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Everything posted by JohnGrisham

  1. Remember a lot of this is province specific, even region specific. Take everything in this thread with a grain of salt, and do your own research to see how it *may* apply to your own situation. But i do agree with alot of the sentiments, but even then FM is still a very good compromise for many, versus some 5-7 year programs. Its not always greener on the other side as a royal college specialist either.
  2. As long as the other two letter writers specifically comment on you applying to FM and how you would be a good candidate for FM without being ambiguous, you will be fine. Apply broadly, if its not too late, apply to a few schools outside ON too just in case.
  3. Its irrelevant. Simply less applicants above that age range applying - societal norms about being "settled" and all that. I had a few colleagues start medicine >40 without an issue. Had to apply just like the rest of us.
  4. I would gather keeping up your skills may play a part of why some steer you towards full-time work? Especially as a new grad, you are still in the solidifying phase where you need to see a lot of cases and continually refine your skills and build build build your repetoire. I think these thoughts are fairly agnostic to specialty and vaguely apply to any field.
  5. To clarify, they practice in Urban centres alongside 5 years after doing the +1 (Rural/semi-rural FM was more so to get a stronger foundation in their perspective). Irony of the +1 is that it ends up creating urban ED docs mostly.
  6. A few colleagues i know, actually were the "stronger" candidates on paper(and clinically) on their pathways to EM, and chose the rural FM and then +1 EM route. Two also applied to the 5 year pathway, got many interviews, but ultimately ranked their desired rural FM programs higher. The common thread was that they were older in age, and didn't want to do 5 years as a resident, and we're comfortable with being a bit "greener" in early practice by the FM+1 route.
  7. Check eligibility on Carms.ca, it should tell you there. AFAIK the r3 fellowships are only for Canadian trained residents, but could be wrong. I think if you come back to Canada, get your CCFP and then apply as a non-resident class...you would be eligible. But anecdotally fellowship programs prefer fresh grads, since they are still "teachable" and not set into practice styles/patterns, but if you are motivated - i have had 1 colleague who worked as a GP for a few years then applied for the EM R3 and worked out.
  8. Similar to Bambi above - but I would say for bigger specialties (FM, psych, IM), it is somewhat of a formality to rule out red-flags. I don't imaging the match rankings would be all that signfiicantly different in these fields without interviews. It is also a chance for students to see those schools/programs/cities and usually that alters OOP lists for most students. With covid - don't know how this factor comes into play. For example, when I did CaRMS, i had a poor interview experience at one OOP school - very disorganized, not very pleasant etc, so it went straight to the bottom of my l
  9. You follow AMCAS. OMSAS has nothing to do with AMCAS. It is stated fairly intuitively in their guide: https://aamc-orange.global.ssl.fastly.net/production/media/filer_public/78/1c/781c2478-d685-4f1e-ae78-07a765ad4e61/amcas_grade_conversion_guide_students.pdf UWO indeed is only ABCDF, so you follow the 3rd table on page 3; therefore yes, "A" = 4.0. It works out great for those who have low "A's in the 80s, so it strongly helps students who otherwise would be A-(3.7) students had they attended other schools. But if you are a B+ student, you get shafted since you otherwise would ha
  10. And on the flip side, I am aware of plenty colleagues who were solid/stellar FM applicants and not match to the home school/province. And certainly all-in on FM and not backing up. They still matched to excellent FM programs no doubt, but 1000's of KM away from home. Though FM is 2 years only, so it wasn't the end of the world and they made their way back home to set up shop. I would say a solid 1/3 of those who applied urban FM from my alma mater, as first choice program, ended up out of province(likely some of those could have matched in province if they ranked rural higher on their
  11. FM is generally easy to match to, as long you are flexible with location and apply broadly. If you are tied to a certain region/city, then it can be sometimes difficult to match to, just the same as 5 year programs. Region specific variation happens all the time. Do your best, and hope for the best - that is all you can do.
  12. It's a hidden secret i think - but also, not relatively common for non-FM docs to go into it. I've seen a few GIM, and EM docs do extra palliative to work in the field; but mostly to either get a "break" from their main field, or to supplement lack of jobs (nephro and cardio fellows who have done palliative training to get extra work).
