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blah1234

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  1. Sad
    blah1234 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. 
  2. Like
    blah1234 got a reaction from premed2232 in Speciality Choices   
    I found shadowing easy enough at my medical school. As a staff I don't mind having learners shadow either. I think it is hard for students to gain a sense of what they like pre-clerkship. Pathologies that sound interesting on paper and in the classroom may not be that fun to deal with on a daily basis as your fulltime job. 

    I think shadowing and asking residents/staff about what they like/dislike about their job might be a good starting point. Unfortunately, people do change as they grow older and their priorities shift. What you love as a medical student may not be what you love as a resident or as a staff physician. I would suggest keeping an open mind and finding a field where you would be okay with the bread and butter (80+ percent) of the job. 

    It is also important to note that academic vs community practices can be very different and I think a lot of the exposure you get as a medical student is skewed towards academic practice which can inaccurately push you towards or away from a field. 
  3. Like
    blah1234 reacted to shikimate 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.
     
  4. Like
    blah1234 got a reaction from shikimate 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.
  5. Like
    blah1234 got a reaction from shikimate 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.
     
  6. Haha
    blah1234 reacted to JohnGrisham in What’s maximum number of hours that clinical clerk can work per week?   
    But when you got that nice bonus on your cheque was a nice feeling back then
  7. Sad
    blah1234 got a reaction from frenchpress in What’s maximum number of hours that clinical clerk can work per week?   
    Yea, the on-call stipend as a resident (~$100?) was pretty insulting given how hard we had to work haha.
  8. Like
    blah1234 reacted to ellorie in What’s maximum number of hours that clinical clerk can work per week?   
    Staff call is also more $$$ which I think is generally motivating for people.
  9. Like
    blah1234 reacted to JohnGrisham in What’s maximum number of hours that clinical clerk can work per week?   
    As an outside observer to this conversation, you should really re-read the tone and way they presented their view to you. They were being very polite and trying to point out some potential blindspots, and encouraging you to not diminish the expressed experiences of others  - no matter how you may not be able to "believe them".

    Your initial tone and inferences that the students simply were clocked in and on social media was a bit off-putting. While the content may be realistic and plausible, its the delivery. I agree, some students are definitely doing that and over-exageratting. But I don't think its fair to just assume everyone is. 

    I definitely had true 80 hours weeks  as a medical student and they were infrequent, and i was definitely spending at least 80% of the time working - and I had worked 80 hours weeks sporadically before Medicine.   And I did notice some of my colleagues would be up all night on some rotations - mostly because they were relatively slower at doing Internal Medicine consults/admits at 3am compared to me; because who in their right mind can function and write up elaborate DDx and treatment plans at 3am? What would normally take maybe 1 hour during the day, can take up to 3hrs at night for many, especially when you factor in lead time to review your cases with the residents or attendings.    

