250+ Unfilled FM Spots Nationally

[indefatigable]

5 hours ago, Andrew said:

FM is a unique beast, so IMO cannot be compared to what you are describing which is subspeciality/fellowship training years like a 5+2 or 5+3. Incidentally, many programs now require a 1-year Master's (or some kind of research) as an add-on during Residency in addition to the usual 5+whatever if you want to have any hope of working in a major hospital/city. This is more of a way to differentiate potential hires rather than for the purpose of "more years of training for more pay".

What you're referring to is legacy from hip replacement/cataract waitlists of old which resulted in a bonus for these procedures, which results in ophthalmologists doing nothing but cataract surgeries all day and getting paid a ton.

In BC, the MSP fee codes weren't changed for basically 10 years since I started working in 2013, with the exception of the recent overhaul with the new LFP payment model (which is basically a 40-50% increase in pay for the same amount of work). But fee codes aren't the only way FMs get paid in BC. Prior to the LFP, we had "Complex Chronic Care Billing codes" for HTN, Diabetes, CHF etc. which billed extra ($100 annually for HTN, $150 annually for DM2, and around $350 annually if I recall correctly for a patient with say DM2 and CKD), and an extra annual longitudinal care bonus was introduced I believe around 3-4 years ago (around $10-20K annually). There are other ways government has paid FMs other than directly through fee codes.

What I think (and really, only time will show if I'm correct or not), is that If/When FM Residency moves to 3 years, the overall Prestige of FM goes up in the eyes of politicians and patients. With a rise in Prestige and training years, it's much easier for FMs to negotiate next time the BC Physician Master's Agreement is up for renewal.

Add a 3-year FM residency, to the pendulum already swinging in favor of increased FM pay (many people complaining they cannot get a FM), and the political will should be there for another juicy increase to FM pay as a result of longer residency.

IMO politicians and patients are simple, they see only the number of years of training. If we made FM a 5-year residency (whether this actually useful or not), the prestige would be on par with specialties.

On the one hand, you do seem to acknowledge that at least ophthalmology earns money from cataract procedures due to billing code legacy rather than length of training or prestige.

 On the other hand, you seem to argue that politicians and public base pay on years of training which appears to be synonymous with prestige.  You argue this despite the previously mentioned examples of relatively large specialties of pediatrics and psych with  4-6 year training length and hence qualify as "prestigious" under your argument . However, as I'm sure your aware, both psych and peds are known to bill on average almost identically to FM despite a 2-3x longer training time.  As such, the link between years of training and pay appears tenuous at best.  

The one kernel of truth is "pendulum already swinging in favor of increased FM pay (many people complaining they cannot get a FM)" - indeed, basic microeconomics of demand >> supply and public opinion is likely a big part of the reason for the longitudinal FM pay increase in BC especially.  Politicians really are only thinking about the next election and not abstract concepts like prestige or length of training.  As an aside, procedural specialties of course have no competing midlevels which helps them with their fee negotations.

5 hours ago, Andrew said:

IMO it's foolish to think an extra year of training won't in some way result in higher pay in the future.

You make recourse to FM "exceptionalism" despite the fact that there is no evidence that this has occurred in other specialties including pediatrics (4+2 vs 3+2 a few years ago) or IM (GIM with 5 vs 4 years of training).  You dismiss fellowships as being hiring necessary which obviates the point that length of training does not correlate with pay. 

On the contrary, I think it's foolish to expect that there would be a pay increase due to an increase in length of training.  NPs are certainly not worried about increasing their training length in orderto demand similar pay/salary to FPs.

It's certainly easy to advocate for increased training length when your own training is done as there is really no downside for you personally and even a possible up-side (even if unlikely).

3 hours ago, Synth1 said:

Family medicine is approximately 50% off-service in both years though (5-6 blocks per year in most programs), we are basically the scut workhorses of the residency system. If the third year is just another year of the same thing I am firmly against. If the third year is directed by learning goals or functions as a supervised practice year it could be beneficial. I'm not as optimistic as you that it will translate in to any improvements for the profession financially or otherwise. 

