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Bleak Job Prospects Post-School?


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I recently spoke with a friend of mine who is finishing up their residency out west and we were discussing the job market for physicians in Canada. It seems like even after all those years of school, internships, etc. the process of getting a stable job (not even in a preferred location) is somewhat of a gamble and job prospects may be bleak. Is this true? Also, are most jobs in medicine obtained by connections and references during your residencies and fellowships? Judging by what my friend is going through, applying for a job is pretty different than in other professions where you scour job listings online or knock on doors. When so much of someone's life and money has been invested into school I feel like finding a job is more difficult than it should be. I may be wrong since I don't hear a lot about physician unemployment but a lot of his classmates are also going through similar situations. 

Can anyone provide some insight into this topic?

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6 minutes ago, offmychestplease said:

There is a HUGE HUGE variance in job prospects in medicine. These are the fields with the best job prospects: very easy to find plentiful work in literally any part of Canada whenever you want-

FM, EM, Derm, Psych, General IM

These are the fields with extremely poor job prospects (ie. you need years of fellowship + graduate degrees + connections to have hope to work in isolated regions of Canada - 

anything surgery (neuro, cardiac, etc), cardiology, rad onc, etc.

Every other speciality is somewhere in between these extremes (ie. there are jobs, likely not where you want them in big cities at least right away)

I think that one of the biggest considerations for me is job prospects. I don't want to go through many years of very difficult training to not have a job at the end, or have a job in somewhere I don't want to be.

 

Wow that really dissuades me from surgery :huh:

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12 minutes ago, offmychestplease said:

There is a HUGE HUGE variance in job prospects in medicine. These are the fields with the best job prospects: very easy to find plentiful work in literally any part of Canada whenever you want-

FM, EM, Derm, Psych, General IM

For these "easier to find jobs" do you wait for job listings like regular jobs or are these all internal hirings from connections, residencies, and so forth?

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1 hour ago, Canadian MED said:

I recently spoke with a friend of mine who is finishing up their residency out west and we were discussing the job market for physicians in Canada. It seems like even after all those years of school, internships, etc. the process of getting a stable job (not even in a preferred location) is somewhat of a gamble and job prospects may be bleak. Is this true? Also, are most jobs in medicine obtained by connections and references during your residencies and fellowships? Judging by what my friend is going through, applying for a job is pretty different than in other professions where you scour job listings online or knock on doors. When so much of someone's life and money has been invested into school I feel like finding a job is more difficult than it should be. I may be wrong since I don't hear a lot about physician unemployment but a lot of his classmates are also going through similar situations. 

Can anyone provide some insight into this topic?

I just finished my residency in Internal medicine (4 year GIM program) and went through the process of looking for a job this year.

I can't comment on various specialties and how easy or hard it is to find a job, there is huge variance in terms of specialties AND locations. I can talk about generalities:

*Generally* it is "easier" to get a job in a specialty that does exclusively/primarily outpatient work (can either join a clinic, or start up your own)

*Generally* it is "harder" to get a job that requires hospital resources (In-patient/ICU beds, OR/endoscopy/procedure time, etc...)

*Generally* it is "easier" to get a job in a more broad specialty then a hyper-specialized one (as the more specialized one requires more resources... see above)

*Generally* it is can be more difficult to find a job in a big/attractive location (Toronto/GTA, Vancouver etc....) than in a smaller/more rural location (big cities are saturated with talent)

 

For me I was able to find a job at a centre I enjoyed and stayed within the city I wanted to live in. I did a more broad specialty, which still has decent job prospects... (although this even in GIM is tightening up...)

 

The process of finding a job is a complete gong show. There are very few posted positions, most of it is word of mouth. I would try to set up electives at sites only if they had openings or the prospect of hiring someone, and a lot of the time I got "we don't know, come do an elective".  I find the whole medical human resource planning, job search and hiring a bit trouble some, but unfortunately that is the way it is.

The one thing that is slightly positive compared to other places is that setting electives at sites that are hiring really gives you a good feel of whether or not you like working at a location instead of blindly accepting an offer and being stuck.

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Yeah pretty much any field requiring a hospital to practice is pretty bad these days. While there is a huge variance between specialties it's also worth keeping in mind that big cities are generally quite hard to practice in for nearly every specialty, though for the less difficult ones @offmychestplease (correctly) listed this really depends on academic vs community medicine; GIM for example i've heard is still really tough to get an academic hospital position in, but community work still exists in big cities (albeit quite a bit less of it than elsewhere). To be clear though this is anecdotal from my experience talking to those in the field, hard to say as I'm not in it (yet).

Edit: Ninja'd by someone who actually knows what they're talking about. Thanks for weighing in @ACHQ

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11 minutes ago, TheFlyGuy said:

Yeah pretty much any field requiring a hospital to practice is pretty bad these days. While there is a huge variance between specialties it's also worth keeping in mind that big cities are generally quite hard to practice in for nearly every specialty, though for the less difficult ones @offmychestplease (correctly) listed this really depends on academic vs community medicine; GIM for example i've heard is still really tough to get an academic hospital position in, but community work still exists in big cities (albeit quite a bit less of it than elsewhere). To be clear though this is anecdotal from my experience talking to those in the field, hard to say as I'm not in it (yet).

