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Everything posted by magneto

  1. I wanted to write a small post in this thread regarding emergency medicine. In general, every single specialty is important and crucial. This is not a post about how emergency medicine is better than other specialists. IT IS NOT (READ line above). But the current situation with COVID-19 highlights need for passionate emergency physicians who love to help others. It is a stressful and challenging time in all parts of medicine. But emergency physicians, nurses, RTs, admin, cleaners, other ED workers etc. are at the front line in this challenging environment. I am very pr
  2. Here are some suggestions: 1. Emergency medicine 2. Emergency medicine 3. Emergency medicine ..... 100. Emergency medicine 101. ICU 102. Anesthesiology Unfortunately, most programs won't interview you without an elective. Even somehow you get an interview, it is rare to be ranked high (there are always exception in case someone mentions an anecdotal story here). The most important part of the application is reference letters. Applicants who get a great or solid reference letter from one program has a very high chance of securing an inter
  3. Yes. I think telemedicine will play a larger role than before for both good and bad reasons. I really hope that COVID-19 situation improves soon. Because it is really affecting the quality and accessibility to health care. I cannot get an appointment with my doctor at all for simple things. Not my family physician fault. It is just a challenging time for everyone. Telemedicine is great but it has limitations. And some patients really need a in-person visit with their family physicians.
  4. Interventional pain management - My guess is through extra-training or apprenticeship or PGY-3 with a pain clinic or MSK clinic. I did not look into it too much so my knowledge is very limited. I hope another member can provide a bit more insight. Infertility clinic - again my knowledge is limited but I am sure family physicians are involved along with OB-Gyne specialists. I don't have much knowledge on both subjects. My advice is to reach out to people who practice in these areas and set up a meeting. You will be surprised how sometimes people are willing to help others. Let me
  5. It is one of the required rotation already in most of the programs. That is more than enough. So use the elective time for something else.
  6. Here are some suggestions: 1. ICU (high yield, you learn a lot about physiology, lots of learning and procedure but long hours, busy call, lots of call and very staff dependent rotation). 2. Anesthesia (it never hurts to get more experience with airway management and learn from specialists). 3. Medical toxicology (lots of learning, you get to appreciate pharmacology/toxicology etc.) 4. Stroke neurology 5. Ultrasound focused rotation (getting experience and learning on POCUS) Don't pick surgical elective. Don't pick cardiology.
  7. I am in the CCFP-EM program and I did not do the STARS/flight like rotation. I know several people who have done the rotation. It is an emerg/acute medicine rotation but could be like pre-hospital EMS type rotation. Hard to predict. Most times patient has been fully stabilized or some-what stabilized by doc where the patient first showed up. But sometimes docs in rural areas may need STARS/fully ED trained MD help and you stabilize the patient. Sometimes you go to the scene. It is a difficult rotation to secure because there is not enough capacity for all learners. The
  8. Several options: 1. Go into peds and then apply for peds-EM. Generally less trauma in peds but sometimes it can be pretty bad. 2. Anesthesia has a bit of overlap (mostly critical care and airway management) with EM. But you will be asked to manage trauma patients there as well. But there will be surgeon/ED doc usually as well. 3. Internal medicine. But you will have to do critical care rotations where you will be exposed to trauma patients. 4. Family medicine only and working in rural or small town EM (but trauma can show up anywhere). Or doing office practice with urgent c
  9. Trauma is a big part of ED and emergency medicine. If you don't feel comfortable with trauma then look into a specialty that overlaps with EM but has less trauma. The other option is to get more exposure and get comfortable with challenging situations. I hope that helps.
  10. I feel that 2 year FM residence was adequate in preparing me to independently practice right out of residency. The thing about Canadian-trained FM vs U.S.-trained is NOT true. Canadian-trained FM docs are competent. College gives them a license to practice. And if the program or college feels that resident is not competent then he/she does not get the license. FM residents will be adequately prepared to start working in a clinic/walk-in-setting right out of residency. I don't think they need to be "coached" or "groomed". Of course, they will keep improving just like any ot
  11. Many people do it. There is a lot of need in remote communities. Only you can know whether you are ready or not. Medicine is medicine. It does not matter whether you are practicing in city vs remote community. If you don't have resources then you make the best out of the situation. If you think patient needs more resources, you call someone where the resources are available. Let's do an extreme example - take a cardiac arrest patient. If you don't have AED or monitor/defibrillation - you can still do CPR. Yes, it is not the best situation. But you have to make do with the resources t
  12. Yes. It is possible. You need to tell you program director early in the training.
  13. What I love most: my education, training and experience have given me the privilege to help any patient (regardless of age, gender, medical illness, course of illness, severity of illness) and I either know how to help them OR how to get help for them OR how to make them comfortable OR how to decrease their suffering. What I like least: Sometimes I know how to get help for my patient BUT I cannot for many many reasons.
