class size :(

[dmleo]

I think I must agree with the statement that there is a shortage of open

positions..Its not that there is a shortage of physicians, but a shortage of

open positions at the hospital. I heard about this many times from my

aunt who is an assistant manager at the human resources department in

Foothills hospital and she always tells me there is a hiring freeze whenver I ask

her about any open positions..even as porters

[sv3]

Yes, Canada may spend more per capita, but it's not necessarily going in exactly where it's needed. North American physicians get paid significantly more than in other countries with universal health care. Is this right? Is it wrong? Who's really to say.

 

Looking at a straight per capita comparison isn't the best method to analyzing healthcare problems. Of course the Canadian system is going to have inefficiencies, but I'm sure they make it up somewhere else which doesn't necessarily show up in paper. I'm not saying one can solve the Canadian healthcare problems with JUST money, but it IS a major factor governing the direction of healthcare (that I think is undeniable). The problems with the Canadian healthcare problem are much more complex than what's being discussed on the forum (we're really just scratching the surface)...otherwise, I'm sure someone would have already come up with a solution by now. Personally, I absolutely love the Canadian healthcare system - despite the inherent flaws. And believe me, I've been on the receiving end of long wait times/shortages (ex. snowboarding accident, soccer injuries, family members hospitalized, etc.).

 

Anyway, thanks for the heads up on healthcare in other countries. I've looked into other countries healthcare systems briefly before my interviews -- particularly France which has the highest rated healthcare system. I didn't look into the particulars regarding per capita spending and such though...it'll definitely be something for me to keep in mind if I'm one of the unlucky applicants who are affected by the cuts this year (or...was simply inadequate as an interviewee this year lol )

 

I wasn't trying to analyze the healthcare problems in Canada (how much time you got?)....I was just simply pointing out that money is not the major problem. You yourself acknowledge that we spend just as much as other countries, but aren't getting the results - doesn't this tell you that the problem lies elsewhere? Perhaps how or what we spend the money on? And i wouldn't be so quick to assume that we make up for ineffeciencies elsewhere. Can you give me an example of where this occurs? (I'm not trying to be smart here, i honestly can't think of one).

There's definitely a ton of interrelated issues we could talk about it, and sure money could be one, but to me, its not the amount that's the problem - its how its handled.

 

and ya......i hope to hell i don't need to go through this crap again next year.

gluck!

[bloh]

I think I must agree with the statement that there is a shortage of open

positions..Its not that there is a shortage of physicians, but a shortage of

open positions at the hospital. I heard about this many times from my

aunt who is an assistant manager at the human resources department in

Foothills hospital and she always tells me there is a hiring freeze whenver I ask

her about any open positions..even as porters

 

Once again, if what you are saying is right then there would be a significant number of unemployed physicians. You will not be able to convince anyone here of that scenario.

 

edit: I'm going to expand a bit on this to do it justice. Canada has one of the lowest per capita rates of physicians among developed countries. France has nearly double the number of physicians as Canada. You will never convince me that we do not have a shortage of doctors. I have had to consult with 2 different specialists and both took more than 3 months just to see. And this is a common trend among many specialties across the country. There is a problem with capacity constraints in the form OR time but this isn't universal across the board as not everyone requires extensive hours inside an operating room.

 

I would imagine that the biggest problem with "no open positions" in big cities is that the physicians are too prideful to work in a place that doesn't meet all their over-the-top requirements. What is stopping a dermatologist (or any other specialist that doesn't need to work directly in a hospital) from opening a clinic in ANY big city?

[Kines.]

UofA Med 2013 student here...

 

1. To address rumours that med students already know about cuts, we do not. I just asked friends in both years 2013 and 2012, and this is news to most of us.

 

2. I would be surprised if the government actually followed through with such a drastic cut in seats. I want to remind all of you that UofA did massive renovations to all our facilities to accommodate an increase in students, and these renos are still on-going. We've also completely re-worked most of clinical, small-group, etc sessions. And our rotations have been re-done. So are they going to make all these changes for one year and then revert back? I highly doubt it.

