Surgical specialties with good job prospects?

[NLengr]

36 minutes ago, user123456 said:

Any thoughts on GSx with ACS? Would have the ability to do gen surg, cover trauma or cover ICU right? So would that mean a pretty good marketability?

I would guess not that much better than some of the other common fellowships. 

All general surgeons are trained to cover trauma and in the community they don't usually have a dedicated trauma guy covering trauma call. And in Canada we just don't have a huge trauma volume so it's not like we are running huge numbers of trauma codes/teams per night necessitating the need for lots of trauma dedicated surgeons. 

Critical Care also had poor job outlooks last I heard too.

If you are to move to a major center and you do general surgery what will very likely happen is during residency you will be told by your program that there is an open spot coming in X number of years in subspecialty Y (usually due to retirement). If they want to have you come back as staff, they will then tell you to do fellowship Y and pray they don't change their mind about you while you are still training. 

That's how most of the academic hirings seem to work in my experience. There is the occasional case where someone leaves a group more suddenly and needs to be replaced, but that seems less common in academia. 

[blah1234]

5 hours ago, NLengr said:

I would guess not that much better than some of the other common fellowships. 

All general surgeons are trained to cover trauma and in the community they don't usually have a dedicated trauma guy covering trauma call. And in Canada we just don't have a huge trauma volume so it's not like we are running huge numbers of trauma codes/teams per night necessitating the need for lots of trauma dedicated surgeons. 

Critical Care also had poor job outlooks last I heard too.

If you are to move to a major center and you do general surgery what will very likely happen is during residency you will be told by your program that there is an open spot coming in X number of years in subspecialty Y (usually due to retirement). If they want to have you come back as staff, they will then tell you to do fellowship Y and pray they don't change their mind about you while you are still training. 

That's how most of the academic hirings seem to work in my experience. There is the occasional case where someone leaves a group more suddenly and needs to be replaced, but that seems less common in academia. 

I agree with this observation. You have to cater to what a group needs in the upcoming future. However, so much of the hiring process is through word of mouth for good positions that it's never quite as simple as just putting a job application in. It can be quite different from medical school/residency where it is a standardized process and an elevator to the top. 

[ZBL]

Agree with what everyone else has said. In speaking with department heads at academic centres, they have all indicated that there is no shortage of applicants in medical and surgical specialties for academic positions, so they have the luxury of waiting for the person who will be the right fit whatever that may be. Many times these people are head hunted years in advance and you’d be none the wiser thinking your chances are “equal” when applying. 

[ACHQ]

23 hours ago, LittleDaisy said:

I think that general internal medicine is saturated in urban areas. Most GIM work in hospitals covering wards and does occasionally outpatient clinic. In GTA, a lot of young grads who are unwilling to leave the city are actually doing 1-2 years of Master or Fellowship trying to get into academic hospitals, who put you into 1-3 years of probationary year with temporary privileges, some staff do end up leaving after not getting along with the group, or not publishing enough papers, or not getting good reviews from their peers. 

If you want to do pure outpatient clinic, you have to make sure that you have enough Family Medicine friends who can recommend you and generate enough referrals to cover the overhead. We usually refer to GIM in academic hospital to expedite the work-up or for query presentation NYD. 

A few of the people that I know are just covering night ER shifts here and there, barely covering the bills. There are higher demands in rural or smaller sized cities for full-time GIM, but after you have a family with a significant partner, it is often difficult to move away from the city. 

It's funny that at beginning of medical school people usually pursue what they love as a specialty, and towards the end of medical school or during their residency, they start to take into consideration location and lifestyle factor. 

GIM *academic jobs* are hard to come by or "saturated" as with any academic jobs (that being said some of the GIM departments at my school have recently hired some new staff, NOT just the "CA's"). However, GIM jobs in the community are pretty easy to find, and if not you can easily locum until something opens up where you want which is usually very quickly (not more than a year or so).

