Med School Programs

[Guest snowpea]

Hi,

 

I was reading through some old posts (here and on another msg board) and there was a lot of discussion about which med schools are "better." A lot of people were discussing the specific program style for each school, ie when exams are written, etc. I was just wondering where people found this information. I would like to do some research. Thanks. :rollin

[Guest strider2004]

A lot of this information comes directly from med students. Every moderator in this forum knows about their med school - they either have already taken a year or two or have received information from their interview weekends.

In all interview sessions that I have been to, the faculty of medicine has put on some kind of information session for the interviewees. Remember that the interview is not only a chance for the committee to learn about you, but for you to learn more about the school.

I guess I'll tell you a bit about Queens.

4 year program

2.5 years of class, 1.5 years of clerkship

Between 2nd and 3rd year, there's a summer research project that you need to accomplish.

We have 3 exams at the end of every semestre. 1 MCQ, 1 written, 1 practical. This means that each exam covers the entire semestre of material and tests you in a different way.

 

The curriculum is hybrid PBL. This means that we have both lectures and PBL. THe PBL portion is minimal, however - only 3 hours a week. Whether or not this is a benefit - it depends on you. MacMaster is 100% PBL and Harvard WAS PBL and has now switched back to lectures.

 

The class size will be around 90 students next year. The advantage is that you really get to know your classmates. The disadvantage is tht you sometimes feel like you're living in a bubble.

Another disadvantage is that it's Kingston. Some people like it but if you're from a place like Toronto or Vancouver, you might not.

 

Hmm..let's see what else - Queens tends to have a good (residencyy) match rate >90% for 1st 3 choices I think.

That should be about it.

[Guest Ian Wong]

Following up on that, here's a little spiel about UBC. Strider is absolutely right in that most information comes word-of-mouth. At the present time, there isn't really a definitive resource that really explains the inner-workings of each medical school. Most publications tend to deal with statistics relating to admissions or to match rates/licensing exam scores, etc. You'd be surprised to learn that most incoming medical students have little to no idea of the actual content of their medical school curriculum; the information just isn't out there.

 

UBC:

 

-Four year program, with the first two years taught with dental students (med and dent students separate into distinct classes for years 3 and 4)

 

-Total class size for Fall 2001: 128 Meds + 40 Dents

 

-Curriculum:

PBL/Lecture Hybrid, with 6 hours of PBL per week.

 

Patient content starts in the first month of medical school in the form of weekly visits to family physicians (one afternoon per week).

 

Clinical Skills teaching starts immediately in first year for one afternoon per week, with the first half of Med 1 devoted to History-taking and communication skills. Interviewing and physical exams specific to each body area are then taught until the end of Med 2 (1.5 years of instruction).

 

Exams are all at the end of the term (no midterms except for the first term of Med 1, which is intended as a warmup "practice" exam). This is tough, as your exams at the end of May will test you on material covered in January, and since there is no midterm, that January material is tested at full-weight. There are MCQ exams for each block, in addition to Lab exams where Gross Anatomy cadavers and prosections are examined, as well as identification of microscopic anatomy, and a small amount of pathological dissections. At the end of both Med 1 and Med 2, there are clinical exams, where you are observed and marked based on your history-taking and physical examination of patient actors, who will fake a disease, and it's your job to figure it out. Yes, all this happens at the end of each term, making it a rather stressful time.

 

Grading scheme is Honours/Pass/Fail. The threshold for a Fail is 60%, and approximately the top 15% of the class receives an honours for each organ system block. Everyone who gets aboove 60%, but isn't in the top 15% of the class receives a Pass, and therefore the numerical grade you receive is not recorded.

 

There is a mandatory 4-8 week rural family practice elective somewhere in rural BC in the summer between second and third year medicine.

 

Two years of PBL/Lectures, and two years of clerkships and electives in hospitals/teaching centers.

 

UBC's got a pretty good match rate as far as I know. I certainly don't think I'll be handicapped applying out of UBC to CaRMS. This year's graduating class sent people into Radiology, Plastics, Emerg, Urology, ENT, Anesthesia, Neurosurg, Orthopedics, etc. No Derm or Ophthalmology as far as I'm aware.

 

Vancouver's a great city except for all the frickin' traffic and lack of parking spots (only compounded with our current hundred day old bus strike...) Luckily, I drive!

 

Ian

UBC, Med 3

[Guest Akane200]

He he, just got back from vancouver with a pile of chinese comic books and j-rock CDs. Free sky train is cool, no left turn lanes are annoying while driving, very few "highways" around, and the flashing green lights are weird (did you know that in TO that flashing green lights means step on it??? :rollin ).