 

3. I also have not heard any rumours from the 2012 year about lower calibre interviewees. I was a set leader and was impressed with both my groups. You guys did great as far as I'm concerned. The interviewers I know of did not say that you were a bad group.

 

4. I remember what it was like to be a premed and genuinely freaked out over any little twitter about med schools. But honestly, for your own health and sanity, you should probably A) Get off this forum and relax, and Accept the fact that it is now post-interview time, and there is absolutely nothing more you can do.

 

 

I agree completely with Kandy. I was also a set leader, and was more than impressed with the candidates. I feel it was very bad form on Jochi's part to have made the comments they made regarding smaller class sizes: wrong time, wrong place, regardless of the validity those views may hold in their mind.

 

I for one am fully enjoying my med school experience, despite the "diluted learning" talk I've read. I have not once felt that I was hindered in my learning. The level of learning is based on what you put into it. People who come to lecture and come prepared to small groups (DL, Gilbert's, CommH, PCC) benefit immensely, and those who don't miss out on being spoon fed and complain about "diluted learning" while they laugh about ditching structured instruction time and lament over independent study assignments. When the proposal for an increase in seats was brought up in years past before they made the increase, they FIRST examined the feasibility with clerkship and residency and got those accommodations in line for the increasing med student number.

 

And, unlike some of my colleagues, I haven't forgotten about the number games we play as pre-meds and the stress we put on ourselves during this time. So I will hope to allay some stress - "hearing" more people got red-flagged than last year may be inconsequential. It's like EBM, team. Anecdotal information regarding something that is trying to be as objective as possible is hearsay and nothing more, and should be disregarded. Check your sources of information (a med student who "heard something" about interviews). If you interviewed, you're in good shape to go to med school (this year or sometime in the future), and you know how you performed at the interview, so just enjoy your lives until May 14 - it's out of your hands. Stress kills, so don't inflict undue harm to yourself.

[dmleo]

Once again, if what you are saying is right then there would be a significant number of unemployed physicians. You will not be able to convince anyone here of that scenario.

 

hmm, ok.

I'm telling you straight up what I heard from her and if this isn't what you

think, I got nothing to say. However, talk to anyone working at the

foothills hospital and you'd know what I told you is true. A hiring freeze,

whether you believe it or not, does occur and it affects everyone.

If you find that there are job posts in the hospital, its only for AHS candidates which means you must already be an employee of the hospital

to apply for that position, not a fresh newbie off the boat.

 

In regards to the unemployed physicians, not all doctors work at a

general hospital and not all doctors who work at a hospital are full-time

workers. I know for certain that specialists in the Vancouver and Toronto

areas have hard time finding jobs at the general hospital because its not

hiring any more people. This is why they turn to private clinics and

associateship.

 

This is becoming longer than I expected, but in regards to your edit,

check this out http://www.cihi.ca/cihiweb/en/smdb_2008_fig2_e.html

Also watch the

which

is a film on the current medical system. In both of these data, there is a clear conclusion that we have more doctors right now

than we ever had. This is also mentioned in the film by Steven Lewis

who is a health policy consultant.

As well, take a look at http://www.cma.ca/multimedia/CMA/Content_Images/Inside_cma/Statistics/12-Phys_per_pop.pdf

This clearly shows you that in 1986, there were 174 doctors per 100,000 population by Province/Territory in Canada while in 2008, there is 195.

So do these numbers not tell you anything? I regret your wait in the

hospitals, but your belief on the shortage of doctors is far from truth.

 

Another factor to consider is that the public hospitals do not have enough funds from the government to hire new doctors that are coming out.

Do you really think that hospitals can accommodate all the graduates

coming out of the residency training? PM me if you want to talk to my

aunt who works in human resources department and she'll tell you whats up.

 

The reason why derm doctors dont open up practices of their own in

"BIG" cities as you called is because of money. Think logically about

how much debt they're in and how much it costs to open up a brand new

practice in a big city like you said. In Vancouver, you need more than

a mill to open up a decent practice in a decent location. Even if you

consider buying an old practice, there is an enormous financial cost.

