b3ar Posted August 1, 2010 Report Share Posted August 1, 2010 I heard GI is one of the more competitive sub-specialties... Just wondering: 1) How does it compare with other IM specialties in terms of competitiveness? What's #1, #2, and where does GI stand? 2) Any significant differences in quality of the GI programs across Canada? 3) Is it common for people to do the GI training in US instead and then come back to Canada to practice? How do the US program compare in terms of quality? 4) What can I do during IM residency to increase my chance? Thanks. Any advice much appreciated! Link to comment Share on other sites More sharing options...
Economist Posted January 17, 2014 Report Share Posted January 17, 2014 I know this is an old thread but this is the only thread about gastroenterology on premed101;; Why is GI such an unpopular specialty on this forum?? I was researching and found that many ppl say GI is a average-good lifestyle with pretty good income but the CMA says avg hours/week for gastroenterologists is 60.1 hrs... What's the job market like in Canada for gastroenterologists? Link to comment Share on other sites More sharing options...
thebouque Posted January 17, 2014 Report Share Posted January 17, 2014 GI is one of the most competitive IM subspecialties Link to comment Share on other sites More sharing options...
medicine man Posted January 17, 2014 Report Share Posted January 17, 2014 GI is one of the most competitive IM subspecialties Not so much anymore. Job market sucks and so lots of people choosing not do the traditionally competitive/lucrative specialities like Cardio/ICU/GI. Nowadays, its GIM and Endocrinology that are competitive, go figure. Link to comment Share on other sites More sharing options...
Economist Posted January 17, 2014 Report Share Posted January 17, 2014 Not so much anymore. Job market sucks and so lots of people choosing not do the traditionally competitive/lucrative specialities like Cardio/ICU/GI. Nowadays, its GIM and Endocrinology that are competitive, go figure. 2012 Gastro First choice - 53, total quota - 47 2013 Gastro First choice - 36, total quota - 42 https://www.carms.ca/pdfs/2012R4_MatchResults/R-4%20-%20table%203%20-%20Discipline%20Choices%20of%20Applicants_en.pdf https://www.carms.ca/pdfs/2013R4_MatchResults/R-4%20-%20table%203%20-%20Discipline%20Choices%20of%20Applicants_en.pdf Based on 2013 match statistics, Critical care and GIM are most competitive.. Why the sudden change in just one year? Link to comment Share on other sites More sharing options...
Real Beef Posted January 17, 2014 Report Share Posted January 17, 2014 Interesting that critical care is so popular considering the job market suck according to recent reports. I guess some people are just eternal optimists. Link to comment Share on other sites More sharing options...
rmorelan Posted January 17, 2014 Report Share Posted January 17, 2014 Interesting that critical care is so popular considering the job market suck according to recent reports. I guess some people are just eternal optimists. It may have a bad job market but it is just an add on really. Diversification and all that. Link to comment Share on other sites More sharing options...
Economist Posted January 19, 2014 Report Share Posted January 19, 2014 Well if every specialty is having a tough time with the job market, then it seems like you can't really do anything about it and not care about it so much. Is the job market so bad that you can't even find a position in rural area? Link to comment Share on other sites More sharing options...
ploughboy Posted January 20, 2014 Report Share Posted January 20, 2014 but it is just an add on really. Beg your pardon? Link to comment Share on other sites More sharing options...
medicine man Posted January 20, 2014 Report Share Posted January 20, 2014 Well if every specialty is having a tough time with the job market, then it seems like you can't really do anything about it and not care about it so much. Is the job market so bad that you can't even find a position in rural area? Specifically for IM subspecialties, the difference between other specialties with poor job markets is that if you are IM certified you can moonlight and make amazing $$. So some people are willing to go into GI for example despite a poor job market because they'd be fine waiting out for a job b/c they'll just moonlight in IM and make a great living. For example, Nephro is a terrible job market right now, but there are fellows I know who are doing a PhD/extra fellowship in Toronto but go about 1 hour out to moonlight and make staff like dollars. If willing to go out even further than more income is possible. Of course its not an academic /permanent position in the city of choice that they crave for but thats why they're doing the fellowships/PhD route. Many residents enjoy IM, particularly consults which happen to be the most lucrative as well so its not as bad of a situation to be vs. some of the surgical subspecialties where you cannot practice a base subspecialty while doing research/fellowships. Link to comment Share on other sites More sharing options...
thebouque Posted January 20, 2014 Report Share Posted January 20, 2014 Not so much anymore. Job market sucks and so lots of people choosing not do the traditionally competitive/lucrative specialities like Cardio/ICU/GI. Nowadays, its GIM and Endocrinology that are competitive, go figure. Well at my school internal residents automatically get a GIM position if they choose to or if they fail in the R4 match. Maybe GIM is competitive elsewhere but it's not the case everywhere. Link to comment Share on other sites More sharing options...
