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2019 CaRMS unfilled spots

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1 hour ago, JuniorDr90 said:

 

I’m surprised 1- by how little do you know about IMGs and their situation in Canada,  2- by the condescending tone to other doctors just because they didn’t have the same « education » as you. 

I won’t be defending my situation here but just few notes fyi ...

- There are thousands of internationally trained doctors who live here in Canada. (It’s an immigration country). We are not here for the medicine, most of us live here to have a better life for our families and kids, we just happen to be very skilled doctors. It would make totally no sense at all that skilled persons live in a society and have to work jobs that are not into their qualifications. 

- The IMGs residency match process in Canada is the most brutal and unfair one in the world. US give better chances, UK, Germany, France, Australia. Everywhere But Canada... which is a shame honestly since again it’s an immigration country. 

- The amount of money we as IMGs invest into the process of obtaining our equivalence and matching is insane, and we are tax payers who pour our life long savings just to have a good future. 

- Yes arriving to Canada we were told there is no guarantee for us to work as doctors, but I for one, will do the impossible to be one. Since I know I am a good doctor and it would be a waste of my life and hardwork to live here for the rest of my life and not be able to work as a doctor. 

- Residency training is where you learn most in your medical career (not med school) so actually having Internationally trained doctors be willing to start over should be valued not condescended. 

So ... 

Saying that CMGs should always have a priority over IMGs while responding to an IMG asking a question about being unmatched and needing help, is quite offensive and rude imo. 

Creating enough jobs and opportunities for everyone (mostly CMGs of course) is the problem here not IMGs, since every other medical system in the developed world knows how to address this situation. 

I'm more sympathetic in cases like yours where we have senior physicians immigrating from other countries to Canada, as opposed to wealthy students who weren't good enough to get accepted in Canada who left for Europe, Australia and the Caribbean. I think we should perhaps separate the streams to distinguish between these 2 categories.

 

But I won't apologize for wanting to prioritize Canadian medical students in a system that is funded by and intended to benefit Canadians. We need to look to take care of our home trained physicians first, and then look to see what's available that can go towards helping IMG's. We DO NOT have a shortage of excellent candidates, so we do not need to be looking outside of our own pool of talent to recruit physicians. Simply put, we can fill 100% of our residency spots with CMG's and the quality of our resident doctors would not suffer at all. 

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35 minutes ago, medigeek said:

lol I swear half the people in med school that I've met think that anyone who "goes into business or banking" is an automatic millionaire or something. And that every other profession has it so well. The reality is, every other profession has it worse or wayyyy worse. And going into the business/finance/banking arena often requires far more work than any surgical residency. The end of the tunnel has far less success waiting than in medicine. Sure, the top 10% in that field kill it and are very rich. But most people who start a business or go into investment banking don't become anywhere near that successful. Most actually fail. 

Most finance/ibanking jobs do not take as much work as a surgical residency, not even remotely close.

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4 minutes ago, sWOMEN said:

CMG > IMG (attending for at least X years in home country) > CSA?

Foreign doctors don't have the same cultural competence as someone who grew up in Canada. 

 

4 minutes ago, 1D7 said:

Most finance/ibanking jobs do not take as much work as a surgical residency, not even remotely close.

You're right, if you're going to become a millionaire in those fields you'll work far more than a surgeon did. 

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52 minutes ago, medigeek said:

lol I swear half the people in med school that I've met think that anyone who "goes into business or banking" is an automatic millionaire or something. And that every other profession has it so well. The reality is, every other profession has it worse or wayyyy worse. And going into the business/finance/banking arena often requires far more work than any surgical residency. The end of the tunnel has far less success waiting than in medicine. Sure, the top 10% in that field kill it and are very rich. But most people who start a business or go into investment banking don't become anywhere near that successful. Most actually fail. 

you're 100% correct. I can't even tell you how many times I lost count hearing Not even medical students, but "premeds" say something along the lines of "if you're competitive enough to just apply to medical school, you'll be top 10% or better in any field." Not only is this statement hilariously false because it glorifies anyone striving to be a doctor but it severely undermines every other field.  This mindset is because a lot of medical students, resident have never actually worked fulltime in other fields and understand the lack of compensation, respect, job security etc that are in every other field beside medicine. I honestly think the only people who truly understand the value and privilege of being in medical school / being a doctor are those who worked in other fields professional / non-trads..

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9 minutes ago, medigeek said:

You're right, if you're going to become a millionaire in those fields you'll work far more than a surgeon did. 

Dollar for dollar, you're right it's a lot harder. But a surgical resident on average works far harder than most analysts/associates.

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1 minute ago, 1D7 said:

Dollar for dollar, you're right it's a lot harder. But a surgical resident on average works far harder than most analysts/associates.

Idk man, the successful IB guys I know fell asleep at 2am while untying their shoes. And successful entrepreneurs are up at 5am to work and their mind is at work 24/7. 

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5 minutes ago, medigeek said:

Idk man, the successful IB guys I know fell asleep at 2am while untying their shoes. 

My closest friends in IB work 12-16 hour days almost every day, but they rarely go without at least some sleep at night. Never more than a full day without sleep.