Exactly -it seems likely that a general rather than directed PGY 3 year would be added which could paradoxically still result in the need for "+1"s/PGY 4 year for focused practice.  

[Findanus]

42 minutes ago, indefatigable said:

On the one hand, you do seem to acknowledge that at least ophthalmology earns money from cataract procedures due to billing code legacy rather than length of training or prestige.

 On the other hand, you seem to argue that politicians and public base pay on years of training which appears to be synonymous with prestige.  You argue this despite the previously mentioned examples of relatively large specialties of pediatrics and psych with  4-6 year training length and hence qualify as "prestigious" under your argument . However, as I'm sure your aware, both psych and peds are known to bill on average almost identically to FM despite a 2-3x longer training time.  As such, the link between years of training and pay appears tenuous at best.  

The one kernel of truth is "pendulum already swinging in favor of increased FM pay (many people complaining they cannot get a FM)" - indeed, basic microeconomics of demand >> supply and public opinion is likely a big part of the reason for the longitudinal FM pay increase in BC especially.  Politicians really are only thinking about the next election and not abstract concepts like prestige or length of training.  As an aside, procedural specialties of course have no competing midlevels which helps them with their fee negotations.

You make recourse to FM "exceptionalism" despite the fact that there is no evidence that this has occurred in other specialties including pediatrics (4+2 vs 3+2 a few years ago) or IM (GIM with 5 vs 4 years of training).  You dismiss fellowships as being hiring necessary which obviates the point that length of training does not correlate with pay. 

On the contrary, I think it's foolish to expect that there would be a pay increase due to an increase in length of training.  NPs are certainly not worried about increasing their training length in orderto demand similar pay/salary to FPs.

Exactly -it seems likely that a general rather than directed PGY 3 year would be added which could paradoxically still result in the need for "+1"s/PGY 4 year for focused practice.  

The only argument I can think of in favor of increasing FM training length to 3 years is that it equals training length of our American counterparts, more easily allowing Canadian FMs to cross the border if things become unfavorable domestically.

[medisforme]

Just to jump in on the discussion re: whether family medicine will increase with more years of training.  I personally feel that is wishful thinking that will never happen, but lack of pay isn't the issue with family medicine, it is the relatively enormous overhead costs that we have compared to what we bill (20-35% of billing goes to overhead depending on where  you live in province). Its also the specialty with by far the most unpaid time (admin, staff mtgs, hiring/firing staff, paying bills, basically running a business, stuff they don't teach you in med school/residency).

 I can only speak for BC with the following. Yes, peds and psych bill roughly the same as FM, but office based peds has no where near the overhead that community FM does and psych has essentially no overhead as almost all psych in BC are either hospital based and/or health authority based. Basically they have more take home pay compared to family docs (when you see people quoting the blue book etc... re: MSP billing numbers and how much docs are billing, that does not take overhead into consideration). Any increases in FM pay over past 20 years (aside from recent LFP model, which in my opinion is the first step in BC gov't taking over and controlling all facets of primary care but that is a discussion for another time) has not even kept up with inflation.  Given the obsession with provincial governments with controlling health care costs (Adrian Dix has made numerous comments re: his bias towards NP's vs family docs here in BC) I don't see any way FM could expect a pay increase just because of another year of residency. Additional training for family docs at present has not resulted in increased pay for that cohort as far as I am aware. (FM+1 in care of the elderly, maternity, sports med etc.).  Even if I were to concede that an extra year of training will result in more pay (which I don't), it would likely have a neutral affect on FM income as overhead costs/MOA salaries etc... will continue to rise as well, probably outpacing any pay increase.

[hero147]

Family docs are also the biggest cohort. Increasing the pay would affect half the physician workforce which is an additional barrier for frequent substantial increases in pay. 