A-Stark Posted January 20, 2014 Report Share Posted January 20, 2014 Every IM program does that. The 2-year GIM fellowship is competitive because it's not yet available everywhere. Link to comment Share on other sites More sharing options...
Economist Posted January 20, 2014 Report Share Posted January 20, 2014 Specifically for IM subspecialties, the difference between other specialties with poor job markets is that if you are IM certified you can moonlight and make amazing $$. So some people are willing to go into GI for example despite a poor job market because they'd be fine waiting out for a job b/c they'll just moonlight in IM and make a great living. For example, Nephro is a terrible job market right now, but there are fellows I know who are doing a PhD/extra fellowship in Toronto but go about 1 hour out to moonlight and make staff like dollars. If willing to go out even further than more income is possible. Of course its not an academic /permanent position in the city of choice that they crave for but thats why they're doing the fellowships/PhD route. Many residents enjoy IM, particularly consults which happen to be the most lucrative as well so its not as bad of a situation to be vs. some of the surgical subspecialties where you cannot practice a base subspecialty while doing research/fellowships. Don't IM sub-specialties enter fellowship after 3 year of IM training? So are they even recognized as qualified internists? Link to comment Share on other sites More sharing options...
BK47 Posted January 20, 2014 Report Share Posted January 20, 2014 Don't IM sub-specialties enter fellowship after 3 year of IM training? So are they even recognized as qualified internists? I believe that after you've completed 4 years of post-graduate training, you write an exam and once you've passed you qualify as an internist. This is regardless of the specialty you pursue. For instance, if you did GI, after 1 year of GI (and 4 years since you've graduated medical school), you write an exam and are a certified Internist and can now moonlight for the last year of your GI fellowship. At least that's my understanding. If theres something incorrect there hopefully a resident can correct it Link to comment Share on other sites More sharing options...
NLengr Posted January 20, 2014 Report Share Posted January 20, 2014 I believe that after you've completed 4 years of post-graduate training, you write an exam and once you've passed you qualify as an internist. This is regardless of the specialty you pursue. For instance, if you did GI, after 1 year of GI (and 4 years since you've graduated medical school), you write an exam and are a certified Internist and can now moonlight for the last year of your GI fellowship. At least that's my understanding. If theres something incorrect there hopefully a resident can correct it That's correct. They write thier RCPC exam in the spring of year 4 (first fellowship year). If they pass they can work as a fully independent general internist. For the life of me, I don't understand why the 2 year general internist fellowship exists. Unless they plan to phase out the 4 year general internist license. Link to comment Share on other sites More sharing options...
BoyInTheBubble Posted January 20, 2014 Report Share Posted January 20, 2014 Don't IM sub-specialties enter fellowship after 3 year of IM training? So are they even recognized as qualified internists? IM's very liberal use of the term "fellowship" has always bothered me. Being a cardiologist is cool and impressive and all that, but the REAL fellows do training after they have their general (aka totally regular) cardiology license. Electrophysiology doesn't take two fellowships, it takes extra training by a cardiologist. Like transplant surgeons do extra training after they become general surgeons (or urologist) and whatnot. Or in ortho you can train to specialize in left 3rd metatarsal-phalangeal joints and such. Link to comment Share on other sites More sharing options...