    That was just me own experience as a medical student, that carried forward into residency. We can only share our experiences, and those of our close peers who have also gone through the path. It is generally reflective in "you don't know how it is, until you go through it". 
  10. Like
    blah1234 reacted to birdy21 in What’s maximum number of hours that clinical clerk can work per week?   
    I've never said (let alone even thought) this before, but if you really think it's BS about med students working these hours, then I hope you don't end up in med school. Working in a step-down ICU unit during a global pandemic did not consist of me sitting around, browsing social media. Infact, any down time I had was spent either sleeping or studying, because you really might only get a couple hours of free time on any given evening. Of course this is not the same for every rotation but please stop trying to discount experiences of something you have not gone through and (clearly) know nothing about.
  11. Thanks
    blah1234 got a reaction from jnuts in (Neurosurg) Realistic advice about job prospects   
    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.
  12. Like
    blah1234 reacted to ellorie in What’s maximum number of hours that clinical clerk can work per week?   
    Not to be rude, but I laughed at the "nobody can work 80 hours per week" comment.
    I didn't do it much in psychiatry but it's so so standard issue in so many of the other specialties.  Just one Saturday call can easily push you to almost 70 without even trying even in psych (and I generally feel like I got off pretty easy from a residency perspective).
  13. Like
    blah1234 reacted to robclem21 in What’s maximum number of hours that clinical clerk can work per week?   
    It may not be 80 hours every week, but there are certainly many weeks where hours worked top 80-90, even as medical student. Furthermore, those hours don't even include when you are coming up to an exam as a clerk and your "not-at-work-hours" are spent studying. As a resident, the number of weeks where you clock 80-90 hours is increased and when you work 1 in 2 weekends, it doesn't take very long for those 80-90 hour weeks to go back to back. If you want to do any 5 year speciality you better be CAPABLE of doing extended work weeks.
    As far as how to get to 80 hours per week.... easy... 2 call (26hrs x 2 = 52) + 2 post call days (0) + 2 x 12 hours days (=24) = 76 hours (plus miscellaneous crap incl. research, teaching, etc. that easily adds 4+ hours) or if you are working a weekend (which is every other weekend for residents and usually once per month for clerks) - 3x 26 hour call (3x26 = 78) + 3 post call days (0) + 1 x 12 hour day = 90 hours followed by right back to work for another 50-60 hour week on Monday (or more with more call). Again, plus any studying or work that needs to be done on your own time. I will also add to this that many small specialties aren't even guaranteed their post-call days or do 1:3 home call that often turns into a busy in-hospital call with no post-call day guaranteed.
    I think there is some value in overnight call (whether its 24 hour or 16 hour) for clerks. Clerks are already shielded from a lot of the work residents and staff do, and its important for them to have a real experience before committing to a 5 year residency and lifetime of a specialty. I don't think it needs to be 1:4 as it is for residents, and even on call they don't deal with much of what residents deal with, but I do believe its important experience. There are lots of cases and other grunt work you do on call that you don't always get exposure to during the days thats an important component of any specialty.
    Anywho... call is shit, and it's not just people on this forum exaggerating. The burnout, fatigue and work are real so I think saying its not 80 hours of actual work is BS and naive. 
  14. Like
    blah1234 got a reaction from ohmyohmy in Question about marriage   
    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.
  15. Like
    blah1234 reacted to JohnGrisham in Question about marriage   
    A lot of overtones of misunderstanding in this post, in general life isn't "fair" but spends some time looking more into it to truly understand what dynamics are at play.

    Yes, often on dissolvement there will be payments etc that can last some time, but it is very much unique and on a case-by-case basis. 

    "Half the value of the medical license"  - this is a new one though, never heard of this and sounds pretty preposterous .

    On the topic of pre-nups, they often aren't worth their weight in paper. As lawyers have shown time and time again, signing something on a piece of paper when times were good, is not iron clad...nor do they serve the purpose people commonly think they do. Jurisdiction variations based on different levels/classes of law of course apply.
  16. Like
    blah1234 reacted to JohnGrisham in Going into FM without liking the core aspects of the program?   
    Rural FM docs I know make anywhere from 300-700k in billings.     It is hugely variable.  Again, when you work clinic, in hospital and Emerg with call/overnight shifts, you are naturally working lots of hours..so you make more. And yes often less overhead in hospital, and even clinics can have less overhead due to leasing costs being lower in some rural centres than big urban centres where real estate is expensive.
    I also know urban docs who comfortable bill 400-500k before overhead cuts, doing mostly community medicine(clinics, care homes, methadone/pain etc).  

    Hugely variable depending on province, practice style and of course - time. The ones billing a lot aren't only working 40hrs a week.
  17. Like
    blah1234 reacted to MDinCanada in Ranking specialties in CaRMS   
    I agree with this, except that Derm isnt super high-paying everywhere in Canada. You'll have to break into cosmetics for the big bucks as well.
  18. Like
    blah1234 reacted to JohnGrisham in Med School as a single mom- possible?   
    I agree, but often its not the medical professionals that make the difference - it is university salaried administrative staff that make the majority of decisions and day to day activities, maybe somewhat steered by semi-salaried administrative MDs who often aren't quite in touch with students needs.

    I'm pessimistic that the system set in place will be a guaranteed boon of support, so it would be pragmatic to assume average to none in terms of special supports.  Unless its legislated(like maternity leave, or pregnancy leave and change of duties), then i wouldn't go in making a huge life decision "assuming the best". 
  19. Like
    blah1234 got a reaction from Keege T in Quality Of Calgary Fm Training?   
    I know one of my close friends who did Calgary FM did not enjoy the program. I can't speak to the program robustly as that is just one person's opinion but their story does seem consistent with some of what has been stated earlier in this thread.
  20. Like
    blah1234 reacted to JohnGrisham in Med School as a single mom- possible?   
    Definitely - and this is why i enjoy contributing to this forum, multiple view points help round out discussion!  I will say that i am biased towards pessimism on this specific topic, given the lack of support the medical school system has shown some of my colleagues with children, and seeing how much work taking care of two young children is for a single parent caregiver.  Definitely don't want to discourage OP, but rather ensure they get the most facts possible about the process through medical school to residency before embarking on the road of working towards pre-reqs etc.