AND GIM in the GTA (which isn't I guess downtown Toronto, but it's still urban/suburban and NOT rural) pays extremely well and doesn't require anything more than your 4 year training in IM (despite what the 5 year GIM people tell you its all BS).

[LittleDaisy]

12 minutes ago, ACHQ said:

GIM *academic jobs* are hard to come by or "saturated" as with any academic jobs (that being said some of the GIM departments at my school have recently hired some new staff, NOT just the "CA's"). However, GIM jobs in the community are pretty easy to find, and if not you can easily locum until something opens up where you want which is usually very quickly (not more than a year or so).

AND GIM in the GTA (which isn't I guess downtown Toronto, but it's still urban/suburban and NOT rural) pays extremely well and doesn't require anything more than your 4 year training in IM (despite what the 5 year GIM people tell you its all BS).

What's the advantage of doing the 5 year GIM program? To work in academic centres?  A lot of people are doing extra year to gain more training and to be more marketable when finding jobs. There might be a misconception. 

[ACHQ]

17 hours ago, LittleDaisy said:

What's the advantage of doing the 5 year GIM program? To work in academic centres?  A lot of people are doing extra year to gain more training and to be more marketable when finding jobs. There might be a misconception.

Yes its a "requirement" for an academic job, but having talked to some current 5 year GIM's and people who have gone through it and are staff now, it doesn't add anything clinically. Plus it doesn't guarantee a job in academics either, as you mentioned most will go onto doing 1-3+ years of CA'ing until they are actually on faculty. It's definitely not necessary to get a job in the community, and by community I mean basically every hospital except: UHN, Sinai, St Mikes, Sunnybrook and Women's.

So that leaves: North York General, Scarborough (which is 3 separate hospitals), Michael Garron/Toronto East, St Joesph's hospital, Humber River hospital, Lakeridge Health, Markham Stouffville, Mackenzie Health (which is building ANOTHER hospital in Vaughn, along with the one they already have in Richmond Hill), Southlake, Credit Valley, Trillium, William Osler (which has two sites: Etobicoke General and Bramptom Civic), Oakville/Trafalger. Thats 17 individual hospitals!!

There is no advantage going the academic route, when you have loss of job security, highly likely go get strung along by doing a CA + Masters/PhD, and loss of at least 300-400k/yr while you are going through that. Even once you are finally faculty you make substantially less when you join these practice plans, than if you were in the community. By substantially, I'm talking about at least 100-200k/year (depending on how much you work in the community).

Plus I've done most of my training in the academic centers, and I have recently done some blocks in the community (large GTA hospitals). The cases you see are basically identical, including the complexity and acuity (if anything the volumes and acuity are higher in the community).

So unless you live/breath/eat/sh**/get high off of/orgasm to research or teaching, don't do academics.

[distressedpremed]

6 hours ago, ACHQ said:

Yes its a "requirement" for an academic job, but having talked to some current 5 year GIM's and people who have gone through it and are staff now, it doesn't add anything clinically. Plus it doesn't guarantee a job in academics either, as you mentioned most will go onto doing 1-3+ years of CA'ing until they are actually on faculty. It's definitely not necessary to get a job in the community, and by community I mean basically every hospital except: UHN, Sinai, St Mikes, Sunnybrook and Women's.

So that leaves: North York General, Scarborough (which is 3 separate hospitals), Michael Garron/Toronto East, St Joesph's hospital, Humber River hospital, Lakeridge Health, Markham Stouffville, Mackenzie Health (which is building ANOTHER hospital in Vaughn, along with the one they already have in Richmond Hill), Southlake, Credit Valley, Trillium, William Osler (which has two sites: Etobicoke General and Bramptom Civic), Oakville/Trafalger. Thats 17 individual hospitals!!

There is no advantage going the academic route, when you have loss of job security, highly likely go get strung along by doing a CA + Masters/PhD, and loss of at least 300-400k/yr while you are going through that. Even once you are finally faculty you make substantially less when you join these practice plans, than if you were in the community. By substantially, I'm talking about at least 100-200k/year (depending on how much you work in the community).

