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medigeek

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  1. Do you think typical midlevels volunteered at any point as a part of getting into their current job position?
  2. I've heard they do at some rural places and also may provide brief coverage at slightly larger places too (but not full time positions). There are definitely family doctors (at rural shops, but not necessarily tiny hospitals) doing the full high acuity scope. This is more common in USA though since GIM and FM are 1:1 equivalents in scope of practice for hospital medicine.
  3. Pretty much same stuff you'd see in FM for adults except it's more concentrated in one area (depending on the doctor) or sometimes more broad if they so wish.
  4. Your first point is universally sort of true for hospital medicine in general in north america. There is institutional variation but if you're doing inpatient medicine then you should like most aspects of inpatient medicine. As for the second, you can have challenging diagnostic workups as a family doctor as well. Don't have to be GIM for that.
  5. I'll answer your last question quick. Working in an ER has less paperwork than doing inpatient work or outpatient clinic work. Quick and simple answer.
  6. So we can destroy medicine? Midlevels are literally the worst part of American healthcare. Just go read some of the American dominant forums and see the daily ranting from doctors. Doctors in Canada need to become more aware of how much of an issue it is and not train midlevels to prevent the same issue from spreading up north.
  7. There absolutely are family docs making mid 6 figures without working brutally hard (but still working hard). There are a million ways to make money in family medicine in Canada. If you're just doing basic FFS, you're doing it wrong.
  8. Any examples of what made the ER/hospitalist exps good? And for Hanover, what sorts of procedures were residents obtaining proficiency in?
  9. Yeah it was an example of little things that need auto-consults. A lot of the protocols are there to up the billing and keep the specialty services busy. Even small rural hospitals in USA often have pretty decent subspecialty availability (state dependent) and advanced imaging available. The rural patient population isn't as big so these consult services essentially will be consulted whenever possible.
  10. The shift from academic center/metro center hospitals in Canada to smaller community and rural is pretty drastic compared to USA. I'd say scope of practice is USA is somewhat consistent across the board until you get very rural. Open ICUs are fairly common in busy metro areas (not just small community/rural) so IM/FM hospitalists can be managing vented patients, placing lines, intubating etc as needed. Of course many hospitals also have closed ICUs (especially academic centers) so ICU doctors have full control and hospitalists only do general floor medicine. And IM/FM would always be on shared
  11. I think most canadian IM docs come out of residency able to do things like paras/thoras, lines, and maybe chest tubes/pigtails. Intubation is a huge plus/minus and I'd say the solid majority will not be highly skilled at airway management, though I'm sure many do it anyway later on. Lines aren't hard to get good at if you've done some already. Maybe take a course to supplement? Chest tubes are easy. And yes you will not have nearly as much subspecialty support in most Canadian hospitals. In many hospitals, you're the actually consultant and the specialty support. Filling the role fo
  12. You learn a lot more medicine in-depth while inpatient and it is definitely heavily applicable to clinic. You also get much better context to evaluate a clinic patient's condition and how bad it can become. It also broads your differential, among other things. So I would say heavy inpatient is of major benefit to docs who want to do clinic only. Also, people change their minds. Especially in FM. You may like X in med school then like Y in residency. Better to be somewhere that trains you better. And honestly programs that are heavily outpatient-only oriented tend to have weaker preceptor
  13. But you know these are exceptional circumstances. I just meant that in general, going somewhere more rigorous for family medicine specifically is a better idea. Even if you just want to do bread and butter outpatient only.
  14. It's 2 years. Go somewhere more rigorous to become as competent as you can.
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