Jump to content
Premed 101 Forums
Sign in to follow this  
obiwankenobi

Robert Chu--Unmatched Doctor Commits Suicide

Recommended Posts

35 minutes ago, mollypercocet said:

 

You're absolutely right, it was after all her choice to go there.

You don't need to be rich to go to the Caribbean. My neighbor was able to put all 6 of his children through university and was able to send one of his daughters to the Caribbean and they're a middle class family. It just depends if you can be approved for a LOC with your parent as the co-signer. Schools in the US, Australia, and Ireland are far more expensive and so is the living cost there.

She saved $1.5 million+ because she's able to practice at the age of 23 instead of 28. So ~300K/year*5 (although if she decided to do a sub-specialty like most rural FMs do she could make upwards of $500K/year). 

 

 

Your friend is super smart I must say. I couldn't imagine doing well in medical school right out of high school. But she probably saved 4 years instead of 5 (since an undergrad is only 4 years, though your friend might've gotten in after 3). And you have to factor in tax and overhead into that 300k figure. So she probably only saved ~700k. Though who knows what that extra 700k would be worth 40 years down the line.

And I don't think your neighbour is middle class. Sending all 6 of your children (assuming the parents paid) with a kid going off to the carribbean (50-60k USD x 4) is not doable on a middle class family's income (which is what? like 70k a year?) unless they had a huge inheritance.

Share this post


Link to post
Share on other sites
12 hours ago, ralk said:

Quoting articles that are over a decade old or from another country does not provide any meaningful evidence for your point. The way both FM and psychiatry are viewed today has changed significantly since 2005 and is far different than what may be occurring in the UK.

I won't deny that there is a small subset of practitioners who look down on FM docs or psychiatrists. I've met a few of them along the way. However, it's no longer a widely held viewpoint and certainly not one that is endorsed on any sort of an institutional level. There's also a small subset of practitioners who look down on IM physicians, surgeons, and pretty much any other specialty, but as with FM and psychiatry, my experience has been that these are a distinct minority. To the extent that people shy away from these specialties, it's far more personal preference of what they want their own careers to look like, rather than looking down on the specialty - and those who choose it - as a whole.

By your other posts, it doesn't sound like you're in medical school yet, meaning you have less direct exposure on how these specialties are viewed by the specialty at large than most of the people on this forum. While this should never preclude you from sharing your own experiences and viewpoints on the matter, you're not in a position to lecture A-Stark, someone far deeper into the profession than you are, about what the general attitude in the profession happens to be. Along those like, I'd ask that please share your own opinion, rather than claiming to know what others think or believe.

I'm just trying to say that it still happens today. I'm glad that from your experience views have changed. I know I don't have direct exposure and I get to see things from a different angle compared to those in med school, residency or practicing medicine.   My opinion was formed by my experiences and a handful of med students I personally know. I'm sorry if I made it seem like everyone looks down on FM and Psychiatry.  

Share this post


Link to post
Share on other sites
12 hours ago, hero147 said:

Your friend is super smart I must say. I couldn't imagine doing well in medical school right out of high school. But she probably saved 4 years instead of 5 (since an undergrad is only 4 years, though your friend might've gotten in after 3). And you have to factor in tax and overhead into that 300k figure. So she probably only saved ~700k. Though who knows what that extra 700k would be worth 40 years down the line.

And I don't think your neighbour is middle class. Sending all 6 of your children (assuming the parents paid) with a kid going off to the carribbean (50-60k USD x 4) is not doable on a middle class family's income (which is what? like 70k a year?) unless they had a huge inheritance.

Haha not my friend. A PGY 2 that I met while I was shadowing. The physician told me about this individual before I had met her and told me how she was 22 and going into her last year of residency. I did not believe/ did not want to believe it. I was the same age at the time and I felt like shit. Anyway, I think she may have skipped a year of high school or started going to school at an early age. 

Oh yeah, I didn't factor the tax because it varies for everyone. 

Actually he is. I come from a rural town where cost of living is fairly low. My neighbor saved up a lot when he was young and had some investments in the town. My neighbors were careful where they spent their money (they bought used clothes). Their kids did get a lot of bursaries and scholarships. 

Share this post


Link to post
Share on other sites
15 hours ago, hero147 said:

Your friend is super smart I must say. I couldn't imagine doing well in medical school right out of high school. But she probably saved 4 years instead of 5 (since an undergrad is only 4 years, though your friend might've gotten in after 3). And you have to factor in tax and overhead into that 300k figure. So she probably only saved ~700k. Though who knows what that extra 700k would be worth 40 years down the line.

And I don't think your neighbour is middle class. Sending all 6 of your children (assuming the parents paid) with a kid going off to the carribbean (50-60k USD x 4) is not doable on a middle class family's income (which is what? like 70k a year?) unless they had a huge inheritance.