[Synth1]

45 minutes ago, medisforme said:

Just to jump in on the discussion re: whether family medicine will increase with more years of training.  I personally feel that is wishful thinking that will never happen, but lack of pay isn't the issue with family medicine, it is the relatively enormous overhead costs that we have compared to what we bill (20-35% of billing goes to overhead depending on where  you live in province). Its also the specialty with by far the most unpaid time (admin, staff mtgs, hiring/firing staff, paying bills, basically running a business, stuff they don't teach you in med school/residency).

 I can only speak for BC with the following. Yes, peds and psych bill roughly the same as FM, but office based peds has no where near the overhead that community FM does and psych has essentially no overhead as almost all psych in BC are either hospital based and/or health authority based. Basically they have more take home pay compared to family docs (when you see people quoting the blue book etc... re: MSP billing numbers and how much docs are billing, that does not take overhead into consideration). Any increases in FM pay over past 20 years (aside from recent LFP model, which in my opinion is the first step in BC gov't taking over and controlling all facets of primary care but that is a discussion for another time) has not even kept up with inflation.  Given the obsession with provincial governments with controlling health care costs (Adrian Dix has made numerous comments re: his bias towards NP's vs family docs here in BC) I don't see any way FM could expect a pay increase just because of another year of residency. Additional training for family docs at present has not resulted in increased pay for that cohort as far as I am aware. (FM+1 in care of the elderly, maternity, sports med etc.).  Even if I were to concede that an extra year of training will result in more pay (which I don't), it would likely have a neutral affect on FM income as overhead costs/MOA salaries etc... will continue to rise as well, probably outpacing any pay increase.

 

I don't know how you open this post with a statement that the issue isn't pay. What you are describing is absolutely an issue with pay. If salary is not keeping up with inflation in the context of overhead that's an issue with pay. If admin time is disproportionate with other specialties and unpaid that's an issue with pay. 

Also, in BC with the new payment model there IS compensation for admin time AND pay has increased significantly. That is the kind of change that needs to happen across the country (though things are already pretty good comparatively in ON with FHOs). We are in agreement that a 3rd year is unlikely to affect FM pay, but I think there is some recognition that FM needs to be more attractive financially, and BC is one of the few provinces walking the walk. Also, FWIW that NP stuff was walked back significantly. I think there is some acknowledgement NPs are part of a solution but not the solution, and that they are not necessarily cheaper. 

[Andrew]

On 3/31/2023 at 12:56 PM, Synth1 said:

Family medicine is approximately 50% off-service in both years though (5-6 blocks per year in most programs), we are basically the scut workhorses of the residency system. If the third year is just another year of the same thing I am firmly against. If the third year is directed by learning goals or functions as a supervised practice year it could be beneficial. I'm not as optimistic as you that it will translate in to any improvements for the profession financially or otherwise. 

Every Residency has "scut". As a FM doctor (generalist), it's helpful to have a better understanding of EXACTLY how some of these other services work. Personally, I've done elective rotations in Infectious Diseases, Plastic surgery and so on, which were not "necessary", but having that additional layer of understanding has made me a much better doctor. Are these extra training hours absolutely necessary? No, you could probably practice fine without them or learn on the job once you graduate, but you would be a worse doctor without being aware of the knowledge you missed (not knowing, and not being aware that you don't know).

If we extend your argument, there's no reason for psychiatrists to even go to med school or do a 5-year residency. We could probably make the entirety of Psychiatry a 2-year training program without med school. Why do they even need to know anything about anatomy or surgery. Similarly, all the surgical residencies have a ton of off service in PGY-1 and some in PGY-2. When I did my training, we had an Ortho PGY2 on Internal Medicine and he would roll his eyes and it was pretty clear he was just going through the motions to pass through this "useless rotation". Why would an Ortho surgeon need any other training besides OR time. Shave 2 years off all the surgical specialties.

The answer to the above, is obviously, that additional training makes you well-rounded and overall a better doctor.

I get where people are coming from, once you go through X number of years of school, you are eager to make money. Personally, even that first year of PGY-1 making $50K felt amazing to me going from nothing to $50K. But I consider medicine to be a lifelong journey. I entered Medicine to help people, and for the respect/prestige. Nobody in my family is a doctor and I didn't go into medicine for money. It took me 3 applications to get into medical school so it took around 10 years to graduate. From the time of graduation, I can probably work a 30 or 40 year career if I have good health.

