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futureGP

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  1. I honestly think with the way most young intensivists I know are working, everyone with an interest in GIM+slight ICU should just do the CCM fellowship. The days of GIM doing ICU is mostly gone unless you are in rural hospitals with 8-10 monitored beds. As IM trained-Intensivists, you can do everything GIM does within the hospital plus work in the ICU. I had thought long and hard about this 5year GIM thing that academic centres are pushing and I think it really only makes sense if you want to be an academic GIM running an academic CTU, doing research on some QI stuff,
  2. Honestly NPs are terribly overpaid for the work they do. Even in academic centres, such a useless job. I would love to hire an extender in a private outpt clinic to allow me to see and bill more patients. But if the salary ends up being 100k with benefits and vacation etc, they better work hard for that money. Probably hard to justify the salary unless they can run a similar list as mine (~15-20 per day)
  3. Gim job exist in gta. You dont need 5-year GIM unless you want academic. if you have frcp in IM you can essentially open a clinic and accept referrals. i guess you could advertise as walk-in IM and do A133, but why do that when you can A135 from GP. The OHIP req. is essentially the same for double the pay. Also, scheduled clinic appts aren’t eligible for SVPs even if it is a weekend or night time clinics. Daytime IM work isn’t so lucrative, maybe 1-2k depending on how fast you are. Plus private clinic means overhead unless you’re doing hospital-based c
  4. IM residency will vary from schools in terms of work life balance. There are relatively chill, well funded programs out there. But expect CTU blocks to be busy. But if you are busy doing what you like, is it really? Back to the life afterwards. Remember that unless you are doing FM, Psych, you will guaranteed have a hard time finding a job around major cities. So unless you are planning on FM or psych, get rdy to locum after whatever specialty you do. For subspecialty matches, I would look at MFM stats on CaRMS and see the numbers for yourself. The match rate is not crazy. It’s a wh
  5. As an MD you can do whatever you are trained in if it meets the needs of the community. Typically the more rural you go, the more FM will be doing. Samething applies to specialties. If no subspecialists around, you are it (IM, general peds, general surg). Mind you, you would have to be quite a distance away from civilization to find gigs like this.
  6. I have to say though. Yeah things can get dull and boring throughout the career, but I think that makes it that much more important that you choose what you like. you dont want to be in your 50s waking up in the morning dreading about how you’ll get through your day of clinics/ward/ORs doing “xxx”. You will find docs who are in their 60s but still love seeing their bread and butter cases. As dull as a chole may be to a gen surgeon, maybe to them it is still the most fun relaxing procedure to do. Same thing could apply to fam doc seeing a prescription refill. Maybe the social
  7. If burnout is a concern at that stage I would not be too worried. With all the smr shifts, codes you are going to, and daytime rounding on inpts it can feel like a grind with no end. The difference between 4year GIM vs 5year GIM is just that. An extra year of training in PGY5 where you could do whatever you want. 5th year could mean more preop, ob exposure, ultrasound training, more subspecialty clinics to get your skills down. Nothing you cant do as a skilled 4year GIM. In the community finding a job won’t be any harder with 4year GIM. outpatient GIM is easy to se
  8. I feel like ICU is so variable depending on the size of your hospital. I figure most of the GTA hospitals are pretty good size and can be considered community-academic if they have >10 vented beds. I can't buy that in >10 vented community ICUs that there is no intensivist overnight. Most of these GTA hospitals are very sizable and would have many emergencies overnight that would demand an in-house intensivist or at least CCRT with ICU attending on-call at home on standby. The ICUs where I've rotated through which are in smaller communities that have at any time 2-3 vented patie
  9. See some of my other posts for details. Both are clinic-based specialties. Endo/Rheum/Allergy/Geri have better billing codes per pt than FM due to them being specialists (typical consult fee of 157 + special premiums for managing chronic patients. Additional tests or procedures like patch testing, joint injections. The caveat is the consults may take long (~20-30 mins), but it's variable up to each individual on how to make it efficient (i.e. simple seasonal allergy consult may take 15 mins, or new diabetes mgmt may take 15-20 mins vs. complicated diabetic patient with complications or i
  10. Community means different for diff people. in the GTA, good luck finding any job in medicine subspecialties except for Geriatrics and maybe GIM. Private cardiology practice isn't what it used to be in the past where you can open up your office, buy yourself an echo machine and start seeing patients. Now you need to be licensed by the province as an independent health facility to do echos which means you need a level 3 echo license which means an echo fellowship. Plus you need to get a license and who will give out a new license in the GTA where it is already saturated with cardio-diagnost
  11. GI was still prty competitive despite the poor job market, must be the combination of simple patient issues and procedural aspects (reflects the huge shift of med students from surgery to medicine that happened a few years ago, they naturally lean towards procedural specialties). Jobs are still pretty tough and almost certainly they need fellowships. A lot of the staff are super young too which reflects the lack of upcoming retirements. Endo/Rheum/GIM/Resp were pretty competitive too due to job aspects (viable pure outpt practice) and lifestyle. Compensation is def rising in clinic subspe
  12. lots of nice discussions. I am biased as I am finishing up Internal Medicine but here are my thoughts. To OP's qn, IM residency depends on where you go. Some residencies are more service-based and will have long-hours and busy days whereas others will be more-or-less chill and even comparable to FM in terms of lifestyle and hours. CTU will always be busy because of service-needs but depending on where you do your residency, subspecialty rotations like Nephro, GI, Resp, Endo, Allergy can be quite chill (8:30-4:30) and as a junior you may see 3-4 patients a day if inpatient (means a lot of
  13. buy bitcoin not now though, wait for it to crash first. high risk, high returns
  14. Many PGY4s that I know took that course during the PGY4 in prep for the Royal College.
  15. I do see your point. In an academic or large community center with access to subspecialty surgeons, then yeah. But if you are in a remote community (it doesnt even have to be that remote), 1-2 hours way from any major center and you are a general surgeon and there is no other surgeons around, then yeah you will have to manage whatever comes through that ER. But as a ENT or Urology, you would never be able to hold those jobs. Likewise, the trend in Medicine could be similar in the sense that In the remote communities, a GIM will have enough reason to cover all subspecialties if nobody e
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