Guest xylem33 Posted April 26, 2006 Report Share Posted April 26, 2006 I was just wondering what were the most competitive residencies/specialities and the reasons, ex - because of salary? prestige? Link to comment Share on other sites More sharing options...
Guest ploughboy Posted April 26, 2006 Report Share Posted April 26, 2006 -----BEGIN PGP SIGNED MESSAGE----- Hash: SHA1 Although not talking about competitive specialties per se, I believe the words of the Fat Man apply to the discussion of competitive/noncompetitive residencies. Thus saith the Fat Man: "'The whole pattern of medical education is backwards: by the time we realize we're not going to be TV docs undressing ripe-titted beauties, but rather House docs disimpacting gomers, we've invested too much time to quit, and we wind up like you poor slobs: stuck. The sequence of training should be reversed...but that doesn't help you now, 'cause now you're invested, and now you're trapped. So? So there are many different specialties you could choose. Most of them involve the same close contact you've had with patients all this year -- touching, being tortured, killing yourself with night call. These are the 'PC - Patient Care' specialties. PC specialties will not be considered here. The macochists may leave.' No one left. '...The NPC - No Patient Care - specialties number six and only six: Rays, Gas, Path, Derm, Ophthalmology, and Psychiatry.' The Fat Man listed these six on the blackboard and told us he would list, with our suggestions, the advantages and disadvantages of each. 'Game theory,' he called it. This chart would 'optimize' our specialty choice. 'First,' said Fats, 'is Rays. Advantages of Radiology?' 'Money,' said Chuck. 'Big money.' 'Exactly,' said Fats, 'a veritable fortoona. Other advantages?' Aside from the assumed 'No Patient Care,' no one could think of any other advantages, and Fats asked for disadvantages. 'Gomers,' I said, 'you do bowel runs on gomers.' 'Narcolepsy,' said Hooper, 'you're always in the dark.' 'Gonads,' said the Runt. 'X rays can fry your sperm. Your first kid comes out with one eye, two teeth, and eight fingers to a hand.' 'Terrific!' said Fats, writing them down. 'Men, we're on our way!' We proceeded to construct a table of the NPC Specialties: Rays * Advantages: Money * Disadvantages: Gomers. Dark offices, narcolepsy. Damaged gonads; 8-fingered progeny. Barium enemas and bowel runs. Gas * Advantages: Money * Disadvantages: Gomers. Boredom punctuated by panic. Astronomical malpractice premiums. Noxious gases, producing bizarre personalities. Contempt, daily, of surgeons. Path * Advantages: No live bodies. Low malpractice premiums. * Disadvantages: Gomers (rare). Dead bodies. Smell of dead bodies and formalin-type picklers. Basement office. Contempt, daily, of all but other pathologists. Depression. Derm * Advantages: Money. Travel to sunny conventions. Naked skin - attraction. * Disadvantages: Gomers. Contagion. Naked skin - repulsion. Ophthalmology * Advantages: Astronomical money. Opportunity, daily, to torment GAS. * Disadvantages: Gomers. Astronomical malpractice premiums. Surgical internship required. Occasional patient care. Psychiatry * Advantages: NO GOMERS! Never touch bodies except in sex-surrogate therapies. Voyeurism, perversion, eroticism, autoeroticism, polyeroticism. Easy on feet. Long lunch hours. Cure - alleged. Many others. * Disadvantages: Hourly wage. Hard on lumbar spine. Multiple accusations from right wingers, cf. 'communist', 'queer', 'pervert'. Contempt, daily, of other doctors except when they are in therapy." -----BEGIN PGP SIGNATURE----- Version: GnuPG v1.4.0 (FreeBSD) iD8DBQFET5x8/HNgbK3bC2wRAjAFAJ9ngV4+bCEAstNM6u8PIaL/GAeSaACfRkPR EjO5a4fD4pV89aSHznJbEBo= =UW6j -----END PGP SIGNATURE----- Link to comment Share on other sites More sharing options...
