Guest RAK2005 Posted October 13, 2001 Report Share Posted October 13, 2001 Hey there, I heard from a classmate, who sits on the faculty meetings, that Queen's will be raising the seat number to 100 for next year. This is a 10 seat increase from the current class, and is a move in the right direction! Bad news is that the goverment has frozen spending increases to the med schools. Translation...higher tuition next year. Link to comment Share on other sites More sharing options...
Guest JD Posted October 14, 2001 Report Share Posted October 14, 2001 I suppose these spots come from the 40 new ones being made available across the province next year? Anyone know how the other 30 will be divided up? Link to comment Share on other sites More sharing options...
Guest Ian Wong Posted October 15, 2001 Report Share Posted October 15, 2001 Hey that's good news for Queens applicants! Tuition on the other hand is not... By the way, has there been any discussion on increasing the number of residency positions in Ontario as a result of the increases in med school enrollment over the past few years? There's no sense in admitting more students into med school if we can't also train them in the specialties that are needed. Ian UBC, Med 3 Link to comment Share on other sites More sharing options...
Guest RAK2005 Posted October 17, 2001 Report Share Posted October 17, 2001 Ian, My understanding from what I heard from an OMA spokesperson is that there will be an increase in residency spots for the upcoming year...however, it was unofficial, and I don't know how many, and which areas the increases will come in. I would guess Family and OB/Gyn for certain. We need more surgeons too.... Link to comment Share on other sites More sharing options...
Guest Ian Wong Posted October 17, 2001 Report Share Posted October 17, 2001 The problem is that family is becoming less and less attractive each year (the number of med school graduates matching into family has declined virtually every year for the last 10-15 years). Too much paperwork, wages that are in no way commensurate with the responsibility of the profession, and a decrease in respect from patients and medical colleagues alike are making family a less desirable specialty (in my opinion). However, it does have the shortest residency, and a wide flexibility in practice options once you finish, and is in demand in both urban and rural settings alike. OB/GYN is even worse! Most obstetricians I've talked to say they wouldn't do it again if they were choosing specialties all over. It's got the lifestyle and call schedule of a surgical specialty, the pay of a non-surgical specialty, the ever-present fear of mal-practice, stiff competition from mid-wives who skim off the easy cases for far higher reimbursements after much less education, and again scorn from most other surgical specialists for the above reasons. Perhaps I'm just cynical tonight (it's been a really long day in the hospital). But there's no way I would ever want to be an OB/GYN. Family doctor perhaps, but never an obstetrician. If Canada wants more med students to train in family medicine and obstetrics, it has to provide more incentives in some way. Otherwise we're headed for an ever increasing deficit and shortage in the future... Ian UBC, Med 3 Link to comment Share on other sites More sharing options...
Guest Jbird Posted October 25, 2001 Report Share Posted October 25, 2001 Perhaps a little more respect for mid-wives Ian. They've been doing it since the beginning of time for a lot less money and even less recognition. They also treat it as something normal and expected rather than as an illness requiring a "cure". Link to comment Share on other sites More sharing options...
Guest Ian Wong Posted October 26, 2001 Report Share Posted October 26, 2001 A study on the numbers and distribution of family doctors was released today. Rather telling in the estimate that Canada is currently short approximately 3000 GP's, although how close to reality this number is isn't something I know much about. I don't know how long this Globe and Mail article will stay up: www.globeandmail.com/serv...eakingnews Rather scary when you consider that from the CaRMS stats for 2001, a total of 349 med school graduates enrolled into their family practice residency, and a further 36 into rural family practice, making a total output of 385 new family doctors in summer 2003. Clearly, the deficit of family doctors won't be made up any time soon by training more physicians here in Canada. www.carms.ca/stats/stats21.htm#choices JBird, as far as midwives go, I actually serve on a UBC committee that as of this year has helped push the development of an undergraduate program in midwifery at UBC. However, I don't think I've said anything that you could dispute in the above post. Midwives have significantly less formal training than obstetricians, can only take the "low-risk cases", and are paid substantially higher for their procedures. I think these two CMAJ articles are particularly telling: www.cma.ca/cmaj/cmaj_today/2000/05_16.htm <!--EZCODE ITALIC START--> Gillespie says midwives provide continuity of care throughout a woman's pregnancy, including labour and delivery, as well as 7 weeks of post-partum care. Calgary midwives typically charge $2500 for these services. Physicians can bill $295 for the delivery alone. By law, midwives are only permitted to work with low-risk pregnancies.<!--EZCODE ITALIC END--> Considering that the delivery is the highest risk portion of the pregnancy, these fees seem out of line to my eyes. www.cma.ca/cmaj/vol-158/issue-11/1505.htm <!--EZCODE ITALIC START--> Dr. Alan Brookstone of Richmond, BC, says his colleagues are also frustrated by government initiatives such as reference-based pricing. In particular, his temperature rises over midwifery legislation that sees midwives paid $2250 per delivery, while physicians receive $700 to $900 for providing care throughout an entire pregnancy. "We are pawns with no control," he says.<!--EZCODE ITALIC END--> As far as my personal beliefs go, if people want a more natural birth, that's their pre-rogative. However, the fact that a midwife doesn't have the surgical skills to support his/her patient should something go drastically wrong with the pregnancy (and whether you hear about it or not on the media, rest assured that it does happen), makes me a little leery of the increased risk. Perhaps this is "medicalization" at its best, but anything less than a perfect outcome for both mother and baby risks a colossal lawsuit, not to mention emotional trauma for the physician and patient alike. I would hope that Ob/GYN's out there approach each patient with the hope of a good outcome for each patient, and if that means erring on the side of caution keeping all your medical resources close at hand (nurses, clean and controllable environment, a delivery suite, and resuscitation gear available for mother and infant alike), I would prefer to err on the side of caution. Being a good doctor means doing your best to stack the odds in favour of your patient. Ian UBC, Med 3 Link to comment Share on other sites More sharing options...
