Thanks for offering to do this, I am a current medical student dealing with an interest in pathology vs clinical medicine. Lots of questions!
For those of us starting the CARMs tour soon and now that your are finishing residency, what would you look for in a pathology residency program? Can you comment on any of the pathology programs across Canada? Which ones do you feel train competent physicians for independent sign out without requiring fellowship?
Can you comment on what the job outlook is across Canada for pathology? Potential for non-employeed positions or starting your own practice - I realize most Pathologist jobs are generally employed/contracted by the province or hospital? What does the future of pathology look like in Canada - for example will there be continue centralization of laboratory services or will general pathologists still remain in demand at community locations, digital pathology?
Any thoughts on the name change from "anatomic pathology" to "diagnostic and molecular pathology"?
Any idea on the competitiveness of Canadian forensic pathology fellowships?
Hello! I started Premed when I was 34, now I am 36 and 2nd year student. I am now regret! Medicine is so intersting!
And + there are a lot of directions so everyone can find proper specialisation for him/herself. Here one of my video (the first), where I`m telling things connected to this topic.
Invite/Regrets: XX Time Stamp: XX:XX Location: IP Stream: English cGPA: 4.00 Current year: 3rd ECs: 1k hrs of research, ~5k total hours of entries, filled all 32 with 10 community service/academic awards, started national non-profit which was recognized by premiere & prime minister
Don't know what to predict. I thought 3Q may be good enough considering strong ECs/GPA, but based on Mac invites, it's looking very iffy ... Anyways, good luck everyone!! May your dreams come true
I find it amusing that our Family Medicine physicians want to increase residency training times, meanwhile our nurse colleagues want to get their NPs to pay parity with GPs with a fraction of the clinical training. Who is this really for? Certainly not the payer, the government doesn't seem to think there is a difference between a GP and an NP as they happily raise salaries for NPs and chase out full service GPs to Hospitalist work (at least in BC).
If the extra year is implemented then there needs to be some lobbying or action of this issue as well. At the very least they need to convince governments that this is actually worth it (when right now it appears they barely think training GPs are worth it). Otherwise it makes much more sense for the average applicant to just do the NP route and save yourself the headache.
If they split it like that, by the time I was done my year of OB and outpatient, I would have forgotten everything about CTU and ICU. Or vice versa. People get good at what they’re doing, and they forget what they aren’t doing. I think part of what actually makes the better 2yr family med programs out there work well is that you spend a lot of time doing family and minimal time doing other less relevant rotations, and then you finish and you start working and keep applying what you learned. More CTU will not make me a better family doctor. More OB also won’t make me a better family doctor, because I have no intention of doing deliveries. But it would provide a heck of a lot more cheap labour to the medical system.
As a non-trad currently going through it, 2 years doesn’t feel like it’s enough to be a strong generalist, but I don’t actually think making it 3 years will fix that. People are moving away from general family medicine and towards niche areas of family practice or inpatient/emerg for many reasons. It is becoming harder and harder to know enough to actually do true full-scope practice. More relevant is that it is EXHAUSTING to be a doctor who does everything - I work with docs like that, and they have no work life balance - and it doesn’t tend to pay that well. And because of that, people often behave like crappy doctors or make mistakes because the current system incentivizes rushing. I think there’s plenty of ‘bad’ doctors out there who could do better under different circumstances, and I don’t think extra training will fix that. ESPECIALLY if it doesn’t come with a pay raise to account for the extra year of training or better support for community practices.
I think it might make more sense if we had something like the extra year in IM, where you could opt to do some extra general training for 6-12 months OR apply for CaRMS +1 OR just stop, and we expanded the options to available (as opposed to only the current +1 programs). But even then, part of what drew me to family was the option to retrain later in my career to be more specialized. I would have seriously considered a speciality if FM was a mandatory 3 years.
Your GPA and ECs seem good, and a quick look at your profile seems that you've limited yourself to just the two schools in Montreal? And I hate to say it but McGill might be off the table after declining an offer as opposed to deferring. So you need to cast a wider net, which may mean writing the MCAT. I agree that a second undergrad or anything GPA wise would have very low return on investment. If you are limited to Montreal for family reasons, all you can do is keep applying and see what sticks. However, if you went from accepted to no interview that's significant.
True...I suppose the major issue though is whether 2 years is enough time - after all the primary concern of the college is making sure people truly are trained well enough to do that job. Ultimately nothing else will really matter to them. One long term problem we have in medicine is simply ALL specialities are requiring us to learn more and more in the same amount of time - at some point something has to give. Right now that is fellowships - which have shifted over time from being relatively rare to basically completely required for a lot of fields, and often more than one for that matter (my specialty training was not 4/5 years - it was 7. As an example almost all radiologists are at 6 for the same job that used to be 5). The overall impact is in a sense an extension of residency without calling it that - because actually making residency longer would shall we say "unpopular". You can deal with that by reducing the scope of what people need to know (by becoming more subspecialized) or by increasing the time of training. Either way there are significant downsides for people. You could also potentially find a way to make residency training more efficient which also as issues as most options there reduce involvement in clinical work that is important but lower yield - the hospital system needs people to just do things in order to operate).
They also have a bit of power move that is always in the background- there is always a fix number of positions out there, and most of the non-family med specialities completely fill. Effectively changing it to 3 years would probably make a lot more grumpy people but not actually change much the number of people going into the field ultimately. It's a zero sum game.
I think a substantial number of med students interested in FM would just pursue a specialty instead if they made FM 3 years (myself included). Consider how many non-trads (who tend to be older) enter the field knowing from the beginning that they're pursuing FM--part of that is because of the shorter training.
FM is great and all, but one great aspect is how you can avoid a 4/5-year residency. FM comes with a ton of responsibility and on average lower pay compared to specialties, so something needs to keep the incentives balanced. If by making it a 3-year residency, they also increased the ability of being paid fairly while still practicing good medicine (e.g., by increasing FHO spots), then I think it would compensate. They could also increase the checks and balances during residency to ensure that competent physicians come through the pipeline.
Making FM residency 3 years takes away one of best things about FM. There's even less reason to pick FM. It does create more jobs and relevance for senior FMs high up in their academia ivory towers.
I'm all for making FM 3 years if they split it like this: a year of emerg, a year of CTU and ICU, and a year of outpatient clinics and OB. All new grads would come out competent to practice general medicine in any of these settings. There's no way cfpc would do something logical like this.