Plus I've done most of my training in the academic centers, and I have recently done some blocks in the community (large GTA hospitals). The cases you see are basically identical, including the complexity and acuity (if anything the volumes and acuity are higher in the community).

So unless you live/breath/eat/sh**/get high off of/orgasm to research or teaching, don't do academics.

Not to mention the politics behind the job hiring process, which @NLengr has already mentioned in previous posts. 

Myself, I really wanted to be in academics during med school but now in residency and hoping to get engaged in a year or two, it's difficult to keep delaying living your life. Most general jobs can you give you some semblance of work-life relationship depending on how you organize your practice. It's tough honestly. If you don't want to do general/comprehensive in your specialty, you probably have to go the academic route and deal with all the politics, hierarchy, etc. In the community, you can make substantially more and not have to deal with some of this, which seeing some of the infighting I see, is really nice to avoid...

[LittleDaisy]

6 hours ago, ACHQ said:

Yes its a "requirement" for an academic job, but having talked to some current 5 year GIM's and people who have gone through it and are staff now, it doesn't add anything clinically. Plus it doesn't guarantee a job in academics either, as you mentioned most will go onto doing 1-3+ years of CA'ing until they are actually on faculty. It's definitely not necessary to get a job in the community, and by community I mean basically every hospital except: UHN, Sinai, St Mikes, Sunnybrook and Women's.

So that leaves: North York General, Scarborough (which is 3 separate hospitals), Michael Garron/Toronto East, St Joesph's hospital, Humber River hospital, Lakeridge Health, Markham Stouffville, Mackenzie Health (which is building ANOTHER hospital in Vaughn, along with the one they already have in Richmond Hill), Southlake, Credit Valley, Trillium, William Osler (which has two sites: Etobicoke General and Bramptom Civic), Oakville/Trafalger. Thats 17 individual hospitals!!

There is no advantage going the academic route, when you have loss of job security, highly likely go get strung along by doing a CA + Masters/PhD, and loss of at least 300-400k/yr while you are going through that. Even once you are finally faculty you make substantially less when you join these practice plans, than if you were in the community. By substantially, I'm talking about at least 100-200k/year (depending on how much you work in the community).

Plus I've done most of my training in the academic centers, and I have recently done some blocks in the community (large GTA hospitals). The cases you see are basically identical, including the complexity and acuity (if anything the volumes and acuity are higher in the community).

So unless you live/breath/eat/sh**/get high off of/orgasm to research or teaching, don't do academics.

Sounds good. I guess that the only good thing in academics, is that you have residents covering calls for you overnight and during the weekend. You won't be paged overnight by nurses for a new admission, new consult or for medication orders. It's totally different when you do admissions yourself in ED while being constantly paged by ward patients issues, compared to reviewing admissions in the AM and see the new patients for 10-20 minutes while delegating the tasks to your whole team before you run to the clinic. 

The pay difference justifies when you become a more senior staff, and trusts your residents and fellows, and let them run the show. 

Working in community as a GIM is very lucrative but also very tiring and demanding. Can you imagine a whole CTU team with 1 staff, 1 senior, 2 juniors, and 2 clerks covering 20-30 patients with endless work; while 1 GIM staff covering 20 ward patients on a daily basis while doing ER consults? 

When I did ER in the community, the GIM in community seems to be burnt out overnight, and would have a higher threshold for admission. 

[ACHQ]

12 hours ago, LittleDaisy said:

...You won't be paged overnight by nurses for a new admission, new consult or for medication orders. It's totally different when you do admissions yourself in ED while being constantly paged by ward patients issues, compared to reviewing admissions in the AM and see the new patients for 10-20 minutes while delegating the tasks to your whole team before you run to the clinic. 