Guest ploughboy Posted April 26, 2006 Report Share Posted April 26, 2006 -----BEGIN PGP SIGNED MESSAGE----- Hash: SHA1 Ok, a serious answer. From what I've seen, ophtho, derm, plastics, 5-year emerg, paeds, rads, are pretty competitive. GIM, general surgery, ortho, uro are somewhat less so, but are still tough to get into. Family, psyche, community med, path, are the least competitive. There's a zillion reasons for this, depending on the specialty. Money, prestige, lifestyle, supply/demand (ie very few residency spots for a given specialty), "yuck factor", scope of practice, mobility are a few of the reasons. What specialties are you considering right now? And of course, within specialties certain subspecialties can be more competitive than other. For example, cardiology and geriatrics are both subspecialties of internal medicine, but cardiology is much more competitive. pb -----BEGIN PGP SIGNATURE----- Version: GnuPG v1.4.0 (FreeBSD) iD8DBQFET5vI/HNgbK3bC2wRAmtOAJ9l+6BjGHjffdrfcam5JAML02DnBwCfTpRT mDC+BQ5TA+L3N8ooljLLveE= =9WYd -----END PGP SIGNATURE----- Link to comment Share on other sites More sharing options...
Guest TimmyMax Posted April 26, 2006 Report Share Posted April 26, 2006 Hey, Geez, pb, why don't you just give away all the secrets of residency?!? Best of luck! Timmy Link to comment Share on other sites More sharing options...
Guest marbledust Posted April 26, 2006 Report Share Posted April 26, 2006 Just a small addition: Ploughboy zeroed in on the specialties that are traditionally the most competitive (derm, ophtho, etc). But it should be pointed out that another side of the competitiveness of the match is the city itself. So, while some specialties might not make it onto the A list, specific programs within them might. Psychiatry, for example, usually has a few spots left over every year and is far from uber-competitive as a whole. But psych programs that are located in what are seen as the more desirable cities to live in (Vancouver, Calgary, Montreal, Toronto) can be very competitive because people really want the spots--or more correctly, they really want the city. Not to slag the cities that are seen as less desireable--they often have programs that might even be better than the big city ones. But people are reluctant to move to these places, and the numbers applying to the programs show that. From what I hear from classmates who matched into it, this holds true for family medicine too Link to comment Share on other sites More sharing options...
Guest xylem33 Posted April 26, 2006 Report Share Posted April 26, 2006 To be honest, I was thinking of path because I've read on these boards that the lifestyle is pretty good, much like Rads. I'm not too sure about how much $$ paths make but I'm assuming they make more than FP's, who, imo, make enough to be well...so I don't see why path would be a bad idea...I certainly do not want the negative effects of being exposed to radiation for a long period of time as a Rad...unless the risks are minute? Link to comment Share on other sites More sharing options...
Guest patentforamenovale Posted April 26, 2006 Report Share Posted April 26, 2006 Yeah, I have a similar question about Peds...and since it's more of a primary care specialty, I must specify that Im looking into a hospital based academic position specifically (eg. Peds Cardiology?). So any thoughts on Lifestyle? Income? Expenses? Any and all thoughts welcome...the people I've spoken to are strangely reluctant to give me specifics.... Link to comment Share on other sites More sharing options...
