Which specialty can make the most money with a decent lifestyle in Ontario over the next 30 years?

[Pakoon]

7 minutes ago, indefatigable said:

Yes - under the new CPSO rules you could do a Derm ACGME residency in Puerto Rico and as long you pass the US boards would be able to work in Ontario.  In other words, the Royal College no longer has effective control on medical licensing (at least in Ontario).

Does this apply to training that isn't equivalent in training years (5 years in Canada versus 4 years in the USA )?

[indefatigable]

30 minutes ago, Pakoon said:

Does this apply to training that isn't equivalent in training years (5 years in Canada versus 4 years in the USA )?

With the caveat that I’m not a lawyer, The CPSO statement makes no mention of length of training - so yes, from what I understand going to the US for residency could save a year and avoid writing the Royal college exams (the only separation is between CFPC and specialty).  Could a Canadian trainee pass the US boards and apply for independence without the Royal college?  The legal possibilities are endless lol.  
 

https://www.cpso.on.ca/News/News-Articles/CPSO-Removes-Barriers-for-Internationally-Educated

[robclem21]

Sorry to hijack this thread, but why not just try to get into a specialty you enjoy? As opposed to one that pays the most or has the best lifestyle. Sure those can be factors, but the 3 specialties you listed really don't have that much in common at all. Do you even know what you want to spend the rest of your life doing. No amount of money is worth doing something you hate.

[Sceptical]

9 hours ago, robclem21 said:

Sorry to hijack this thread, but why not just try to get into a specialty you enjoy? As opposed to one that pays the most or has the best lifestyle. Sure those can be factors, but the 3 specialties you listed really don't have that much in common at all. Do you even know what you want to spend the rest of your life doing. No amount of money is worth doing something you hate.

I think it would be unfair to assume that all Med-3's should have an idea of what specialties they should be enjoying and doing for the rest of their lives. Some have decided to gun for certain specialties since day one (incidentally, often for the high paying / lifestyle ones), whereas others are more swayed by the clerkship rotations they experience. I still find it somewhat difficult to understand what it means to get into a specialty one "enjoys". The "enjoyment" is prolly a combination of job/intellectual satisfaction, "prestige", earnings, lifestyle, geography, etc. 

Some see medicine as an end in itself, and even the process of applying to med school, CARMS, etc. feeds into this. Others (perhaps like myself) see medicine as a means to achieve other things in life. A "lifestyle" specialty could mean having more time to spend with family, especially when the kids are still young, and in one's hobbies/projects. A high-income specialty could mean less of a struggle when starting out as a junior staff and the possibility of early retirement.

 

Edit: spelling corrections 

[jhenerose88]

22 hours ago, indefatigable said:

Yes - under the new CPSO rules you could do a Derm ACGME residency in Puerto Rico and as long you pass the US boards would be able to work in Ontario.  In other words, the Royal College no longer has effective control on medical licensing (at least in Ontario).

A hypothetical 3 year CMG could do GIM in the US and start working back in Ontario after 6 years of total training as IM staff; while future 4 year CMGs in FP will need 7 years of total training. 

Thanks, these new rules were recently effective a couple weeks ago right? Also, while I understand the 3 year CMG -> 3 year GIM residency in US -> Ontario after 6 years.

 

How come you mentioned 4 year CMG -> 3 year FP residency in US -> Ontario after 7 years?

 

Couldn't a 3 year CMG -> 3 year FP residency in US -> Ontario after 6 years?

 

Sorry, just a bit confused.

 

Also, is there a reason you mentioned Puerto Rico Derm residency? Is it easy to get a Derm residency spot in Puerto Rico? 

 

Thanks!

[indefatigable]

30 minutes ago, jhenerose88 said:

Thanks, these new rules were recently effective a couple weeks ago right?

Yes, exactly

Also, while I understand the 3 year CMG -> 3 year GIM residency in US -> Ontario after 6 years. How come you mentioned 4 year CMG -> 3 year FP residency in US -> Ontario after 7 years?

