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Edict

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Everything posted by Edict

  1. The horror that is a surgical residency is real. You have to recognize that choosing to do neurosurgery will mean you make sacrifices in every aspect of your life. Who you date, where you live, what you can do for hobbies, your relationships with your friends and family. Read: fewer opportunities and time for relationships and friends, little choice in where you live for the rest of your life (which also goes on to affect relationships with everyone), little time for hobbies (pick one or none). The hours are brutal, the visceral pain of being overworked will be real, but unlike almost any job
  2. The ones that avoid investing too much of their budget into external medicine...
  3. I would say surgical residencies are worse than IM in general. surgical residencies tend to be worse than medicine especially R3+, but in R1 and 2, surgical residencies tend to still have it busier but less so. Generally speaking for general surgery your 1st and 2nd years are mostly 70-100 hour weeks 1 in 4 call. You start at 6:30 on average and finish around 6pm on average. You stay post-call until 11-12pm on average. General surgery and similar rotations will average 75% of your year. Your days are incredibly busy and you typically are covering multiple things at once, OR, ward, consul
  4. I will say family contacts matter at the selection stage only if that person is in the department and has political power within that department. Other than that, even in related specialties or at other centers the effectiveness is diminished greatly, it may even backfire a little because the expectation is that you have an easier time getting papers and accomplishments.
  5. If you didn't get what i was referring to, nevermind. Just stay home.
  6. That's not actually true. In surgery, clerks are enormously helpful. I didn't believe it when i was a clerk, when residents told me, but as a resident i realized it is very true. Even in other rotations like emerg or family, sometimes even a conversation or a chat with a patient makes them feel cared for or allows them to bring information to the team that otherwise wouldn't be shared.
  7. Still, they paid money to learn and if they are seeing non infectious cases, it is still learning. In my opinion, they are doctors in training. Ultimately, this is what we (as physicians) are getting paid the big bucks and the respect to do. You can't have your cake and eat it. It's like choosing to be a firefighter and deciding not to go into the burning building, or choosing to be a soldier but refusing to actually fight on the frontlines. Ultimately, if infectious cases aren't your thing, there are obviously great specialties out there that have much lower risk of getting infections.
  8. Also, GIM has that flexibility with work locations and even subspecialties will have their IM license and can moonlight. In terms of the financials and work life balance, GIM has surgery beat by a long shot.
  9. If you look at GIM, they make more than surgery if you look at how much they make per hour. The only IM based specialties that make less are those that are purely clinic based (so endo, allergy, rheum etc), but any that do hospital based work especially ones with call make more, including GIM. You can't just compare averages here as a larger percentage of IM doctors don't work as many hours as surgeons. One of the biggest benefits of IM is the ability to pick up shifts, call shifts, weekends and set up your own schedule. For most surgeons you need to have a patient base and operating privilege
  10. Just pick the shorter one. You'll find that there are always ways to extend your training, but you'll also find that in most cases, by the end, you don't want to. I personally don't think Fam Med should be just 2 years for the reasons you are talking about, but I mean it more in terms of the lowest common denominator, i don't know if someone who does the minimum amount necessary for lets say a 3 yr med school and then a 2 yr residency is going to be good enough to be independent at least for the first few years.. If you are keen and willing to work hard, as i'm sure you are, you'll do fine in
  11. I think word is finally getting out that surgery isn't a good deal on paper anymore. In Canada, surgeons are making less than internists (and many other specialties) per hour worked, less flexibility in terms of hours, more training, fewer jobs, less flexibility in location. At this point, unless you love to cut, you probably shouldn't do it and the reality is these are the incentives the government has gone with so people are responding to that.
