inquirer007 reacted to zoxy in Congratulations to those who matched in the NRMP today!
Step2 CS was P/F anyway and the vast majority passed. It was never utilized for sorting people for residency. All it ever accomplished was black listing the poor souls who got an F for eternity. The reason that Step1 was used by residency programs over Step2CK is that some applicants wouldn't have taken Step2CK before the sending in their applications. Step1 was the only standardized data that program directors had for comparing applicants. So now with Step1 going P/F, program directors will mandate that all applicants must take Step2CK before sending in their applications and use Step2CK to sort applicants.
IMO, this move is extremely short sighted for three reasons. Firstly, it will just shift the mental burden from Step1 to Step2CK. Secondly, if you performed poorly in Step1, you would previously know that you'd be out of the running for competitive specialties like Ortho, Derm, Plastics and make yourself more competitive for a backup specialty. But now, if you get your Step2CK scores a couple of months before sending in your applications, you won't have that time for making yourself competitive for the backup. Thirdly, with less objective data for residency application, the process will become more arbitrary and applicants will be forced to apply to more programs. This will mean that program directors will have less time to spend on each application and will put an even greater emphasis on Step2CK cutoffs to make the pile of applications manageable. Program directors were not consulted when Step1 was made P/F and are dreading future cycles.
A slight positive is that data has shown Step2CK to be superior than Step1 in predicting future performance in residency and board exams. Anyway, the American match is still hell of a lot more objective than CaRMS. Thank you for attending my soliloquy delivered two weeks too late.
inquirer007 reacted to shikimate in Rank the 4 years of medical school from easiest to hardest
1st (easiest) > 4th > 2nd > 3rd
you feel like a million bucks going to medical school,
spend the summer lounging and dipping in a pool;
white coat ceremony you feel ever so blessed,
smile for camera because you are sharply dressed.
banks eager to loan you 250K at less than prime,
no longer rely on ramen counting nickels and dime;
no need to aim for 4, because courses are all pass or fail,
fancy yourself high class reading "Desire Caught by the Tail".
4th (not bad)
fall of 4th year is a hectic and busy with electives,
going new places and taking staff's stupid directives;
feeling good you're gonna match to your first,
hiphop to the hospital feeding that energy burst.
come carms panic set in and not feeling so hot,
worry not match, unemployed and you'll go rot;
match day, and you get your second prize,
hey, at least my debt is only half your size.
2nd (so so):
excitement of first year is already wearing thin,
write a research paper only to throw it in the bin;
do observership and feel like senior resident's tool,
have no answer to the questions and look like a fool.
go on vacation this summer and LOC is getting tight,
can't repay, you know who'll call you day and night;
how come everyone else know what they'll do?
not match, and my pants will be soiled by poo.
first day at the hospital don't know where things lie,
hyperventilate at arounds feeling you are gonna die;
get asked to name 20 diseases, you can only name seven,
the other 13? they are named after guys already in heaven.
try to set up electives at some distant faraway land,
COVID hit, and they might as well chop off my hand;
finally finished calls and clerkship is coming to a close,
better ace my electives or gonna regret the life I chose.
inquirer007 reacted to 1D7 in Is a mid-level creep a problem in Canada?
The situation reminds me of medical school where we'd regularly have mandatory small group discussions on the roles of allied health (incl. NPs) and "interprofessional days". Literally everyone was the self-described "quarterback"/essential of the medical team. Everyone but the docs basically spent hours patting themselves on the back. I don't believe unsafe expansion in scope of practice will be as severe for reasons CGreens described.
But to some extent it will happen because these professions regulate themselves and many do not understand the level of training it takes to be safe. As to your point regarding the AMA/CMA, physicians do a very bad job claiming credit where it's due. Historically with homeopaths (i.e. complete incompetents), physicians have been politically passive. Even when they directly interfere with care on an individual level, physicians generally avoid direct confrontation.
inquirer007 reacted to W0lfgang in Are Residents in Canada Overworked and Underpaid?
Considering how much money we stand to make once we're through to the other side, how much we get paid as residents is irrelevant. We also have the option of going into more debt if your salary isn't enough for your lifestyle. Everything we do up until we make consultant money serves to get us there and if it takes a lot without pay, so be it. It's all more than worth it once you're there. As long as you have the means to support yourself (ie LOCs) up until you make real money, you should be happy.
You could argue that you don't want to have to dip into your LOCs. I would argue that having that pressure to live with a smaller income isn't necessarily a bad thing, because most spend what they make, if not more. There's such a thing as 'living like a resident' when consultants talk about strategies to save.
Also, say we do get a significant raise. That won't come without consequences. There's one big pot that we all draw from. That raise will catch up to all of us sooner or later.
I say look at the big picture and consider what you'd be making 10 to 20 years down the line. Be happy that you're in a position that tens, if not hundreds of thousands of people would kill to be in, which is getting harder and harder to attain by the year.
inquirer007 reacted to tb_or_not_tb in Climate in Diagnostic Radiology
Thanks for input and great point about unpredictability of future trends.