The Caribbean schools that take you straight from high school are the ones that cost more like 80k-100k TOTAL for all 4 years. That's no chump change, but i think that's why their family was able to afford it. These schools are usually ~35-40 state accredited i.e. he/she was likely really smart (+lucky) to make it out of those odds. 

The Caribbean schools that cost 50-60k/year are the 50 state accredited popular one's. For those, you're right. You do need to come from a family that's well off. Not everyone has a house that's semi-paid off to use as a collateral to get student loans. 

Share this post


Link to post
Share on other sites

I am not sure what Ontario is planning to do, but it looks like a trend of reduction of medical school enrolment is beginning again. 

The Minister of Health in Quebec announced that they will slash 17 spots across the four Quebec medical schools starting the next application cycle (2017/2018). This will continue for two more years, resulting in a total reduction of 51 spots (17 x 3 = 51). This is to restore the balance of doctor:population ratio and to curb the risk of creating jobless doctors.

Share this post


Link to post
Share on other sites
On 6/19/2017 at 9:22 AM, MSWschnoodle said:

I don't really think most people were disparaging IMGs or bashing diversity in Canada. Lots of IMGs and CSAs come to the Canadian system with the knowledge and abilities necessary to be excellent physicians. I think the point made about protecting the CMG's interests over others is valid not because CMGs are "better" than anyone else but because the Canadian taxpayers have already made a HUGE investment by virtue of them being CMGs. The average taxpayer investment to educate a single medical student is incredibly substantial (estimates range from 100k-250k+ depending on what province you're in and how much funding your school gets). To spend that kind of public money to provide an education to a CMG and then have that MD degree be essentially worthless because of a lack of residency spots is ludicrous. I think IMGs bring a lot to the table and there should be a way for qualified IMGs to enter the Canadian system for practice... but the system also has a fiduciary duty to the taxpayers of this country to ensure that the investment made in medical students is something that, in the end, benefits the taxpayers that made the investment. An MD who cannot practice benefits nobody.

Now, Canadian students who choose to go to another country to do their medical education because it is easier to gain admissions to those institutions do so knowing full well that the route to come back is difficult and becoming more difficult each day. It is a calculated risk. Either way, it is obvious the system cannot support the number of people who would like to practice in it. There will always be a limiting step in medical education. Ideally that rate limiting step should be at the admission to medical school level so we don't have students completing years of schooling and costing thousands of taxpayer dollars only to be unable to practice because they cannot get a residency. For-profit institutions in other countries have unfortunately found a way to capitalize on student desperation and offer what looks like a way to circumvent the limiting step of admissions. I know many Canadian students who study abroad (including a couple of my friends) choose to do so because medicine is their dream and they are unable to get in to a Canadian institution (be that for reasons of luck or GPA or interview ability). I feel for them but at the end of the day the job of the Canadian medical system has nothing to do with any one individual's career aspirations or dreams... the job of the Canadian medical system is to provide quality, sustainable healthcare to the Canadian population. A big part of fulfilling this obligation includes ensuring that the investment made in medical education pays off for the taxpayer. 

Residency matching is going to be a huge challenge in the coming years. As far as what can be done... a lot of people have already posted and discussed some potential ideas on how this could be addressed. Given the number of stakeholders in the game, I suspect it will be a very difficult problem to solve, but it is a worthwhile discussion to have. At the end of the day the medical system has a finite capacity for practicing physicians. Any possible solutions need to work within the confines of this capacity issue. I suspect the solution lies in a combination of the below (many of which have been mined from other responses in this thread):

1. Add more residency spaces - not entirely feasible due to the need to balance residency positions with jobs at the end of residency. Potentially there could be something to say for removing the french-only residency positions from the calculation of available residency positions since not all students can fill these (not eliminating the spots, just calculating the numbers differently).
2. Reduce the number of medical school spaces - not ideal, but if residency positions continue to be cut then medical school positions should also be decreased by the same number. 
3. Limit entry of IMGs/CSAs into the system, but this is done at the expense of diversity in the case of IMGs. I personally think this kind of approach throws the baby out with the bath water but it is also an elephant in the room that needs to be acknowledged. 
4. Find a way to entice more students into the French-only residency positions - this is where a majority of the "empty" residencies exist each year but many students do not meet the language requirements. Ideally there would be a way to entice those who do meet the language requirements to preferentially fill these positions.
5. Increase the obligation of medical schools to support and assist unmatched students in getting a residency - ensure all medical schools have a plan in place on how to deal with un-matched students that goes beyond "get them into a grad program and hope they figure it out next match"
6. Have a general rotation year available to students who do not match - similar to the "extended clerkship" offered by some schools. 
7. Restrict all residency positions to CMGs until CMGs have all matched, then open remaining positions to IMGs/CSAs - again, this is at the expense of diversity and I question if this would also prevent programs from being able to recruit the most qualified/best candidates for their residency positions. 
8. Have CaRMs provide more information to students/home schools about WHY the did not match. Whether that is interview scores or just having each school choose from a drop-down list of options about why they chose not to interview/rank a student etc. It is hard to improve for the next match if you don't know why the first match did not go well for you. I suspect privacy legislation would make this difficult, but honestly I think good quality feedback would go a long way in solving this problem. As it stands now schools try to give you their best guess if you don't match, but nobody really knows. It's like trying to shoot at targets while wearing a blindfold - your school can tell you in board terms where the targets are, but it's really tough for them to help you aim when they can't see down the same sight line. 


