A question about this CaRMS match chart

[jerkstore]

courtesy of one tooty-

 

 

Assuming I'm reading that correctly, why do you figure cardiac surgery is so low on the list? Roughly only half of the quota filled? I figured as far as surgery goes it is a very prestigious and high paying speciality. All the rest of them seem to be in about the place I'd expect them to be, but this one stands out as an anomaly to me.

 

Why do you submit this is?

 

 

On a side note, what is the difference between an emergency medicine physician, and a physician who works in the emergency room? My FP spends a good 3 nights a week in the emergency room here in Markham, and I know of many others who rotate through there as well.

[Med0123]

1- where did you find this chart? is it from CaRMS 2012 1st iteration?!

2- because job prospectives are poor in cardiac surgery

3- 5 years program emergency medicine aim to train physicians who will be able to work in major tertiary hospitals with important case load and taking care of patients with some specific characteristics (trauma, burns, ...). This 5 years program is very popular due to the amazing curriculum it provides (check it out on carms website, you'll be surprised how this residency looks ridiculously cool).

[jerkstore]

1- where did you find this chart? is it from CaRMS 2012 1st iteration?!

2- because job prospectives are poor in cardiac surgery

3- 5 years program emergency medicine aim to train physicians who will be able to work in major tertiary hospitals with important case load and taking care of patients with some specific characteristics (trauma, burns, ...). This 5 years program is very popular due to the amazing curriculum it provides (check it out on carms website, you'll be surprised how this residency looks ridiculously cool).

 

No I made it myself, and as always I give tooty credit for everything I do.

[Med0123]

but where do the data come from?

[jerkstore]

"Here is a list from Carms 2011 sorted roughly by their relative competitiveness"

 

- tooty

 

That's all I know sorry.

[jerkstore]

Well yeah but, I was talking about Cardiac Surgery and that doesn't really fall under the negatives you listed.

 

But you both mentioned job prospects, and I could see that being low for a Cardiac Surgeon (is this Cardio Thoracic?).

 

Thanks.

[Blake]

Not too shabby for neurosurg.

[rmorelan]

1- where did you find this chart? is it from CaRMS 2012 1st iteration?!

2- because job prospectives are poor in cardiac surgery

3- 5 years program emergency medicine aim to train physicians who will be able to work in major tertiary hospitals with important case load and taking care of patients with some specific characteristics (trauma, burns, ...). This 5 years program is very popular due to the amazing curriculum it provides (check it out on carms website, you'll be surprised how this residency looks ridiculously cool).

 

Although 2+1 family docs have also been known to get into tertiary centres as well to be fair. The doesn't seem to be much difference in job opportunities after being in practice for a while.

[wcoast11]

Why do you think community medicine (Public Health & Preventive Medicine) is so low on the list? From reading moo's posts on other threads, it seems like it's a pretty interesting specialty that allows one to do quite a lot, both clinical and policy activities.

 

Are job prospects bad in that area too?

[inspiring-curmudgeon]

I don't understand why plastics is so competitive nowadays when the job market is so tight. I wonder what the residency graduates do while waiting for a job (or a job in the right location).

[lostintime]

Botox? Cosmetic stuff? Nothing wrong with that if there are no jobs anyway.

[thebouque]

1- where did you find this chart? is it from CaRMS 2012 1st iteration?!

2- because job prospectives are poor in cardiac surgery

3- 5 years program emergency medicine aim to train physicians who will be able to work in major tertiary hospitals with important case load and taking care of patients with some specific characteristics (trauma, burns, ...). This 5 years program is very popular due to the amazing curriculum it provides (check it out on carms website, you'll be surprised how this residency looks ridiculously cool).

 

3 years er docs can work in tertiary emergency rooms as well (and since you're in Quebec, currently there are PREMS for pgy 3 er docs in major urban centers but almost none for pgy5s).

[1234]

Cardiac Surgery isnt a really desired specialty because:

 

1. Lack of exposure in pre/clerkship

2. Medicine, preventative care and cardiology has cut into CABG numbers drastically.

3. Due to #2, lack of jobs

4. Hours are terrible.

5. Developing proficiency in CV surgery takes an inordinate amount of time, more than most other surgery (other than NS). I've seen people on their 7th fellowship not having developed the know-how or competence.

6. Call is extremely stressful - dissections, etc.

[jerkstore]

7th fellowship?

 

How long is a fellowship?

[rmorelan]

I don't understand why plastics is so competitive nowadays when the job market is so tight. I wonder what the residency graduates do while waiting for a job (or a job in the right location).

 

Not all applicants really look that far into the future for the job market. First of all it is often what is the job market going to be like in 7-8 years (actually if you are a plastics gunner it could be easily 10 years from now), and of course most medical students are type A people that don't believe we cannot succeed as well

[mavrik13]

Why do you think community medicine (Public Health & Preventive Medicine) is so low on the list? From reading moo's posts on other threads, it seems like it's a pretty interesting specialty that allows one to do quite a lot, both clinical and policy activities.

 

Are job prospects bad in that area too?

 

Job prospects are decent from what I hear, but are non-existent in major urban areas. Not only will you have to move, but most likely you will have to move into a nondesirable semi-rural area.

 

I don't understand why plastics is so competitive nowadays when the job market is so tight. I wonder what the residency graduates do while waiting for a job (or a job in the right location).

 

Don't think the job market is that bad - and if it is that bad, it usually takes a few years for the backlog to impact residency choices.