When I view 1 additional year of training through that lens, it is a microscopic amount of time over a total journey of 40-50 years, and even if I had to re-do Residency today, I wouldn't mind doing 1 extra PGY-3 year at $70K. Yes, this year will have scut, but one will be a better doctor for it, if one makes use of his/her time to actually learn things, rather than taking the attitude that non-specific rotations are throwaways.

[Andrew]

On 3/31/2023 at 3:03 PM, indefatigable said:

 

You make recourse to FM "exceptionalism" despite the fact that there is no evidence that this has occurred in other specialties including pediatrics (4+2 vs 3+2 a few years ago) or IM (GIM with 5 vs 4 years of training).  You dismiss fellowships as being hiring necessary which obviates the point that length of training does not correlate with pay. 

On the contrary, I think it's foolish to expect that there would be a pay increase due to an increase in length of training.  NPs are certainly not worried about increasing their training length in orderto demand similar pay/salary to FPs.

It's certainly easy to advocate for increased training length when your own training is done as there is really no downside for you personally and even a possible up-side (even if unlikely).

Exactly -it seems likely that a general rather than directed PGY 3 year would be added which could paradoxically still result in the need for "+1"s/PGY 4 year for focused practice.  

There is a proven association between a University degree and increased wages. The justification for spending the time/tuition to do University, foregoing earning minimum wage + interest for 4 years is that it pays off later on (studies show that a University degree generally pulls ahead at 10 years onward when compared to minimum wage). Medicine is this but to the extreme, you are foregoing Undergrad + Med School + Residency time/wages for more income later on.

This is how the public/patients view it (the ones that have a thought other than "all doctors are overpaid because their annual income is in the top 5%"). If government wants to increase wages/fee schedule for any doctor, they need sell the public/patients on the idea so as to not lose the next election. The best selling point that caused the BC LFP increase was patients not being able to find "FM" and going to the Victoria Legislature to protest en-mass. Extra training time is a good selling point that the government can use to sell the public on future increased wages/fee schedule for FM.

The examples you provided me of Fellowships or GIM 3/4/5 years are different because those are not the length of the core residencies. They are add-ons used to secure jobs in major cities/large hospitals, whereas without them you can graduate fine but will work rurally. The best comparable example would be you telling me that an FM 2+1 add-on doesn't pay anything extra.

With FM we are talking about extending the CORE RESIDENCY.

As for advocating for increased training length, I don't know enough about the reason WHY they are doing it, but it seems to be reasonably well thought out https://www.cfpc.ca/CFPC/media/Resources/Education/AFM-OTP-Report.pdf

It has nothing to do with "I've graduated already so you should do an extra 1 year". The CFPC should be doing whatever they feel is best for FM training, and I'm all for it.

[indefatigable]

1 hour ago, Andrew said:

There is a proven association between a University degree and increased wages. The justification for spending the time/tuition to do University, foregoing earning minimum wage + interest for 4 years is that it pays off later on (studies show that a University degree generally pulls ahead at 10 years onward when compared to minimum wage). Medicine is this but to the extreme, you are foregoing Undergrad + Med School + Residency time/wages for more income later on.

This is how the public/patients view it (the ones that have a thought other than "all doctors are overpaid because their annual income is in the top 5%"). If government wants to increase wages/fee schedule for any doctor, they need sell the public/patients on the idea so as to not lose the next election. The best selling point that caused the BC LFP increase was patients not being able to find "FM" and going to the Victoria Legislature to protest en-mass. Extra training time is a good selling point that the government can use to sell the public on future increased wages/fee schedule for FM.

The examples you provided me of Fellowships or GIM 3/4/5 years are different because those are not the length of the core residencies. They are add-ons used to secure jobs in major cities/large hospitals, whereas without them you can graduate fine but will work rurally. The best comparable example would be you telling me that an FM 2+1 add-on doesn't pay anything extra.

