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shikimate

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  1. Like
    shikimate got a reaction from premed0220 in Hospital Volunteering   
    I would consider that clinical experience since you are interacting with patients. Sounds like it's quite varied and I think you can probably come up with a lot of positive points from that experience. I think in the US they have more leeway, but as long as you explain it well I think the Americans will understand.
    As an undergrad volunteer it is very hard to actually do "clinical" things, because of regulations and liability on the part of nurses, doctors, hospital etc, maybe unless it's part of research. 
  2. Thanks
    shikimate got a reaction from Naruto in How much time/break do we get between med school and residency?   
    Looks like McMaster convo is usually late May. Between end of May and July 1 you have 4 weeks, which in theory should work.
    But in case of surgical complications or unforeseen delay in surgery, might be risky.
    Also how confident are you that you will recover well enough to start residency on full steam.
    But then again when u start residency it's very hard to get more than 2 weeks off as vaca, unless you plan to take a more prolonged LOA for medical reasons.
    Bit of gamble either way, no correct answer here, you have to weigh pro and cons.
  3. Thanks
    shikimate got a reaction from Aspiring-Doctor in honest opinion please!   
    Yeah it's basically true. Pick something that's not crazy intense and even better maybe some flexible scheduling (aka don't go to UofT and pick a full year lab course that's only worth half a credit).
    Also if you have prior knowledge or work experience in some area that can be quite a leg up.
    Also consider which province you will go to and if it will give you IP status just by studying there, could be big advantage.
    Of course if you can get some scholarship $ for ur second degree that's always nice.
    Lots to consider.
     
  4. Thanks
    shikimate got a reaction from MilwaukeeProtocol in Ask questions about emergency medicine here   
    Looks like you know Ontario, examples would include Kincardine, Listowel, and towns around that size. Slightly larger cities like St Thomas and Woodstock depends, but certainly doable. Bigger cities >100K would be a challenge
    Disclaimer: this is only anecdotal evidence, I have no connection to any EM program/department.
  5. Haha
    shikimate reacted to magneto in Ask questions about emergency medicine here   
    Here you go:

     
    Just joking here with the picture above.
    I don't have a definition.
    However, there are some medical students who just don't give a good vibe to others. Examples include bad mouthing other services/consultants/nurses/medical students etc. There is also a fine line between being confident and arrogant; and gunners sometimes don't know that line. Some people resume/electives are super focused on 1 specialty and reviewing comments from their other rotations show that they might not be as good/team player/intelligent as shown on when working on the specialty that they are gunning for.
    In my opinion, if you like one specialty then you should work hard towards it. But also show up on all the other rotations with the same enthusiasm. I hope that helps.
  6. Like
    shikimate got a reaction from powdermonkey13 in Should one keep going if...   
    What you feel is completely normal. You are doing fine; need proof? You just said you haven't failed any exams.
    Some people call it imposter syndrome, kinda funny name but good description. When you congregate with the top 1% of course it'll amplify your weaknesses. 
    Here's an analogy, even the worst NBA player will probably beat out 99.9% of your average joe basketball player out there.
    Now here's the serious stuff:
    the volume of material is a problem, especially stuff you haven't covered in undergrad. So the key is to find a study method that quickly infuses the high yield material. There are numerous YT videos and channels and books and stuff about this. For example osmosis is a good YT channel worth checking out.
    You wanna maximize every minute of your studying. Your goal is not to score 99% on your exam, your goal is to score enough points so you pass and have a margin of safety (aka if pass mark is 60, don't aim for 65, aim for like 70-75%). If you try to score 99% on your royal college exam you'll die studying.
    Here is a corollary, if you play baseball, are you going to swing for HR every time? Answer is no, you wanna have a reasonable average and play for other aspects of the game (eg. sacrifice, not ground into double play etc). If an easy pitch come along, go for it, but you gotta play the "game" "holistically".
    So clerkship is very different, a lot more people skills, soft skills, "thinking on your feet" skills. Very rarely do they fail someone purely on medical knowledge.
