Question of ethics..?

[Alastriss]

I hope you were on drugs when you wrote this post.

 

I hope you can have something a bit more intelligent to say, but thanks for coming out.

[Alastriss]

no, now they are giving people from those areas the opportunity to increase their chances of getting into medical school by using lower admission cut-offs. It doesn't mean they are guaranteed an in. You were saying "make them go there in exchange for leaner admission cutoffs" which is very different for two reasons: 1) right now, those who get in through a SWOMEN/NOSM advantage don't agree to anything and 2) just because they have that advantage doesn't mean they are guaranteed admission. So if we start telling people "sign here and we'll let that 3.X slide" then my question to you is, doesn't that jeopardize the system?

 

Someone already mentioned some of the factors that deter people from rural medicine, I think those need to be addressed if we want a long-term solution.

 

Oh what you said is what I meant. Sorry I wasn't being clear. I was just suggesting letting people who are not originally from rural areas to enter these pools by their credentials (volunteering) and intents. This opens the possibility of attracting people in rural areas. Secondly I am suggesting using return of service agreements, similar to what is being imposed on IMGs. For having the opportunity to be in a pool that increases their chances of getting accepted, they will be giving back x years of service. Of course you need to make sure a few things are happening:

 

1) the pontetial physicians are able to cope with this lifestyle (which is why they would have to be assessed on their informativity as well as their ability to cope and adapt).

2) you are able to transition the patients to a new physician when a physician leaves which is going to be a big problem - it essentially means reestablishing entire therapeutic relationships all over again.

 

This isn't a long term solution, but the type of long term solution you are looking for is something that will require development across multiple sectors (not just health-care) so we need something in the "middle run". It would be interesting to look at some rural health-care policies in Australia, from what I hear they have a lot of rural areas and servicing them has been a hot topic from a policy point of view.

 

I remember reading a study suggesting that a big problem with attracting physicians from urban areas to rural areas is their inability to adjust to the lifestyle. In which case some sort of incentive programs have to be in place, and I am NOT talking about throwing money. We might reach a point where increasing their salaries is what we are doing but seeing diminishing returns on the results.

 

I plan on doing some considerable research, I have some rural health-care economics papers that I wouldn't mind sharing if you want me to PM to you, Spanishfly.

[Halcyon]

I plan on doing some considerable research, I have some rural health-care economics papers that I wouldn't mind sharing if you want me to PM to you, Spanishfly.

 

Send them to me too!

[Halcyon]

I don't see why any of these policies mandate that you spend x years practicing in rural areas. I *think* they use past living history as a criteria to make sure you can adjust living in rural areas, but a non-rural applicant with volunteer in rural experience who signs a return of service contract will more than do the trick.

 

here's the REAL problem. The fact that these policies actually do lead to increasing physicians. It is just that they do so at an inefficient rate, which eventually takes these seats from urban kids who could really use it. However, I don't really think anyone cares for these urbanites.

 

 

ok so based on what halcyon and truffle said, it seems that these rural applicants are academically hindered. I think this really articulates why "lower cutoff" policies are a bandaid to the problem. The objective here should be to improve education delivery, supply, and accessibility so these "lower cutoff" policies are eventually removed, but that's easier said than done.

 

Haha...disadvantaged does not equal academically hindered.

[Alastriss]

Haha...disadvantaged does not equal academically hindered.

 

 

I meant disadvantaged = academically hindered. In some respects, rural applicants may have hard time accessing study sources for say, the mcat.

 

Will PM them to you in 24-48 hours btw.

[Halcyon]

I meant disadvantaged = academically hindered. In some respects, rural applicants may have hard time accessing study sources for say, the mcat.

 

Will PM them to you in 24-48 hours btw.

 

Thanks!

 

We all know how we can get Alastriss fired up! This is not the first thread I've seen this occur

[truffle]

I meant disadvantaged = academically hindered. In some respects, rural applicants may have hard time accessing study sources for say, the mcat.