With FM we are talking about extending the CORE RESIDENCY.

Higher education is a great example.  

Let's take it a step further - what about a PhD?  After all, this is obviously MORE training and another degree after Bachelor's at a University - so shouldn't it earn MORE money?  Surprisingly - no!  The marginal benefit of doing a PhD in terms of financial benefit is almost negligible over most disciplines - sure there are some exceptions (analogous to interventional cardiology, etc.), but the authoritative quote from an economist article:

"A PhD may offer no financial benefit over a master’s degree. It can even reduce earnings"

https://medium.economist.com/why-doing-a-phd-is-often-a-waste-of-time-349206f9addb

In economics there's something called the "law of diminishing returns" - at a certain point the investment in time/training has only limited returns in terms of additional competency/pay.  Indeed, most posters, with the exception of yourself, seem to think that from at least a financial perspective there will be no significant financial benefit from a PGY 3 year.

As was pointed out above, in FM, there are already +1 s which DO NOT increase pay.  

But, hey, there was an increase in CORE RESIDENCY in FM already!   That happened in the early 1990s with the abolition of the rotating internship.  Is there any evidence of any pay change?  None that I know of!  Please feel free to provide such evidence if you think there is any.  

The one thing that will likely happen is a decrease in supply of FPs (like what happened after the end of the rotating internship) which COULD indirectly increase pay - as possibly demand >>> supply.  This is basic microeconomics and has nothing to do with length of training.    Here's a quote from a study.

"Extending residency length has the potential to cause declines in physi- cian supply over the short to medium run. There are both direct effects on physician supply through delays in cohorts as well as indirect effects through substitution away from family medicine residencies."

https://stephensonstrobel.com/files/HEPaper.pdf

 

[Andrew]

10 minutes ago, indefatigable said:

Higher education is a great example.  

Let's take it a step further - what about a PhD?  After all, this is obviously MORE training and another training after Bachelor's at a University - so shouldn't it earn MORE money?  Surprisingly - no!  The marginal benefit of doing a PhD in terms of financial benefit is almost negligible over most disciplines - sure there are some exceptions (analogous to interventional cardiology, etc.), but the authoritative quote from an economist article:

"A PhD may offer no financial benefit over a master’s degree. It can even reduce earnings"

https://medium.economist.com/why-doing-a-phd-is-often-a-waste-of-time-349206f9addb

In economics there's something called the "law of diminishing returns" - at a certain point the investment in time/training has only limited returns in terms of additional competency/pay.  Indeed, most posters, with the exception of yourself, seem to think that from at least a financial perspective there will be no significant financial benefit from a PGY 3 year.

As was pointed out above, in FM, there are already +1 s which DO NOT increase pay.  

But, hey, there was an increase in CORE RESIDENCY in FM already!   That happened in the early 1990s with the abolition of the rotating internship.  Is there any evidence of any pay change?  Not as far as I can tell!

The one thing that will likely happen is a decrease in supply of FPs which COULD indirectly increase pay - as possibly demand >>> supply.  This is basic microeconomics and has nothing to do with length of training.    Here's a quote from a study.

"Extending residency length has the potential to cause declines in physi- cian supply over the short to medium run. There are both direct effects on physician supply through delays in cohorts as well as indirect effects through substitution away from family medicine residencies."

https://stephensonstrobel.com/files/HEPaper.pdf

 

Medicine is funded by government so the fee schedule decisions are multifactorial with too many confounding factors to analyze this way. Because really if government had it's way there would be no increases ever save for inflation.

What I would ask you, is are there any studies of private-pay doctors, perhaps in other countries, and does the pay of these private-pay doctors have any association with years of training (do we even have statistics on this?)

Even if you don't think the PGY-3 year will result it increased pay. Do you think it results in increased respect/prestige in the eyes of the public/patients/other doctors?

[HeroX37]

5 hours ago, Andrew said:

Medicine is funded by government so the fee schedule decisions are multifactorial with too many confounding factors to analyze this way. Because really if government had it's way there would be no increases ever save for inflation.