Edit: Ninja'd by someone who actually knows what they're talking about. Thanks for weighing in @ACHQ

You're not wrong, and with the economy taking a downturn, governments will  want to reign in spending, I see job prospects getting worse (even though tbh the job market has not improved at all since when I started medical school in 2012...).

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21 minutes ago, ACHQ said:

*Generally* it is "easier" to get a job in a more broad specialty then a hyper-specialized one (as the more specialized one requires more resources... see above)

How would you classify the different IM subspecialties in terms of broad vs. narrow? Would you say that something like med onc is broad because there is so much cancer in Canada, and  it doesn't require lots of equipment like rad onc or an ICU/OR (most of the time). Or by broad do you just mean something like GIM which can kind of treat most of anything unless its a particular uncommon or tough case that might need a specialist?

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52 minutes ago, zxcccxz said:

How would you classify the different IM subspecialties in terms of broad vs. narrow? Would you say that something like med onc is broad because there is so much cancer in Canada, and  it doesn't require lots of equipment like rad onc or an ICU/OR (most of the time). Or by broad do you just mean something like GIM which can kind of treat most of anything unless its a particular uncommon or tough case that might need a specialist?

By broad I mean general.

The fact that they are referred to as SUB-specialties tells you that its probably narrow. Yes a general cardiologist or (insert sub-specialty here) will see a lot of varied presentations but they will be limited to the heart.

I would say that IM sub-specialties are *still* better off than most surgical (and other procedure/resource intensive) specialties for the following reasons:

- You can always do GIM locum/call (even if things are tightening up there is still work to do the worst shifts, which pays well)

- You can always do more of a outpatient based practice (and many of them are purely outpatient based anyways)

The problem is that sub-specialist WANT to practice their own subspecialty to the full breadth/scope. That means although they can get work it may not be exactly what they wanted/envisioned, unlike a surgeon who cant find work...period.

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Most people find a job after residency or first fellowship, of which the total length of time rarely exceeds 6-7 years post-medical school. In a few specialties it is common to do multiple fellowships or even advanced degrees, but you'd know that was the reality walking into those specialties tbh.

Typically 'difficulty finding a job' in medicine means you may have one or a few option(s) but the option(s) may be in an undesirable location, involving work you don't really enjoy (e.g. being forced into taking on general cases in your specialty, only able finding work doing locums, lacking elective OR time, getting undesirable cases dumped on you, etc.). This sounds like what your friend is going through, and it the reality of almost all surgical specialists; though increasingly more and more medical specialists are experiencing this too.

I wouldn't let this dissuade you from medicine though. Like I said, most still find a job. And if flexibility was high on your priority list chances are you'd do something like family medicine.

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I definitely wouldn't be turned off of medicine by job prospects. Compared to most other fields, the job prospects are excellent, especially nowadays when hiring in other fields is scarce. Yes, the job prospects are abysmal in certain fields (neurosurg, cardiac surg, many other surg specialties), but even in certain surgical specialties (which are worse than the vast majority of non-surg specialties), you can find a job without a fellowship in a community hospital outside the largest cities (for Ontario, cant speak for other provinces).

For non-surg specialties, the majority of people (cardio, nephro, rad onc aside) get jobs immediately after their residency if they're looking to work in the community or immediately after a fellowship/Masters if they want to work academic. 

And yes, the vast majority of jobs in medicine are never posted online, but that's the case for most fields. Using connections and word of mouth are the name of the game for finding jobs in life (fortunately or unfortunately, depending on how you feel about networking) and medicine is no different. 

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9 hours ago, Canadian MED said:

I recently spoke with a friend of mine who is finishing up their residency out west and we were discussing the job market for physicians in Canada. It seems like even after all those years of school, internships, etc. the process of getting a stable job (not even in a preferred location) is somewhat of a gamble and job prospects may be bleak. Is this true? Also, are most jobs in medicine obtained by connections and references during your residencies and fellowships? Judging by what my friend is going through, applying for a job is pretty different than in other professions where you scour job listings online or knock on doors. When so much of someone's life and money has been invested into school I feel like finding a job is more difficult than it should be. I may be wrong since I don't hear a lot about physician unemployment but a lot of his classmates are also going through similar situations. 

Can anyone provide some insight into this topic?

Having worked jobs in and out of medicine, finding work in medicine is a lot easier than many other competitive professions. I trained in FM and once I got my licence, finding work was as easy as cold calling local clinics to see if they need physicians. For surgical assist and hospitalist positions, I got them by emailing local hospitals' respective departments and connecting with the department chief. Doing your electives at sites where you want to be definitely helps for scoping out lay of the land. Pick a generalist specialty and it won't be too difficulty finding full-time work.

The non-clinical jobs I've had, they were 90% networking/referrals and 10% luck (right time, right place). Talk to your friends in finance/accounting/biglaw. For them, networking is a full-time job in itself with fairly rigid expectations and quite different from "networking" in medicine (a lot easier imo).