 

Will PM them to you in 24-48 hours btw.

 

plus, when you read about all these 3rd and 4th year undergrads on PM101 who'd been doing research and hospital volunteer work since highschool, where do you think these kids are from? probably not rural areas. to get research exposure especially, either your highschool has connections, or your family has connections. i know this guy who's been doing summer lab research since the end of grade 10. his mother worked in a lab in the university network in toronto. i didn't ask how he got the job, but you can guess.

 

and a lot of the rural kids i know are not as "worldly" as city kids. they are less likely to have traveled or done work abroad. there are exceptions though.

 

rural kids can also be disadvantaged in athletics. if you want to be remotely pro, you have to train where there's a team, support and funding.

[truffle]

I meant disadvantaged = academically hindered. In some respects, rural applicants may have hard time accessing study sources for say, the mcat.

 

Will PM them to you in 24-48 hours btw.

 

please PM me as well. thanks!

[meme me]

and a lot of the rural kids i know are not as "worldly" as city kids. they are less likely to have traveled or done work abroad. there are exceptions though.

This is an amazingly offensive generalization.

 

rural kids can also be disadvantaged in athletics. if you want to be remotely pro, you have to train where there's a team, support and funding.

Lol! So now you have to have professional athletic experience to practice rural medicine? What does this have to do with anything, other than the perpetuation of a negative attitude towards rural life?

[japlanet]

plus, when you read about all these 3rd and 4th year undergrads on PM101 who'd been doing research and hospital volunteer work since highschool, where do you think these kids are from? probably not rural areas. to get research exposure especially, either your highschool has connections, or your family has connections. i know this guy who's been doing summer lab research since the end of grade 10. his mother worked in a lab in the university network in toronto. i didn't ask how he got the job, but you can guess.

 

and a lot of the rural kids i know are not as "worldly" as city kids. they are less likely to have traveled or done work abroad. there are exceptions though.

 

rural kids can also be disadvantaged in athletics. if you want to be remotely pro, you have to train where there's a team, support and funding.

 

Please don't make it sound so awful. There are also plenty of advantages to living in rural areas that city kids don't get.

 

I think that preferential admissions programs are not trying to be 'affirmative action' by saying that smart rural kids might have lower GPAs than equally smart city kids. Rather, it is a crude way of trying to train doctors who are more likely to work there.

 

I've seen too many smart kids from my highschool use the excuse that they don't have opportunities to get ahead. They are just as smart and just as capable and have just as many opportunities as I did, but they are on their 3rd baby and I am graduating university. Its more of a mindset then anything else. There is no actual reason why kids from rural areas cannot do well.

[truffle]

This is an amazingly offensive generalization.

 

Lol! So now you have to have professional athletic experience to practice rural medicine? What does this have to do with anything, other than the perpetuation of a negative attitude towards rural life?

 

you missed my point. my point is that people who grew up in rural areas have less opportunity for to have an EC such as this one:

3rd year undergrad, 4 summers of research, work in AIDS clinics in africa and india, summited mount kilemanjero (spelling?), player in XXX/provincial junior league hockey team, varsity football, etc. etc.

 

i was only countering some people's claims that rural applicants should be filtered by the same cutoffs because they aren't that disadvantaged. please don't take what i said out of context. it was a continuation of a discussion

 

i did not say rural applicants have no advantages.

[Alastriss]

This is an amazingly offensive generalization.

 

Lol! So now you have to have professional athletic experience to practice rural medicine? What does this have to do with anything, other than the perpetuation of a negative attitude towards rural life?

 

Ok not to be rude or anything, but a little critical reading can go a long way.

 

He said most rural kids HE KNOWS. He did not say, most rural kids. Therefore because he said that comment regarding kids HE KNOWS he isn't making any generalizations, because they very population he is questioning isn't general.

[meme me]

Ok not to be rude or anything, but a little critical reading can go a long way.