What I would ask you, is are there any studies of private-pay doctors, perhaps in other countries, and does the pay of these private-pay doctors have any association with years of training (do we even have statistics on this?)

Even if you don't think the PGY-3 year will result it increased pay. Do you think it results in increased respect/prestige in the eyes of the public/patients/other doctors?

I do not think the public will care at all whether or not family medicine is a 2 or 3 year specialty. Even when you speak to other healthcare workers, most of them don't know the intricate details of length of training for residency; they just know it's quite a lot. 

The idea that we'll get more paying from FM going to 3 years is laughably bad. 

[anonymouspls]

Family is quite lucrative if you know what you're doing. One of my mentors is a hospitalist who billed (redacted - lets just say a lot) last year and I think few specialties will beat the income potential / hour of a family physician that is keen and optimizes their time. This is part of the reason I was definitely thinking about family and would not have minded ending up on the other side of CARMS as a family physician.

Moving the residency to 3 years I absolutely don't agree with and I would have never considered family if it was 3 years. At that point you are 1 year away from having access to the better billing codes of a 4 year internist, and 2 years away from being any type of specialist you want. Family being 2 years is a MAJOR pulling factor currently, don't see why you would take this away when you're already starting to see a downward trend for the specialty.

[SaraD0c]

Hi everyone hope you are doing well! I'm gonna (hopefully) graduate from medical school next year at Udem (university of Montreal) and I want to do my FM residency at UBC. So I wanted to know which of the 20 sites availables on the CARMS website for UBC are often unfilled ? Because I have many friends who tried to be matched at UBC FM but none of them got accepted (but they were only choosing Vancouver and Victoria sites). They all told me that UBC always privileged their own students and that it was almost impossible to do FM residency there ? I' canadian by the way so CMG group !

[frenchpress]

4 hours ago, SaraD0c said:

Hi everyone hope you are doing well! I'm gonna (hopefully) graduate from medical school next year at Udem (university of Montreal) and I want to do my FM residency at UBC. So I wanted to know which of the 20 sites availables on the CARMS website for UBC are often unfilled ? Because I have many friends who tried to be matched at UBC FM but none of them got accepted (but they were only choosing Vancouver and Victoria sites). They all told me that UBC always privileged their own students and that it was almost impossible to do FM residency there ? I' canadian by the way so CMG group !

None. UBC family is extremely competitive, and a total crapshoot, even for UBC grads - they don’t actually privilege their own students that much, and most sites end up with quite a mix of people from across the country. But they get 600+ applications every year. The year I did carms I heard they got over 700.

For the last several years UBC has either completely filled or had only 1-2 spots in very rural areas. Last year there was one spot in Fort at John, this year there were spots in Rural Prince George. 

[SaraD0c]

OK so basically I have to put all the 20 sites on my list of choices and I could have a chance to be matched even if its in rural places ? So its really hard but specifically for the town places which I understand. I think I will only pass one interview even though I have many choices for the same university. Thank you !

Ps: if there's someone who lives or lived in these rural places, feel free to share your experience (the weather, the accessibility, the people, cost of life including rent..)

Thank in advance

[hero147]

On 4/3/2023 at 1:54 PM, Andrew said:

Every Residency has "scut". As a FM doctor (generalist), it's helpful to have a better understanding of EXACTLY how some of these other services work. Personally, I've done elective rotations in Infectious Diseases, Plastic surgery and so on, which were not "necessary", but having that additional layer of understanding has made me a much better doctor. Are these extra training hours absolutely necessary? No, you could probably practice fine without them or learn on the job once you graduate, but you would be a worse doctor without being aware of the knowledge you missed (not knowing, and not being aware that you don't know).

