Nuclear medecine

[Mathimatiquement]

Hello

I was wondering how competitive nuclear medecine is in Quebec

[SpeakWhite]

Hi, Christian Dubé here. It's a bit early to be thinking about CaRMS when you're in the process of applying to Med-P. You can't predict that far in advance. Statistically, you're most likely to end up in family medicine in Kuujjuaq (maybe even more likely with my new reform that just dropped!)

[Mathimatiquement]

4 hours ago, SpeakWhite said:

Hi, Christian Dubé here. It's a bit early to be thinking about CaRMS when you're in the process of applying to Med-P. You can't predict that far in advance. Statistically, you're most likely to end up in family medicine in Kuujjuaq (maybe even more likely with my new reform that just dropped!)

Thank you for the clear answer

[Mathimatiquement]

On 3/30/2023 at 5:07 PM, SpeakWhite said:

Hi, Christian Dubé here. It's a bit early to be thinking about CaRMS when you're in the process of applying to Med-P. You can't predict that far in advance. Statistically, you're most likely to end up in family medicine in Kuujjuaq (maybe even more likely with my new reform that just dropped!)

Maintenant que je suis accepté, est-ce que je pourais avoir de l'information?

Now that I am admitted, can I get info?

[anonymouspls]

Nuc med is quite competitive in French Canada. Its easier in English speaking Canada but there arent that many spots (1 at Western and 1 at Mcgill, the rest are combined programs with rads.)

I know someone who matched nucs this year in English Canada and he was an average to slightly above average applicant, so if you want it and apply broadly it shouldn't be an issue.

[Mathimatiquement]

2 hours ago, anonymouspls said:

Nuc med is quite competitive in French Canada. Its easier in English speaking Canada but there arent that many spots (1 at Western and 1 at Mcgill, the rest are combined programs with rads.)

I know someone who matched nucs this year in English Canada and he was an average to slightly above average applicant, so if you want it and apply broadly it shouldn't be an issue.

If I apply myself in my studies, is it realistic to set this as a goal?

[Mathimatiquement]

2 hours ago, anonymouspls said:

Nuc med is quite competitive in French Canada. Its easier in English speaking Canada but there arent that many spots (1 at Western and 1 at Mcgill, the rest are combined programs with rads.)

I know someone who matched nucs this year in English Canada and he was an average to slightly above average applicant, so if you want it and apply broadly it shouldn't be an issue.

Is nuclear medecine a speciality a lot of med students want to do? I find it very interesting.

[anonymouspls]

26 minutes ago, Mathimatiquement said:

Is nuclear medecine a speciality a lot of med students want to do? I find it very interesting.

I told you the competitiveness so the rest is up to you. Its not very competitive in English speaking schools but there are very few spots. I would recommend you do something to stand out / show interest like getting a nuc-related pub.

Getting into any specialty from here on out is not nearly as hard as getting into medical school. Youre looking at 13% chance for the latter vs 45-50% for the most competitive specialties. Congrats on getting in!

[Mathimatiquement]

23 minutes ago, anonymouspls said:

I told you the competitiveness so the rest is up to you. Its not very competitive in English speaking schools but there are very few spots. I would recommend you do something to stand out / show interest like getting a nuc-related pub.

Getting into any specialty from here on out is not nearly as hard as getting into medical school. Youre looking at 13% chance for the latter vs 45-50% for the most competitive specialties. Congrats on getting in!

thanks for the info. I am really ready to put in the work required to stand out.

By any chance, do you have the carms acceptance rates for nuclear medecine, rad-onc and radiology accross the 4 qc universities?

[Sceptical]

For PGY-1 entry via CARMS, NM is generally on the less competitive side compared to many other specialties according to CARMS data when looking at the big picture. However, year-by-year "competitiveness" is extremely variable for both PGY1-5 and PGY6-7 NM programs due to the very small number of spots and applicants. Essentially, it boils down to a near-stochastic process where even the addition of one or two candidates can turn an application process from noncompetitive/shoo-in to one where the selection committee may have to choose 1 candidate out of 3 applicants (hypothetical numbers). Also due to the scarcity of NM trainees, you will have a hard time finding many of these voices on pm101. 

[Mathimatiquement]

3 minutes ago, Sceptical said:

For PGY-1 entry via CARMS, NM is generally on the less competitive side compared to many other specialties according to CARMS data when looking at the big picture. However, year-by-year "competitiveness" is extremely variable for both PGY1-5 and PGY6-7 NM programs due to the very small number of spots and applicants. Essentially, it boils down to a near-stochastic process where even the addition of one or two candidates can turn an application process from noncompetitive/shoo-in to one where the selection committee may have to choose 1 candidate out of 3 applicants (hypothetical numbers). Also due to the scarcity of NM trainees, you will have a hard time finding many of these voices on pm101. 

do you prefer NM or radiology? How do they compare in term of work load/type of task?

Are rad-onc and rad competitive in QC?

[Sceptical]

3 minutes ago, Mathimatiquement said:

do you prefer NM or radiology? How do they compare in term of work load/type of task?

Radiology has a much higher call burden (evenings/overnights/weekends) and generally higher acuity patients in the hospital setting. Otherwise, to me they're both very similar. Fundamentally, you just sit in front of a workstation and produce reports. You can work in both disciplines anywhere in Canada (except Quebec) as long as you have the correct training/certifications. 

[Mathimatiquement]

1 minute ago, Sceptical said:

Radiology has a much higher call burden (evenings/overnights/weekends) and generally higher acuity patients in the hospital setting. Otherwise, to me they're both very similar. Fundamentally, you just sit in front of a workstation and produce reports. You can work in both disciplines anywhere in Canada (except Quebec) as long as you have the correct training/certifications. 

