation) or the armed forces recruitment surge. I wonder how many the army signed on.

Considered leaving medicine, but this comes with approximately 200k of debt that would have been converted to a 10 year term loan, approx 2k/month in payments, with another 50k in OSAP loans. I was more on the frugal side, and self-funded both undergrad and medical studies. My peers from undergrad have been earning at 70-95k/year salary and graduated with low 5 figure debts.

For any premeds reading this, avoid medicine as it is now a high risk game. If I had worked after undergrad and gambled all my earnings away on bitcoin and weed stocks I still would be ahead, while having flexibility where and what field I work in. Having to seriously consider the rural spots (La Ronge, Fort Mac, Grande Prairie, Nunavut, etc) in the 2nd iteration made me realize how much I had taken job portability for granted.

Closely following the match this year. I fear it will be the same or worse, with no rescue from the govt this time.

I saw an article where the armed forces got a total of 5 recruits last year into FM programs. There were more spots than that offered but that's how many managed to get through the recruiting process.

I also find it scary how your school admin admitted they didn't foresee how tight the match would be. They only made enough spots to barely clear the unmatched backlog. Isn't it simple arithmetic to realize it's going to be tight?

One can only hope for this year that the somewhat cleared backlog of Ontario students has helped. The slight addition of FM spots in Dalhousie may help too. But we're really grasping at straws.

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10 hours ago, dryorku said:

you mean in general? even going to Canadian schools?

Yes he's referring to his experience as a Canadian grad. I wholeheartedly agree with the sentiment that medicine is not all that its made out to be. If you absolutely love it, and know what you are getting yourself into (extremely hard to gauge until you are in) then go for it, but otherwise find a different career. 

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Just now, dk3what said:

Yes he's referring to his experience as a Canadian grad. I wholeheartedly agree with the sentiment that medicine is not all that its made out to be. If you absolutely love it, and know what you are getting yourself into (extremely hard to gauge until you are in) then go for it, but otherwise find a different career. 

The biggest thing I tell pre-meds and pre-clerkship students is that a huge problem with medicine is that the road is so long that a lot of students may get trapped before they realize that the job isn't a good fit.

It is very hard to evaluate the job until you get deep in the trenches. 

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12 minutes ago, blah1234 said:

The biggest thing I tell pre-meds and pre-clerkship students is that a huge problem with medicine is that the road is so long that a lot of students may get trapped before they realize that the job isn't a good fit.

It is very hard to evaluate the job until you get deep in the trenches. 

Oh for sure. I did not have any family members in medicine and had no clue what I was getting myself into. I thought I knew, did all the "research" but I truly only realized how bad and inflexible the job market once I was in. Funny enough, I think part of the problem is that people in medicine themselves (staff/faculty) don't realize how quickly the situation has changed over the last 4-7 years. They are usually shocked when I tell them about the elective portal process, CARMs process, etc. 

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43 minutes ago, dk3what said:

Yes he's referring to his experience as a Canadian grad. I wholeheartedly agree with the sentiment that medicine is not all that its made out to be. If you absolutely love it, and know what you are getting yourself into (extremely hard to gauge until you are in) then go for it, but otherwise find a different career. 

It isn't but I am not as brutal in my assessment as some people here are making it out to be. It is far from perfect but it isn't that most people are working in places they hate or jobs they hate. That being said you mostly will hear from the people that are super passionate about it or rather bitter. 

Ha, we will see what category I will fall into in 2 years when I hopefully get a staff position. 

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24 minutes ago, rmorelan said:

It isn't but I am not as brutal in my assessment as some people here are making it out to be. It is far from perfect but it isn't that most people are working in places they hate or jobs they hate. That being said you mostly will hear from the people that are super passionate about it or rather bitter. 

Ha, we will see what category I will fall into in 2 years when I hopefully get a staff position. 

I'm sure a large proportion of doctors work jobs they like in locations they want to be in. However, if we subsegment the overall group into recent grads I wonder what the breakdown would be.

I would say that in my graduating class there are both unhappy and happy docs. But, almost everyone I know had to make some sort of compromise with regards to their jobs (mostly taking full-time positions in undesirable communities or back-to-back locums).