    Let me give u an example. Once an attending (whom I have very low opinion of) was asking everyone on the team causes of some arrhythmia (who cares). People before me have already  answered stuff like drugs, congenital, lytes abnormality, etc. So I basically had no answer. I realized nobody have mentioned autoimmune, so I mentioned "autoimmune disease" without specifying anything. He was surprised I "knew" this answer because he went on this big blurb about how some autoimmune disease could cause myocarditis and pleuritis and EKG abnormality blah blah blah. I HAD NO CLUE ABOUT THE ANSWER lol, just goes to show you how bit of street smarts goes a long way in clerkship lol.
    Lastly, the worse people in clerkship are the tools who think they know everything and make sure everyone around them knows that. I've seen one such d****bag go unmatched 2 years in a row, he says he feels so destroyed and don't know why lolz.
  7. Sad
    shikimate reacted to throwaway_33 in Think twice about matching to a residency program in Alberta.   
    I'm a resident in a training program in Alberta. The political situation is not looking so hot right now, and I wanted to share some information that I want you all to be aware of when interviewing here and when making your rank order lists. 
    First of all, there is Bill 21, which allows the Ministry of Health to restrict prac ID / billing numbers as of April next year. It allows the government to restrict new doctors to only work in certain regions of the province. For instance, if the government deems there to not be a need for your given specialty in an urban area, they may decide not to grant you a billing number. Even if you grew up in Alberta, and trained in Alberta. Practically speaking, details of this are very uncertain right now, but what we know is that Bill 21 applies to all specialties, and most think that it will impact family medicine the most. The UCP government even advertise this front and centre: https://www.alberta.ca/physician-resource-planning.aspx Here's another article on this: https://cmajnews.com/2019/11/21/bill-21-practice-permits-1095835/. The most frustrating thing about this is that there is no guarantee that I will get a job in the city I live in here in Alberta, despite the fact that my family is here and that I trained here. 
    The relationship between Alberta doctors and the government has deteriorated substantially in the last couple of years. There is talk of cutting physician fee codes, which may happen April of this year. They've already cut GP codes. Personally, I know a lot of doctors who have already moved away from Alberta, and there is very little trust that exist between doctors and the government. 
    Lastly, is COVID vaccinations. I am a resident on the front lines, and I have not been vaccinated. This is a throwaway account, and without going into specifics, I am on the front lines, seeing patients. I work long hours on call and I see patients regularly in the emergency department. Residents in my program have advocated to our program director, to the department, to PGME. We have sent letters to higher ups and officials in the Alberta government to no avail. All we get is empty platitudes and "be patient". The most frustrating thing is that preceptors I'm working with have been vaccinated, and often times, I am spending more time in the emergency department than they are. Nurses in the emergency department are vaccinated and I am not. I think actions speak louder than words. This just goes to show how much they care about the health and well being of residents. To be fair, depending on the specialty, residents have been vaccinated depending on the rotation (for instance, in medicine, ICU, etc.) so depending on who you talk to, some residents may have been vaccinated and some may be waiting months longer. 
    Over all, things have been very frustrating over the last year. It would be good to generate discussion about how other residents in Alberta feel about all of this. I just want you to have a more balanced view and make the most informed decision possible when deciding to do residency in Alberta. 
  8. Like
    shikimate got a reaction from MDinCanada in Should one keep going if...   
    So if u wanna match to most specialties, mostly it's personal interactions and LOR. This excludes ultra-competitive ones where yeah you gotta know stuff inside out just to get an attending to smile at you. So if you are like bottom quartile in your med class, no worries, not end of world at all. On your elective, do some reading, know the basics and some advanced stuff, but more importantly, earn some "street cred" in that program and specialty.
    There goes a joke about med school class:
    - the top 1/3 of class become academians with titles and salutations longer than their actual name.
    - the middle 1/3 of class become well respected community practitioners that everyone waves at supermarkets.