Guest Kirsteen Posted October 26, 2001 Report Share Posted October 26, 2001 Hi there, Regarding midwives from the Obs/Gyn side... One of my best pals, an Ob/Gyn, has practiced in Scotland, England, and did a stint in the Obs/Gyn unit here in TO at Mt. Sinai. One of the questions she was asked during one of her interviews for her consultancy position was her opinion regarding midwives. In her practice (and she prefers to focus her efforts primarily on the Ob half of the Ob/Gyn designation) she feels that midwives are an essential and great resource. In her words, "A good midwife can make or break a delivery unit." Given the paucity of Ob/Gyns per shift, and the uncontrollable nature of the timing of births, she would rather a skilled midwife handle the "routine" births and leave the more complicated cases to her. Indeed, she maintains that the skills proffered by some midwives are invaluable, e.g., being able to manually turn a breech baby in utero, etc. Interestingly, when out in Vancouver a few months back, meeting with some folks over at an Obs/Gyn unit the topic of midwives arose again. One of the prominent Ob/Gyn people there is avidly trying to increase the role of midwives in Ob/Gyn departments at BC hospitals, akin to their usage in the UK. His opinion is that, unlike in the UK, many Canadian women like to know that their doctor will be there to "catch the baby's head". Echoing my pal's sentiment, he mentioned that he felt that this role would be much better served by a midwife, freeing up his time and skills to more freely cope with any, more challenging deliveries, of which there can be apparently many. Anyway, just some interesting thoughts from the inside... Cheers, Kirsteen Link to comment Share on other sites More sharing options...
Guest Sarah371 Posted November 26, 2001 Report Share Posted November 26, 2001 Procrastinating studying CHE to add my two cents about OB/GYN.......from what I have observed about OB/GYNs is that they are one of the happiest specialities going. Everyone says that this or that speciality has a lack of respect.....surgeons put down the internal medicine people and visa versa. I did hear something about the government thinking about picking up some of the tab for insurance....thus bringing it down to a more reasonable level. I am going to meet with some OB's over the holidays so I will let you know what's said after. As for mid-wives...I think that we should be glad that women now have options concerning their reproduction and delivery care. I echo other sentiments here about mid-wives looking after low risk deliveries, free OB's to handle the more complicated ones.......anyway most mid-wives work along with doctors who have admitting privledges should something go wrong. As I said just my two cents. SARAH Link to comment Share on other sites More sharing options...
Guest xX driad Xx Posted February 7, 2002 Report Share Posted February 7, 2002 Hi Ian I wanted to briefly respond to a couple of things that you said in your post. First, in BC, midwives make more per delivery than a dr.- I would not agree, but are you aware that is the TOTAL of their pay. They do not bill per visit the way a dr is entitled to. Their care is also followed up in the home for 6 weeks post partum and they are on site for the delivery for far longer than the majority of drs I have worked with. As far as education – midwives have education levels appropriate to their training… what more needs to be said about that. According the the WHO the are the acknowledged experts in low risk pregnancies – why would the have the complete spectrum of med/surg skills available to an OB when that is not their scope of practice? I would encourage you to look to the Home Birth Deomonstration Project for the facts of the rather extensive study under taken in BC. The reality is that there are far fewer problems in home birth than you seem to perceive because there are less interventions to begin with. There is also not the over reliance on technology I have seen in hospitals, coupled with a more constant monitoring of the pregnant, and subsequently labouring woman. During the HBDP, the only true difficulties arose in hospitals that had not been properly equipped for transfer of care… As far as your involvement with the UBC midwifery program… I had not seen you to date – are you one of the many behind the scenes campaigners that those of us who advocate for regulated midwifery very, very much appreciate? Link to comment Share on other sites More sharing options...
Guest Ian Wong Posted July 3, 2006 Report Share Posted July 3, 2006 Floating to the top... Ian Link to comment Share on other sites More sharing options...
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