U of T rejects 2400+ people every year...

[10wattbulb]

That's if you can get there and that's a big IF to begin with. You make it seem like it's a walk in the park: 'oh, I'll go into medicine'.

 

Lol

 

Err... I'm obviously talking about those who make it in Med school...

[seeking1]

Why is it that premeds can't wrap their heads around the concept of physician glut and the need for it to be addressed in a holistic and systemic manner?

 

Are you so willing to get into med school now only to be potentially screwed 6-10 years from now when problems will be worse, not better?

 

Because most premeds come from a science background, and in science the only way to succeed is to become more specialized?

 

aaronjw, you understand that its only the specialists who are facing a job market glut right now, right? The 'holistic' manner to address the problem is to stop people from becoming so specialized and to have them go into primary care.

 

Is this a problem, from your perspective? To me, its not. If people want better work from their primary care physician, perhaps they should pay for better training and CME for primary care.

[aaronjw]

Because most premeds come from a science background, and in science the only way to succeed is to become more specialized?

 

aaronjw, you understand that its only the specialists who are facing a job market glut right now, right? The 'holistic' manner to address the problem is to stop people from becoming so specialized and to have them go into primary care.

 

Is this a problem, from your perspective? To me, its not. If people want better work from their primary care physician, perhaps they should pay for better training and CME for primary care.

 

And you don't think that if changes aren't made now that it won't trickle down to FM? Sure people will be able to open up shop but keep going the way it's going and FM will become over populated and diluted.

[moo]

I really don't agree with you on this, moo. It's easy to make such a comment once you've already been accepted into Med school and are already an established MD. It is in your advantage to encourage a "numerus clausus" policy to keep MD salaries and job status as high as possible.

 

There are many regions across Canada that have a hard time recruiting doctors. Some patients have to wait for months and months on end before they can see a specialist. For Heaven's sake, some people can't even find themselves a family doctor!

 

So you'd rather train for 10 plus years only to realize that there are no jobs where you want to work or no jobs period? Or be stuck in a miserable specialty? Great. Why don't we open the floodgates and let everyone who wants to be a doctor in.

 

MD spots need to be cut by 50% at least.

[moo]

It's easy for moo to make this comment because he probably has friends who are now finishing their 5 year residencies and additional fellowships and still can't find a job. Seriously. Ask any chief resident in any surgical field what their job prospects are like...it's ugly.

 

Including myself. None of the job offers I've had require my FRCPC. I wasted an additional three years specializing. I'm lucky I have my general license. Premeds don't get it. Think long term. The instant gratification of the med school acceptance will gradually wear off, especially when youre nearing the end of your grueling residency training with no end in sight to the training because you need multiple fellowships just to land a job at Podunk, Canada

[moo]

Why is it that premeds can't wrap their heads around the concept of physician glut and the need for it to be addressed in a holistic and systemic manner?

 

Are you so willing to get into med school now only to be potentially screwed 6-10 years from now when problems will be worse, not better?

 

It's called instant gratification. Which is just about the worst attribute one can have.

[moo]

Sorry guys, but the job prospects in medicine are much better than in many other fields. Speak to the journalists, grad students, artists, scientists looking for tenure track positions, firefighters, people in the manufacturing industry, teachers, etc... Other people have a way harder time to find a job than the MDs.

 

While there are some disciplines in medicine that are not very much in demand, there are very few doctors who don't find work soon after completing their residency. I do however feel that all Med students should be provided with stats and advice on the different medical specialties so that they can have an idea of what the job prospects are like in X or Y discipline before embarking in X or Y.

 

Tell that to my peds sub specialty friends, or the med onc fellows graduating this year or my ophthal friend who can't get OR time despite finishing a retinal fellowship, begging me for referrals. Or my 21 other specialty colleagues finishing this year with only 3 job openings across the country. Or the Royal College commission looking into the problem.

[aaronjw]

I could be wrong but I believe the biggest hindrance to addressing physician glut comes from the CMA. It's not in their best interest to have less physicians. As less physicians = less fees so of course they don't want that and it's not *their* problem if physicians have troubles finding work after graduation and residency.

[moo]

And you don't think that if changes aren't made now that it won't trickle down to FM? Sure people will be able to open up shop but keep going the way it's going and FM will become over populated and diluted.

 

Very true. Don't think FM is immune to this problem. The tide is changing even in something like psych, long thought to be immune from job market changes. My psych friend told me that just 5 years ago you could come out and basically do what you were interested in. Now grads are just lucky to get any job in a big market like Vancouver. You don't think in a few more years time with this short sighted increase in docs, psych grads will soon not have their pick of location? Four years ago we all laughed at the neurosurgeons because they couldn't find jobs. It's now spreading to other specialties, just when my cohort of grads from the mid2000s are finishing, BEFORE the crazy 100% increase in med school spots. I feel sorry for those just starting. I shudder to think what the job market will be like then. Even if folks suddenly retire, you got my cohort and future docs doing multiple fellowships wanting to come back to Canada if they went to the US (there hasn't been a brain drain to the US since the early 00s).