 

Anyways, here's my schpeel on U of T meds:

 

First two years taught in lectures and PBL. For first year, there are 3 block courses: Structure & Function (anatomy, biochem, physio), Metab + Nutrition (biochem, physio), Brain and Behaviour (neuroanatomy, neuro physio). PBL is from 4 to 6 hours per week (depending on the block course) and taught in the hospitals. Lectures are about 3 to 5 hours everyday (except on days that we have DOCH or ASCM, then about 2-3 hours lectures at times).

 

Two longitudinal courses are ASCM 1 and DOCH 1. We have ASCM (clinical skills: interview and physical exam) once a week for four hours. DOCH is the determinants of community health, and runs for about 4 hours each week.

 

In second year there are two block courses: pathobiology, and foundations. DOCH 2 and ASCM 2 are also longitudinal.

 

Class size = 190 last year (should be larger for the incoming year). Tuition: $17 000 incoming.

 

Exams occur once every four weeks. Most exams are not cumulative for material tested before (except in M+N, DOCH).

 

Grading scheme is honours/pass/fail. >80 is honours, >60 is pass. However, a grade in the 60s will be looked at by the board of examiners, and remedial work may be recommended. In order to pass first year, you must pass Structure and Function (weighted 3.9 courses for the year as opposed to 1.1 for some of the other courses).

 

Third and fourth years are spent in clinical clerkship.

 

The only thing about Toronto is finding housing (other than that, it's a great city). Can be expensive, and cost of living is high within downtown.

[Guest anon]

Hey, don't forget that if you go to UofT you can spend your Friday nights freezing in -20 degrees outside MuchMusic trying to get on Electric Circus. Yippeeee!

[Guest Clairisa]

Sorry to have to ask but what is a MCQ test? Haven't seen this acronym before.

thx

Clair

[Guest YongQ]

MCQ=Multiple Choice Question.

 

About which med schools are "better," really in Canada they're all top quality and all (anglophone at least) match about the same on CaRMS (you may hear things about #1 matching rates, but these differences are absolutely negligible and mostly dependent on the actual people in the class in that year).

I'm sure you know this already, but really (and every school will say this) the issue is finding the right school for you. Do you want lots of options re: research experience? Then check U of T, Alberta, or UBC. Want a small class size? Try Calgary. Want early clinical exposure? Try McGill... and it goes on and on.

[Guest snowpea]

Thanks everyone for all the helpful info. :rollin I was hoping that I could find out this information on the schools' websites, but I guess not.

 

Strider2004 - Oh no! You have to do a research project at Queens! I dread research! :lol

[Guest strider2004]

Snowpea,

The research you do doesn't have to be boring benchwork. It can be as clinical as interviewing patients and collecting data on their journey through the health care system. Maybe some radiologists are trying to improve the resolution of blood in the brain with MRIs. I know somebody who's doing his research project with NASA in Houston. Okay, so maybe I like research.

 

Strider

[Guest snowpea]

Strider - I don't mean to offend. I am very impressed with people who want to do research just because I have never had the knack for it. I don't really have the patience to wait for results.

[Guest strider2004]

Snowpea,

I find research rather frustrating at times as well. I just don't want you to pass over Queens because of its research component.

[Guest RAK2001]

I like the fact Queen's has a research component, and think it is a skill most MDs should have (to some degree). By the way Strider (in response to your earlier post), I think the length of the 3rd year clerkship has lengthened... I got a letter from Birtwhistle saying that the phase I curriculum has shortened to accomodate a longer elective period. I hope this is indeed the case.

[Guest strider2004]

RAK,

Are you serious? Damn. I'm always the last to know Was this in your acceptance package? I'll try to find out what I can. Unfortunately, it wouldn't apply to me because I had a full 4 month phase I.

[Guest RAK2001]

Yeah, this was in my registration package, although the actual schedule was not given to us, so I don't know how much shorter the earlier phases will be. All I nkow is Dean Birtwhistle said "we have made changes to the curriculum to lengthen the clinical clerkship... to give you an earlier exposure to clinical rotations to aid with career choice"... which I assume means that we will be more in line with U of T and UWO's clerkship schedule. He also said if you are weak in science you can START reading Biochem and Physiology NOW (Yeah right! :b ).

[Guest Ian Wong]

Yeah, stay away from the books! Reading stuff this summer'll only make you go insane. Realistically, you will probably only have a summer after both first and second year. After that, fahgetaboutit until after residency is over, and that's a heck of a long time to be working at high intensity. This is made even worse if you think you want to go into a competitive specialty, in which case you might be spending some of your second year summer trying to get extra clinical or research experience in that field. It's best to rest up and have some fun (my opinion!).