Did I miss anything when rounding up the ideas in this thread? I find system discussions like this really interesting - I'd love to hear more of the unique ideas that people have about how to begin solving the residency matching problems. 

Sorry to bring this thread back but you made some exceptional points. I strongly agree with your solution 7 "restrict all residency positions to CMGs until CMGs have all matched, then open remaining positions to IMGs/CSAs". Is there any way to speak with carms policy makers and advocate for these ideas?

Australia/New Zealand already has implemented this system for years so I don't know why Canada has been so slow to adopt this, especially after a tragic event like this.

 

Share this post


Link to post
Share on other sites
On 6/21/2018 at 12:27 PM, strawberryjams said:

Sorry to bring this thread back but you made some exceptional points. I strongly agree with your solution 7 "restrict all residency positions to CMGs until CMGs have all matched, then open remaining positions to IMGs/CSAs". Is there any way to speak with carms policy makers and advocate for these ideas?

Australia/New Zealand already has implemented this system for years so I don't know why Canada has been so slow to adopt this, especially after a tragic event like this.

 

Historically there were no residency spots for IMGs at all. IMGs in Winnipeg sued in human rights court in 1999 that IMGs were discriminated against by not being able to apply through CaRMS. Their case went to mediation in 2004 and the result was that Winnipeg agreed to allow IMGs to apply in first round. Based on this CaRMS changed their policy everywhere to allow IMGs to apply through separate streams. So that's why they can't do away with IMGs completely. Note that it's incredibly hard to find reports of this online, without paying for newspaper archives. The most comprehensive source I could find was: http://www.legalaid.mb.ca/pdf/PILC_history.pdf, a description by the legal aid firm that represented the IMGs.

Share this post


Link to post
Share on other sites
6 hours ago, bearded frog said:

IMGs in Winnipeg sued in human rights court in 1999 that IMGs were discriminated against by not being able to apply through CaRMS.

Seriously? That actually worked? Where's our guy from a few months ago who wanted to launch that human rights lawsuit for his unmatch? We need to tell him his plan wasn't farfetched after all and that we will all eat our socks. 

The more I progress through med ed the more I come across these precedents that would make the Buddha shoot someone. The state of the system is less and less surprising.

Share this post


Link to post
Share on other sites

I think the question we need to ask is who decides how the carms match system works? 

Also is there any way to speak to the management team of carms? Like the policy makers who decide how the cmg/img system priority works?

It is common sense to match all CMGs first and then let the remaining spots go to IMG/CSA. I dont even understand why there needs to be a debate or consultation on this. Its almost laughable how inefficient this system is.

Lets look at Western Australia residency match priority for example:

Intern Priority Categories: 1. All graduates of WA medical schools, who are Australian citizens, Australian permanent residents and New Zealand citizens. 2. Graduates of accredited Australian/New Zealand medical schools, who are Australian citizens or permanent residents or New Zealand citizens and who completed secondary school education in WA. 3. International graduates of WA medical schools, who are able to fulfil the visa requirements of the Department of Immigration and Citizenship. 4. Other graduates of accredited Australian/New Zealand medical schools, who are Australian citizens or permanent residents or New Zealand citizens. 5. International graduates of other accredited Australian medical schools, who are able to fulfil the visa requirements of the Department of Immigration and Citizenship. 6. Other graduates of accredited New Zealand medical schools, who are permanent or temporary residents. 7. Other International Medical Graduates (IMGs) applying for an Internship who can demonstrate compliance with the requirements as set out in the Medical Board of Australia’s ‘Limited registration for postgraduate training or supervised training or supervised practice’ registration standard.(http://www.medicalboard.gov.au)

I think after a tragic event like this, the policy makers need to be contacted and med students across Canada need to advocate the importance of a priority based system. No IMG applications should be considered until the CMG match rate is 100%. 

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
Sign in to follow this  

×