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So I thought this would be a lot easier. But I find myself being super confused about how to rank some FM programs especially since we weren't able to interview in person.

I'm looking for any comments about any of the Ontario FM sites.

Western probably has me most conflicted with all the sites so If someone could compare the regional, city and rural sites, I would really appreciate it. I was initially really liking the regional program but I'm hearing conflicting comments. Or any comments at all from a clerk that rotated at one of these sites.

I would prefer to live in Ontario for family, but some of these BC programs are super attractive. I'm actually tempted to rank them higher over Ontario sites because I just feel better informed. 

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So this is a great question to reach out to programs and ask if they can connect you with current residents who may be able to give you the most honest answers. I know in peds the applicants usually got the chief residents contact details if they had questions of this sort. Residents usually are very honest and don't sugar coat things ha.

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7 hours ago, cookie_m said:

So I thought this would be a lot easier. But I find myself being super confused about how to rank some FM programs especially since we weren't able to interview in person.

I'm looking for any comments about any of the Ontario FM sites.

Western probably has me most conflicted with all the sites so If someone could compare the regional, city and rural sites, I would really appreciate it. I was initially really liking the regional program but I'm hearing conflicting comments. Or any comments at all from a clerk that rotated at one of these sites.

I would prefer to live in Ontario for family, but some of these BC programs are super attractive. I'm actually tempted to rank them higher over Ontario sites because I just feel better informed. 

I'm not sure anyone can give you a detailed comparison because few people have really done much work beyond a few sites at each school. It has been some years since I rotated through these places.

Western:

Regional West (Mt. Brydges): I had a great time as a medical student there. Residents seemed to get pretty decent ER/hospitalist at the regional hospital in Strathroy. A big selling point is that you can live in the main city and drive about 45-50 minutes to the hospital.

Rural (Hanover): I had a pretty good time here as well. It's pretty busy/intense compared to an urban FM program since you cover ER, admit and follow your own patients as a hospitalist, and take on OB call. There was at least 1 FM physician providing anesthesia coverage and another doing palliative. The program is pretty small so whenever there's a procedure, you'll be the one doing it. My general sense was that it was a pretty good educational opportunity if you wanted to practice rurally after and practice a broad scope of FM. But it would be overkill if you just want to mainly work in an urban setting, plus it's ~2 hr away from the closest big city.

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On this topic, does anyone have an ideas/insights about the differences in call requirements across FM sites across Canada? Not sure if I'm misinterpreting this, but UBC FM sites seem a lot more call heavy than Ontario sites, for example.

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1 hour ago, yup said:

On this topic, does anyone have an ideas/insights about the differences in call requirements across FM sites across Canada? Not sure if I'm misinterpreting this, but UBC FM sites seem a lot more call heavy than Ontario sites, for example.

Would like to know this too!

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4 hours ago, 1D7 said:

I'm not sure anyone can give you a detailed comparison because few people have really done much work beyond a few sites at each school. It has been some years since I rotated through these places.

Western:

Regional West (Mt. Brydges): I had a great time as a medical student there. Residents seemed to get pretty decent ER/hospitalist at the regional hospital in Strathroy. A big selling point is that you can live in the main city and drive about 45-50 minutes to the hospital.

Rural (Hanover): I had a pretty good time here as well. It's pretty busy/intense compared to an urban FM program since you cover ER, admit and follow your own patients as a hospitalist, and take on OB call. There was at least 1 FM physician providing anesthesia coverage and another doing palliative. The program is pretty small so whenever there's a procedure, you'll be the one doing it. My general sense was that it was a pretty good educational opportunity if you wanted to practice rurally after and practice a broad scope of FM. But it would be overkill if you just want to mainly work in an urban setting, plus it's ~2 hr away from the closest big city.

Any examples of what made the ER/hospitalist exps good?

And for Hanover, what sorts of procedures were residents obtaining proficiency in?

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byron urban family clinic was boring, basically back pain and prescription refill. Once somebody came in with active nosebleed and everyone got excited.

I heard victoria site u get to do some ob stuff but workload is busier. the area of town is sketchy though.

st joes generally good impression from other people, pretty close to university shopping and transit.

I don't know much about the regional sites but be ware in the winter these rural roads get pretty rough if you are not used to them. In the summer they are wonderful but personally I would not live in these small towns during the winter. Once it snows it's like you are locked in with nothing much to do.

St Thomas is a nice city, small size, pretty quiet, close to London, pretty cheap, and hospital has many service u can rotate through. If I were doing FM I'd consider it. Woodstock also not a bad city but bit further from London but close to KW area.

London is expanding so fast road congestion is crazy, housing price flying to the moon, just not what it used to be. Feel like Mississauga lol.

 

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As a medical student I really enjoyed the Regional North (Ilderton) site at Western! 

The were many opportunities to do procedures in the clinic, the preceptors there were enthusiastic about teaching, and it was a 20 drive from downtown London. I never rotated through St. Mary's Hospital or Exeter ER, though, so I unfortunately can't comment on the full range of resident experiences. 

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15 hours ago, yup said:

On this topic, does anyone have an ideas/insights about the differences in call requirements across FM sites across Canada? Not sure if I'm misinterpreting this, but UBC FM sites seem a lot more call heavy than Ontario sites, for example.

My impression has been quite the opposite, the sites at UBC that I've talked to residents about seem to have fewer call shifts than many other programs! 

 

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2 hours ago, RepresentativeSalad said:

My impression has been quite the opposite, the sites at UBC that I've talked to residents about seem to have fewer call shifts than many other programs! 