Also factor in the pay for the receptionist, equipment (for skin beauty stuff), rent, and the rest of overhead and probably starting a family as a new doctor (who is probably in his early 30's). So yeah, I see why

docs cant just open up places like you'd like them to.

 

and lastly, don't make a comment saying I'm trying to convince you.

I'm writing down what I know and I frankly don't give **** if you agree with

me or not. I could certainly be wrong in my facts, but that doesn't mean

I was trying you convince you as there is nothing to convince in the first place, but I apologize if I came across as being belligerent in this post

 

edit: As I read your post again, I realize I missed a point. You are suggesting that Canada has a shortage of doctors

OVERALL, right? However, back in the 80's, the Gov decided to cut the med school size because they thought

there were way TOO MANY doctors. this is when the per capita ratio of physicians was lower than what we have now.

But the problem is, Gov did increase the # of docs around, but the hospitals and public health sect did not grow

proportionally to accommodate all the new docs and the increased population. So, its not that we have a shortage of

doctors (because we were fine before even with smaller per capita ratio of doctors), but that we have a shortage of

funds going into expanding the public health care such as general hospitals, tertiary medical centres, etc

[bloh]

Dmleo, you are arguing a point I never made. None of us on this forum are interested in the "life and times of an aide making 11$/hr". Hiring freezes on support staff in hospital is real; I know real well, since my ex could not get a job for that fact alone.

 

I never argued nor brought that fact up to the table. I am talking strictly about physicians. You are missing the forest from the trees. Canada may have more physicians NOW but it does not mean that we are saturated when it comes to physicians. Compare the per capita rates of Canada and any European nation and you will see that they have on the average 50% more physicians. We have extensive waiting times and they do not. That speaks volumes.

 

Your point about the cost of setting up a practice is exactly my point. It is not that there aren't opportunities and openings but that physicians aren't willing to take on a gamble and do it. A cost of 1 million (not to mention that's peanuts in Vancouver) is negligible when you consider the fact that any derm worth anything can easily make 300k+ without breaking a sweat.

[dmleo]

Dmleo, you are arguing a point I never made. None of us on this forum are interested in the "life and times of an aide making 11$/hr". Hiring freezes on support staff in hospital is real; I know real well, since my ex could not get a job for that fact alone.

 

I never argued nor brought that fact up to the table. I am talking strictly about physicians. You are missing the forest from the trees. Canada may have more physicians NOW but it does not mean that we are saturated when it comes to physicians. Compare the per capita rates of Canada and any European nation and you will see that they have on the average 50% more physicians. We have extensive waiting times and they do not. That speaks volumes.

 

Your point about the cost of setting up a practice is exactly my point. It is not that there aren't opportunities and openings but that physicians aren't willing to take on a gamble and do it. A cost of 1 million (not to mention that's peanuts in Vancouver) is negligible when you consider the fact that any derm worth anything can easily make 300k+ without breaking a sweat.

 

Firstly, the hiring freeze is not just on the support staff..Do you honestly

believe the current medical system can hire the majority of the docs that

graduate?

Secondly, the per capita rate that you like to keep bringing up...have you

ever thought about the tax rate in those European countries compared to Canada? France, Poland, Italy, Austria, Germany sure may have higher

per capita of doctors, better healthcare and what not. But, you must

remember that these countries all have much higher income taxes than us....

We have extensive waiting times because we pay less tax so less money

is available to expand the hospitals and reduce those times...

Thirdly, you really make a million dollar sound like $10..I'm personally

a business major and I know for certain most people are not as adventurous

as you hope when the financial burden is over a million dollars.

Also, you say they easily make 300+ without a sweat, but can they do that

as soon as they open up? and is there a guarantee that he can make that

much until he pays up all the debt (overhead, rental, etc) and be in the

positive to buy a house, car, provide for family assuming that he opens up a

brand new practice by himself as you suggested.

