Where do most average medical students end up going - Do we just end up doing FM?

[lovemedicinesomuch]

11 hours ago, shikimate said:

I'd say a lot of people end up in FM only because:

1) school admins want to show a high match rate, so their incentive is to make you rank more programs so you match something somewhere. Once you match and they give your MD degree they wash their hands clean. Which means there are people in lesser competitive specialties who shouldn't be there. So be wary of their incentives when taking in their advice.

2) the system is terribly set up such that people who need time to decide on their future or may need a few more years to become competitive at something are robbed of that opportunity. I would've loved to do derm and if you tell me I could spend 2-3 more years of rotating internship or house officer to become competitive I would've likely taken that opportunity. But obviously our system doesn't work that way.

3) the licensing system is a failure and operates in a cartel like manner. People who have MD but not residency cannot even function as physician assistants. That means all your bets must be placed correctly during medical school, hence people probably over hedge. I read before that in Missouri, people with MD but no residency are allowed to function as physician assistants and are regulated. That allows them to gain experience and connection for future residency positions. I would applaud a system like that. 

 I heard that in US one can work as a GP with just 1 PGY of training. You may be limited in your work opportunities, but you can still find somewhere rural and practice. I think if Cda has something like rotating years or prelim year- there will be less unwilling residents in the system.

Shikimate: you should consider a derm residency if you are into derm. You can do it as a second residency, your path background will be an asset

 

[blah1234]

15 hours ago, shikimate said:

3) the licensing system is a failure and operates in a cartel like manner. People who have MD but not residency cannot even function as physician assistants. That means all your bets must be placed correctly during medical school, hence people probably over hedge. I read before that in Missouri, people with MD but no residency are allowed to function as physician assistants and are regulated. That allows them to gain experience and connection for future residency positions. I would applaud a system like that. 

I agree. I think there is basically no room for error anymore as there is no longer a "default" type of doctor. I personally think we should bring back the internship or at least give students the ability to do something with their degree with partial or no residency training. I'm not saying they should be independent but they should be able to function under supervision in the clinic. Right now it's basically all or nothing for students and that creates perverse incentives with regards to applications and matching. I would easily work with medical students or residents that are looking to buy more time before pursuing their passions over some of the PAs and NPs that I've worked with.

[shikimate]

11 hours ago, lovemedicinesomuch said:

 I heard that in US one can work as a GP with just 1 PGY of training. You may be limited in your work opportunities, but you can still find somewhere rural and practice. I think if Cda has something like rotating years or prelim year- there will be less unwilling residents in the system.

Shikimate: you should consider a derm residency if you are into derm. You can do it as a second residency, your path background will be an asset

 

The US separates the concept of "licensing" from "employment"

- for the purpose of licensing, states require either 1 or 2 years of residency. They do not require you to have finished residency, or become board certified, or pass higher exams beyond USMLE/COMPLEX steps.

- but for the purpose of job, employment, etc, yes most universities, hospitals, medical centers etc require you to be board certified, either in US or somewhere else. Some insurance may also have such requirements for reimbursement and payment purposes. This could vary greatly with employer of course.

- but that does not exclude other revenue streams outside of institutions and employers. For example, you can open your own clinic and take cash. If you have what it takes to attract the clientele, bravo, good for you. You can open your own medical marijuana business. You can work for some government agencies, such as Office of Indian Services. You can be some billionaire's personal physician etc. The possibilities are endless outside of the traditional sense of joining a clinic/hospital. 

- I think the above system gives a lot more opportunities to physicians, but the flip side is the skillset and qualification of physicians may become more mixed, and there may be some aspect of "caveat emptor" for those seeking care. It's a more "mixed market oriented" if you will. Whether it is superior or inferior to our system is up for debate.

[LukaJkovac]

On 12/13/2021 at 11:12 AM, socialjustice said:

I am currently in clerkship, and have noted clerkship to be difficult. I feel that I am average at best. I was wondering where do average medical students end up doing for specialty. Do they end up being in FM, since it is difficult to be a competitive applicant for anything else if you are just an average medical student?

 

aww common, you're whipping through 100 specialties so of course youre going to feel under equipped. You're getting pimped by specialists who's been in that field for years to decades. How much you want to bet that these specialists would be stumped on some of the stuff that you would know? You're just starting out, of course you're going to be green on the floor. You're a med student so clearly you're competent. Pick a specialty you enjoy and give it 5-7 years of residency and you're going to be a rock star.

Stay safe

[Edict]

On 12/18/2021 at 8:40 PM, LukaJkovac said:

aww common, you're whipping through 100 specialties so of course youre going to feel under equipped. You're getting pimped by specialists who's been in that field for years to decades. How much you want to bet that these specialists would be stumped on some of the stuff that you would know? You're just starting out, of course you're going to be green on the floor. You're a med student so clearly you're competent. Pick a specialty you enjoy and give it 5-7 years of residency and you're going to be a rock star.

Stay safe

100%, there are definitely areas of medicine that medical students know much better than specialists or residents. It feels like a lot in medical school and it is, people surprise others every year because the match is not based on some arbitrary ranking and it is much more random than that. I wouldn't limit your own aspirations based on your own perceptions unless feedback is coming to you directly to improve.