[moo]

I could be wrong but I believe the biggest hindrance to addressing physician glut comes from the CMA. It's not in their best interest to have less physicians. As less physicians = less fees so of course they don't want that and it's not *their* problem if physicians have troubles finding work after graduation and residency.

 

Not the CMA but residency programs. Programs rely on resident slave labor so it's not in their best interest to cut positions.

[esus]

Shouldn't there be a massive drop in physicians in 5-10 years as all the baby boomers start retiring, or am I mistaken?

[aaronjw]

Shouldn't there be a massive drop in physicians in 5-10 years as all the baby boomers start retiring, or am I mistaken?

 

There are only 9000 physicians 65+ And another 16000 that are 56-64

 

http://www.cma.ca/multimedia/CMA/Content_Images/Inside_cma/Statistics/02SpecAge.pdf

[moo]

Shouldn't there be a massive drop in physicians in 5-10 years as all the baby boomers start retiring, or am I mistaken?

 

Many MDs work till they are 70-80. Even part time. That's at least another 20-30 years for the boomers. I have 2 MDs in my clinic who are "retired". One is 73. He works four days a week and just cut down by 1 day this month because he was "getting tired". The other is 66. He works 3 days a week. My family doc has a partner, again, semi retired in his 70s working 3 days a week.

 

This is what they told us when we started school 10 years ago. And again it's what they told us when we started residency. It's clear this is not happening. And when retirements do happen, someone with more fellowships and training takes the spot which is what is happening in my specialty in all the desirable spots in BC.

[Kasiunut]

Honestly too, many physicians aren't retiring because they can't afford to. I spoken to many people who are physicians or whose parents are physicians and they admit that they are just bad with money (I'm not saying all physicians are, but a surprising amount are, at least that I've heard).

 

One guy told me that his dad, an ENT, has so much debt that he's literally living pay cheque to pay cheque. He lived a lavish life style - kids all went to expensive private schools, wife didn't work, they traveled a lot, bought a cottage, have fancy cars etc....but he didn't save anything. He's currently in his mid 60s and not only has no retirement (unless I guess he sells all his assets) but has substantial debt on top of that.

 

Another couple, who have a cottage next door to my parents, both docs (one is a surgeon, the other a radiologist) are in their mid-40s and JUST finished paying off their students loans and LOCs that they accumulated while training (which was prolonged because the woman, who is the surgeon, had 2 kids in the middle of her residency). They are only now just starting to actually enjoy the money they are making and I seriously doubt that they'll be retiring by the time they are in their mid-60s, as that's only 20 years away.

 

A friend of mines husband just finished his ortho surg residency and wasn't able to find a permanent job. He's doing locums at various hospitals around Ontario, which I guess is good that he's employed but its hard on him (and their family, since they just had a baby) because he has to travel so much. One week he might be in Barrie, the next in Hamilton then in North York. Its tough because he'll often either have to drive a long way or end up staying in hotels a lot.

 

This is the reality of medicine in Canada.

[moo]

Honestly too, many physicians aren't retiring because they can't afford to. I spoken to many people who are physicians or whose parents are physicians and they admit that they are just bad with money (I'm not saying all physicians are, but a surprising amount are, at least that I've heard).

 

One guy told me that his dad, an ENT, has so much debt that he's literally living pay cheque to pay cheque. He lived a lavish life style - kids all went to expensive private schools, wife didn't work, they traveled a lot, bought a cottage, have fancy cars etc....but he didn't save anything. He's currently in his mid 60s and not only has no retirement (unless I guess he sells all his assets) but has substantial debt on top of that.

 

Another couple, who have a cottage next door to my parents, both docs (one is a surgeon, the other a radiologist) are in their mid-40s and JUST finished paying off their students loans and LOCs that they accumulated while training (which was prolonged because the woman, who is the surgeon, had 2 kids in the middle of her residency). They are only now just starting to actually enjoy the money they are making and I seriously doubt that they'll be retiring by the time they are in their mid-60s, as that's only 20 years away.

 

A friend of mines husband just finished his ortho surg residency and wasn't able to find a permanent job. He's doing locums at various hospitals around Ontario, which I guess is good that he's employed but its hard on him (and their family, since they just had a baby) because he has to travel so much. One week he might be in Barrie, the next in Hamilton then in North York. Its tough because he'll often either have to drive a long way or end up staying in hotels a lot.

 

This is the reality of medicine in Canada.

 

Could not agree more. Business skills are so important in medicine. I didn't take any business courses in my math and physics degree but have picked up a lot of pointers from friends, colleagues, accountants, along the way. Making a ton of money does not mean you will have money in the end if you don't know how to manage it. One of the biggest mistakes docs make is not budgeting and not budgeting enough for taxes. As a resident your taxes get deducted automatically. When you are in private practice, you have to budget accordingly and things get even more complicated if you're incorporated. Docs end up owning money to the CRA and with interest, that can add up.