 

He said most rural kids HE KNOWS. He did not say, most rural kids. Therefore because he said that comment regarding kids HE KNOWS he isn't making any generalizations, because they very population he is questioning isn't general.

Thanks Alastriss, but I don't need a lesson in critical reading from you. And you're not being rude, just irrelevant.

[truffle]

Please don't make it sound so awful. There are also plenty of advantages to living in rural areas that city kids don't get.

 

I think that preferential admissions programs are not trying to be 'affirmative action' by saying that smart rural kids might have lower GPAs than equally smart city kids. Rather, it is a crude way of trying to train doctors who are more likely to work there.

 

I've seen too many smart kids from my highschool use the excuse that they don't have opportunities to get ahead. They are just as smart and just as capable and have just as many opportunities as I did, but they are on their 3rd baby and I am graduating university. Its more of a mindset then anything else. There is no actual reason why kids from rural areas cannot do well.

 

this is where i really disagree with you. there are plenty of very decent and smart rural kids, but they just have more challenge in looking good on paper at the time of application (GPA, MCAT, ECs). although admission committees all say they don't want only cookie cutter applicants, certain things do score brownie points consistently.

 

in the long run as long as the rural kids get admitted, there probably won't be much difference between rural kids and city kids. but they need to be admitted first.

[truffle]

Thanks Alastriss, but I don't need a lesson in critical reading from you. And you're not being rude, just irrelevant.

 

oh just letting you know, i don't consider myself that worldly either. i've never been to africa, europe, south asia, central america, south america, australia, new zealand, the pacific islands.

[japlanet]

this is where i really disagree with you. there are plenty of rural kids, but they just have more challenge in looking good on paper at the time of application (GPA, MCAT, ECs). although admission committees all say they don't want only cookie cutter applicants, certain things do score brownie points consistently.

 

in the long run as long as the rural kids get admitted, there probably won't be much difference between rural kids and city kids. but they need to be admitted first.

 

My point was, that from my own experience growing up in a rural area, I feel that I am just as competitive as anyone else, not because I get special treatment from anyone but because I *worked* for it. The ECs you do in highschool are limited, yes, but med schools don't care about them, only what you do in uni matters. And yes, my highschool wasn't very academically stringent, but I used first year to catch up, and my marks for that year aren't great, but the rest of my years make up for it.

 

From my own experience, many of the kids I grew up with used where we lived as an excuse not to try. But I firmly believe that they would be just as successful as me had they tried.

 

So certainly, this is my own personal bias from my personal experience, but I DO NOT believe that rural kids have a harder time with GPA, MCAT, ECs etc because all that matters is university, which is relatively easy to get into, and what you do with the time you have there. All my marks, ECs etc are based on what I did in university, where I grew up didn't make me more or less competitive than anyone else.

 

I'm saying that the rural kids who should be admitted WILL be admitted on their own merits.

[meme me]

oh just letting you know, i don't consider myself that worldly either. i've never been to africa, europe, south asia, central america, south america, australia, new zealand, the pacific islands.

worldly ≠ well-traveled

[Ninjaface]

Here's a real example of rural disadavantage - I am from the Yukon and our hospital does not have enough people available to volunteer to merit the hiring of a volunteer co-ordinator - therefore noone is allowed to volunteer at our hospital. I have also had to limit the number of schools I apply to for the sole reason that a return flight from my town to any other Canadian city is a minimum of ~$600.

 

That said, I plan on getting in on my own merits. I do agree with the policy of counting Northerners as residents of multiple provinces - giving us above quota seats is a little bit more questionable, but I'm sure as heck not complaining. I'm also not lacking in ECs. MCAT, etc were not any harder, though I did have to fly somewhere else to write them. $$$$

 

As for world travel, I don't think being Northern disadvantaged me that much. I've backpacked and/or volunteered in 33 countries, 27 of them 3rd world, all on my own dime.