 

My understanding from my discussion with residents and my experience on rotations here is that it’s very site and rotation dependant at UBC. There are some sites that maximize 1:4 overnight call on a lot of rotations (particularly most of the urban and some of the mid-sized programs), while other sites you’re more often looking at ~1 call / week (1 weekend / month). Some sites are also more/only evening call (no post-call day), while others you’re doing a lot more overnight call.  

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Thank you so much @ihsh, @shikimate& @1D7 this has been super helpful. 

To the person wondering about UBC call requirements, it was dependent on site, and there are some super chill ones. I wrote some of them down, so if you want specifics let me know and I can post them for other people to see. Some sites do no overnight (till 11) call while some do unless on OB (and sometimes hospitalist). 1:4 is the UBC consensus.

I happen to like having a post call day. I hate working till 11 because things always come up I always end up staying later and showing up early the next day. I always feel like I should have just stayed anyways, but that's just me.

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13 minutes ago, cookie_m said:

Thank you so much @ihsh, @shikimate& @1D7 this has been super helpful. 

To the person wondering about UBC call requirements, it was dependent on site, and there are some super chill ones. I wrote some of them down, so if you want specifics let me know and I can post them for other people to see. Some sites do no overnight (till 11) call while some do unless on OB (and sometimes hospitalist). 1:4 is the UBC consensus.

I happen to like having a post call day. I hate working till 11 because things always come up I always end up staying later and showing up early the next day. I always feel like I should have just stayed anyways, but that's just me.

That would be great if you could post them, or please feel free to personally message me! Were you able to gather if 1:4 is standard amongst the Ontario schools as well? This hasn't really come up in the info sessions I've attended. 

Thanks for your help!

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25 minutes ago, cookie_m said:

Thank you so much @ihsh, @shikimate& @1D7 this has been super helpful. 

To the person wondering about UBC call requirements, it was dependent on site, and there are some super chill ones. I wrote some of them down, so if you want specifics let me know and I can post them for other people to see. Some sites do no overnight (till 11) call while some do unless on OB (and sometimes hospitalist). 1:4 is the UBC consensus.

I happen to like having a post call day. I hate working till 11 because things always come up I always end up staying later and showing up early the next day. I always feel like I should have just stayed anyways, but that's just me.

Would also like to know the specifics. Thank you!

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So I realized that I didn't write a lot of the programs down, but this is what I recorded: (I'm thinking the majority of the rest were super cush or 1:4-but if someone else adds to this It would help everyone else)

Prince George: I didn't write the actual number but wrote "a lot of call is in hospital"; OB call is 1:2

Rural Fort St. John: 1 day/week

Vancouver Fraser: OB: 1:4

Abbotsford: R1-1:4; R2-1:6

Nanaimo: overnight call only for OB; Hospitalist only until 11 pm

Victoria: call is 4 times per month

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51 minutes ago, yup said:

That would be great if you could post them, or please feel free to personally message me! Were you able to gather if 1:4 is standard amongst the Ontario schools as well? This hasn't really come up in the info sessions I've attended. 

Thanks for your help!

Don't know about the Ontario ones

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2 hours ago, cookie_m said:

So I realized that I didn't write a lot of the programs down, but this is what I recorded: (I'm thinking the majority of the rest were super cush or 1:4-but if someone else adds to this It would help everyone else)

Prince George: I didn't write the actual number but wrote "a lot of call is in hospital"; OB call is 1:2

Rural Fort St. John: 1 day/week

Vancouver Fraser: OB: 1:4

Abbotsford: R1-1:4; R2-1:6

Nanaimo: overnight call only for OB; Hospitalist only until 11 pm

Victoria: call is 4 times per month

I have some slight differences for some of these UBC sites in my notes (and based on experiences rotating though several of these sites as a clerk). It’s hard to be exact because it can vary a lot with rotation. The max is 1:4 overnight in hospital (1 weekend in 4), 1:3 overnight out of hospital (1 weekend in 3). The collective agreement with scheduling rules is here: https://residentdoctorsbc.ca/bargaining-benefits/scheduling-stat-holidays/

Rural sites generally ~1/week plus 1 weekend per month (including FSJ). Several residents talked about taking on more than this in some cases though in order to get more volume (often Obs). Some are evening call and some are overnight home call, and some have some overnight in hospital (e.g, I wrote down FSJ has overnight, some sites for Obs, or apparently just practically for some residents because of distances to drive home) but I don’t have great notes on which are which. Some of the rural sites also have mandatory rotations in the bigger centres, and for these should expect up to the maximum on some rotations. 

Mid sized and urban sites: generally up to 1:4 overnight, but varies with rotation, with some rotations having little to no overnight call. Some have evening call for some rotations (e.g. psych is common evening only, in some of the mid sized sites like chilliwack some other specialty call (e.g. surgery) mostly evening). The urban sites in general seem to have more overnight call than evening. Surrey sounds like there’s more rotations with no overnight call compared to Vancouver Fraser and St Paul.

Victoria: ~ 4 times per month on some rotations (E.g. I think this was the blended family / Obs in R1), but up to the max 1:4 overnight on other rotations (I have Peds, IM CTU written down as examples). Usually overnight call. Some residents here also talked about feeling they sometimes needed more shifts on the lighter rotations to get volume (again mostly for obs).

Nanaimo and Abbotsford: both are overnight call for Obs only, remainder of specialties evening call with no post-call day (technically off at 11, but practically often there until midnight - at least in my experience). 
 

Edited by frenchpress
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I checked the call schedule for London CTU, and the FM residents typically do 5-6 calls per block. The number of calls is significantly reduced for people rotating through St. Thomas.

Edit: Western's website lists the possible locations for each rotation (link) Call requirements are generally lower if you go to a site outside of London. I don't know how important the number of calls is in the grand scheme of things, though. FM residency is only 2 years, after all, and usually you only do home call when you are on FM rotations anyway.

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