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It depends on location and specialty. Any specialty that's tied to the hospital is going to have more limited job opportunities. So basically any surgery field right now has a pretty bad job market, neurosurgery and ortho being the worst. There are things like Rad Onc that used to be really bad too but now the job market is opening up for them. If you become an internist / FM you can pretty much work anywhere you want including downtown Toronto. Academic positions in any specialty are tough to get. You will get a job in any specialty in Canada, but you may get an undesirable location depending on your specialty. 

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On 6/24/2020 at 12:06 AM, anonymouspls said:

It depends on location and specialty. Any specialty that's tied to the hospital is going to have more limited job opportunities. So basically any surgery field right now has a pretty bad job market, neurosurgery and ortho being the worst. There are things like Rad Onc that used to be really bad too but now the job market is opening up for them. If you become an internist / FM you can pretty much work anywhere you want including downtown Toronto. Academic positions in any specialty are tough to get. You will get a job in any specialty in Canada, but you may get an undesirable location depending on your specialty. 

 

On 6/23/2020 at 11:55 PM, 1029384756md said:

Having worked jobs in and out of medicine, finding work in medicine is a lot easier than many other competitive professions. I trained in FM and once I got my licence, finding work was as easy as cold calling local clinics to see if they need physicians. For surgical assist and hospitalist positions, I got them by emailing local hospitals' respective departments and connecting with the department chief. Doing your electives at sites where you want to be definitely helps for scoping out lay of the land. Pick a generalist specialty and it won't be too difficulty finding full-time work.

The non-clinical jobs I've had, they were 90% networking/referrals and 10% luck (right time, right place). Talk to your friends in finance/accounting/biglaw. For them, networking is a full-time job in itself with fairly rigid expectations and quite different from "networking" in medicine (a lot easier imo).

 

On 6/23/2020 at 10:26 PM, Galaxsci said:

I definitely wouldn't be turned off of medicine by job prospects. Compared to most other fields, the job prospects are excellent, especially nowadays when hiring in other fields is scarce. Yes, the job prospects are abysmal in certain fields (neurosurg, cardiac surg, many other surg specialties), but even in certain surgical specialties (which are worse than the vast majority of non-surg specialties), you can find a job without a fellowship in a community hospital outside the largest cities (for Ontario, cant speak for other provinces).

 

On 6/23/2020 at 7:12 PM, 1D7 said:

Most people find a job after residency or first fellowship, of which the total length of time rarely exceeds 6-7 years post-medical school. In a few specialties it is common to do multiple fellowships or even advanced degrees, but you'd know that was the reality walking into those specialties tbh.

Typically 'difficulty finding a job' in medicine means you may have one or a few option(s) but the option(s) may be in an undesirable location, involving work you don't really enjoy (e.g. being forced into taking on general cases in your specialty, only able finding work doing locums, lacking elective OR time, getting undesirable cases dumped on you, etc.). This sounds like what your friend is going through, and it the reality of almost all surgical specialists; though increasingly more and more medical specialists are experiencing this too.

 

On 6/23/2020 at 3:44 PM, ACHQ said:

For me I was able to find a job at a centre I enjoyed and stayed within the city I wanted to live in. I did a more broad specialty, which still has decent job prospects... (although this even in GIM is tightening up...)

 

Appreciate all the input guys. It seems like not all of my buddy's classmates "networked" really well during their final few years of training and feel that they may not have enough strong connections in their pockets for when they graduate. When searching for jobs, can students apply nationally across Canada or are they somewhat restricted to the Province in which they completed their residency? If I'm not mistaken there seems to be different licensing procedures associate with each Province; have any graduates actually got licenses for other areas just to broaden their search for employment?

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On 6/23/2020 at 1:58 PM, Canadian MED said:

I recently spoke with a friend of mine who is finishing up their residency out west and we were discussing the job market for physicians in Canada. It seems like even after all those years of school, internships, etc. the process of getting a stable job (not even in a preferred location) is somewhat of a gamble and job prospects may be bleak. Is this true? Also, are most jobs in medicine obtained by connections and references during your residencies and fellowships? Judging by what my friend is going through, applying for a job is pretty different than in other professions where you scour job listings online or knock on doors. When so much of someone's life and money has been invested into school I feel like finding a job is more difficult than it should be. I may be wrong since I don't hear a lot about physician unemployment but a lot of his classmates are also going through similar situations. 

Can anyone provide some insight into this topic?

While I agree that jobs in an ideal world should be easier to come by, I don't think the situation right now is untenable. The days of waltzing into a job are now over, but at the same time, we've increased medical school spots, we've made it harder to kick out residents who aren't performing to par and this is the result (according to the old guard).

The process of getting a stable job not in a preferred location is only challenging in some specialties like surgical ones. I generally tell people considering surgery to first be open to the idea of the long training and the long hours, but second to be open to the idea of forced to move you and your family around. Its rare to see a surgeon not have to move around for at least one of residency, fellowship or staff. 

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