[bloh]

Unlike you I will provide actual statistics:

 

France:

Top marginal tax rate (49.8%)

Per capita physicians (3.4 per 1000)

 

Canada:

Top marginal tax rate (46.4%)

Per capita physicians (2.1 per 1000)

 

Belgium:

Top marginal tax rate (59.3%)

Per capita physicians (4.0 per 1000)

 

Australia:

Top marginal tax rate (46.5%)

Per capita physicians (2.8 per 1000)

 

 

Netherlands:

Top marginal tax rate (52.0%)

Per capita physicians (3.7 per 1000)

 

 

Now that we have debunked the false information you have given, could you also provide a source pointing out to all these unemployed physicians?

[dmleo]

The OECD collects data on 30 member countries and annually calculates what it calls the tax "wedge" for each -- the combined effects of personal income tax, employee and employer social security contributions, payroll taxes and cash benefits.

 

Tax burdens around the world

Country Single, no kids Married, 2 kids Country Single, no kids Married, 2 kids

Australia 28.3% 16.0% Korea 17.3% 16.2%

Austria 47.4% 35.5% Luxembourg 35.3% 12.2%

Belgium 55.4% 40.3% Mexico 18.2% 18.2%

Canada 31.6% 21.5% Netherlands 38.6% 29.1%

Czech Republic 43.8% 27.1% New Zealand 20.5% 14.5%

Denmark 41.4% 29.6% Norway 37.3% 29.6%

Finland 44.6% 38.4% Poland 43.6% 42.1%

France 50.1% 41.7% Portugal 36.2% 26.6%

Germany 51.8% 35.7% Slovak Republic 38.3% 23.2%

Greece 38.8% 39.2% Spain 39.0% 33.4%

Hungary 50.5% 39.9% Sweden 47.9% 42.4%

Iceland 29.0% 11.0% Switzerland 29.5% 18.6%

Ireland 25.7% 8.1% Turkey 42.7% 42.7%

Italy 45.4% 35.2% United Kingdom 33.5% 27.1%

Japan 27.7% 24.9% United States 29.1% 11.9%

Source: OECD, 2005 data

 

If you want Jan 1, 2010, http://www.worldwide-tax.com/

I never mentioned about physician unemployment, I said its harder for

specialists to find jobs in the public hospital.

 

According to what you provided, Canada's 2.1 doesnt seem "50% or more" behind the European

countries as you mentioned.

[apache]

wow, good thing i got in last year, im pretty sure i would have lost both my spots to seat cuts if i applied this year... that sucks

[dmleo]

As well, please look at http://www.kpmg.ca/en/services/tax/documents/2010_FederalandProvIncomeTaxRates4Q2009.pdf

 

http://www.taxtips.ca/taxrates/canada.htm

The top marginal tax rate you showed does not apply to the public

as it is meant for the high income earners such as physicians.

The argument was to compare the average income taxes of the countries,

not the top marginal tax rate for the highest income earners.

[apache]

I totally agree... med school gives back exactly what you put into it... I don't feel hindered in my learning either, I think there's just more of a responsibility to be an independent learner that some people aren't used too, the wet labs are great, most instructors are good, if you're more independent there's always podcast, your free to shadow as much as you like, there's work in the community, most of my small groups, gilberts, clinical skills preceptors have been excellent... in terms of the quality of the education i think theres no a lot to complain about... in fact, compared to undergrad i think i'm getting a real value for what i'm paying

 

--------------

 

I for one am fully enjoying my med school experience, despite the "diluted learning" talk I've read. I have not once felt that I was hindered in my learning. The level of learning is based on what you put into it. People who come to lecture and come prepared to small groups (DL, Gilbert's, CommH, PCC) benefit immensely, and those who don't miss out on being spoon fed and complain about "diluted learning" while they laugh about ditching structured instruction time and lament over independent study assignments. When the proposal for an increase in seats was brought up in years past before they made the increase, they FIRST examined the feasibility with clerkship and residency and got those accommodations in line for the increasing med student number.

[bloh]

My data are directly from the CMAs report on european systems.

