JohnGrisham

Agreed with most of the above - being a US medical student is the ultimate trump card. Not having the heavy burden of being above average with exam scores, and all the travel back and forth from abroad as a true IMG back to North America.. is priceless (and conversely very expensive the other way around). Unfortunately, there aren't nearly as many seats for Canadians at USMD/USDO schools. A quick google search shows only about 60 Canadian matriculants to USDO programs in 2018, but may be higher as there are additional matriculants that were listed as dual citizens(some of which being Canad

It is definitely problematic, but suppose one could argue they are apart of the circle of care - and if the secretary did something negative, that it would be the attendings license on the line. Realistically MOAs will see most of the incoming faxes/consult reports/labs etc anyways, so taking it one step further to edit for grammar etc perhaps isn't a huge divergence from what they already have access to? I'm not condoning it, and i wouldn't personally ever have someone who isn't at least a nurse editing my dictations, but it is relatively common for MOAs to finalize dictations and "pret

This isn't really relevant, unless they actively decrease the number of non-family medicine specialty spots - I wouldn't worry about that, there has not been a decrease in Neurology spots, and dont think that would be coming anytime soon! Be a strong clerk, show interest in neuro and do electives to get LORs -do some research if you're interested too. Neuro hasn't been super competitive, and there is a lot of self-selection to it. If you really want neuro, work hard, and apply broadly, you'll likely match if its your first choice discipline. Even more so if you're willing to throw in pedia

Definitely becoming more common! Especially with younger trainees willing to do further training/fellowships open to royal college trainees in other areas. It definitely is a great way to help prevent burn out. Some that I have seen recently were pain fellowship, palliative and addictions. Most of the time(jurisdiction dependent), it does require further training however(or if you can build the extra fellowship into the 5 year base program etc).

The fundamental differences of Canada vs the US is one important thing to consider: Canada is based on cost-control; US is based on maximizing profits. If the govt could replace all FM MDs with NPs, and patients still get seen, and on average are still "just as happy", they could care less - many people right now already dont have family MDs. The system already has a non-negligible percentage of wasted fee-for-service visits by family docs and specialists alike. "easy consults" to specialists, shouldn't exist as frequently as they do. Its frustrating to no end. The system is being overburd

Agree across the board. NPs are great in specialty clinics and focused practice styles - a good one working in the same setting after a few years, often can function as a competent PGY1/PGY2 WITHIN that scope. A surgical NP managing day to day ward issues is a good example of this. The issue is when the NPs start to deviate, or come across cases that do not fit the patterns or things they have seen - fundamentals are greatly lacking. This is not an insult, it is simply factual - nursing is a different skillset then medicine, and nursing school is very very different than medical school. A NP m

You are right, there is a newish NP in one of the local clinics, that did a US NP degree. Though i think hers was half in-person at least.

There are older FM docs more than happy to employ NPs to increase their bottom line and make money. It slowly makes things worse for the younger generations. In BC, the recently introduced salaried primary care contracts pay NPs more per patient than MDs, and then to double the insult - NPs generally will have much less complex patients, and are allowed to simply say "not in my scope" and defer to an MD. Ultimately if it takes off, you'll have MDs getting more and more disproportionately complex patients. This would still be a long ways away though - and the easy solution is not to succmumb

Might be region dependent, but you definitely can't underestimate the concentrated learning in the +1 EM year, to then set the stage for further early career development while in practice. I think the "matter of time before you catch up" may be accurate to some extent, but highly variable. There is a reason that the +1 EM year exists. And there is also a reason it still isn't equivalent to full royal college EM, despite many in practice with +1 EM, often "catching up" depending on centre of practice etc. If you plan on practicing rurally, then yes the additional +1 Anesthesia training is v

Well, this firstly isn't accurate in all provinces, and not all practice settings. Take a step back, and first tell us where you ultimately would like to practice? That will frame the discussion - as well as if your partner will continue to work as an RN or as an NP, again will alter dynamics.

Counselling.

My point was that the vast majority of those positions are rural, and MDs can also go rural and make more money. I.e. a rural pediatrician would be making more than an urban pediatrician.

As a family doc you can go to rural places in some provinces and instantly gain a 30% premium on your FFS billing as well. Having a friend whos wife did travel nursing, it definitely paid well but was more rural places, where she would just be there for work 1-2 weeks then go back home to her city.

Majority of hospitalists simply do the regular FM program. The +1 is often only 3-6 months anyways, and theres only a handful of spots. It is definitely not necessary in most large centres, simply because there aren't anywhere close to enough +1 programs to be able to meet demand.

You have just under 9 months to continue to fill in any gaps before the next US application cycle, so you are in excellent shape. Overall good chances, apply broadly to USMD, and see what happens. I'd consider adding USDO if you want to be fully sure of an acceptance, but i think with good essay/personal writing, you should be able to ride the high of your stats into a few interviews. The big part is luck - visas, international student status, etc will cause the wild card. Texas ties can be good, but youll have to email all the Texas schools and ask them how they will consider you (oos/is/inte