Guest ploughboy Posted April 26, 2006 Report Share Posted April 26, 2006 -----BEGIN PGP SIGNED MESSAGE----- Hash: SHA1 Hey there, I wouldn't worry about damaged gonads and 8-fingered progeny if you go into rads. _House of God_ (from which that excerpt was taken) is humour/satire and shouldn't be taken completely seriously. Besides, the field has advanced since the 1970s, when the book was written. Now rads sit at home in their pajamas reading films/CTs/MRIs remotely, and the only radiation they have to worry about is from their computer screens (Ian - I'm joking, I'm joking!) Marbledust is entirely correct about residency location being another important factor in the competitiveness of various programs (you still thinking psyche, marble?). I think salaried hospital-based paths make about about a quarter million per year in Ontario, based on a quick glance at the latest and greatest Public Sector Salary Disclosures(1). I'm not sure what the remuneration is for paths in the private sector (private labs, etc) or what opportunities hospital-based paths have to augment their income by working for private labs. Path isn't particularly competitive. The traditional knock against path is that unless you do your own biopsies, you don't get to see a lot of (live) patients. You do, however, get to interact with a lot of people, since you're the "doctor's doctor". It's not like you're stuck in a basement lab all day. You've probably read Zooropa's thread around here about pathology, eh? It's a pretty good resource about what path is really like. It's a hugely important specialty, since the diagnoses you make will determine the course of treatment for dozens of patients every day. I could never be a path, though - in no small part because I'm *incredibly* bad at histology. We had some path small-group sessions recently, and where some of my classmates were totally nailing all the questions our preceptor was asking about the slides we were looking at, I was like "Umm...the colours are really pretty..." Timmy - in the space of two days I've spoiled a movie for you and spilled all the secrets of residency. Gosh I'm a blabbermouth! pb -----BEGIN PGP SIGNATURE----- Version: GnuPG v1.4.0 (FreeBSD) iD8DBQFET+uG/HNgbK3bC2wRAtrMAJ9a4SsZnILlqHPMLQR74sic87HtbwCfZMXS S4G9YJiL8lHDq3UHVlXoj3s= =MuD/ -----END PGP SIGNATURE----- (1) Ontario Public Sector Salary Disclosure. Link to comment Share on other sites More sharing options...
Guest Talon01 Posted April 26, 2006 Report Share Posted April 26, 2006 That was a good book! Link to comment Share on other sites More sharing options...
Guest UWOMED2005 Posted April 26, 2006 Report Share Posted April 26, 2006 One thing many people won't point out for you: Many of the super competitive specialties are competitive BECAUSE they are competitive! Medical schools are chock-full of Type A keeners who a) want to be seen as successful and don't want to be seen as having matched to a 'lesser' less-competitive specialty. Matching to plastics seems impressive. Matching to pathology or family med might make some think "2nd round." Pathology is the perfect example - great pay, great lifestyle. Yet it routinely doesn't fill? I wonder why. Link to comment Share on other sites More sharing options...
Guest xylem33 Posted April 27, 2006 Report Share Posted April 27, 2006 Well then, hopefully path stays that way by the time I have to match for it, which should be in about 6 or 7 years... thanks for the inside scoop ploughboy! and as for being competitive b/c they are competitive...that's quite discouraging but you can blame our way of life for that i guess :\ Link to comment Share on other sites More sharing options...
Guest medbella Posted April 27, 2006 Report Share Posted April 27, 2006 Hey i was just looking at the carms chart (carms site -> statistics & reports -> statistics) to get an idea of the competitiveness of the different residencies and was wondering what the difference was between "% of students matched to first ranked program" and "% of students matched to first choice of discipline". I assume the first refers to a specific residency at a certain school, and the latter refers to just getting into the general discipline you wanted most, but not necessarily at your first choice school. Can anyone confirm? Link to comment Share on other sites More sharing options...
Guest Kirsteen Posted April 27, 2006 Report Share Posted April 27, 2006 Hi there medbella, Yes, your interpretation is correct. For any CaRMS applicant, matching to first ranked program is the ideal. Especially for those applying to super-competitive specialties, matching to the first choice of discipline is often a happy and relieving event. Cheers, Kirsteen Link to comment Share on other sites More sharing options...
Guest Gavanshir Posted April 27, 2006 Report Share Posted April 27, 2006 Can someone please list all the subspecialties of IM? Is oncology one? Thanks. Link to comment Share on other sites More sharing options...
Guest anitabanita Posted April 27, 2006 Report Share Posted April 27, 2006 oh my goodness am - that ploughboy post was so awesome house of god? I wanna get that book...no idea what it is about - i'll go google it rite now! Link to comment Share on other sites More sharing options...
Guest JewelLeigh Posted April 27, 2006 Report Share Posted April 27, 2006 I'm probably forgetting some, but off the top of my head: Cardiology Respirology Gastroenterology Nephrology Dermatology (though can also be a separate residency) Rheumatology Medical Oncology (which differs from Radiation Onc) Endocrinology Hematology Infectious Disease Geriatrics and I think Neurology (though can also be a separate residency) Link to comment Share on other sites More sharing options...