 

Also, using France as an example:

 

2.1/3.4 x 100% = 160% (i.e. 50%+ more physicians)

[bloh]

As well, please look at http://www.kpmg.ca/en/services/tax/documents/2010_FederalandProvIncomeTaxRates4Q2009.pdf

 

http://www.taxtips.ca/taxrates/canada.htm

The top marginal tax rate you showed does not apply to the public

as it is meant for the high income earners such as physicians.

The argument was to compare the average income taxes of the countries,

not the top marginal tax rate for the highest income earners.

 

Ok then how about this:

 

France:

Expenditure on healthcare as a % of GDP: 11%

Per capita physicians (3.4 per 1000)

 

Canada:

Expenditure on healthcare as a % of GDP: 10%

Per capita physicians (2.1 per 1000)

 

Belgium:

Expenditure on healthcare as a % of GDP: 10.3%

Per capita physicians (4.0 per 1000)

 

Australia:

Expenditure on healthcare as a % of GDP: 8.7%

Per capita physicians (2.8 per 1000)

 

 

Netherlands:

Expenditure on healthcare as a % of GDP: 9.5%

Per capita physicians (3.7 per 1000)

 

In conclusion, nearly every country has more physicians per capita and spends less on healthcare. Can we drop this issue now?

[Rock*]

I totally agree... med school gives back exactly what you put into it... I don't feel hindered in my learning either, I think there's just more of a responsibility to be an independent learner that some people aren't used too, the wet labs are great, most instructors are good, if you're more independent there's always podcast, your free to shadow as much as you like, there's work in the community, most of my small groups, gilberts, clinical skills preceptors have been excellent... in terms of the quality of the education i think theres no a lot to complain about... in fact, compared to undergrad i think i'm getting a real value for what i'm paying

 

--------------

 

I for one am fully enjoying my med school experience, despite the "diluted learning" talk I've read. I have not once felt that I was hindered in my learning. The level of learning is based on what you put into it. People who come to lecture and come prepared to small groups (DL, Gilbert's, CommH, PCC) benefit immensely, and those who don't miss out on being spoon fed and complain about "diluted learning" while they laugh about ditching structured instruction time and lament over independent study assignments. When the proposal for an increase in seats was brought up in years past before they made the increase, they FIRST examined the feasibility with clerkship and residency and got those accommodations in line for the increasing med student number.

 

Wait until clerkship. If I'm occasionally scrubbed into the OR just to stare at the backs of 2 attendings, 2 fellows, 2 residents, a scrub nurse and an anesthetist work on a patient with a class size of 125-135, I shudder to think what it would be like when there's up to an extra 50% more clinical clerks wandering around the hospital. The scary thing is that despite all the class time available to you in the first two years of med school, clerkship is when you do the real learning and retention.

[dmleo]

Ok then how about this:

 

France:

Expenditure on healthcare as a % of GDP: 11%

Per capita physicians (3.4 per 1000)

 

Canada:

Expenditure on healthcare as a % of GDP: 10%

Per capita physicians (2.1 per 1000)

 

Belgium:

Expenditure on healthcare as a % of GDP: 10.3%

Per capita physicians (4.0 per 1000)

 

Australia:

Expenditure on healthcare as a % of GDP: 8.7%

Per capita physicians (2.8 per 1000)

 

 

Netherlands:

Expenditure on healthcare as a % of GDP: 9.5%

Per capita physicians (3.7 per 1000)

 

In conclusion, nearly every country has more physicians per capita and spends less on healthcare. Can we drop this issue now?

 

I'll make my final post on our debate and here's what I think,

although the GDP spending on healthcare in Canada is comparable

to European countries, it must be remembered that European

healthcare is much more privatized than Canada so the Gov spends

less money on paying doctors.

 

This means, regardless of the GDP spending, it matters where that

money is being spent. In 2009, Canadian Gov spent $183.1 billion

on the healthcare, but about 26B of that went to paying doctors

while only 51B was spent on funding hospitals. You see something wrong here right?