To make more $$$ than a surgeon, the road is definitely a harder and less well-defined in finance. The trade off is that the pay ceiling is vastly higher--MDs can make as much as several surgeons combined.

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24 minutes ago, medigeek said:

Foreign doctors don't have the same cultural competence as someone who grew up in Canada. 

 

You're right, if you're going to become a millionaire in those fields you'll work far more than a surgeon did. 

Don't worry, there are plenty of Canadian attendings that don't have much cultural competence either.  Sometimes we overblow the lack of cultural competence that some FMGs may have. The ones who become competitive enough to even apply generally are fine.  Sure you get a sexist, dismissive one every once in a while...but we have plenty of those Canadian born too. 

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2 minutes ago, sWOMEN said:

I wonder how much teaching about indigenous health, LGBTQ health, harm reduction, etc. goes on in the Middle East, India and other common IMG (not including CSA) hotspots

I wouldn't say it's the teaching that's necessarily the issue but rather just not having grown up here. And the style of medical practice overseas (including europe) is not always up to par with north america. An attending of 10 years exp overseas may not necessarily bring good practice habits.

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21 hours ago, medigeek said:

I'm all for defending our own but lets stay on planet reality. Not in a million years would I have gone to the Caribbean but they do their rotations in the US and ultimately have to pass (do well on) the USMLEs which is the peak level of medical knowledge globally. Europe/Australia do have shady clinical training though as anything outside of Canada/USA I'd be skeptical towards. 

I don't have a very strong opinion on this debate, but I would say. As someone who has written the steps I don't think they are the end all and be all. In fact, in some ways they are often somewhat outdated. The issue I see is if your school solely focuses on the USMLE, you will have knowledge gaps. The reason we like the steps is they are a good adjunct to studying clinical medicine otherwise.

There is a lot that the USMLE emphasizes that is not seen often in clinical practice and there is a lot of finer management details that are not seen in the USMLE. The USMLE tends to favour a lot of rare diagnoses, worst case scenarios and focuses almost entirely on diagnosis and investigations and really has a lot less on common cases (that you need to know the details for in order to succeed in clerkship) and treatment. Anyone who's taken the USMLE will know the huge emphasis on almost all aspects of TB, Syphilis and HIV as well as disproportionate attention to zebras like glycogen storage disorders, genetic disorders, NF I, II, Lesch-Nyhan syndrome etc. where in real life you will most likely not see any of these cases unless you specialized in that area. On the flip side, you will learn very little about the management of an MI, Pneumonia or CHF but you will see that everywhere on the wards. 

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27 minutes ago, Edict said:

I don't have a very strong opinion on this debate, but I would say. As someone who has written the steps I don't think they are the end all and be all. In fact, in some ways they are often somewhat outdated. The issue I see is if your school solely focuses on the USMLE, you will have knowledge gaps. The reason we like the steps is they are a good adjunct to studying clinical medicine otherwise.

There is a lot that the USMLE emphasizes that is not seen often in clinical practice and there is a lot of finer management details that are not seen in the USMLE. The USMLE tends to favour a lot of rare diagnoses, worst case scenarios and focuses almost entirely on diagnosis and investigations and really has a lot less on common cases (that you need to know the details for in order to succeed in clerkship) and treatment. Anyone who's taken the USMLE will know the huge emphasis on almost all aspects of TB, Syphilis and HIV as well as disproportionate attention to zebras like glycogen storage disorders, genetic disorders, NF I, II, Lesch-Nyhan syndrome etc. where in real life you will most likely not see any of these cases unless you specialized in that area. On the flip side, you will learn very little about the management of an MI, Pneumonia or CHF but you will see that everywhere on the wards

 

 

 

Everything you wrote is pretty much on point, except for maybe this. You need to realize, steps aren't just testing you on zebras, perhaps in Step 1 there is quite a bit of those present. But as you progress to the CK and Step 3, you tend to read and be tested on management of said diseases. 

After taking Qe1i felt the exam was indeed odd and relied on testing more primary care/geriatrics topics. Which I felt was more in line with how the CMGs are educated in medical school and pretty much pave the way into a career in FM.

5
5

 

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22 hours ago, medigeek said:

There's no evidence that beyond rare anecdotes, what you say actually happens. For an IMG to match, they need to score around the 80-95th percentiles on a of couple board exams. Otherwise, you have no shot. So what are you talking about exactly?

And yeah man life has gotten harder. It isn't just medicine. Try to open a business or become a dentist or engineer. See how it goes. 

Yep you're right...the grass isn't greener on the other side. Dentists have their own issue with international trained dentists (ITDs) and the expansion of clinics opening at every single plaza. At least medicine has the residency barrier, for dentistry you can do schooling in Ireland, Australia, New Zealand and walk right back into Canada to practice provided you pass the single licensing exam. Combined with high overhead, saturation, etc, dentistry isn't as desirable as before but you could still make a good living.  

Although, I know a few physiotherapists making real good money (net 250k+) while working only 35 hours a week mostly managing their clinics. Doesn't mean that we should all become physiotherapists though...