I see you are doing your NM residency, do you prefer the diagnostics aspect or the therapy aspect (ie. radiolgand) of NM?

[Sceptical]

You can also refer to @rmorelan's take from this old thread, which I agree with: 

 

[Sceptical]

1 minute ago, Mathimatiquement said:

I see you are doing your NM residency, do you prefer the diagnostics aspect or the therapy aspect (ie. radiolgand) of NM?

To date, there is not enough volume on the therapy side to occupy your entire day. In centers where you're responsible for therapy, most of your day is still spent on the "diagnostics" side. 

[Mathimatiquement]

1 minute ago, Sceptical said:

To date, there is not enough volume on the therapy side to occupy your entire day. In centers where you're responsible for therapy, most of your day is still spent on the "diagnostics" side. 

Thanks for the info.

 

I know that there is currently a lot of reaserch in radioligand for imaging and therapy (like PSMA), which is what interests me the most about the field. Do you think the NM field is growing or shrinking (especially in QC if you have that info)?

[Sceptical]

16 minutes ago, Mathimatiquement said:

Thanks for the info.

 

I know that there is currently a lot of reaserch in radioligand for imaging and therapy (like PSMA), which is what interests me the most about the field. Do you think the NM field is growing or shrinking (especially in QC if you have that info)?

Growing, yes, but slowly, with factors generally outside of your control (e.g. regulatory issues, political will). It's still difficult to know if this will translate into a lot more new NM staff positions. Overall, the NM field by the end of my career will look different than today's. 

 

To answer your prior question, for CARMS applications, radiology generally is more competitive than NM or RO because of many factors: remuneration, greater visibility of radiology in med school training, students interested in surgical disciplines backing up with rads, perceived prestige/lifestyle associated with a ROAD specialty (although this is antiquated by now), etc, etc. 

[Mathimatiquement]

8 hours ago, Sceptical said:

Growing, yes, but slowly, with factors generally outside of your control (e.g. regulatory issues, political will). It's still difficult to know if this will translate into a lot more new NM staff positions. Overall, the NM field by the end of my career will look different than today's. 

 

To answer your prior question, for CARMS applications, radiology generally is more competitive than NM or RO because of many factors: remuneration, greater visibility of radiology in med school training, students interested in surgical disciplines backing up with rads, perceived prestige/lifestyle associated with a ROAD specialty (although this is antiquated by now), etc, etc. 

Are rad-onc and radiology also growing fields? I know there is always the fear of AI taking over the diagnosis part of radiology. Also, what is the residency process for these 3 specialties?

[anonymouspls]

47 minutes ago, Mathimatiquement said:

Are rad-onc and radiology also growing fields? I know there is always the fear of AI taking over the diagnosis part of radiology. Also, what is the residency process for these 3 specialties?

AI and midlevels will merc primary care specialties and specially things like Emergency Medicine and Anesthesia long before diagnostic specialties like Rads will be taken over. The cliche CARMS line is AI will impact these specialties, which is true probably within our careers. I personally think the future of all medicine (25-50 years out) is AI. Very algorithmic job we have here. 

Rad-onc is currently a growing field with good job market because of new indications for radiation (oligometastatic disease). As you have more advancement in immunotherapy and targetted therapies you will have patients living longer, so they will need even more radiation. Lot of residents these days are getting jobs out of residency without a fellowship for example. 

Rads is also an in-demand field these days. More geographic flexibility than rad-onc in that you can pretty much work where you want. Though almost everyone does a fellowship in rads. 

Nuc-med is a very small field so hard to comment. Job market has a history of being tight but supposedely it's improving with new therapeutic advancements. If you do Rads + Nuc med combined residency job market is excellent. 

Residency: 

Rad onc residency depends on your institution (i.e. not Toronto haha) but is overall one of the chilliest residency experiences in the 5 year specialties along with Nuc med.

Rads residency is hard, but not as hard as rads staff life

Nuc med residency see above 

[ChemPetE]

To clarify a bit - would not clarify rad onc residency as entirely ‘chill’. Still busy with research, treatment planning etc. Call is variable on institution.

Our graduating residents each this year had multiple job offers in residency. BC had a 100k raise as a retention effort to their oncologists, as well as productivity bonuses. We even ourselves are having trouble getting enough qualified rad oncs for our own local positions. Market has done a 180.

From the news yesterday, BC is now also sending some patients to the US for treatment due to capacity issues.

 

[anonymouspls]

5 hours ago, ChemPetE said:

To clarify a bit - would not clarify rad onc residency as entirely ‘chill’. Still busy with research, treatment planning etc. Call is variable on institution.

Our graduating residents each this year had multiple job offers in residency. BC had a 100k raise as a retention effort to their oncologists, as well as productivity bonuses. We even ourselves are having trouble getting enough qualified rad oncs for our own local positions. Market has done a 180.

From the news yesterday, BC is now also sending some patients to the US for treatment due to capacity issues.

 

Ha, what I would call “chill” when comparing residencies with each other is not the same as what the rest of the world thinks of it. Youre still looking at 55-60 hour weeks in rad onc residency, which is better than most specialties still.

[Mathimatiquement]

25 minutes ago, anonymouspls said:

Ha, what I would call “chill” when comparing residencies with each other is not the same as what the rest of the world thinks of it. Youre still looking at 55-60 hour weeks in rad onc residency, which is better than most specialties still.

What i meant to ask was more about the length and different types of things you see and learn during the different residencies. I expect residency to be a lot of work, but i know i'll be ready no matter what.