     
  21. Like
    blah1234 reacted to JohnGrisham in Med School as a single mom- possible?   
    Yes, my main point was that enlisting for medical school and residency for 6 years is a big undertaking without any support (based on what the OP has presented, they are pretty much on their own. Again if this is not the case, then it can help favourable for this goal of medicine), and not to forget we are all assuming they are already a competitive applicant and haven't taken into account time to do the MCAT, buff grades(if applicable) and buff non-academics(if applicable).

    Doing a 2 year accelerated nursing program and practicing as a nurse is infinitely easier route than 6 years of medicine/residency, when you factor in the significant time away from kids.  Nursing shift-work is often very flexible, go into a 0.5 set line and pick up shifts whenever you want. Increase workload as the kids get older, and move into other roles (admin, nurse practitioner etc) for even more pay. Some provinces have Nurse Practitioners that are closing the gap with FM and for OP, this is something strongly to consider. I have many loved ones in nursing, and the flexibility is great. That's all, just wanted to put that as a potential option. Similar with OT and PT - again only 2 years of commitment for the period of "lack of control".  2 years versus 6 is a big difference when you take into account growing children. Again, maybe the OPs kids are 10+ and its less of an issue, something to think about.

    "Just because you can, doesn't mean you should" - only OP knows their situation and what they think their family can handle. I would 100% want them to pursue their passion of medicine and we need more non-traditional representation. But i'm not going to paint rosy pictures of the process of medical school and residency. Medical schools can only accomodate so much for clerkship and residency - Yes staff life as a FM doc is very much in your control and much better in hours and $ than an RN - but you have to go through 6 years of lack of control and long hours to get there.  The financial costs associated with it are somewhat buffered by access to govt loans, bursaries and LOC - but debt will definitely be large. Logistics and nannies are a huge cost that shouldn't be understated - raising kids is a full-time job on its own, so if OP is studying and going after their MD, they will need support, and it seems the support they will have access to is via paid support.
  22. Like
    blah1234 reacted to JohnGrisham in Med School as a single mom- possible?   
    Sounds like you will be mostly relying on yourself, as you don't have much family support. I can not imagine how difficult that would be - seeing many colleagues who did medicine/residency with kids in 2 parent families..but having lots of family support.

    First two years (textbook) phase can be more doable(but meaning you will need to study a lot after the kids are put to bed and that  your attention will take away from the kids), but definitely 3rd/4th year you will need a lot of nanny support - which is going to be extremely expensive. I guess it also depends how old your elementary kids are - and if they are getting more self-sufficient? Presumably you work a "9-5" job right now to support yourselves. The hours will just be a lot more.

    While you can get some concessions from the schools, don't count on it - and be prepared for a lot of lack of control throughout the whole process.

    I would strongly consider Nursing, PT or OT - as a means to get into healthcare, and get well paid careers with much more flexibility than medicine and the training process to ultimately become a FM docs as you stated.

    It is possible, but will require a lot of planning(logistics), discussions with the kids to see what their thoughts are, and as well financial planning (luckily generally can get large LOCs in canada, but still need to do the math for live-in nanny care etc).
     
  23. Like
    blah1234 got a reaction from MaudeB in Med School as a single mom- possible?   
    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 research and exams it is much harder than clerkship. However, I will note that you are interested in family medicine which is much more reasonable compared to a specialist residency. You will still likely find it hard to balance work, study, and family.
    I'm honestly not sure if that 72 hour max was a thing when I was a clerk or resident but I often worked more than that without factoring in studying. I did have weeks or months where things were a more normal pace however I don't think you should ever expect a true 9-5 for a while.

    I think it will be a huge challenge and you will feel the strain of trying to juggle every ball. Frankly, the medical establishment is very uncaring at times and won't be considerate of your personal situation. I think you can find champions to support you but also be prepared for that.
  24. Like
    blah1234 got a reaction from offmychestplease in (Neurosurg) Realistic advice about job prospects   
    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.
  25. Like
    blah1234 got a reaction from medhopefull1984 in (Neurosurg) Realistic advice about job prospects   
    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.
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