Working in community as a GIM is very lucrative but also very tiring and demanding. Can you imagine a whole CTU team with 1 staff, 1 senior, 2 juniors, and 2 clerks covering 20-30 patients with endless work; while 1 GIM staff covering 20 ward patients on a daily basis while doing ER consults? 

When I did ER in the community, the GIM in community seems to be burnt out overnight, and would have a higher threshold for admission. 

Overnight on call, as a staff in the community, you "want" to be paged even if its silly because every patient seen overnight gets a premium code. A lot of those premiums are more than the partial assessment codes themselves! That's why on call GIM in the community is so lucrative.

Also, in the community covering an inpatient unit alone is much easier than in academic centers. The community has built in efficiencies to make your life way easier.

I was regularly seeing 8-10 patients as a R3 at Toronto East with ~3-4 of them being new admits (which I would have to do a full consult as the staff would bill that way and rightly so cause they don't know the patient). With all that work (including reviewing and discharging patients) I would still get out by 4ish (and I would take some time to eat lunch, go to teaching etc...). We did have the help of a PA (who would see between 5-8 patients as well). I mean sure it can be busy with 25-30 patients (that would be pretty high, most times its between 20-25), especially with no other help, but even then I wouldn't expect to be out later than 6, especially as a staff when I can plough through and not have to review or go to teaching etc... The community is built for efficiency, meaning the staff do absolutely no scut.

Most places in the community separate MRP work from the ER consults (you do one or the other not both, usually).

Yes you can burn out from doing too much overnight work. Most staff usually do a lot more earlier on and then dial back. Most  staff that are settled (e.g. don't need to pay off debt, have bought a house etc...) don't do more than 1, MAYBE 2 overnights a month (some do 0). Usually they might do 1 weekend rounding a month to Q2months. Its a sweet lifestyle once you don't care about making more than 300-350k, if you want to make 400+k than yeah you have to sacrifice lifestyle a bit

[The Ace of Spades]

On 6/24/2019 at 3:09 PM, ACHQ said:

Yes its a "requirement" for an academic job, but having talked to some current 5 year GIM's and people who have gone through it and are staff now, it doesn't add anything clinically. Plus it doesn't guarantee a job in academics either, as you mentioned most will go onto doing 1-3+ years of CA'ing until they are actually on faculty. It's definitely not necessary to get a job in the community, and by community I mean basically every hospital except: UHN, Sinai, St Mikes, Sunnybrook and Women's.

So that leaves: North York General, Scarborough (which is 3 separate hospitals), Michael Garron/Toronto East, St Joesph's hospital, Humber River hospital, Lakeridge Health, Markham Stouffville, Mackenzie Health (which is building ANOTHER hospital in Vaughn, along with the one they already have in Richmond Hill), Southlake, Credit Valley, Trillium, William Osler (which has two sites: Etobicoke General and Bramptom Civic), Oakville/Trafalger. Thats 17 individual hospitals!!

There is no advantage going the academic route, when you have loss of job security, highly likely go get strung along by doing a CA + Masters/PhD, and loss of at least 300-400k/yr while you are going through that. Even once you are finally faculty you make substantially less when you join these practice plans, than if you were in the community. By substantially, I'm talking about at least 100-200k/year (depending on how much you work in the community).

Plus I've done most of my training in the academic centers, and I have recently done some blocks in the community (large GTA hospitals). The cases you see are basically identical, including the complexity and acuity (if anything the volumes and acuity are higher in the community).

So unless you live/breath/eat/sh**/get high off of/orgasm to research or teaching, don't do academics.

Agreed. Not sure why everyone wants to do academic medicine so bad. Community practice is where it's at.

[Edict]

On 6/23/2019 at 6:07 AM, user123456 said:

Any thoughts on GSx with ACS? Would have the ability to do gen surg, cover trauma or cover ICU right? So would that mean a pretty good marketability?

Trauma is a hard job to get, there are way more people who would like to do trauma and a lot fewer centers that do it. ICU is incredibly lucrative and as such is oversaturated especially in academic centers. General surgery itself is also oversaturated and generally speaking if you want an academic job you'll need to do a masters and fellowship or more. 