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8 minutes ago, blah1234 said:

I'm sure a large proportion of doctors work jobs they like in locations they want to be in. However, if we subsegment the overall group into recent grads I wonder what the breakdown would be.

I would say that in my graduating class there are both unhappy and happy docs. But, almost everyone I know had to make some sort of compromise with regards to their jobs (mostly taking full-time positions in undesirable communities or back-to-back locums).

I wouldn't say that is all that unusual historically though - people often had to start off in some place and work up the food chain. None of this is to say it is fun, and they fail to advertise the reality of medicine far too often. Part of the bias is in academia you are more likely to stay put than many other community jobs and that is all we see in training (people there forever ha). My friends in the community have bounced around a lot more, or have worked themselves up. 

Often not talked about is even in academic the first few years are often "suboptimal" as you are working up to become a partner. 

 

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9 hours ago, jfdes said:

This is incredibly saddening, and terrifying, to hear.

It's saddening, terrifying, and disturbingly not unexpected in the circumstances. I can't even begin to speculate on this individual case, except to say that from my perspective, I can empathize why this whole medical school, CaRMS and residency process might lead to someone feeling suicidal and even going through with it.

Between the stresses of debt, postponing your life and making huge sacrifices... and then either not matching without any hope of ever matching in the future, or maybe you matched to a specialty you don't want in a location far away from your family or friends, it can drive you bonkers. But of course everyone tells you that you should apply for everything you can get your fingers on because matching is better than not matching at all... only for you to end up having to split away from your family/spouse so you can do residency X in city/town/hamlet Y for 5 years because this is what medicine entails. And if you're in that boat, everyone will consider you lucky because at least you matched!

It would be nice to just give this all up and start all over in another career but the debt I've incurred makes it difficult to do anything else... my relatively measly residency income is the only way I can make debt payments and keep the lights on at home. Most people by the time they've started residency are not 22 years old anymore and can't just put life on hold again to start a brand new career path.

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2 hours ago, rmorelan said:

I wouldn't say that is all that unusual historically though - people often had to start off in some place and work up the food chain. None of this is to say it is fun, and they fail to advertise the reality of medicine far too often. Part of the bias is in academia you are more likely to stay put than many other community jobs and that is all we see in training (people there forever ha). My friends in the community have bounced around a lot more, or have worked themselves up. 

Often not talked about is even in academic the first few years are often "suboptimal" as you are working up to become a partner. 

 

Having spoken with many of my more senior colleagues (which I understand is anecdotal evidence) I would have to say that the compromises my friends had to make are much more significant in comparison. My ortho friends alone have had to struggle for jobs in a way that people didn't have to decades ago. 

I agree with you that things aren't rosy even in an academic setting. However, I don't think academia was as crazy before in terms of hiring requirements either having heard about how people just bumbled their way into jobs after residency.  

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1 hour ago, shematoma said:

It's saddening, terrifying, and disturbingly not unexpected in the circumstances. I can't even begin to speculate on this individual case, except to say that from my perspective, I can empathize why this whole medical school, CaRMS and residency process might lead to someone feeling suicidal and even going through with it.

Between the stresses of debt, postponing your life and making huge sacrifices... and then either not matching without any hope of ever matching in the future, or maybe you matched to a specialty you don't want in a location far away from your family or friends, it can drive you bonkers. But of course everyone tells you that you should apply for everything you can get your fingers on because matching is better than not matching at all... only for you to end up having to split away from your family/spouse so you can do residency X in city/town/hamlet Y for 5 years because this is what medicine entails. And if you're in that boat, everyone will consider you lucky because at least you matched!

It would be nice to just give this all up and start all over in another career but the debt I've incurred makes it difficult to do anything else... my relatively measly residency income is the only way I can make debt payments and keep the lights on at home. Most people by the time they've started residency are not 22 years old anymore and can't just put life on hold again to start a brand new career path.

I think the system makes it hard for people to leave because they're not starting from scratch. They're starting miles behind their peers with lost years of income and student debt which I think causes these feelings of depression and outcomes like suicide.

I think if tuition was regulated back down to a reasonable level maybe we could avoid a lot of these issues. 