  13. Generally the Palliative docs i know still do para's if you count that as a procedure (malignant ascites etc), some have done thoras as well for supportive management, but definitely not much more than that.
  14. Or, as my colleague says "maybe we need to rethink having 1000 people living 1500km away from major centres, and expecting anywhere close to a level of quality care that is standard". I think we always say there is a "need" - but do we really "need" to have vast spread out small centres endeavouring to have higher level of quality care, without the efficiencies of clustered concentrated centres for quality of care? Unlike other countries that often have better transport infrastructure, and less natural geographic barriers - Canada is so wide spread...and I think there is something to be
  15. Your guess is as good as mine - often find some research coordinator job. The opportunities for those with only an MD are not as glamorous as people often make it seem. The average medical student often doesn't have much real world translatable experience in the business world/consulting world etc. Sure many do, but those that often do, aren't the ones going unmatched - because they realize how powerful any residency is from making an income stream and then slowly building up lateral interests. I.e. a colleague of mine left a surgical residency after 2 years, and went into FM. Now has his
  16. Doesn't mean they can't be one in the same - Uworld will cover most common topics that you should know as a clerk, and then some. If all you did was UWORLD, you would be in a strong footing for knowledge base- and then apply it to the real world on a day to day basis by learning the "flow" and guidelines for your respective rotation.
  17. Are you sure they wont show both grades on the transcript? You have nothing to lose other than time/money to get the A or A+(dont forget not all schools consider an A=4.0, and may consider it 3.9, and only A+ =4.0). If you have nothing else better to do with your time, then take the bit of extra time and get the A.
  18. As for AFIB, definitely not auto-consulted cardio, but at the same time if its a new onset - they will probably need to see cardio (or GIM if you dont have cardio) eventually, to arrange for the further non-acute investigations/workups and follow-up. Just a matter of when, not if.
  19. Generally yes, it would be up to the Hospitalist to decide if they want to consult. Again, when you're being paid hourly, and managing 15+ patients, you tend to err on the side of maybe consulting out 1-2 of your super complex patients to GIM if you can, to ease your load and manage your 7 days on service more sustainably. While some will continue to manage the complex patients, others realize burning out from overworking isn't the most sustainable to maintain a full time hospital based practice for the long term.
  20. In Canada, majority of hospitalist services are run my FM trained docs, and GIM are consultants(not always) who also follow their own patients, so if you have a complex multi-system issue, or if things get dicey, you can consult Internal medicine, and they either provide direction or take over care. A lot of it is site-specific and centre specific, and often for a flow perspective. Academic centre hospitalists are often covering 12-20 patients and new admits for their shifts, so theres no sense managing a DKA patient which is mostly time/checkinglabs/adjusting mgmt and not necessarily c
  21. EGDS, Scopes, Bronchs is not common place in all community hospitals, not by a long shot for GIM. If you are within an hour of a major metropolitan centre, there will be someone to send non-urgent stuff to like GI or Gen surg who does EGDs/Scopes. Further out, sure there are GIMs doing them, but its not super common still - and certainly you can negotiate what you will offer as service, if it's not comfort level. This might be province specific however. Certainly the tertiary hospitals I have worked in, the GIMs still have access to subspecs for punting certain procedural work too. Rural
  22. Just wait until next summer to apply, and keep building experience this year. Its not a race to get into medicine, and if youre a strong applicant, try to get into a Canadian or American medical school for the peace of mind.
  23. Province dependent, but the safest bet is to do a PGY4 fellowship/chief year, to at least match the 4 years of GIM minimum...
  24. I know many SGU grads, and given that SGU has placed about 1000 Canadian/US residents each year, I would think as a very successful business...they probably know what they are doing - and expect things to transition smoothly for 2024. If they are willing to go through this process, they probably have a very high suspicion it will go in their favour. They would not risk their golden goose medical admissions process on it. That said, attend a mainland US school before attending any carribean school. That, or there is something seriously insidious behind the scenes, and they are relying
  25. I think many people who go through this process(of getting foreign commonwealth residency training accounted for..outside of FM) generally will say it's not as straight forward when factoring in different provinces, and the beauracratic paperwork, and training differences etc etc. If I was the OP, I would target US medical schools - because there should be less hoops with ACGME American residency training versus otherwise(because if you go unmatched to Canada, your next step would be a US residency anyways). A
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