  12. FIT - hundred percent. You need to be happy at your program to do well, if you don't fit into the culture, don't fit into the city or are away from family and friends, you aren't going to perform your best and you ultimately won't get into a good fellowship if you so chose to seek one. The prestige that you are talking about may get you an interesting conversation or two at international conferences, potentially some more curiosity from US doctors when networking at conferences, but it means nothing if you can't back it up and one huge factor is FIT. You'll also find a lot of prest
  13. Stick with Internal Med. Based on your description, you still would really enjoy IM subspecs. The important thing to realize is that not liking CTU is incredibly common amongst IM applicants, in fact it is almost the elephant in the room. You only spend maybe 15 months on CTU/GIM in your entire 3 years. That is peanuts in the grand scheme of things. In other countries you may spend 2-3 years doing a rotating internship of sorts. The only thing to keep in mind is that not everyone who wants an IM subspec gets into it, so it is important to be willing to do GIM. The truth though is if you
  14. It really depends on how they backed up. They are more likely to get zero FM interviews despite applying broadly if they had 1. 0 FM electives 2. truly did not even like FM to begin with and it showed 3. red flags on their CV 4. no demonstrated interest in going rural or being open to that idea. While it is true there are empty FM spots each year, no program wants to fill a spot with someone who they know has absolutely no interest in their specialty and program and is highly unlikely to stay after residency. I'm sure with these schools they have accepted people like this in the past onl
  15. Yeah but that is for a competitive specialty, the OP was saying in general. I don't know where they got the number from but it broadly makes sense to me at least. There is also way more to an applicant than how many first author pubs they have. I've also done file review and an applicant who has done a PhD is going to be expected to have more publications than someone who is fresh out of medical school and just because you have 20 publications, if we somehow know that you had family connections to get those publications i.e. parents are academic doctors etc. then it also won't be looked
  16. I was in your SAME position. maybe i'm dumb or very skeptical, but somehow the CaRMS explanation didn't make enough sense for me. I actually didn't understand it right all the way until CaRMS and i actually made some poor decisions in hindsight based on that mistaken thinking. I went to the NRMP which uses the same algorithm, but they have a video that worked for me. http://www.nrmp.org/matching-algorithm/ After that, I went back to the CaRMS explanation and it all made sense. There is absolutely NEVER a situation where you are better off ranking a school 1st which is actuall
  17. I think people who are gunning for 1 specialty will do 8 weeks in their specialty and the rest in related but scattered to show their commitment. In my opinion though, the cap does allow you to go for 2 specialties more easily than before. Electives demonstrate interest and commitment, but they also give you reference letters. You can be competitive doing 8 weeks in 2 specialties to both specalties. You will lose some points on commitment potentially, but on the flip side you probably will be able to get strong reference letters in both specialties which in the past you may not have been
  18. I wouldn't worry too much, a lot of this stuff tides over. Alberta is going through a rough patch economically, but like a lot of government made solutions to crises they are often poorly thought of and poorly done and come with a lot of loopholes.
  19. Sorry that you are in this situation. Its always worth applying second round to a surgical residency spot, especially one that is in the specialty you already applied for. But know that the chances are going to be very slim. Many of these unfilled spots are because they didn't find someone they liked, or it was a CMG spot they are reserving for an IMG or vice versa. The main point though is, if a program wants someone, they will find a way to get them in.
  20. The 4th year has a good point. The issue with subspecialty electives is you usually run into subspecialists that only deal with their subspecialty. your general IM knowledge isn't going to impress them as much. Cardio and Ottawa Heart is going to expect a lot. Are you interested in cardiology? If so, you probably have some research and some enhanced knowledge which will serve you well. If you aren't, i'd considering switching it because you may have a hard time getting a good letter. These cardiologists are more used to internal medicine residents and cardiology fellows and will probably expec
  21. From what I've heard at least, UBC IM does take a lot of its own. Given that, and the fact that you like UBC, I don't think its worth changing. You already have east coast electives, so I don't think Mac is a must go unless you have it in your top 3 programs. Mac IM is similar to Western IM except its more service based, more research and has a more "hardcore" reputation.
  22. I think I can somewhat answer this q well. From a PD's perspective, its very challenging to use the scores much for anything. Very few applicants provide their scores. Which makes it hard to compare applicants. Different PDs and surgeons value different things. Some bemoan the lack of ability to test surgical skills in their applicants, others bemoan the lack of academic and scholastic ability testing. The latter are more likely to look for these things and value them. If you run into one of those PDs/adcom people, it may help if your scores are high and they know the distribution of scores. I
  23. If you love Vancouver for those reasons, you probably will like Toronto, but neither Western or Queens is like that. I would choose to go to Western or Mac for an elective. Queens is a smaller program, a more relaxed program, but also a small university town. Western's IM is also considered a more relaxed, less service based program with good teaching. Both programs aren't particularly strong on research. London is a mid-sized university town and closer to Toronto.
  24. See above You sound similar to me actually. You definitely sound like you are born for the acute medical field. Serious hard working people, hands on, decision making, innovation, research, efficient. I think Surgery, Anesthesia, IR, Cardiology and EM really fit your alley. They all have differences, so if interested, you can share any interest you have in any specific organ system, and lifestyle, also how many years of training you want to do and whether or not you want to do academics or are you open or interested in community. The one acute medical field I would throw
  25. I actually think its perfectly reasonable to split your electives especially because you have a lot of weeks of electives. The key to getting an interview is being a strong candidate, not necessarily to be a one specialty gunner. There used to be a dogma about electives being king, but the truth is a perfect elective setup will not work for everyone if you aren't a strong candidate in person. IM is still more likely to take the well rounded all star likeable potential gen sx gunner than an IM gunner who apparently didn't have the strongest performance on their elective. A one specialty g
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