At least in toronto academic sites, the standard is to hire people as clinical associates for a couple of years which is like a midgrade role between fellowship and staff. You get 50% of your staff billings and you get some time to do research or other stuff and people make do. 

[hamham]

2 hours ago, The Ace of Spades said:

Agreed. Not sure why everyone wants to do academic medicine so bad. Community practice is where it's at.

I think it's the prestige that comes with it. You get to feature in the teaching hospital monthly/yearly magazine. You get to become the poster boy of the hospital (I know H&N cancer surgeons whose faces were seen on side-walls when Princess Margaret Cancer Centre was undergoing renovations several yrs ago. You have the opportunity to make a name for yourself in research by publishing hundreds/thousands of papers in peer-reviewed journals. Even better if you can come up with a new method to improve healthcare, and have it named after you (just ask Dr. Yuzpe). You get to teach the future generations of medicine, and future doctors will continue to remember your name for a long time to come (at least I remembered the gastroenterologist and nephrologist who taught me key lectures in pre-clerkship). All these of course come at a price, but many are willing to go the extra mile to make a name for themselves. 

[Edict]

1 hour ago, hamham said:

I think it's the prestige that comes with it. You get to feature in the teaching hospital monthly/yearly magazine. You get to become the poster boy of the hospital (I know H&N cancer surgeons whose faces were seen on side-walls when Princess Margaret Cancer Centre was undergoing renovations several yrs ago. You have the opportunity to make a name for yourself in research by publishing hundreds/thousands of papers in peer-reviewed journals. Even better if you can come up with a new method to improve healthcare, and have it named after you (just ask Dr. Yuzpe). You get to teach the future generations of medicine, and future doctors will continue to remember your name for a long time to come (at least I remembered the gastroenterologist and nephrologist who taught me key lectures in pre-clerkship). All these of course come at a price, but many are willing to go the extra mile to make a name for themselves. 

academic vs community is the difference between living to work and working to live. Community is all about getting the job you were hired for done and thats it. In exchange you fade into anonymity and get to enjoy your life more and make more money. Academic is all about doing the job you were hired plus other stuff be that research or teaching, a chance to change or impact your field and a chance to be a part of change in your field or make an impact on future doctors. 

Its a tough choice and depending on the incentives you see people make choices based on that. 

Additionally, many international fellows come to Canada each year looking for a job and these people can only get academic jobs. As such they make academic hiring much more competitive as we canadians have to outcompete people who are willing to make much deeper sacrifices for the same job. 

[NLengr]

13 hours ago, Edict said:

You get 50% of your staff billings and you get some time to do research or other stuff and people make do. 

Thanks BUUUUUUUUUUULLLLLSHIT imo. I always wondered fool would agree to that? You work damn hard for that money and they're fleecing you for half a million dollars or more after spending a decade treating you like a slave (med school, residency +/- fellowship). Stockholm syndrome at it's finest......

[NLengr]

11 hours ago, Edict said:

academic vs community is the difference between living to work and working to live. Community is all about getting the job you were hired for done and thats it. In exchange you fade into anonymity and get to enjoy your life more and make more money. Academic is all about doing the job you were hired plus other stuff be that research or teaching, a chance to change or impact your field and a chance to be a part of change in your field or make an impact on future doctors. 

Its a tough choice and depending on the incentives you see people make choices based on that. 

Additionally, many international fellows come to Canada each year looking for a job and these people can only get academic jobs. As such they make academic hiring much more competitive as we canadians have to outcompete people who are willing to make much deeper sacrifices for the same job. 

The funniest thing is nobody outside of the immediate surrounding medical community gives two shits about academic medicine anyway. It's not like people living in Ottawa know who the academic cardiologists in Toronto or Calgary are. The academic guys are fooling themselves. In the grand scheme nobody gives a shit about them either. They aren't Connor McDavid, Justin Beiber or Kawhi Leonard. Nodody knows them outside their little bubbles. In smaller cities or rural areas community docs can be just as prominent in the public eye, if that's what gets you off.