    - the bottom 1/3 of class become filthy rich capitalists who collet medical office rent from the middle 1/3, and then "donate" it to the top 1/3 for research fund, and then cashes out $$$ when their discovery goes IPO. That's how you score a 5 bagger, 10 bagger, not seeing 5x more patients per hour lol.
  9. Like
    shikimate got a reaction from jb24 in Should one keep going if...   
    So if u wanna match to most specialties, mostly it's personal interactions and LOR. This excludes ultra-competitive ones where yeah you gotta know stuff inside out just to get an attending to smile at you. So if you are like bottom quartile in your med class, no worries, not end of world at all. On your elective, do some reading, know the basics and some advanced stuff, but more importantly, earn some "street cred" in that program and specialty.
    There goes a joke about med school class:
    - the top 1/3 of class become academians with titles and salutations longer than their actual name.
    - the middle 1/3 of class become well respected community practitioners that everyone waves at supermarkets.
    - the bottom 1/3 of class become filthy rich capitalists who collet medical office rent from the middle 1/3, and then "donate" it to the top 1/3 for research fund, and then cashes out $$$ when their discovery goes IPO. That's how you score a 5 bagger, 10 bagger, not seeing 5x more patients per hour lol.
  10. Like
    shikimate reacted to AncientDentist in Dental profession - positives and challenges?   
    I was exactly in your shoes, reading all of these forum posts during dental school and fretting about whether or not the efforts were worth it. I can tell you, that as a newly graduating dentist, you will almost definitely be in the top 1% of earners in Canada (if you make some concessions about where you want to live and practice, i.e. you don't NEED to work in GTA). You will be pleasantly surprised with how much you can make with relatively modest efforts on your part. You won't be "on-call," you won't have to skip lunch and work 12 hour days, and you can pretty much choose what kind of dentistry you want to practice. You will almost certainly find a job right out of school (again, need to be a bit flexible here) and will start taking home a salary that most other professionals need to earn over a lifetime (and most will still not make as much as you).
    BUT. You will not necessarily be wealthy. If, perhaps in the olden days, a dentist was making more money than he/she knew what to do with, then dentistry has "fallen" from that level. Nowadays, you will need to be financially literate and financially responsible in order to become wealthy. You will need to live well below your means. Dentistry is not a special invitation to become a millionaire. It isn't even really a head-start. Your peers may have started working 10 years earlier and may been saving and investing while you were still digging yourself deeper and deeper into debt. Once you realize the reality of your situation, and once you CHOOSE to live a lifestyle which brings you happiness and is well within your means, you will definitely find that dentistry is a prosperous profession for you. You will love what you do, and because you are responsible with your finances, you will find that it really will bring you wealth.
    Again, I want to emphasize that being a dentist doesn't entitle you to wealth, you need to remove that mentality from your mind altogether (I still remember financial advisors coming to us in dental school and proclaiming that we "won the golden ticket" by being admitted into dental school). All this mentality does is pressure you to live a lifestyle well above your means and will most certainly mean you will "not even pay off your student debt" or "make a comfortable living."
    Reality check: a vast majority of Canadians have a "comfortable living" making half of what you will make. Live like they do (and save/invest/pay off debt with the rest). 
    Read a few books on the matter too, I really wish I was informed in first year dental school. Start with "Wealthy barber returns" and you'll enter into the rabbit hole of personal finance forever - best of luck!
  11. Like
    shikimate reacted to bellejolie in Emailing Programs for an Interview - Advisable or No   
    if you're respectful there is no reason they would do something like that. If you're obviously arrogant or demanding then yes word will spread. But asking and being polite, in the context of feedback, emphasizing your interest in the program etc gets you a second look and as many have said has worked out in people's favours. Carms is much more fluid and open to these things than entry to medical school is. 
  12. Like
    shikimate got a reaction from NoMatchNoProblem in Emailing Programs for an Interview - Advisable or No   
    I agree with previous posters. Try emailing the PD or someone in the program you have contact with. Be succinct but courteous. 