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1 hour ago, sWOMEN said:

I wonder how much teaching about indigenous health, LGBTQ health, harm reduction, etc. goes on in the Middle East, India and other common IMG (not including CSA) hotspots

And i wonder how much of that is done in Canadian schools as lip-service, and most medical students brush off and sit on FB/**DELETED** during.... i'm sure many can agree lots of students brush off what they consider "Fluff"

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4 hours ago, JuniorDr90 said:

Creating enough jobs and opportunities for everyone (mostly CMGs of course) is the problem here not IMGs, since every other medical system in the developed world knows how to address this situation. 

If those systems in the developed world have solved those problems...why are IMGs not going there?  

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I believe that we as doctors should pretty much understand the perspective of others and how they live their experiences.

It is correct to defend for CMG positions but never should we do that by discrediting other people and claiming to have a privillage upon other human beings. You have no idea what others go through. It is easy to judge and be rude.

Some of my friends are IMG ( immigrants not CSA) and they suffer alot. There are no spots for them and they are truely excellent candidates and have tons of experience and research ! Yet ending up as working in a cornerstore or a taxi driver. They have families and it is extremely difficult to work that way after being honoured doctors in their countries. If you look at the stats, like 750 candidates applied for 10 positions available in IM at u o t !!

Just imagine the brutal and unimaginable and fierce competition ! Like seriously how they do it !! 

So enough please by spreading judgements and poor comments of who is better and who is not ! It is so sick !!

We have problems in our system and yes we need more spots and funding !

And congrats to those who matched and best of luck to those who didn't :)

 

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4 hours ago, medigeek said:

lol I swear half the people in med school that I've met think that anyone who "goes into business or banking" is an automatic millionaire or something. And that every other profession has it so well. The reality is, every other profession has it worse or wayyyy worse. And going into the business/finance/banking arena often requires far more work than any surgical residency. The end of the tunnel has far less success waiting than in medicine. Sure, the top 10% in that field kill it and are very rich. But most people who start a business or go into investment banking don't become anywhere near that successful. Most actually fail. 

In terms of hours, a surgical residency is probably the same workload as ibanking in terms of hours worked in the office. consulting is probably equivalent to a medical residency.  

Each side works different kinds of hours, but I think surgical residents likely work as harder if you factor in the disturbed sleep cycles, as well as studying, reading and research. The main benefit is that your job is rather stable which is something I do think we overlook. The very fact that you can tell yourself that you will be employed for the next 5 years or more is actually something we probably undervalue as doctors. 

 

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4 hours ago, Edict said:

The main benefit is that your job is rather stable which is something I do think we overlook. The very fact that you can tell yourself that you will be employed for the next 5 years or more is actually something we probably undervalue as doctors. 

 

Medicine is a case of you are trading pretty much all flexibility involving location, pay and work environment for extreme job security. 

As for residents vs investment bankers (etc.), I don't think anyone has pointed out that bankers are fully lisenced independent workers. Residents can't work on thier own legally. From that point of view, comparison to a staff surgeon is more accurate. 

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17 minutes ago, robclem21 said:


Overall, looks better than last year, but definitely a really rough year for certain schools.

342329547_ScreenShot2019-02-28at7_40_31AM.png.1709d128b683cbd5f8c4fc5492f60130.png 

Agree

I think overall it is better this year. Maybe it is because more people choose FM (especially in Quebec where there a 41 spots left compared to around 75 last year) and other less competitve disciplines. 

I think next year will be interresting as the number of unmatched applicants was higher year after year and this year there are 174 compared to 222 last year! That’s a huge difference!! (But still not perfect.!)

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8 hours ago, JohnGrisham said:

If those systems in the developed world have solved those problems...why are IMGs not going there?  

Most of them do ! Except the ones that choose first to live in Canada (because of the advantages which are incomparable to anywhere else) then look to be licensed.

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1 hour ago, JuniorDr90 said:

Most of them do ! Except the ones that choose first to live in Canada (because of the advantages which are incomparable to anywhere else) then look to be licensed.

Unfortunately though, there really isn't a shortage of doctors in Canada like there may be elsewhere. The issue IMGs face currently is that our immigration system isn't really looking at need for jobs when selecting immigrants. Perhaps a section in our points system that gives extra points for those who have skills in jobs that are currently in high demand would be a better idea. This way, immigrants who do come to Canada are better able to adapt and find a job. 

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4 hours ago, NLengr said:

Medicine is a case of you are trading pretty much all flexibility involving location, pay and work environment for extreme job security. 

As for residents vs investment bankers (etc.), I don't think anyone has pointed out that bankers are fully lisenced independent workers. Residents can't work on thier own legally. From that point of view, comparison to a staff surgeon is more accurate. 

I get that investment bankers are fully licensed independent workers, but the realities are more similar between the two jobs. Surgical residents in effect are making real patient decisions with real consequences overnight and sometimes in the OR. Not every cut you make is always watched over by a staff in every case you do. Same with investment banking analysts. Ultimately, most analysts are doing work that is assigned to them by their bosses, similar to residents. Additionally, staff surgeons are often in their mid 30s when they began which you can't really compare to a 22 year old newly minted ib analyst. 

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