As for changing the field of medicine, I'd venture that 95% of physicians in academic setting make zero difference to the practice of medicine. Unless you are an academic superstar, you aren't changing anything.

The other trade off of academia and community is in academia, you are giving up a lot of operating and patient care to residents/fellows in exchange for research/teaching time. If you got into medicine to cut or to provide direct hands on care, academia sucks.

[ACHQ]

1 hour ago, NLengr said:

The funniest thing is nobody outside of the immediate surrounding medical community gives two shits about academic medicine anyway. It's not like people living in Ottawa know who the academic cardiologists in Toronto or Calgary are. The academic guys are fooling themselves. In the grand scheme nobody gives a shit about them either. They aren't Connor McDavid, Justin Beiber or Kawhi Leonard. Nodody knows them outside their little bubbles. In smaller cities or rural areas community docs can be just as prominent in the public eye, if that's what gets you off.

As for changing the field of medicine, I'd venture that 95% of physicians in academic setting make zero difference to the practice of medicine. Unless you are an academic superstar, you aren't changing anything.

The other trade off of academia and community is in academia, you are giving up a lot of operating and patient care to residents/fellows in exchange for research/teaching time. If you got into medicine to cut or to provide direct hands on care, academia sucks.

This x infinity. Literally took the words right out of my mouth.

 

people are absolutely crazy to put themselves through the hell it takes to become faculty these days. It might have been viable 15-20 years ago when you finished residency you come on as staff/faculty (with little to no hoops to jump through) but those days are long gone and people these days get strung along and F$&@ED to the max, and it’s only going to get worse. 

Its horrible to see this is not department limited and extends to both surgical and medical specialties... get out while you can and save yourselves your precious youth, lifestyle and $$$$$$$

[LittleDaisy]

15 hours ago, Edict said:

Trauma is a hard job to get, there are way more people who would like to do trauma and a lot fewer centers that do it. ICU is incredibly lucrative and as such is oversaturated especially in academic centers. General surgery itself is also oversaturated and generally speaking if you want an academic job you'll need to do a masters and fellowship or more. 

At least in toronto academic sites, the standard is to hire people as clinical associates for a couple of years which is like a midgrade role between fellowship and staff. You get 50% of your staff billings and you get some time to do research or other stuff and people make do. 

Wow I wasnt aware that clinical associates are paid by 50 percent of their salaries in Toronto, is that a common practice in all specialties across UofT? This seems crazy that so many people are willing to sacrifie a few more years, trying to please senior staff and being nice to medical students and residents for decent evaluations, publishing under pressure, to eventually hope to land a position in academics. .

[ACHQ]

17 minutes ago, LittleDaisy said:

Wow I wasnt aware that clinical associates are paid by 50 percent of their salaries in Toronto, is that a common practice in all specialties across UofT? This seems crazy that so many people are willing to sacrifie a few more years, trying to please senior staff and being nice to medical students and residents for decent evaluations, publishing under pressure, to eventually hope to land a position in academics. .

I know in the department of medicine at UofT its between 20-30% depending on the specific hospital (which is still very high) and you get NONE of the practice plan benefits, AND because you submit your Billings to the practice plan, technically they get a cut of your Billings for ANY work OUTSIDE of academics (e.g. locum shifts)!!!!! 

[NLengr]

8 minutes ago, ACHQ said:

I know in the department of medicine at UofT its between 20-30% depending on the specific hospital (which is still very high) and you get NONE of the practice plan benefits, AND because you submit your Billings to the practice plan, technically they get a cut of your Billings for ANY work OUTSIDE of academics (e.g. locum shifts)!!!!! 

Medicine eats its young.