  14. The scope for prehospital doctors is anything to everything. For routine transport, advanced paramedics will go. For complicated transport, very sick patients - staff physician or fellow or senior resident will go. 5 year FR-EM can apply to all transport fellowships. 2+1 EM's can apply for some transport fellowships.
  15. For same amount of work? There is no magic formula. If you are really going to make me guess than overall it will go something like this: hospitalist > EM > outpatient doc. No data what so ever to back up my claim. Anectodal story I heard from someone else. There is a doctor who had a full time EM workload + full time FM practice with a number of rostered patients that is not ethical. Billed a good amount. A really good amount. Would I follow him? No. I have other hobbies and interests and priorities.
  16. Here you go: Just joking here with the picture above. I don't have a definition. However, there are some medical students who just don't give a good vibe to others. Examples include bad mouthing other services/consultants/nurses/medical students etc. There is also a fine line between being confident and arrogant; and gunners sometimes don't know that line. Some people resume/electives are super focused on 1 specialty and reviewing comments from their other rotations show that they might not be as good/team player/intelligent as shown on when working on the specialty
  17. Hard to compare the earning potential. I believe FM-hospitalist and EM's will both earn roughly more or less in the same ballpark. I don't have any data to back that up other than some anectodal stories.
  18. I am not sure how to answer this question. I will try to be positive and others can take on the other side of the debate. In my opinion, many Canadians do not have easy accessible access to health care outside of going to ED/urgent care center. Unfortunately, finances play a big role in running family physician clinics and walk-in-clinics. Sometimes patients may not be able to see their doctor right away. I know that's a problem for me. My own family doctor usually has a wait time of roughly 2-3 weeks. There are good reasons. My family doctor is trying his best but unfortunately he c
  19. Yes, it is realistically possible to have an exclusive mental health practice as a GP. I believe that mental health is rising and there are not enough psychiatrist/mental health allied care professionals. The more people who are genuinely interested in mental health are needed to help the community. Try to get some extra training. There are some +1 programs out there I believe. If not +1 then do extra electives in psychiatry or try to arrange a 3-6 month informal training with a psychiatrist. If you feel comfortable diagnosing/managing mental health then extra training might not be needed. You
  20. There is no magic formula. 2+1 program was already competitive but over the last few years it has become more competitive. I think one of the reason is that 5-year FR EM program is becoming more popular each graduating year. And medical students are becoming more strategic from day 1. So most students who are interested in 5-year FR EM program often back up with FM programs. Here is my take on it: 1. Try to decide soon (rather than late) in your FM residency whether you will apply for 2+1 EM. 2. Arrange as many electives as you can in places where you want to match.
  21. Pasting from my other thread. As far as I know family doctors have their own codes for pretty much everything. I did my own billing as a resident. There were family medicine codes for everything from standard visit to procedures to OB to palliative care to hospitalist etc. The only specialty that have similar codes/pay between family doctors and specialists is emergency medicine where 2+1 grads and 5 year FR grads have similar pay (but only in some provinces not all).
  22. As far as I know family doctors have their own codes for pretty much everything. I did my own billing as a resident. There were family medicine codes for everything from standard visit to procedures to OB to palliative care to hospitalist etc. The only specialty that have similar codes/pay between family doctors and emergency medicine is 2+1 grads and 5 year FR grads (but only in some provinces not all).
  23. Hard to answer this question. In 100% fee for service, there are different codes for standard visit vs comprehensive visit vs mental health visits. Mental health visits pay a lot more (about 3x) than standard visit (one system problem, for example BP check up and prescription refill. In rostered patients + part of your fee for service, standard visits pay you only ~ 15% of the full amount because rest of your income comes form yearly stipend for each patient that you take on your roster. However, for mental health visits in most provinces, you get to keep the full 100% of your fee fo
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