[tooty]

The instant gratification of the med school acceptance will gradually wear off, especially when youre nearing the end of your grueling residency training with no end in sight to the training because you need multiple fellowships just to land a job at Podunk, Canada

 

I heard this is true for urban sites but it seems there are lots of positions in rural areas, esp the general specialties like family, internal, peds, gen surg. Where I'm at, a town of 10,000, we're constantly looking for new recruits. Much less desirable locations than urban sites though, unfortunately.

[wcoast11]

Including myself. None of the job offers I've had require my FRCPC. I wasted an additional three years specializing. I'm lucky I have my general license. Premeds don't get it. Think long term. The instant gratification of the med school acceptance will gradually wear off, especially when youre nearing the end of your grueling residency training with no end in sight to the training because you need multiple fellowships just to land a job at Podunk, Canada

 

moo, all your other posts make it seem like you love community medicine

 

So having the benefit of hindsight, what would you recommend to a med student who was also interested in your field of work? (Some family medicine, some public health). If not community medicine (since your FRCPC was "wasted" as you say), then what?

[Robin Hood]

I found this (but it's in French):

http://www.newswire.ca/fr/story/961665/les-futurs-medecins-choisissent-la-medecine-de-famille-plus-que-jamais

 

Basically, the number of new FM residents increased 11% (384 vs 347) from last year in Quebec. This is due to the increased exposure to FM and increased valorization of FM during med school. This seems to work more than penalities.

[Robin Hood]

Could not agree more. Business skills are so important in medicine. I didn't take any business courses in my math and physics degree but have picked up a lot of pointers from friends, colleagues, accountants, along the way. Making a ton of money does not mean you will have money in the end if you don't know how to manage it. One of the biggest mistakes docs make is not budgeting and not budgeting enough for taxes. As a resident your taxes get deducted automatically. When you are in private practice, you have to budget accordingly and things get even more complicated if you're incorporated. Docs end up owning money to the CRA and with interest, that can add up.

 

The same bad budgeting skills seem to apply to med students. A good portion of the LOC is spend for vacations in Cuba.

[aaronjw]

The same bad budgeting skills seem to apply to med students. A good portion of the LOC is spend for vacations in Cuba.

 

Any stats to confirm this?

 

Now if I were a med student and spent some money on a trip somewhere I'd feel absolutely no guilt for doing so. People need vacations.

[moo]

I heard this is true for urban sites but it seems there are lots of positions in rural areas, esp the general specialties like family, internal, peds, gen surg. Where I'm at, a town of 10,000, we're constantly looking for new recruits. Much less desirable locations than urban sites though, unfortunately.

 

For now, this is true.

[moo]

moo, all your other posts make it seem like you love community medicine

 

So having the benefit of hindsight, what would you recommend to a med student who was also interested in your field of work? (Some family medicine, some public health). If not community medicine (since your FRCPC was "wasted" as you say), then what?

 

It's hard to say. I love public health for sure. But I can't say I'm pleased with the job situation. I am lucky as I have my general license and can do contracts and consulting, be the research guru for family med residents and teach. None of this requires a FRCPC of course, but it gives you more legitimacy and The program in and of itself teaches you a lot of skills, from practical management skills, to running and chairing a meeting to budgeting in addition to all the epi and research skills. I'm just frustrated that my ideal job has not come about. I guess I would say the FRCPC is wasted in that the jobs don't require you to have one, but the resident taught me a lot of valuable skills.

[moo]

Any stats to confirm this?

 

Now if I were a med student and spent some money on a trip somewhere I'd feel absolutely no guilt for doing so. People need vacations.

 

Cuba is cheap. But I think it's good for students to learn how to make a budget, unless you live off mommy and daddy and have an infinite source of income. I definitely recommend residents make a budget. And I recommend with that budget, finding 100 bucks in savings that you can cut out (that you don't need) and putting it into a low interest but safe investment such as a money market fund. For me, I discovered that I could cut out my landline and my cable TV (and use an antenna so I wasnt missing much) in residency, saving 100 bucks a month there. For others, it may be packing a lunch instead of eating out. I put this in a tax free savings account for a rainy day. The Jews call this a Shalom fund and it's a practical way to survive in today's economy.

[medigeek]

Why is it that premeds can't wrap their heads around the concept of physician glut and the need for it to be addressed in a holistic and systemic manner?

 

Are you so willing to get into med school now only to be potentially screwed 6-10 years from now when problems will be worse, not better?

 

What's wrong with doing family medicine? As far as I know, a family doctor has no problem getting in a job in toronto/gta.

[Robin Hood]

I heard this is true for urban sites but it seems there are lots of positions in rural areas, esp the general specialties like family, internal, peds, gen surg. Where I'm at, a town of 10,000, we're constantly looking for new recruits. Much less desirable locations than urban sites though, unfortunately.

 

The problem is not the physician/population ratio. Canada's physician/population ratio is lower than the OECD average it seems.