[monocle]

On 6/24/2019 at 4:09 PM, ACHQ said:

Yes its a "requirement" for an academic job, but having talked to some current 5 year GIM's and people who have gone through it and are staff now, it doesn't add anything clinically. Plus it doesn't guarantee a job in academics either, as you mentioned most will go onto doing 1-3+ years of CA'ing until they are actually on faculty. It's definitely not necessary to get a job in the community, and by community I mean basically every hospital except: UHN, Sinai, St Mikes, Sunnybrook and Women's.

So that leaves: North York General, Scarborough (which is 3 separate hospitals), Michael Garron/Toronto East, St Joesph's hospital, Humber River hospital, Lakeridge Health, Markham Stouffville, Mackenzie Health (which is building ANOTHER hospital in Vaughn, along with the one they already have in Richmond Hill), Southlake, Credit Valley, Trillium, William Osler (which has two sites: Etobicoke General and Bramptom Civic), Oakville/Trafalger. Thats 17 individual hospitals!!

There is no advantage going the academic route, when you have loss of job security, highly likely go get strung along by doing a CA + Masters/PhD, and loss of at least 300-400k/yr while you are going through that. Even once you are finally faculty you make substantially less when you join these practice plans, than if you were in the community. By substantially, I'm talking about at least 100-200k/year (depending on how much you work in the community).

Plus I've done most of my training in the academic centers, and I have recently done some blocks in the community (large GTA hospitals). The cases you see are basically identical, including the complexity and acuity (if anything the volumes and acuity are higher in the community).

So unless you live/breath/eat/sh**/get high off of/orgasm to research or teaching, don't do academics.

 

Does this apply to most specialties in Toronto (the whole clinical associate thing)? I've done my fair share of academic slavery, but I wasn't planning on doing any more beyond a fellowship (already have a Masters) to at least have a shot at an academic position. If I'm asked to CA, I don't know what I'd do as I've been working towards this goal for several years now. I think that's very unfair and akin to daylight robbery considering you could be losing anywhere from 150-300K a year while going through it.

I don't get off/orgasm over research or teaching at all, but I'm willing to do it if it secures me a spot. This is some real bullsh**, incredibly discouraging!

[LittleDaisy]

21 minutes ago, ACHQ said:

I know in the department of medicine at UofT its between 20-30% depending on the specific hospital (which is still very high) and you get NONE of the practice plan benefits, AND because you submit your Billings to the practice plan, technically they get a cut of your Billings for ANY work OUTSIDE of academics (e.g. locum shifts)!!!!! 

they get paid 20-30 percent or their FFS gets cut 20-30?? I cant believe that there are so many people competing for academic medicine and surgery positions, when this seems so ridiculous?!

[ACHQ]

31 minutes ago, NLengr said:

Medicine eats its young.

I learned that the hard way like most people. I still like what I do overall, but some of the things I have seen, heard and experienced are truly mind boggling and leave a sour taste in your mouth. You think that in a field where you're supposed to care for people would be devoid of these things, but that's just me being naïve.

18 minutes ago, LittleDaisy said:

they get paid 20-30 percent or their FFS gets cut 20-30?? I cant believe that there are so many people competing for academic medicine and surgery positions, when this seems so ridiculous?!

They get a cut of 20-30% of your total billings. Meaning you get anywhere between 70-80% back

22 minutes ago, monocle said:

 

Does this apply to most specialties in Toronto (the whole clinical associate thing)? I've done my fair share of academic slavery, but I wasn't planning on doing any more beyond a fellowship (already have a Masters) to at least have a shot at an academic position. If I'm asked to CA, I don't know what I'd do as I've been working towards this goal for several years now. I think that's very unfair and akin to daylight robbery considering you could be losing anywhere from 150-300K a year while going through it.

I don't get off/orgasm over research or teaching at all, but I'm willing to do it if it secures me a spot. This is some real bullsh**, incredibly discouraging!