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8 minutes ago, blah1234 said:

Having spoken with many of my more senior colleagues (which I understand is anecdotal evidence) I would have to say that the compromises my friends had to make are much more significant in comparison. My ortho friends alone have had to struggle for jobs in a way that people didn't have to decades ago. 

I agree with you that things aren't rosy even in an academic setting. However, I don't think academia was as crazy before in terms of hiring requirements either having heard about how people just bumbled their way into jobs after residency.  

quite possibly not depending on the time and the field. For instance in the early 2010s you couldn't get a radiology job if your life depended on it anywhere in NA. Now in the US and many parts of Canada there is a shortage and jobs are falling off trees. Four years from now who knows. Ortho is a particular bad case for quite some time now. I mean flat out terrible really. Others are probably somewhere in between. 

I am not trying to make this out to be super rosy but at the same time it isn't disastrous as sometime I feel it is portrayed - overall. That doesn't mean that in particular cases it isn't horrible, and for those people it doesn't matter what the average situation is. If I was sitting in some place reading plain films on dial up for a living I probably would feel similar.  

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3 minutes ago, blah1234 said:

I think the system makes it hard for people to leave because they're not starting from scratch. They're starting miles behind their peers with lost years of income and student debt which I think causes these feelings of depression and outcomes like suicide.

I think if tuition was regulated back down to a reasonable level maybe we could avoid a lot of these issues. 

I don't think it makes a difference if tuition is $5,000 or $35,000 because the real costs are much much higher. First there's the opportunity cost of not making any income during 4 years of medical school. Then if you don't match in CaRMS you lose another $100,000+ when you factor in lost salary and tuition and another year of cross-country electives and CaRMS tours.

Then there's the fact that you've put life on hold for another 4 years, delaying marriage, family, etc. An immense personal cost that's hard to quantify.

Most of us would be fine if they left tuition as is... and just focus on increasing the number of CMG residency spots and/or cutting medical school spots. Period.

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5 minutes ago, blah1234 said:

I think the system makes it hard for people to leave because they're not starting from scratch. They're starting miles behind their peers with lost years of income and student debt which I think causes these feelings of depression and outcomes like suicide.

I think if tuition was regulated back down to a reasonable level maybe we could avoid a lot of these issues. 

True - it really is a trap (plus any argument for tuition reduction would be very likely come at reduced doctor income - and they would put up massive resistance to that for obvious reasons. This field really does tend to slap its young around at times).

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1 hour ago, rmorelan said:

True - it really is a trap

Honestly at this point I would just like to be able to get out now and go back to being an engineer. I could make good money, work better hours, not be bullied and disrespected and have a job in a location I want.

Unfortunately that won't happen. I'm trapped in medicine till retirement. I am looking for other jobs. The locations still aren't ideal but I can't stay where I am. This place is killing me and my family. Anything is better than the current situation. 

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6 minutes ago, NLengr said:

Honestly at this point I would just like to be able to get out now and go back to being an engineer. I could make good money, work better hours, not be bullied and disrespected and have a job in a location I want.

Unfortunately that won't happen. I'm trapped in medicine till retirement. I am looking for other jobs. The locations still aren't ideal but I can't stay where I am. This place is killing me and my family. Anything is better than the current situation. 

Yeah every time I read about your situation I feel terrible - I mean it is one of the worst possible outcomes. I really hope you track down some escape route as quickly as possible and get out of it. 

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Just now, rmorelan said:

Yeah every time I read about your situation I feel terrible - I mean it is one of the worst possible outcomes. I really hope you track down some escape route as quickly as possible and get out of it. 

I think NLengr's experiences are not that far off from what a lot of my surgeon friends experience. I think that's why I'm more pessimistic about the overall situation than you. Even if I'm content, I'm afraid for the thousands of students that go through the system with the possible risk of being rewarded with these outcomes despite their years of hard work and perseverance. 

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37 minutes ago, rmorelan said:

Yeah every time I read about your situation I feel terrible - I mean it is one of the worst possible outcomes. I really hope you track down some escape route as quickly as possible and get out of it. 

Me too. I have a couple leads at this point.

This place was not as advertised. I actually worry about the next person who replaces me when I leave.

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