 

By the way RAK2001, could you please e-mail me? I've got a project for which I'd really appreciate your help. mdpremie@yahoo.com

 

Ian

UBC, Med 3

[Guest BCgirl]

Ian,

 

Do you know what you want to specialize in?

[Guest Ian Wong]

Well, now that we're completely off the topic (this thread was excellent by the way, and I sure hope that we can produce something like this for the other schools once we get more reps/moderators), I'm looking very heavily into otolaryngology, otherwise known as ENT/Ear Nose and Throat.

 

I've been doing an elective in it for the past two weeks, and got a fair bit of exposure to it during my rural elective as well. It is a specialty that I thought I would like from the outset because of the complex head and neck anatomy (Anatomy was my favourite med school subject by far), fine detail surgery (poking around deep within ears and noses, etc), and a reasonable working lifestyle (yeah, being a trauma surgeon would be cool, but I value my free time as well, and I think there's a lot of other stuff I want to do within my lifetime in addition to practising medicine).

 

ENT also offers an incredible array of sub-specialties within the head and neck region. This includes everything from fine detail work like ear drum grafts, removing cancers surrounding nerves, and doing endoscopic sinus surgery to bigger stuff like head and neck cancers that need removal of large segments of jawbone, followed by a graft from the fibula to reconstruct the mandible. You can even branch into a lot of facial plastic surgery. ENT is a specialty that involves patients from all age groups, which can be a bit of a rarity. Finally, it's a very hands-on and procedure-oriented specialty, which suits my personality. I don't want to walk around trying to figure out what to do, I'd rather be the one doing it!

 

However, one piece of advice I have to all the incoming med students is to be completely open-minded as to what your specialty choices are. Before getting into med school, I had this idea that internal medicine was what I wanted to do. Nothing cooler than working in a hospital trying to diagnose and manage a multitude of patients with complex diseases.

 

When I first got into med school, I thought about Pediatrics and in particular Neonatology, because I really enjoyed the thought of being able to help the most helpless people in our population. I also relished the idea that helping these patients was helping the next generation of people on this planet, with your patients essentially becoming a legacy. I still think that it would be much more satisfying to aid someone and know that they now had a chance to live out their life rather than manage the care of an adult or a senior who already had experienced that chance to live.

 

In the two years since then, I've entertained many different specialties. These were ones that I seriously considered, enough that I went and investigated further as to what I could expect in that career: Orthopedic Surgery, Ophthalmology, Urology, General Surgery and Surgical Oncology in particular, Radiation Oncology, Anesthesia, and Neurosurgery.

 

Each of these specialties has something unique to offer as well.

 

Orthopedics generally has a healthy population base, and the ability to make someone mobile again is very satisfying.

 

Ophthalmology, well, I think eyesight is something truly special, and being able to improve someone's vision is pretty amazing.

 

Urology has a wide variety of sub-specialties in it as well, running the gamut from urologic oncology to fertility.

 

General Surgery, particularly if practised in a smaller city/rural setting offers an incredible range of procedures. I think there would be a great deal of personal satisfaction to be trained to operate in most/all areas of the human body (there's the anatomy geek inside of me talking).

 

Radiation Oncology has the best lifestyle of all of my choices, and there's something intrinsically satisfying about nuking cancer.

 

Anesthesia is a very hands-on specialty, and requires an incredible knowledge base and very quick thinking. One of the anesthetists I know described anesthesia as a controlled and monitored poisoning, which is all it really is. However, it requires a depth of knowledge in pharmacology, and combines this with a detailed familiarity of internal medicine.

 

Neurosurgery? Well, I found neuroanatomy really cool and very interesting, and there's just something about being able to call yourself a neurosurgeon. Neuroanatomy, and the workings of the human brain are an incredibly fascinating area.

 

Of course, there's downsides to every specialty, and that's something that each medical student has to take into account when choosing a specialty. I think each specialty has something great to offer, and the hardest part of medical school, I think, is knowing yourself well enough that you can say: "In the future, I want to be living in this area of the world, doing this type of work, and my personality and financial vision are best compatible with XYZ specialty, so I'm going to work towards it."

 

Ian

UBC, Med 3

[Guest RAK2005]

Ian,

 

Have you given any thought to Neurology (I myself have thought about this area) instead of neurosurg? Less call, better lifestyle, but minus the surgery part!

[Guest YongQ]

Yeah, I volunteered at an MS clinic and a brain injury rehab during undergrad, and I found the lifestyle of the neurologist to be most agreeable. They seem to have a LOT of spare time, but the ones I talked to spent it mostly on doing research.

[Guest RAK2005]

That mix of neuro and research is what really appeals to me... I like a mix of things, so it sounds good to me (probably not to some though!). I need to spend more time in neurology to get a feel of what is REALLY involved.