If we extend your argument, there's no reason for psychiatrists to even go to med school or do a 5-year residency. We could probably make the entirety of Psychiatry a 2-year training program without med school. Why do they even need to know anything about anatomy or surgery. Similarly, all the surgical residencies have a ton of off service in PGY-1 and some in PGY-2. When I did my training, we had an Ortho PGY2 on Internal Medicine and he would roll his eyes and it was pretty clear he was just going through the motions to pass through this "useless rotation". Why would an Ortho surgeon need any other training besides OR time. Shave 2 years off all the surgical specialties.

The answer to the above, is obviously, that additional training makes you well-rounded and overall a better doctor.

I get where people are coming from, once you go through X number of years of school, you are eager to make money. Personally, even that first year of PGY-1 making $50K felt amazing to me going from nothing to $50K. But I consider medicine to be a lifelong journey. I entered Medicine to help people, and for the respect/prestige. Nobody in my family is a doctor and I didn't go into medicine for money. It took me 3 applications to get into medical school so it took around 10 years to graduate. From the time of graduation, I can probably work a 30 or 40 year career if I have good health.

When I view 1 additional year of training through that lens, it is a microscopic amount of time over a total journey of 40-50 years, and even if I had to re-do Residency today, I wouldn't mind doing 1 extra PGY-3 year at $70K. Yes, this year will have scut, but one will be a better doctor for it, if one makes use of his/her time to actually learn things, rather than taking the attitude that non-specific rotations are throwaways.

Additional training does not always equate to being a better doctor. If anything, if it's not relevant to your field of interest, it probably makes you a worse doctor. There is opportunity cost to these things. If you spent the next year in a pathology lab, you'd come out of the lab a worse family physician than you are today. Skills and knowledge do atrophy when you're not using them. 

[frenchpress]

1 hour ago, SaraD0c said:

OK so basically I have to put all the 20 sites on my list of choices and I could have a chance to be matched even if its in rural places ? So its really hard but specifically for the town places which I understand. I think I will only pass one interview even though I have many choices for the same university. Thank you !

Ps: if there's someone who lives or lived in these rural places, feel free to share your experience (the weather, the accessibility, the people, cost of life including rent..)

Thank in advance

Yes, everyone has a chance. Although your likelihood of matching rurally is going to be quite low if you can’t show a good connection or reason to want to do rural training on your application. Why exactly you want to go to UBC? Do you actually want to do rural medicine there?

When you do CaRMS you will have opportunities to meet with the residents at these various sites. Probably you will get more valuable and targeted information by asking them at that time, than letting your question be buried in a post on a different topic.  Or post in the UBC forum specifically.

[struggling2getin]

8 hours ago, SaraD0c said:

They all told me that UBC always privileged their own students

During the town hall this year, if I remember correctly, the program director mentioned that ~1/3 of selected residents (from CaRMS 2022) did their MD at UBC.

[medisforme]

On 4/3/2023 at 5:56 PM, HeroX37 said:

I do not think the public will care at all whether or not family medicine is a 2 or 3 year specialty. Even when you speak to other healthcare workers, most of them don't know the intricate details of length of training for residency; they just know it's quite a lot. 

The idea that we'll get more paying from FM going to 3 years is laughably bad. 

I agree, FM training in US is 3 years and there is essentially no prestige whatsoever associated with being a family physician there.  From talking with residents and viewing discussions on studentdoctornetwork it appears that with obvious exceptions, FM is either a choice for those with less than stellar grades/CV's or relegated to back up choice for almost everyone.

Also, to address several posts that commented on CFPC having the best interests of rank and file family physician as their priority  (in regards to proposed change to 3 year residency), I couldn't disagree more.   A lot of the board lives high up in ivory towers and do not have their ears to the ground in terms of current issues affecting FP's.  For example, there have been at least 3 extremely controversial (basically tone deaf ignorant) editorials in Canadian Family Physician (basically the journal CFPC puts out) over past 1.5 years that have drawn a lot of outrage from family docs in the trenches.  The one that comes most to mind was from June of 2021 basically criticizing family docs for being overly focused on finances and not on patient care (I believe the title of the article was Family Medicine is not a business); completely tone deaf to the crisis in family medicine with more and more docs walking away from office based primary care due to high overhead costs.