Unfortunately you CANNOT get a faculty position without doing some CA work. On rare occasions they have people come on as faculty that don't do CA work but that would constitute maybe 1% (or even less), meaning its the exception not the rule. This applies to ALL medicine specialties for sure (and it seems like surgery as well, and I wouldn't be surprised if it applied to ALL academic positions in the faculty of medicine). I've heard similar things happening at other sites across Canada (although not as brutal as UofT). These things are even being promoted by Senior admins (department and faculty heads) as necessary!

TBH why go for an academic position then when "I don't get off/orgasm over research or teaching at all". Just finish residency and start working in the community where you can make $$ and have a semblance of a life.

 

[monocle]

10 minutes ago, ACHQ said:

I learned that the hard way like most people. I still like what I do overall, but some of the things I have seen, heard and experienced are truly mind boggling and leave a sour taste in your mouth. You think that in a field where you're supposed to care for people would be devoid of these things, but that's just me being naïve.

They get a cut of 20-30% of your total billings. Meaning you get anywhere between 70-80% back

Unfortunately you CANNOT get a faculty position without doing some CA work. On rare occasions they have people come on as faculty that don't do CA work but that would constitute maybe 1% (or even less), meaning its the exception not the rule. This applies to ALL medicine specialties for sure (and it seems like surgery as well, and I wouldn't be surprised if it applied to ALL academic positions in the faculty of medicine). I've heard similar things happening at other sites across Canada (although not as brutal as UofT). These things are even being promoted by Senior admins (department and faculty heads) as necessary!

TBH why go for an academic position then when "I don't get off/orgasm over research or teaching at all". Just finish residency and start working in the community where you can make $$ and have a semblance of a life.

 

What I want to do lots of work with can only be done in large centres (robotics), and it's always been kind of the dream to be faculty in a metropolitan city. I've jumped through all the hoops so far, and I think I've got a step up on most of my peers on terms of academics. Now, if I'm being asked to be a clinical associate my opinion might change. I would be very hesitant to enter that kind of a deal which only realistically grant me a shot, and not a position, at the end of it.

It's very discouraging to hear that this kind of craziness is the new normal.

[ACHQ]

1 hour ago, monocle said:

What I want to do lots of work with can only be done in large centres (robotics), and it's always been kind of the dream to be faculty in a metropolitan city. I've jumped through all the hoops so far, and I think I've got a step up on most of my peers on terms of academics. Now, if I'm being asked to be a clinical associate my opinion might change. I would be very hesitant to enter that kind of a deal which only realistically grant me a shot, and not a position, at the end of it.

It's very discouraging to hear that this kind of craziness is the new normal.

I'm not a surgeon (far from it), but my understanding is the use of robotics in medicine is still limited (even if the technological advancements in the field make it possible). Also if that is what you would want, you would definitely need to do research in that field (i.e. come on as faculty and be a clinical scientist or investigator) where you would only be asked to do at MOST 50% clinical work (most of which would be done by residents/fellows anyways) and of that how much would actually involve robotics?

You will 100% be asked/told to do: fellowship(s)/sub-fellowship + more advance research training (Ph.D, even though you have a masters) + Clinical associate work (Which they will say you can combine with a Ph.D/sub-fellowship, to spin it to make it seem worthwhile).

This is the new norm and it is bonkers. The faster people realize it the faster than can cut loose and get out. Unfortunately this will not change because the supply for crazy competitive doctors willing to make years and years of sacrifice to get those faculty positions is not going way. If most people/everyone just refused to do that then maybe you'll see it retract but that ain't happening.

[ZBL]

I should also say that you don’t need academia to do research or influence change in your field. If you actually are the real deal in your specialty, opportunity will come to you rather than you having to search it out in academia. It all comes down to how you look at it - if you have a PhD in robotics, you could start a robotics company but probably wouldn’t make much right away. If you also had an MD, you could practice 50% of the time and do research the other 50% for your robotics company. That’s 50% less money than a normal community doctor, but it’s also about $200,000K more than you’d have made otherwise by just starting the company with no other income source.