    Programs do screw up sometimes, so you never know if they got your name mixed up between interview and reject list.
    Also other candidates may decline interview or switch time slots, possibly creating new open interview slots. So even if they put you on a "waitlist" it creates some chances.
    Somewhat unrelated, but I know people who were rejected for fellowship / job, but kept in touch with the person in charge (aka. ask them to keep their CV in file in case something showed up), then some time later, after they've moved on, they get phone calls asking if they are still interested in the fellowship/job. For example one place had hired a candidate last year but the candidate failed their RC exam so offer was rescinded, and then they were scrambling to hire someone else.
    TL;DR: never hurts to try.
  13. Like
    shikimate got a reaction from blah1234 in (Neurosurg) Realistic advice about job prospects   
    You made a good point about the TN visa. You can still go to US on a J1 and try to work in a rural area to get waiver, or try to get institutional H1B sponsorship (usually limited to large academic centers).
    Anecdotally I know of ENT people working in US (large cancer center) without US board certification, on an institution sponsored visa (not sure what type). I am not sure if board certification affects billing for these people or not.  
    So overall getting medical license in US is easy, but board certification varies by specialty. For example small rural places in US desperate for doctors will accept someone without FM boards (eg. a resident with 1-2 years experience in IM/FM, etc). Again their employment model is very different, so I guess that could open certain doors and close other doors.
     
  14. Like
    shikimate reacted to blah1234 in (Neurosurg) Realistic advice about job prospects   
    Perhaps there's US pressure to prevent the influx of Canadians but I honestly find that a little hard to believe as well as the number of specialists we produce is not that large in comparison to their existing training pipeline. I think the job markets for things like family medicine and neurosurgery are pretty good in the US (as neurosurg has more opportunities in the community compared to Canada).

    I honestly have no idea what the policy logic is as I'm assuming my colleagues learned their history facts from their professors who were probably in the know. That combined with my pessimism with how the government increasingly wants to manage us as resources is probably why I came to that conclusion.
    You might be right that they don't think about us at all. Given that medical research and knowledge are largely focused around US centres (due to funding) I would always assume that our training would parallel theirs given the similarities. It just seems really odd that we wouldn't adapt our curriculum to match unless there was some other pressure involved. But maybe that's just misplaced paranoia.
  15. Like
    shikimate reacted to blah1234 in (Neurosurg) Realistic advice about job prospects   
    The government doesn't care if there aren't jobs available they just care if there is a supply which can only help them deliver patient care. My neurosurgery colleague told me that a big reason why the curriculum doesn't match up was because there was an effort to prevent a brain drain to the US a while back. I don't know if this is true as this is just their hearsay.
    While there may not be a full staff position there are usually random locums that people can secure which still provides the end goal of patient care which the government cares about without any consideration for the needs of new graduates.
     
  16. Like
    shikimate got a reaction from MDinCanada in Why do people say dentists make more than doctors?   
    You'll never make a lot of $ if you take a salary or do the work yourself, even if you work 24hrs a day non stop.
  17. Like
    shikimate got a reaction from Hopefulm in -   
    You have to remember US applicants need significantly lower GPA and MCAT to get in compared to internationals, so the stats are likely misleading.
    You could try DO schools for sure, apply to as many as you can.
    Applying in September likely had a major negative effect. As early as possible they say.
    You should consider applying to some lower tier schools that are Canadian friendly, Wayne State for example.
    Your MSc and MCAT certainly are positives, but unfortunately overall GPA is still suboptimal.
    Next cycle if you want to apply again you should apply broadly, early, and add a bunch of DO schools to increase your chances.
     
     
  18. Like
    shikimate got a reaction from neurologist19 in Are there proper books out there on professional and moral demeanors of a physician?   
    CMPA has a bunch of stuff on their website, which may be helpful. But keep in mind their position is usually very defensive, and usually bit idealistic.