Guest Kirsteen Posted April 27, 2006 Report Share Posted April 27, 2006 Hi there, Regarding the above, Dermatology and Neurology are residencies quite separate from Internal Medicine. You apply to each for entry into each in the first year of residency unlike the IM sub-specialties where you apply after a number of years of IM training. Cheers, Kirsteen Link to comment Share on other sites More sharing options...
Guest summervirus Posted April 28, 2006 Report Share Posted April 28, 2006 Here is a complete list of IM subspecialty training programs in Canada: www.departmentofmedicine....a/R4match/ As an aside, Neurology and Dermatology have traditionally been subspecialties of IM but became independent around 10 years ago. But, there is talk that Dermatology will again be an available as an option through IM, rather than exclusively a direct-entry program. Link to comment Share on other sites More sharing options...
Guest marbledust Posted April 28, 2006 Report Share Posted April 28, 2006 Regarding the above, Dermatology and Neurology are residencies quite separate from Internal Medicine. You apply to each for entry into each in the first year of residency unlike the IM sub-specialties where you apply after a number of years of IM training. This doesn't really pertain to the thread, however I found it interesting: At Dalhousie you go into derm after matching into Internal Medicine and completing 2 years in either IM or Peds (at Dalhousie). You can't get into Derm at Dal through carms. When I did an elective at Dal I worked with an IM resident desperately hoping to land the derm spot for the following year (and dreading staying in IM if it didn't work out ) From what I recall, he said at least one other school in Canada does this as well, but I can't recall which one off the top of my head. Link to comment Share on other sites More sharing options...
Guest summervirus Posted April 29, 2006 Report Share Posted April 29, 2006 That's interesting. I know that Dalhousie indeed offers a dermatology position to IM residents. I'm not aware of any other schools that have a similar spot available right now but there is discussion of opening more of these spots in the future. Hmm, I'll post the news if I find out which other schools may have similar positions like Dal. Link to comment Share on other sites More sharing options...
Guest therealcrackers Posted April 29, 2006 Report Share Posted April 29, 2006 If you really want Derm, but don't want to go through the ultracompetitive 6-position and 20-applicant CaRMage, you can do family and then tailor your practice to handling all but the most serious of dermatologic problems, along with a variety of other things. You wouldn't be able to call yourself a dermatologist, but you might function as one... However! This strategy might also work for emerg (2+1), but will not work for plastics, ortho, ophtho, or radiology... Link to comment Share on other sites More sharing options...
Guest Lurkergonepublic Posted April 30, 2006 Report Share Posted April 30, 2006 you can do family and then tailor your practice to handling all but the most serious of dermatologic problems, along with a variety of other things. You wouldn't be able to call yourself a dermatologist, but you might function as one... Maybe, but would you be able to use the same billing codes as a dermatologist, and receive the same renumeration for services? I suspect not, so if you're attracted to it for the money rather than a general 'love of skin,' it might not be close enough. Link to comment Share on other sites More sharing options...
Guest UWOMED2005 Posted April 30, 2006 Report Share Posted April 30, 2006 so if you're attracted to it. . . rather than a general 'love of skin,' What? A reason to go into dermatology other than a love for skin lesions? Link to comment Share on other sites More sharing options...
Guest Lurkergonepublic Posted May 1, 2006 Report Share Posted May 1, 2006 What? A reason to go into dermatology other than a love for skin lesions? :rollin Well, I've heard these nasty rumours... Link to comment Share on other sites More sharing options...
Guest cracked30 Posted May 4, 2006 Report Share Posted May 4, 2006 UWO2005 is right. Many are competitive because they are. I don't understand it. We hurt each other and ourselves in this job. I want everyone to repeat after me... "I will never do call for free or just my billings, being available to answer questions is work." Expect 300 to 1000 dollars per night to be on call as a consultnat or GP. Someday we will get there. Link to comment Share on other sites More sharing options...
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