[japlanet]

Here's a real example of rural disadavantage - I am from the Yukon and our hospital does not have enough people available to volunteer to merit the hiring of a volunteer co-ordinator - therefore noone is allowed to volunteer at our hospital. I have also had to limit the number of schools I apply to for the sole reason that a return flight from my town to any other Canadian city is a minimum of ~$600.

 

That said, I plan on getting in on my own merits. I do agree with the policy of counting Northerners as residents of multiple provinces - giving us above quota seats is a little bit more questionable, but I'm sure as heck not complaining. I'm also not lacking in ECs. MCAT, etc were not any harder, though I did have to fly somewhere else to write them. $$$$

 

As for world travel, I don't think being Northern disadvantaged me that much. I've backpacked and/or volunteered in 33 countries, 27 of them 3rd world, all on my own dime.

 

Where did you go to university? I didn't have to travel for MCATs or go too far for interviews because I based it out of where I go to school.

 

Otherwise, I totally agree with you.

[SpanishFly]

I remember reading a study suggesting that a big problem with attracting physicians from urban areas to rural areas is their inability to adjust to the lifestyle. In which case some sort of incentive programs have to be in place, and I am NOT talking about throwing money.

I plan on doing some considerable research, I have some rural health-care economics papers that I wouldn't mind sharing if you want me to PM to you, Spanishfly.

 

I agree that an incentives program not solely based on money is necessary. Some studies I've read on this indicate that financial motivation isn't as important as they thought it would be, but there are other ways to move people that aren't directly cash-related (although money is involved in all of it). You said that major reforms need to be made across sectors and I agree. I'm talking about training the population in the area to use the technology etc. and introduction of this technology into the area so physicians have more access to them. If the doctors think they won't have ready access to diagnostic tools, he/she may be discouraged about their prospects of practicing first-world medicine. If these things were available to rural physicians, it would be more enticing for them to set up practice in the middle of nowhere (which is something I think the Windsor program is trying really hard to do).

 

And sure, I'd love to read some more on the topic, thanks.

 

I think that preferential admissions programs are not trying to be 'affirmative action' by saying that smart rural kids might have lower GPAs than equally smart city kids. Rather, it is a crude way of trying to train doctors who are more likely to work there.

 

I agree with you on this one. I don't think its harder to be a "smart" rural kid, but I do think there are certainly more difficulties in obtaining EC experiences, which is just as important these days as a great GPA/MCAT.

 

Here's a real example of rural disadavantage - I am from the Yukon and our hospital does not have enough people available to volunteer to merit the hiring of a volunteer co-ordinator - therefore noone is allowed to volunteer at our hospital. I have also had to limit the number of schools I apply to for the sole reason that a return flight from my town to any other Canadian city is a minimum of ~$600.

MCAT, etc were not any harder, though I did have to fly somewhere else to write them. $$$$

 

Thanks for your input, its interesting to get some insight from someone directly affected. I think the point of real interest to me is the financial factor you mentioned. Many people might dismiss it, but I think it can make a really big difference if you can't afford to actually go through this ridiculous application process. It's also very unfortunate that you can't volunteer at a hospital for reasons that wouldn't exist in a large urban centre...you would think your hospitals probably need volunteers more so for that reason, its just a vicious cycle.

Anyways, I think its really great that you've traveled so much, I'm incredibly envious

[Ninjaface]

Where did you go to university? I didn't have to travel for MCATs or go too far for interviews because I based it out of where I go to school.

 

Otherwise, I totally agree with you.

 

 

I went to school in Lethbridge. However, at the point I wrote my MCAT I had jsut returned from a year of travel in SOuth America and wanted (NEEDED) to go home to get a job, but instead had to stay down at my mother's in Sask for my 3 week crash study and writing because I could not afford to bounce around. SO it was even more expensive than I made it sound really, counting the 3 work-less weeks.