    If you wanna learn more you should join the variety of physician FB groups, people will talk about scenarios they've encountered and how things went.
    There is no correct answer usually, it's like history, it's written by the victors.
    Sometimes good defense is the best short term offence. Aka try to de-escalate in the moment, but document strategically, report to the appropriate authorities, and make long term plan to discharge this patient and be ready for counter-attack if they want to bite back.
    Patients are humans , and human are animals, and animals bite and go berserk for no reason. Some animals can't be tamed. You can't expect a hyena to be persuaded to go vegan.
  19. Like
    shikimate reacted to bigoof in Failed a second assessment - will I have trouble progressing to the next year?   
    haha thanks for the encouragement! I definitely feel like we got trolled as they just put gave us a super heavy anatomy exam right in the middle of two cardiology block exams and I have never studied so hard in my life. Some people I know didn't even make it through all the material. The struggling part is so accurate I feel, but we also do get to see our class average and usually it's been in the 80s so I feel like most people are doing quite well. Oh well, just gotta learn from my mistakes and see how I can do better the next time!
  20. Like
    shikimate got a reaction from bigoof in Failed a second assessment - will I have trouble progressing to the next year?   
    I don't know about UT policy, but as long as it doesn't show up on MSPR or transcript I doubt it'll ever have any effect on CaRMS. Maybe if you fail 2 courses that's a bigger deal. Hard to say without knowing the official policy. Hate to say this but UT trolls their students (not just med students, but in general) wayyyyy to often, they make people's life miserable for the sake of making people's life miserable.  
    People struggle more often than people realize. Nobody likes to tell other people they didn't do well on something, so everyone thinks every other person is doing perfect except themselves. It's not a big deal if you just have to re-take a test or re-do an assignment.
    You said you are getting >90% in other exams, so you're smart guy and you can overcome this. You are definitely smarter than I was as a first year med student lol.
    I've seen people repeat year(s) for academic and personal reasons. In the end they matched, maybe not top notch specialty but they are doing residency just like other people. Once you finish residency and get board certified, patient's don't give a damn what mark you got in your anatomy class. Med school is full of road bumps, but as long as you keep the end goal in sight, you'll find ways to overcome them.
    Even when you are attending **** will happen, last month I just found out a well respected GI guy perfed someone scoping. If he was a resident he probably would get a not meet expectation evaluation for that day lolz but life goes on and he's still employed.
  21. Like
    shikimate got a reaction from MDee2B in Are there proper books out there on professional and moral demeanors of a physician?   
    CMPA has a bunch of stuff on their website, which may be helpful. But keep in mind their position is usually very defensive, and usually bit idealistic.
    If you wanna learn more you should join the variety of physician FB groups, people will talk about scenarios they've encountered and how things went.
    There is no correct answer usually, it's like history, it's written by the victors.
    Sometimes good defense is the best short term offence. Aka try to de-escalate in the moment, but document strategically, report to the appropriate authorities, and make long term plan to discharge this patient and be ready for counter-attack if they want to bite back.
    Patients are humans , and human are animals, and animals bite and go berserk for no reason. Some animals can't be tamed. You can't expect a hyena to be persuaded to go vegan.
  22. Like
    shikimate got a reaction from honeymoon in Ranking specialties in CaRMS   
    Lastly in residency there will be staff who make you feel bad, useless, make you think you gotta beg them for a fellowship or something. That's their game to get you to become their academic slave. It's all mind games. You gotta remember what I said earlier, YOU PASS EXAM = YOU GET BOARD CERTIFIED = YOU GET PAID THE SAME (or even more than those losers, if you are smart with billing and accounting).
    That's why it's so important to feel confident for your board exam. Never a bad idea to start studying early. Just like MCAT, find out early what's high yield, and start using all the resources you could find. Once you are confident about your ability to pass your boards, all the voices saying you suck are just flatus. Play safe in residency, if you are competent and work reasonably hard and study reasonably well, you'll get through it. Of course every PD wants to extract as much out of their employee (aka, YOU) as they can, but you don't owe them anything.