It's a bit tangential, but in Canada IM has traditionally had much longer training than FM.  But, now in Canada, FM is also moving towards 3 year training  like the US system.  So the comparison is simply pointing out that with both these changes, in the future, one may be able to work as staff in IM faster than FM - which is a big paradigm shift.  Unlike the US, one of the big draws of FM in Canada has traditionally been the short training length which actually used to be only be 1 year 30 years ago.   

Couldn't a 3 year CMG -> 3 year FP residency in US -> Ontario after 6 years?

For sure - although, like mentioned above, at least in Canada the implicit tradeoff has been a shorter length of training with less renumeration in FM vs longer length of training and higher renumeration in IM.  However, under the changes, the length of training in both IM and FM could be equal,  but IM would continue to have much better renumeration.  

Sorry, just a bit confused.

Also, is there a reason you mentioned Puerto Rico Derm residency? Is it easy to get a Derm residency spot in Puerto Rico? 

People sometimes mainly consider the most well-known brand schools in the US and not consider lesser known programs.  I would assume that Puerto Rico is less competitive than places like Harvard, but I don't know much about it.

 The broader point that I was trying to make was simply that going to any US program would allow accreditation in Canada. Since the US is so big and varied, there are some schools in the US which may be less competitive than top US or Canadian schools that you may have a good chance at as a USMG.  

 

[jhenerose88]

42 minutes ago, indefatigable said:

 

this is incredibly helpful. thank you so much! 

 

I was not aware that FM in Canada is moving to 3 year. That's a big bummer as someone who was considering FM residency in Canada. Do you know when this effect could take place? I graduate in a couple years, so are my dreams of a 2 year FM residency down the drain now?

[robclem21]

18 hours ago, Sceptical said:

I think it would be unfair to assume that all Med-3's should have an idea of what specialties they should be enjoying and doing for the rest of their lives. Some have decided to gun for certain specialties since day one (incidentally, often for the high paying / lifestyle ones), whereas others are more swayed by the clerkship rotations they experience. I still find it somewhat difficult to understand what it means to get into a specialty one "enjoys". The "enjoyment" is prolly a combination of job/intellectual satisfaction, "prestige", earnings, lifestyle, geography, etc. 

Some see medicine as an end in itself, and even the process of applying to med school, CARMS, etc. feeds into this. Others (perhaps like myself) see medicine as a means to achieve other things in life. A "lifestyle" specialty could mean having more time to spend with family, especially when the kids are still young, and in one's hobbies/projects. A high-income specialty could mean less of a struggle when starting out as a junior staff and the possibility of early retirement.

 

Edit: spelling corrections 

I completely agree with you, and I'm not saying that i assume all third year med students should have already figured out what they want. I certainly didn't decide what I wanted to do until late in medical school, and definitely a major component of why we rotate through all specialties in clerkship is to help gain a better understanding of each one. However, even if most med students/residents see medicine more as a "job" now (myself included) and less of a "life's work", the truth is that no matter what specialty you go into, you will be well compensated in the top 1% of earners, and even a job with little-to-no call requirements, you will still spend 50+ hours a week on the low end working. I think specialties with a good "lifestyle" (whatever that means to you) is something definitely worth considering, but given the strong earning potential in any specialty, you should certainly strive to find something you ENJOY doing given that over 50% on avg. of your waking hours every week will be spent doing it.

[indefatigable]

On 4/15/2023 at 3:15 PM, jhenerose88 said:

this is incredibly helpful. thank you so much! 

I was not aware that FM in Canada is moving to 3 year. That's a big bummer as someone who was considering FM residency in Canada. Do you know when this effect could take place? I graduate in a couple years, so are my dreams of a 2 year FM residency down the drain now?

You should be good - the earliest proposed lengthening of FM residency is 2027.