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gogogo

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Everything posted by gogogo

  1. In smaller specialties, who you know can significantly influence where you end up with a job. Does the same apply to FM at all (perhaps to a more nuanced degree)? I know that FM has a great job market, but some clinics must be better than others (e.g., better operated/admin, better location, busier vs. more relaxed, more collegial patients, lower overhead, etc.). Moreover, in the GTA--where I hope to practice--getting an FHO usually requires taking over from a retiring FP. Considering all of this, it seems that connections may help. So, does getting a job at a "better" FM clinic (or even knowi
  2. I've been reading U.S. med school forums, and there, a 3/5 evaluation, though formally labelled as "meets expectations," is implicitly understood to mean that the student did not do well. Does the same apply to Canadian clerkship evaluations? What does "meets expectations" mean in the Canadian clerkship context and how do program directors view that? I'll be applying to FM in Ontario.
  3. I agree with you, medmedmed132. It's a patronizing waste of time how some staff/rotations treat you. I've sat in the OR watching 1-4 hour surgeries with zero acknowledgment by the staff. I can't ask questions because he's/she's busy teaching the resident/fellow, and besides, I don't care for surgery so I don't have many questions to ask. Some will respond that you need to "show initiative," but that's the typical mindset that the system is always right and we are always wrong. Showing initiative doesn't work when you have staff that don't care to teach you and either give you a few words when
  4. How and which province? That’s amazing pay (assuming 220k after overhead) for what seems to be an easy schedule of 3-4 working days. And what’s “planning clinic”?
  5. What are the downsides to urgent care? Is it something you could do full-time (speaking about the GTA)?
  6. Don't psychiatrists make ~250k with options to make even more (I'm going off the CMA profile)? That'd be an after-tax income of about 150k. You could live frugally for a year ($4000/month) and put ~100k towards the debt, no? Just asking because psych pay is such an enigma.
  7. I agree, the opinions on this board are going to be biased because of the limited sample. But I'm starting to take them seriously because they align with what I'm hearing from FM grads that I've met/spoken to outside of the forum. All are from one of the bigger cities in Ontario. I completely agree with the financial analysis. In fact, I made the same argument in another thread comparing FM to PA or FM to FRCPC; when you consider the years of lost income, the higher earning option (i.e., FM > PA or FRCPC > FM) typically doesn't equal the lower earning option until 40s or 50s, and
  8. Of the ~10 recent FM grads I’ve spoken to, all but one are doing something other than office-based FM. I’m starting to reconsider FM because of it. Can you elaborate on why office FM is incompatible with grads’ life goals? What about FHOs? And what are you and the others who left medicine doing now?
  9. What's good for learning medicine at a clerk level? I don't want to study UWorld if it'll just make me good at test-taking (vs. actually learning medicine effectively).
  10. When you say fall through the cracks, do you mean they end up leaving medicine entirely (because they couldn't get into residency)? What do they end up doing instead with their MD?
  11. I was going to ask whether the heavier programs (e.g., 1:4 call) are really necessary if the plan is to only do regular family clinic. I guess it's still a good idea. I will look into the program descriptions, etc. but from your experience/anecdotes, which are the more rigorous programs in Ontario that train highly competent FM?
  12. It seems like there's a lot of variation in FM programs. Where do you get this info?
  13. Why is it considered a conflict of interest rather than just convenience? As a patient, I'd be happier to pick up my prescription right next door to my doctor's, rather than drive to an unaffiliated pharmacy. Or is it thought that the physician will be more inclined to prescribe (even if not medically necessary) because of the free rent? Do doctors actually feel that pressure from attached pharmacies?