Unfortunately, a some people in this discussion jump to conclusion that income is the only factor in OP's calculus. What is omitted in their reasoning is that compensation is just one of the important factors that differentiaties between a good match and the best match.
I do not advocate anyone to go into specialty that has 0 intellectual appeal to them, but is highly lucrative - seeing that such path leads to misery is a pearl of wisdom by captain obvious. However, I do advocate for a compatible specialty with a good income over another equally compatible specialty with lower income.
Anyway, a lot of anxiety and stress in medical field comes from the needless repression of materialistic self, often mediated by social pressure. Neglecting money/prestige and focusing on naive maximalist idealism is a common trait of an undifferentiated premed, whereas mature physcians embrace the pluralism of motivations and accept colleagues with diverse drives, whether it's lifestyle, intellectual appeal, money, altruism or raw status-seeking.
inquirer007 reacted to humhum in Salaries of specialists adjusted for overhead expenses
It always confuses me the outward glamour that medical students think people in Silicon Valley have. I worked in the Silicon Valley industry specifically for many years, and let me tell you, it is shit work compared to day in the clinic. You may think 150K/year is good income, except either you are worked to death doing the most meaningless repetitive tasks like debugging the latest issue of a crappy app that will be obsolete in 6 months, or you are constantly living with the threat of getting laid off in the umber-competetive industry that is basically defined by "disruption" and permanent state of flux and transience , or you are paying most of your income for housing and still commuting a good chunk of your waking hours. You probably will see your engineer friend get hired out of school by Tesla (oooooh), and think that now he is an object of envy. Let me tell, I will not trade a PGY1 year for being an engineer at any company in Silicon Valley. The competitiveness in the workplace is brutal, and your employers are not constrained by any ethical values when it comes to doing WHATEVER it takes to polish their quarterly earnings. You do that for 15 years, you will still be at best a middle class earner, and look back at your professional life being basically defined as nothing but having been a gadget-maker.
And you have to remember, you are now comparing a completely different market to your employment opportunities in Canada. The earnings of the tech sector in Canada compared to states is a fraction of the numbers you are quoting above. We can start talking about how much orthopaedic surgeons, bariatric surgeons, cosmetic surgeons, etc. make in the states, and Silicon Valley engineers have nothing over these money-making factories in the private medical world..
The real high-earners in the tech world are the successful start ups, or the top-tier executives. In the former, you might be impressed by the survival-bias stories, but the reality is that vast vast vast majority of start ups fail miserably, with huge losses. In the latter, you can set your sights on becoming CEO, but to get there as a bottom-feeding engineer, you have to pass through the Valley of Death. That is the valley of first having to become a middle-manager. Do you know who is the first to get laid off in any "restructuring"? Hordes upon hordes of middle managers. Again, following the careers of my colleagues now that we are nearly 14 years out of comp sci degrees, for many, their life has basically one lay off after another. They are not living on the streets by any stretch, but far from the rosy picture you might extrapolate from the earnings of starting engineers in one isolated area in California.
inquirer007 reacted to Hanmari in Thoughts on "Think medical school is for you? You're probably wrong"
I have never been in the field for altruistic reasons and never will be. I have always been a person with a mindset these writers would denounce as unfit for medicine. Didn't stop me from getting into med school and didn't stop me from matching. Doesn't stop me from being a competent resident, because having priorities elsewhere doesn't mean I want to be a bad doctor to my patients nor does it mean I'm going to slack off on learning.
Sure there have been days in premed, med school, and even in these few short months into residency that I thought medicine isn't for me. Is it because of the reasons I came into medicine for? No, it's because some things in medicine are the quality of melena frothed with C. diff and no amount of love for the field is going to change my perception of that. Would getting through those moments be easier if I had more altruistic motives? Maybe. Can I replace said motives with other equally powerful ones? I do it every day. Every day I walk into hospital knowing this is a step towards the life I envision for myself. I better become a damn competent doctor to attain that life, and that involves all the professionalism towards patients that these sanctimonious parrots seem to think only stems from martyrdom.
From day one of premed I have been laughing at writings like these and know that I am proof to myself that the only thing you need in this longass journey is conviction for whatever you want most out of all this. It could be helping others. It could be whatever else you love about medicine. It doesn't have to be.
inquirer007 got a reaction from masterofnone in Seeing Ref.Letter Status in OMSAS after Submission?
inquirer007 reacted to Nizatidineee in Making An Informed Decision About Mac
I will address the clerkship stream lottery, because I believe that is the most important concern one should have.
Okay, so your top three is (1) Peds, (2) Internal Medicine, (3) Surgery, so ideally you would want to complete those cores before your electives (not possible at Mac), and certainly before CaRMS!
Let's take the class of 2019 schedule because it is the most updated, and the streams go through very few alterations every year. There are 16 "streams", but for all intents and purposes, there are 8.
To explain, there are 2 grey streams, 2 orange streams, 2 dark blue streams, etc. The differences between the colours are *huge* (different number of elective weeks, different arrangement of cores and electives), but the differences within the colours are not that big (maybe a 2 week elective is in a different place, but all the cores are in the same order). So, for the purpose of simplifying things, let's work with the 8 colours.