medicine man Posted January 21, 2014 Report Share Posted January 21, 2014 That's correct. They write thier RCPC exam in the spring of year 4 (first fellowship year). If they pass they can work as a fully independent general internist. For the life of me, I don't understand why the 2 year general internist fellowship exists. Unless they plan to phase out the 4 year general internist license. Basic breakdown. Everyone who enters Internal Medicine now will likely write 2 RSCPC exams. Everyone will do: For example for those going into GIM Years 1-3: Core IM Year 4: Start Fellowship. Write the Internal Medicine exam. Qualified Internist Year 5: Finish fellowship. Write GIM subspecialty exam. Qualified now as a General Internist. The point of GIM fellowship is to give an extra year for training in Cardiology (for stress tests, Holters which are mandatory for the GIM fellows), Obstetric Medicine (mandatory) plus extra ICU (i believe mandatory). Many places now offering ECHO or Bronch skills in the extra GIM year. If you are qualified as a regular Internist, you can still run CTU, you can still do inpatient consults, but you likely cannot do outpatient GIM in an academic centre, obstetric medicine or have skills to do outpatient Cardiology stuff like stress tests or Holters etc..But of course intstead you can practice your subspecialty such as GI, Respirology or whatever. And this extra year I believe has to be predominantly clinical, you can't get away with doing 1 year of research like in some subspecialties. They won't phase out the regular Internist qualification. Many subspecialists would like to (sometimes have to b/c lack of $$ in their own subspecialty) practice regular IM. BUT don't be surprised if in the future at big academic centres like Toronto that they will want their CTU staff to have GIM label, not b/c of its better but mainly because its Toronto and they can. Hope this helps Link to comment Share on other sites More sharing options...
BK47 Posted January 30, 2014 Report Share Posted January 30, 2014 Anyone able to comment on particularly strong GI programs? Any tips / insights for matching to GI? Apart from the standard doing research, etc. It seems most core IM programs don't give too much elective time outside their own centre... I suppose its not common but is it possible people match to programs for a fellowship where they didn't spend much if any elective time for GI? Link to comment Share on other sites More sharing options...
Vidhya Posted January 30, 2014 Report Share Posted January 30, 2014 That's correct. They write thier RCPC exam in the spring of year 4 (first fellowship year). If they pass they can work as a fully independent general internist. For the life of me, I don't understand why the 2 year general internist fellowship exists. Unless they plan to phase out the 4 year general internist license. I was told (perhaps incorrectly) that the 4-year general internist programs will be gone in 2015. Is this correct? Link to comment Share on other sites More sharing options...
NLengr Posted January 30, 2014 Report Share Posted January 30, 2014 I was told (perhaps incorrectly) that the 4-year general internist programs will be gone in 2015. Is this correct? No idea, I'm a surgical resident. One of the internal residents will have to comment. Link to comment Share on other sites More sharing options...
A-Stark Posted January 31, 2014 Report Share Posted January 31, 2014 The point of GIM fellowship is to give an extra year for training in Cardiology (for stress tests, Holters which are mandatory for the GIM fellows), Obstetric Medicine (mandatory) plus extra ICU (i believe mandatory). Many places now offering ECHO or Bronch skills in the extra GIM year. Yes, that's the "point", and while it (might) apply for echo or bronch skills, there are plenty of community general internists who have been doing all these things for years. This is especially true of stress tests - they've been read by general internists forever. If you are qualified as a regular Internist, you can still run CTU, you can still do inpatient consults, but you likely cannot do outpatient GIM in an academic centre, obstetric medicine or have skills to do outpatient Cardiology stuff like stress tests or Holters etc..But of course intstead you can practice your subspecialty such as GI, Respirology or whatever. And this extra year I believe has to be predominantly clinical, you can't get away with doing 1 year of research like in some subspecialties. I would be very cautious about saying "cannot" in this context, not that most specialists have any interest whatsoever in practicing outpatient GIM. Of course, internists trained under the existing 4-year training program will still do all those things. They won't phase out the regular Internist qualification. Many subspecialists would like to (sometimes have to b/c lack of $$ in their own subspecialty) practice regular IM. BUT don't be surprised if in the future at big academic centres like Toronto that they will want their CTU staff to have GIM label, not b/c of its better but mainly because its Toronto and they can. I really don't know that many subspecialists who look forward to CTU coverage or medicine call. As for the "academic centre" angle, that should set off alarms that credentialism is playing a large role in this. I was told (perhaps incorrectly) that the 4-year general internist programs will be gone in 2015. Is this correct? I don't believe so. The real elephant in the room will be the move to competency-based postgrad education, the implications of which will affect pretty much everyone and in a not-especially-predictable way. Link to comment Share on other sites More sharing options...
entangledphoton Posted January 31, 2014 Report Share Posted January 31, 2014 Can you give more information about the forthcoming competency-based curriculum? When is it going to be phased in? Link to comment Share on other sites More sharing options...
NLengr Posted January 31, 2014 Report Share Posted January 31, 2014 As for the "academic centre" angle, that should set off alarms that credentialism is playing a large role Academic Center? Credentialism? Impossible. I agree with you that you don't need an extra year to learn to broch. I did a bunch in ICU. It's honestly not that hard. Link to comment Share on other sites More sharing options...
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