[Guest Ian Wong]

Neurology has a pretty good lifestyle as long as you don't need to take call for internal medicine. There's a bit of a perception that Neurology is a "nerdy" specialty, probably because it takes a lot of brains to work with brains.

 

The possible downsides to Neuro are that it doesn't make a lot of money; it's a five year residency, which is as long as most surgical specialties, but pays like an internal medicine specialist as far as I understand. This sounds a bit petty, but if you're going to do a long residency on top of medical school and undergrad, cost and repayment of debts is a definite factor.

 

The other downside, for me, comes in terms of personal satisfaction. Yes, you will make the diagnoses when everyone else is scratching their head, but what are you going to do about it? Many neurological diseases are permanent or degenerative, and there's not a lot of cures for the diseases that you encounter. Stuff like Alzheimers, MS, multi-infarct dementia, Parkinsons, etc. For a procedure-oriented person like myself, where I want to dive in and get something done to fix the problem, a career in Neurology would be very frustrating.

 

However, I agree with you. It's a really cool field with a huge knowledge base. Lots of good research going on.

 

Ian

UBC, Med 3

[Guest RAK2005]

I know that this is waaaaay off the original poster's topic, but what the hell...

 

Ian, I took a look at some salaries for BC Neurologists, and the range was approx. $200-250k (average of five or so specialists). I am not sure what internal meds salaries are like, but an income of, say, $225k will likely pay off most of my debts within a reasonable time frame... the truth is that I have a neuroscience bias (I did my MSc in the field) and the fact that so much is unknown, or unravelling is a perk for me!!

 

My other thoughts have been to Rheumatolgy (after int. med) or physical medicine and rehab .... all of these areas have ties to my undergrad (Physiotherapy) and masters work and were of interest... the key to all of these are that the diseases and conditions are often progressive, and MDs work to "manage symptoms". The time I spent in these areas were frustrating and fascinating at the same time. I guess I don't have a surgeon's perspective of "get in there and see what we can fix".

[Guest strider2004]

I've been trying to figure out the whole physician salary thing. I'm going to be pulling information from everywhere so it might not be consistent but at least it will give you some idea. Some sources(speaking about Ontario only) will tell you that surgeons average around the $280-350k range(cardiac is more around $400-500k) and family physicians average around the $160k range.

 

Using Ian's numbers for family physician fees(assuming that all the physician does is histories and physicals), a FP makes about $390k before costs, $190k after costs so about $110k after tax(depending on the province).

 

25% of UWO med students(according to their survey) will graduate with a debt of >$100k. Obviously many will have much less debt than that. But if you graduate with a $100k debt and net $110k 2 years later, it's still quite a long time before you can pay everything off.

 

Many people(including the Ontario government) think that doctors buy a Mercedes Benz the day after they graduate from med school. It's actually much longer than that. Expect to live like a student until the end of residency(since some banks require you to start paying off your principal in residency) and then you have to concentrate on getting rid of your debts. (This is where MD management steps in)

 

The problem with long residencies is that you can't pay off your debt until much later. And once you're done with your student loans, you have a mortgage, a family, etc. A lot of physicians want to start families after med school or even during(or before). This is tough to do when you're 7 years out of med school and at age 35 making $60k(gross) doing neurosurgery.

 

I was leaning towards radiology when I first got into med school because of my physics and computer background. I'm now thinking of general surgery because of the challenge. Time? I figure I can pay off more debts if I'm not spending any money. And I won't be spending money if I'm stuck in the hospital 100hrs/wk, right? Like Ian, I like having concrete objectives.

[Guest Ian Wong]

Here's a link regarding physicians salaries in BC, based on which specialty you are in. Table 2C is one of note:

 

www.hlth.gov.bc.ca/msp/irm/9899/practitioner.pdf

 

Something that you'll each very quickly here is that pathologists seem to have it all over everyone else. It's important to recognise that as a physician, you can bill for any procedures that are done by one of your employees. Therefore, a pathologist who not only analyzes a blood smear, but also has the patient come in and has his/her phlebotomist draw the blood can bill for both procedures. Of course, the pathologist then has to pay the annual wages for all of that practice's employees, so their very high billing ranges aren't necessarily indicative of what they actually take home.

 

Here's another by the US Bureau of Labour Statistics, and this is for US physicians, and in US dollars.

 

www.bls.gov/oco/ocos074.htm

 

 

I think it's important to note that there are many billing codes, and therefore each procedure pays differently. Another is that it is probably of crucial importance to find a specialty that you will enjoy practising. Financial aspects aside, I didn't get into medicine for the long haul only to enter a specialty that I hated. I want to enjoy my work, and be happy each morning that I enter the office.

 

Ian

UBC, Med 3