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Everything posted by blah1234

  1. You are evaluating these patients for a 3rd party (e.g., law firm) and thus it's not a traditional therapeutic relationship. It can often be antagonistic because you can be the expert that's evaluating a patient to deny a disability claim or for a civil proceeding or some other non-traditional medical purpose.
  2. I think if you do more lucrative things like EMGs or medicolegal work your income potential should be higher than FM if you adjust for rate/hour. I have PMR friends that don't do any medicolegal work though as they didn't like the atmosphere with the patient evaluations so just be aware of that.
  3. Constant coffee I suppose. As you get "better" at medicine (e.g., knowing an approach to chest pain off by heart, or knowing how to take a relevant history fast) it feels less mentally exhausting. However, this is counteracted by the fact you get more pushed onto you as you get better so I guess it's a wash. Honestly, I took whatever free time I had and just rested. Exercise was on the table but sometimes I was just too tired given all the demands (clinic, research, studying, etc.). I think most people can probably handle the hours, it just won't be a pleasant couple of years. At times you
  4. Yea, there are specific immigration exceptions for MDs made for rural need in the US but those communities seem rough to work in based on my understanding.
  5. 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 w
  6. For what it's worth I used to be a professional before joining medicine as well and there are other fields where 80+ hour weeks are fairly regular and include pretty intense hours too. Perhaps there isn't the need for overnight call but weekend work can easily drive up the hours.
  7. 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 o
  8. Yea, the on-call stipend as a resident (~$100?) was pretty insulting given how hard we had to work haha.
  9. I've also never seen a list and found out mostly through word of mouth. I feel like this is almost intentional as you don't want to inform students what their options are so they stick around in Canada in high-need fields. Could be an interesting initiative for CFMS as you just need a couple of students to do some phone calls and website research to compile a spreadsheet for medical students to get informed about future cross-border employment issues.
  10. In many ways the grueling training exists to prepare for your staff life. I think for most fields the hours do get better as staff. I will say that some of my friends do more call than they did in residency (e.g. OB/GYN in certain communities). I think it's more manageable because you know what you're doing, you're the boss now, and the hour to hour is probably less jam packed compared to an academic centre. However, I know that I'm not as fast or as energetic compared to my youth so those call shifts will take a toll as you get older (which is also supported by other older clinicians). As
  11. 100% agree. I had many weeks as a clerk and resident where it was actually 80+ hours of pure work. Literally running around trying to put out fires. It's not the norm (at least not in my specialty) but you need to be prepared because it does happen.
  12. I would also like to emphasize that you should not bank on a pre-nup. It is not as strong a defense as people think.
  13. The fee schedule can provide a good view in terms of what your earning potential is. At some point to hit high billings you just need to put in long hours as the codes are the codes. There are stipends and bonuses that can cloud the matter but at the end of the day most physicians will be dependent on FFS.
  14. I agree with erring on the side of pessimism. I think there are a lot of supportive champions in medical school but the system as a whole has not historically helped students with various struggles. I would not anticipate getting special treatment just because you are a single parent.
  15. Depending on the cost of nannies and how long you need them, the financial advantage of being a FM vs another HC profession like nursing becomes more blurred. It may become a question of how much this dream of yours matters to you and how much you value time with your children both in the near-term (training) and the long-term (staff life). It may be worth mapping out all the logistics before you commit to starting to see how easy it is to find & pay for the support you need for your children.
  16. Clerkship was busy because you had very little control and you had to complete your tasks while studying for relevant exams. While some rotations were less busy (e.g. family medicine) you are still looking at having to rotate through fields such as CTU, General Surgery, where you are expected to do overnight call which can get quite busy. While you do get that post-call day I found I needed it to recover. Weekends were also needed often to study to improve knowledge but also to prepare for exams. Residency was similar as it was a combination of busy and non-busy rotations but factor in re
  17. Yea, it's going to be very hard without a support system. You'll need nannys which can be expensive over time. Also, how will call work? I've only heard of medical exceptions for reduced call requirements. Will you be able to trust your child with hired help overnight while you work? I personally could not imagine having children during my medical training but I know people in much busier setups (e.g. 2 surgery residents) somehow raising a child so it must be possible somehow. Although perhaps it's a lot of hidden support structures and paid help that I don't see overtly. I wish I had
  18. Probably from the long surgical wait lists. They don't understand we don't have the capacity to pay for more OR time for underemployed surgeons. I don't like how the government just portrays the surface level issues when it's really a huge funding problem at the core.
  19. I've seen this many times with students and I really want to convey that what you may love as a student you may not love as a resident or attending. People's priorities change as their life situation changes (e.g. marriage, children, illness, etc.). I'm not saying you won't love it forever, but the road is very long and the payoff may not be as immediate as some of your peers.
  20. I'm not holding my breath for this. Lots of bureaucratic hurdles in medicine and this learning tax is just free money. I wish an alternative being proposed was something like giving people who have a licentiate a way to moonlight in walk in clinics or something. If they won't remove the test they might as well add some practicality back in for us.
  21. That's really impressive. Probably the first case (in my limited student sample set) where I've heard that someone is graduating debt free from scholarships and financial aid. You're easily leaps and bounds ahead of your peers.
  22. Yea, Western students have it pretty good since it's a better housing market. I remember UofT students having substantial debt loads, especially if they lived by themselves downtown. I do think the premium associated with paying for more convenient location or solo housing during clerkship/residency is worth it. Those years can be stressful enough that small optimizations in lifestyle can make a huge difference for your mental health.
  23. I think that's including people who have parental support too and pay very little. Kind of checks out with medical students I used to teach telling me they had 200K+ in debt.
  24. I've never practiced in Quebec so this is all second hand but isn't it hard to get a PREM in desirable areas (e.g. Montreal)? I thought that was a complaint I've heard from colleagues. Also are those figures gross billings before overhead? Figures seem a bit higher than Ontario if it's after overhead.
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