For grey stream, internal medicine and peds are in the middle (after 8/10 weeks of your electives), and your surgery core is right before the CaRMS deadline.
For orange stream, surgery is after ten weeks of electives (so hopefully you have decided on what you want to do before you complete any of the three cores -- not a problem faced at 4 year programs), and medicine and peds are after that.
For dark blue stream, internal medicine is after ten weeks of electives (so hopefully you already decided what you want to do), surgery is after that, and peds is post-CaRMS.
For green stream, peds is after 4 weeks of electives, surgery is more in the middle, and internal medicine is post-CaRMS.
For yellow stream, internal medicine is after 4 weeks of electives, peds is right after, and surgery is post-CaRMS.
For pink stream, surgery is after 4 weeks of electives, peds is right before CaRMS, and internal medicine is after CaRMS.
For light blue stream, peds is after 8 weeks of electives, internal medicine is in the middle, and surgery is post-CaRMS.
For red stream, peds is after 10 weeks of electives, surgery is right after, and internal medicine is right before CaRMS.
It's good to have a real-life example like this. So, if you want to keep all three options theoretically open, that eliminates all of the streams which have the core post-CaRMS, so dark blue, green, yellow, pink, and light blue, leaving open grey, orange, and red.
For grey, orange, and red, your first core of interest (peds, internal, or surgery) is after 8 or 10 weeks of your electives (your stream will have 8 - 12 weeks electives pre-CaRMS total). That is, you will realistically have to decide which of the three specialties you want before having completed *any* of those cores. Once again, this is not a problem faced at other 4-year programs because they complete all of their cores first before any of their electives.
So if you end up in orange (one of three viable streams for you), and you decide to do 8 or so weeks of your electives in peds, and then do your internal medicine core, and have a change of heart, well... Sorry.
This is confounded by the fact that you do not get to choose which stream you want. You rank them, and a lottery happens. Students have been placed in their 8th and 9th ranked streams, which for you would automatically rule out one of your top three specialties. Also, this is a decision you have to make in March or April, just 7 months or so into medical school. Other students do not have to make this choice until midway through third year, if that!
For the purposes of disclosure, peds is also now competitive! For this year, the ratio was 0.77 (to compare, optho was 0.71). The most competitive are emerg, derm, and plastics (hovering between 0.52 and 0.57).
This is a decision that you shouldn't take lightly. I cannot speak to McGill's curriculum as I am not too familiar with it, but I thank you for providing an example to walk through for the clerkship streams.
I have also heard that the reputation Mac students have is that they aren't as strong on their electives. Well, is that really surprising? Many of us have not completed our core rotation in that specialty! Some of us don't do internal medicine until after CaRMS!
inquirer007 reacted to BoopityBoop in Any Thoughts On This Article Re: Entitlement In Medicine
To a certain degree I agree with you about the backpacks... It really is unnecessary and serves no sentimental value other than to flaunt the fact that you're a canadian medical student. It's similar to leather jackets engineering students love wearing.
However, I completely disagree with your viewpoint about the white coat ceremony. Admitted students should be allowed to formally celebrate their acceptance into the school and future profession with their new peers, future colleagues, and most importantly - their family. Yes, they get the stethoscope and the white coat, but it's also a formal way of introducing the hippocratic oath and some of the expectations of them as students and future practitioners.
If the students who weren't admitted feel envious, that's their own problem. The "toxic" envy is felt by the extremely insecure and bitter students who didn't get in, not caused by the students who did. The admitted students shouldn't be punished and prevented from celebrating their accomplishment. Why should they be made to feel bad about other students not getting in when they had no control over it?
In addition, why does the public feel mistrust in medical students and their white coat ceremony? Are medical students publicly wearing their white coats and stethoscopes 24/7 and criticizing anyone and everyone for not being doctors? Are medical students cutting in front of the line of McDonald's and saying, "look at my white coat, I'm a medical student, give me my chicken McNuggets"?
Unless all medical students are intentionally bragging about getting into medical school and the general public is forced to watch the white coat ceremony every year, I don't understand how the white coat ceremony is responsible for creating the "sense of distrust" and how students present themselves in a "different class". There are similar ceremonies for those in engineering, the navy, the army, the police academy, and even post-secondary education graduates. Should all those ceremonies be banned because those who aren't in the ceremony are all envious? Should they be banned because the "public" senses distrust? The last time I checked, it wasn't the police academy graduation ceremony that created mistrust in the police with the public but rather the everyday actions and the decision making of members in their profession.
inquirer007 reacted to DC-Comics in Western Gpa Calculation Unfair?
"Can't please everyone"
Haha, well, they obviously don't mind pleasing Mac and York students
I guess the point of this thread was to point out the "unfairness" of how the GPA is calculated depending on the school you attend. Why can't all schools just be normal and stick to the percentages Why the need for a 12-scale system?
Such is life.
inquirer007 got a reaction from purplemermaid in Western Gpa Calculation Unfair?
For Western dentistry they DON'T use GPA. You just calculate your average like any other average. Like a mean of your courses.
For Western meds, they use the latter (in your response). That is, you convert each course to GPA, then average those. In fact, that's how GPA is always calculated