    And start networking for jobs early, both academic and community. Go to as many events as possible, make cold calls, write those cold emails, don't fear rejection, sometimes it takes a few tries to open up a door. If you have an opportunity, do some site visits on your day off. Never dismiss somebody because their hospital is small or they aren't hiring right now, they could easily pass your name to someone who might be hiring (but not publicly posting their job), or give you a boost when your prospective employer calls them for reference. You'd be surprised how people know other people, and someone you met before, who you've probably half forgotten, had a good impression of you and get called by your recruiter. 
    Most jobs aren't posted, especially the good ones. The good ones that get posted have a lot of fakes (aka they already hired someone but have to post an ad for regulatory purposes). Just remember that. 
     
  23. Like
    shikimate got a reaction from honeymoon in Ranking specialties in CaRMS   
    And yes, 5 year residency can be quite draining, especially I'd say year 2-3 when it's a steep hill to climb and you gotta get into the deep end of learning that specialty. Gather resources, that's key, get all the notes, past tests, and whatever your specialty uses that's "high yield". Yeah it's nice if you can do some projects on the side but your first and foremost goal should be to 1) get certified, 2) get a job.
    I would say finding like minded people/residents is the key. Not all your co-residents will have the same aspiration as you, and that's fine. If you can find 1-2 people that you really get along with, that could instantly boost your synergy. Don't just talk about residency stuff, talk about job searching, investing, relationship etc, look for synergy in every aspect of your life. Find a few staff who you also work well with. Do lots of electives and learn the world outside your academic center.
    Don't waste your time trying to please everyone, maybe at beginning when you are weak and newbie it's ok, but once you are in PGY3 and ready to carve out your own path, start really contemplating and reflecting who's been your ally and who's been your enemy for the last 3 years. Don't get trapped in academia, I've seen that happen all too often, people get so happy like they won Lotto Max when their poster gets accepted to some Garbage Journal of Medical Oddities.
  24. Like
    shikimate got a reaction from Pakoon in Ranking specialties in CaRMS   
    Lastly in residency there will be staff who make you feel bad, useless, make you think you gotta beg them for a fellowship or something. That's their game to get you to become their academic slave. It's all mind games. You gotta remember what I said earlier, YOU PASS EXAM = YOU GET BOARD CERTIFIED = YOU GET PAID THE SAME (or even more than those losers, if you are smart with billing and accounting).
    That's why it's so important to feel confident for your board exam. Never a bad idea to start studying early. Just like MCAT, find out early what's high yield, and start using all the resources you could find. Once you are confident about your ability to pass your boards, all the voices saying you suck are just flatus. Play safe in residency, if you are competent and work reasonably hard and study reasonably well, you'll get through it. Of course every PD wants to extract as much out of their employee (aka, YOU) as they can, but you don't owe them anything.
    And start networking for jobs early, both academic and community. Go to as many events as possible, make cold calls, write those cold emails, don't fear rejection, sometimes it takes a few tries to open up a door. If you have an opportunity, do some site visits on your day off. Never dismiss somebody because their hospital is small or they aren't hiring right now, they could easily pass your name to someone who might be hiring (but not publicly posting their job), or give you a boost when your prospective employer calls them for reference. You'd be surprised how people know other people, and someone you met before, who you've probably half forgotten, had a good impression of you and get called by your recruiter. 
    Most jobs aren't posted, especially the good ones. The good ones that get posted have a lot of fakes (aka they already hired someone but have to post an ad for regulatory purposes). Just remember that. 
     
  25. Like
    shikimate got a reaction from LostLamb in AGE? Consensus   
    Um, when you go into the same clinic for the nth time, see the same complaint, ask the same question, order the same labs, prescribe the same rx, it gets pretty routine.  Like 95% of community practice is like that, yeah after 5 years into practice you'll know what I mean.
    Unless you are in academia, even then a lot of your clinical work is gonna be the routine stuff.  
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