 

Cardiac Surgery isnt a really desired specialty because:

 

1. Lack of exposure in pre/clerkship

2. Medicine, preventative care and cardiology has cut into CABG numbers drastically.

3. Due to #2, lack of jobs

4. Hours are terrible.

5. Developing proficiency in CV surgery takes an inordinate amount of time, more than most other surgery (other than NS). I've seen people on their 7th fellowship not having developed the know-how or competence.

6. Call is extremely stressful - dissections, etc.

 

7th fellowship? Can't see that... maybe a 7th year fellow (which wouldn't be extraordinary, since the residency is 6 years long).

[jerkstore]

Anybody know how a psychiatry or family med residency plays out?

 

Are family med residencies done in a hospital? If so what do they do if you're not learning something specific?

 

I also can't picture how a psychiatry residency is done, do you sit in the shrink's office and listen in?

[thebouque]

Anybody know how a psychiatry or family med residency plays out?

 

Are family med residencies done in a hospital? If so what do they do if you're not learning something specific?

 

I also can't picture how a psychiatry residency is done, do you sit in the shrink's office and listen in?

 

Family medicine: 2 years residency, done in family medicine units. You have a variety of inpatient rotations done in an affiliated hospital (peds, obgyn, internal medicine). You also have ER rotations or ER calls as well as floor calls. There's an important outpatient exposure to family medicine (standard office practice) where as a resident you follow your own patients (you're always supervised by an attending but he's not in the same room of course). This outpatient activity is either longitudinal (X number of hours per week) or as a block.

 

Psychiatry: 5 years residency, the 1st year is off service (so you do maybe 1-2 months of psych usually, no more). You rotate through internal etc, a bit like a glorified 3rd year of clerkship (as is the case in a lot of specialties since the internship year has been abolished).

Then you do psychiatry rotations in various general psych dpts as well as subspecialized dpts (pedopsych, psychosis, mood/anxiety disorders etc). Usually there is a heavy emphasis on inpatient psychiatry but you do follow your own patients. You don't ''shadow a shrink and listen in'' (even med students don't necessarily do that on their psych rotation), you're pretty much on your own but youre supervised (the more advanced you are the less supervision you need and you have more responsibilities). The amount of psychotherapy varies from place to place but it's never a big part of the training.

 

Peace

[thebouque]

Cardiac surgeons don't work in those regions because they would not be able to sustain a practice with the volumes that present to those locations. Rural cardiologists are a better investment for hospitals because they can intervene in emergency and they have the volume of acute patients to sustain a practice. Cardiac procedures, for the most part, aren't that acute (other than dissections). Patients can travel to a major center, and the volume at major centers is completely reasonable because even they don't get floods and floods of patients.

 

 

 

Yes it is that bad. And the issue has nothing to do with the change in pure numbers of cardiac surgeons. It has to do with the change in scope of practice and a huge reduction in CABG interventions secondary to preventative care and early intervention with cath. Thus hospitals aren't getting the volumes, and thus, aren't taking on more cardiac surgeons.

 

 

 

 

^Dude he was talking about plastics and community med, not cardiac surg.

[itimebomb2]

Not all applicants really look that far into the future for the job market. First of all it is often what is the job market going to be like in 7-8 years (actually if you are a plastics gunner it could be easily 10 years from now), and of course most medical students are type A people that don't believe we cannot succeed as well

 

Type A's also tend to avoid situations where they know they are likely to fail...

 

It's hard not to care about job prospects. I mean it's one thing if you can only find satisfaction in life doing one thing - but if you can find joy in a few specialties, not finding a job for the first few years can hurt a lot.

 

First of all, you're talking about foregoing 2-300k in lost earnings per years for each year you have to do an extra fellowship. There are scores of orthos out there who have done 4-5 years of fellowship. I know a FRCSC cardiac surgeon who is redoing his residency in gen surg.

 

These days, your career as a surgeon is only realistically about 30 years or so - a few extra years takes a significant chunk out of that. Not to mention you're spending the best years of your youth as a slave.

 

Cardiac surgery is extremely unappealing due to job market factors and all prospects are only looking worse. It would be foolish not to take that into consideration. Oh and cardiac surgery is not the same as thoracic (gen surg).

[jerkstore]

Why do you say surgeons only have a 30 year shelf life?

 

**** I'd be like 37 by the time I'd be done residency, must I retire at 67?

 

I'd kill to be a surgeon until it kills me.

[rmorelan]

Why do you say surgeons only have a 30 year shelf life?

 

**** I'd be like 37 by the time I'd be done residency, must I retire at 67?

 

I'd kill to be a surgeon until it kills me.

 

His point is probably you have to potentially include that residency and fellowship time into the max shelf life - a lot of surgeons bottom out at 60 or so.

 

Some are really grueling - I know the cardiac boys are in a lot of pain at the end. Call takes a lot out of you over years and years.

[jerkstore]

But there's no mandatory retirement age like for a Pilot right? Shaky hands and whatnot...

 

Ah screw it I'll just be a Dermatologist...probably come out looking better in the end due to free samples.

[rmorelan]

But there's no mandatory retirement age like for a Pilot right? Shaky hands and whatnot...

 

Ah screw it I'll just be a Dermatologist...probably come out looking better in the end due to free samples.

 

No mandatory retirement I know a almost 80 cardiac surgeon. Still going.

 

But long surgeries that are easy when you are late 20s early 30s aren't as easy later one. I was surprised how often attendings would comment on that (one told me straight up surgery is a young man's game, they are quite open that post call days or even post, post call days they are not 100%).

[astrogirl]

Type A's also tend to avoid situations where they know they are likely to fail...

 

This is so extremely true.