 

I just finsihed paying $400 for my Whitehorse to Calgary flight and $600 for my Calgary to Whitehorse. I still need to bounce around on busses down there too. Luckily I am currently a teacher and an after school tutor, so the student spring break co-ordinates with my interview times and thus I am not missing much work for them. I'll jsut stay in Saskatchewan for the whole 3 weeks rather than return to my home in between interviews.

 

Yes, I count myself as blessed for having been able to do as much travel as I have. I lived cheap though. Like $15 a day cheap. I also slept under the desk in my office for the last 3 months of my grad school to save up for the SOuth America trip. Less than $10,000 to travel for a year, get close to fluent in spanish, and beef up the heck out of my ECs (volunteering) was well worth it in my opinion though. I also did a similar year between undergrad and MSc. This thread isn't about me though so I'm gonna shut up now...

[Alastriss]

Thanks Alastriss, but I don't need a lesson in critical reading from you. And you're not being rude, just irrelevant.

 

Ummm Not really. I mean, it is relevant in that your accusation of truffle's grossly offensive generalization is just thrown out the window.

[Alastriss]

I agree that an incentives program not solely based on money is necessary. Some studies I've read on this indicate that financial motivation isn't as important as they thought it would be, but there are other ways to move people that aren't directly cash-related (although money is involved in all of it). You said that major reforms need to be made across sectors and I agree. I'm talking about training the population in the area to use the technology etc. and introduction of this technology into the area so physicians have more access to them. If the doctors think they won't have ready access to diagnostic tools, he/she may be discouraged about their prospects of practicing first-world medicine. If these things were available to rural physicians, it would be more enticing for them to set up practice in the middle of nowhere (which is something I think the Windsor program is trying really hard to do).

 

And sure, I'd love to read some more on the topic, thanks.

 

 

 

I agree with you on this one. I don't think its harder to be a "smart" rural kid, but I do think there are certainly more difficulties in obtaining EC experiences, which is just as important these days as a great GPA/MCAT.

 

 

 

Thanks for your input, its interesting to get some insight from someone directly affected. I think the point of real interest to me is the financial factor you mentioned. Many people might dismiss it, but I think it can make a really big difference if you can't afford to actually go through this ridiculous application process. It's also very unfortunate that you can't volunteer at a hospital for reasons that wouldn't exist in a large urban centre...you would think your hospitals probably need volunteers more so for that reason, its just a vicious cycle.

Anyways, I think its really great that you've traveled so much, I'm incredibly envious

 

 

 

Just in response to the bolded part. Sure we could do that, but we shud look at a few things. Centers like that cost a lot of money, and they work with a high per capita density when a lot of people in nearby areas can really benefit from the proximity. Would this work with the per capita density of rural areas?

 

Secondly, this is actually not completely relevant to what you said but at one of my interviews the physician said that they determined it was more cost effectives to fly patients in via choppers to medical centers than it is to set them up closeby, but I think she was referring to high urgency/trauma patients.

 

What is are some rural healthcare policies in Australia? Anyone know? It was/is a hot topic over there.

[meme me]

Ummm Not really. I mean, it is relevant in that your accusation of truffle's grossly offensive generalization is just thrown out the window.

You can defend that fact that he said, "kids he knows" all you want, but it's obvious that he's implying that his observation of the unworldiness of rural kids holds true, in general, for the rural population. He doesn't have to explicity state something to have his remark imply it. Hmm... critical reading... hmm... read words more carefully? Not quite, but thanks for pointing out what words he used and which ones he didn't.

[ashleym]

K, I'm just throwing this out there, it's might not be a good idea but I'm curious to know what people think. What if the private health care was allowed, but ONLY in rural areas. So, private medical clinics and hospitals could be opened in rural towns, and the government would be relieved of some of the burden of funding medical facilities in all these places. It would further act as an incentive for Canadians to practice rural medicine because they would have the opportunity to open their own practice.

 

Does this make any sense?