  14. I agree with everyone that you have a really great shot at getting into med school. But I'll be honest: Why do you want to do this? If you think when you're 65 you'll end up regretting not being a doctor, then sure, do it (though I'll point out that research on people's regrets at the end of life show that career regrets are few and far between, with most people actually regretting that they didn't spend more time with their loved ones). From a financial perspective, this is likely not going to help you that much (see my post history). From a wellbeing perspective, you'll find that much o
  15. I agree with some of the things you said, like how specialists can just discharge patients ("you should ask your family doctor about that"). And the degree of paperwork in FM is staggering. ...But some of the things you said seem like they apply to a lot of medicine. For instance, isn't most of what we do in medicine not curative (unless you're in surgery)? This came as a surprise to me when I entered med school, but looking across specialties, I feel that much of medicine is management or monitoring or ruling out/avoiding the worst case scenario rather than "fixing" (again, unless you do
  16. Wow, I didn’t realize you could do EM with just CCFP 1 hour outside of Toronto. Which cities are you talking about? And do you think the standard CCFP residency provides sufficient training for working in these settings, or did these staff go out of their way to get enough EM experience during residency to be comfortable with it as new staff?
  17. For sure, but looking at the same 2018 document on FHOs I posted (found here), it says the average FHO capitation per patient is $139.12 (page 16 of the pdf in the "Key Features of FHO Models" section). $139 x 1000 patients lines up pretty well with the $150,000 quoted by the 2 FHO doctors I spoke to. Of course, you could have a panel that gets more per patient, but by these calculations, it seems that the vast majority of patients would have to be elderly and complex. My calculations must be wrong/missing something given that people always say FHO is lucrative (e.g., the quoted 400k for
  18. I read that article too, hence my confusion with how it doesn't line up with what the FHO doctors told me. I don't think either of them had any motivation to obfuscate their true earnings. Having said that, I think the 3.5 days noted is wrong. The FHO GP I shadowed with the 2000 roster building to 3000 would wake up every weekday at 4, study until 7, run errands, then be at his clinic seeing patients from 9-5. No work when he got home or on weekends; he did this 5 days a week. And he was never not working from 9-5...jumping from room to room, filling charts, making referrals, etc.
  19. If you're willing to share and out of curiosity, how much are they actually making (i.e., how much does it differ from perceptions of them being insanely rich)?
  20. Thanks for answering. What number would you put on "+++ hours"? I don't judge the doctors for doing so because I'm not there yet, but it's unfortunate to see this type of care. Do you know much about the FHO model I'm describing? Is a 1200 roster closer to 240k billing or 400-500k?
  21. You could just create a section in your CV that's "Submitted Manuscripts" and list them there. It's not as impressive as a list of publications, but at least it lets you show your work and commitment to the specialty.
  22. It seems accepted wisdom that FHO GPs are typically making a comfortably high salary; I've seen it mentioned here that billings of 400k-500k is the FHO ballpark before overhead. I've just shadowed 2 FHO GPs, and both told me that with a roster of 1000, you bill ~150k before overhead. I've heard that the average roster is ~1200 patients (corroborated by data on page 14 here). Extrapolating, that means the average FHO GP should be billing 1.2 x 150k = 180k. I know they can also bill a small percentage of FFS for each visit, but that's capped around 60k, so even with that maxed, they should be bi
  23. Hey, I would love to be wrong about this, because I could've pursed another career after my previous degree, made low six figures without any school debt, and called it a day. Instead, I chose med because of many reasons, one of which is that I thought it would be financially smarter. Too bad I only realized what I wrote in the other post once I got into med school.... But tell me, how am I underplaying it? I showed how the net worth is essentially equal for both careers with very simple math. The "double increase" that FM is making is simply compensation for the head-start that the PA (o
  24. From a purely economic perspective, it depends on how old you are, how much you expect to make as a family physician, your salary as a PA, and the expected value of your PA benefits + pension. I'll make a few assumptions to show you the math, but you can change them for a more accurate outlook. This message looks long, but it's pretty straightforward, so I encourage you to read it to the end. But for a quick spoiler: Probably not worth it. My assumptions: Age: 25 FM Ontario average income: $250,000 post-overhead = $150,000 after income tax PA salary: $120,000 = 84,000 afte
  25. Wouldn't a leave of absence hurt down the line? I know that when you renew your license, you have to indicate whether you took leave and whether you've had a medical condition that could affect you as a physician. Checking both of those boxes sounds like a red flag, but I'm not sure how the college treats you if you check those boxes. Edit: Of course, I'm not suggesting that LoA shouldn't be taken, but am hoping that more experienced members can chime in about whether that will have implications for the career/licensing in the future.
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