 

To compare Canadian and European countries, each country has their

own unique medical care that cant be easily compared. here is a quote

from an article from CMAJ that compared the French and Canadian healthcare systems,

 

"According to the latest tallies available from the WHO (2004), France has 203 487 physicians, or 3.37 per 1000 people. Nurses number 7.24 per 1000 or just over 437 000 in total. Canada's doctor to population ratio is roughly 2.14 per 1000, with a slightly higher nurse to population ratio of 9.95 per 1000. France also has nearly double the number of hospital beds available per capita."

 

Although we may have less doctors, we use much of our GDP paying them

and cant afford to have more hospitals. However, France already

has more than enough public hospitals and much of their medicine is

already privatized so less money is spent on paying docs who work in public institutions.

 

I didn't want to argue over any of these with you or anyone in particular

and hopefully lets just end it here..

[bloh]

 

This means, regardless of the GDP spending, it matters where that

money is being spent. In 2009, Canadian Gov spent $183.1 billion

on the healthcare, but about 26B of that went to paying doctors

while only 51B was spent on funding hospitals. You see something wrong here right?

 

 

No I don't, do explain. What percentage of healthcare in France is private and how does it relate to a 60% discrepancy in the number of physicians?

 

This has all gone sideways from the initial argument that Canada can use and requires more physicians; we are nowhere near saturation levels in any field.

[sv3]

No I don't, do explain. What percentage of healthcare in France is private and how does it relate to a 60% discrepancy in the number of physicians?

 

This has all gone sideways from the initial argument that Canada can use and requires more physicians; we are nowhere near saturation levels in any field.

 

more like sideways from the initial thread.....you know...small class size at UC. Get a room already!

[dmleo]

No I don't, do explain. What percentage of healthcare in France is private and how does it relate to a 60% discrepancy in the number of physicians?

 

This has all gone sideways from the initial argument that Canada can use and requires more physicians; we are nowhere near saturation levels in any field.

 

I don't have the numbers on the percentage of privatization of healthcare in France and I don't think there is any number because there are too many gray areas in healthcare that involves both the private and public and I don't have the expertise on French medical system.

 

However, I do know that when doctor salaries costs 26 billion dollars,

and not even a double is going into the hospitals (51B) while 30B is

spent on pharmaceuticals, the Canadian healthcare budget cannot

fund the medical schools as much as the French healthcare would who

has less to worry about paying the current doctors.

 

As the stats show, both countries have similar GDP spending on healthcare, but the fact that one has 60% more physicians while the other has to cut down a bunch of med school spots, just shows that

the Canadian medical system is obviously problematic.

 

Lastly, in regards to the discrepancy of physician numbers between the

two countries, more funding goes into med schools in France than in Canada so more doctors come out.

 

And the idea of privatization, http://www.euro.who.int/document/e83126.pdf states that only 62% of all hospital beds in the country

are publicly owned and the rest run by either non-profit sectors and private sectors. So this is a huge difference from Canada where virtually

all hospital beds are publicly funded.

[dmleo]

and regardless of our discussions, nothing will change so I'm just gonna

accept the fact that cuts in med school are most likely going to happen.

 

I'm glad I was able to have this discussion though because I understand

your point of view on the shortage of doctors as the main problem in Canada

whereas I see the lack of control in careful Gov. spending on health care as the main problem.

[Rdub]

Hi,

One thing that can be done in the meantime, and could maybe make a difference, is writing your MP to explain how you don't want cuts to be made to Alberta class sizes. The link is below. Find your area, click on your MP and their email is there.

Just a thought.

http://www.ratemymla.ca/alberta-mp-list

[sv3]

Hi,

One thing that can be done in the meantime, and could maybe make a difference, is writing your MP to explain how you don't want cuts to be made to Alberta class sizes. The link is below. Find your area, click on your MP and their email is there.

Just a thought.

http://www.ratemymla.ca/alberta-mp-list

 

good call......something positive to do.

[Meeko]

Just got an email from the Dean of Medicine at the UofAlberta... looks like there is going to be more cuts to the number of students being accepted next year. He didn't give a number yet, but it is confirmed.

[eyeopener]

brutal. do applicants get this email or just med students?

[eyeopener]

ps. I really hope this isn't an April Fool's joke... (or rather, I hope it is because that might mean the news is not true)