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

[Robin Hood]

Discretion & good judgment are so very important. Arrogance has its own rewards.

 

The problem is that arrogant people don't realize this, but one way or another, they will get their wake-up call.

[aaronjw]

Reduce? Maybe. Eliminate? No. Its been established that people who are better looking end up paid more, have higher positions etc than people who aren't as good looking. They are usually more confident and come off more knowledgeable so many people don't even realize that is why they pick/vote for those people.

 

I used to see it all the time when I did interviews at the place I worked. But it can back fire - one guy was a bit too smooth - he started to HIT ON one of the interviewers (who was married!) and she mentioned it to one of the partners. Right away the partner was like "Ok, whats this guy's name? Cross him off the list". This guy blew his chance - the partner didn't even want to look at his resume or grades!

 

Probably cause the partner was hoping to bang the woman who did the interview. Us dudes like to ditch our competition.

[moo]

Thats not true ... they just dont want to. I was born in the former Yugoslavia and guess what in the early 1990's during th civil war and the US bombing us people were VERY happy to uproot their families and move. We sponsored a family from the 'old country' and they moved to rural NS ... they lost EVERYTHING and their university degrees meant nothing here. They worked as janitors and the such until they did schooling here and got resettled.

 

ANYONE can uproot their family and move ... its just that they dont want to and feel as if they are owed not to be bothered or inconvienanced with that. The world doesnt care that you did so much schooling and paid so much .. that was their choice to do that. No one forced them to do all that training. The reality now is that if they want a job they may have to move.

 

Again, I do sympathize as I would like to be near my family (brothers, parents) but it is something I had to do but I am just trying to make a point that people need to snap out of feeling they are owed something for their training and cost incurred. I know of a Ph.D in Anatomy who works at a photo/camera store .... he was not owed a professorship ... he should have known there wasnt local work or been prepared to move to the US or abroad to teach. He chose not to seek international work ... he was not owed anything ... a sad story however.

 

Then med schools need to be realistic with students. Fact is, our program keeps recruiting people but only us, the seniors are telling the truth about the job market. It's all hush hush from the big wigs at the top. This is what's bothering me. Cut positions in these specialties if there are no jobs. That will force students to end up in family med... Which hopefully won't become saturated too.

 

And as for not moving, I made a conscious decision not to move, not only because of family, but because of my well established family practice. I have built up a huge practice in four years, just bought in to my practice, so there's no way I can move. I'm in a unique situation because I have two careers. But my friends in other specialities would jump at a chance to move, only they can't because there is nothing across the country and very little in the US (eg, my peds rheum and peds onc friends)

[future_doc]

The problem is that arrogant people don't realize this, but one way or another, they will get their wake-up call.

 

A good thing actually and not a problem as these people reach their level of incompetence as their egos lead them down a slippery slope which can be a one way road.

[Kasiunut]

Probably cause the partner was hoping to bang the woman who did the interview. Us dudes like to ditch our competition.

 

LOL! Maybe, though I doubt it cause that particular partner had a very, very pretty girlfriend half his age...but then again, he definitely pick pretty over plain when he did interviews with women...

[moo]

BTW, if you want to reduce the number of applicants, make all the premeds read moo's story, so that those who though med was rosy will realize that it's not the case, and those who are more motivated by money than medicine itself will have to think twice before signing up.

The same should be done to delusional med students and residents.

 

They won't care. I've been warning premeds here for months now. You think that has deterred people from super specializing?

 

People just need to know, getting into med school is not even 10% of the battle. I teach second year med students and they all have this rosy picture of things as well. They think that you will automatically get a job when you finish your specialty residency.

 

This reminds me of the teaching fiasco in this province, where only 30% of students got mostly TEMP jobs last year because there is a glut of teachers and not enough positions. The schools took on so many students because it was a cash cow to them. The govt really needs to say to the schools, to stop lying about job prospects so students can make an informed choice. Same as in medicine. As i said, don't feel sorry for me. I've got things I can do with my life, and I'm financially stable. I'm just warning future premeds med students to really consider job prospects when selecting your specialty because that's something that med students rarely had to do when they were choosing their specialty. As it stands now, the system won't change (highly doubt spots will be cut because it's politically not feasible AND premeds don't want it. The other solution of reinstating the internship year as brookbane suggested is never gonna happen), so you have to adapt. Drill programs about job prospects during the residency fair or interview. If they are not honest with you, talk to senior residents. True, predicting the market in 5-10 years is difficult, but you can still get a sense of how things are currently and plan accordingly.

[aaronjw]

Moo:

 

Question if you don't mind...

 

What do you think about someone doing a 2+1 (FM+EM) and trying to a 1yr trauma fellowship afterward?

 

I'd I'd like to do this because I'd prefer to live/practice in a smaller centre that has a small community hospital. MAYBE even into a rural'ish area.

 

Do you think this opens up a person to be multi-employable through both private practice and community practice in a hospital setting - splitting time between both to keep from being bored? Lol

[future_doc]

moo, you always tell it as it is and give us a perspective of realism which is greatly appreciated.

[Robin Hood]

They won't care. I've been warning premeds here for months now. You think that has deterred people from super specializing?

 

People just need to know, getting into med school is not even 10% of the battle. I teach second year med students and they all have this rosy picture of things as well. They think that you will automatically get a job when you finish your specialty residency.

 

This reminds me of the teaching fiasco in this province, where only 30% of students got mostly TEMP jobs last year because there is a glut of teachers and not enough positions. The schools took on so many students because it was a cash cow to them. The govt really needs to say to the schools, to stop lying about job prospects so students can make an informed choice. Same as in medicine. As i said, don't feel sorry for me. I've got things I can do with my life, and I'm financially stable. I'm just warning future premeds med students to really consider job prospects when selecting your specialty because that's something that med students rarely had to do when they were choosing their specialty. As it stands now, the system won't change (highly doubt spots will be cut because it's politically not feasible AND premeds don't want it. The other solution of reinstating the internship year as brookbane suggested is never gonna happen), so you have to adapt. Drill programs about job prospects during the residency fair or interview. If they are not honest with you, talk to senior residents. True, predicting the market in 5-10 years is difficult, but you can still get a sense of how things are currently and plan accordingly.

 

Quebec has announced the end of the FM shortage in 2016, so maybe they will do a decrease and other provinces may follow suit. UdeM's number of spots didn't increase last year compared to the year before. UdeS called for a decrease, and so did med students. As for premeds, their opinion won't matter. But a decrease may take years, and I don't think I will be radical (like cutting spots to 1/2 in 2016), that could be a great risk (physicians retiring, new doctors refusing crazy workload, etc.).

[moo]

Well at least right now, if you want to be a family doctor, it's not bad (YET). But I can see how in the future it might be hard even getting a job as a family doctor. I have seen walk-in clinics during the day in urban areas where the doctor is almost twiddling their thumbs.

 

Happens to me occasionally. There were times in one of my locum clinics in an over serviced area where I would see about 4-5 patients in a 4 hour shift. Don't think it can't happen, although I've built up quite a large practice, it rarely happens to me now, but new grads may take longer to build up loyalty than before, ESP in urban areas.

[lostintime]

Yeah I mean the market COULD always look better, but I agree, if it's not going to look better for at least 5 years (Which CAN be predicted by what's happening now), you have to decide what you are going to do with all this debt.....

 

And the rotating intership, wouldn't that "Steal" jobs away from family doctors (through 2 year residency program) and then the GP market gets saturated? Although I guess good for patient care?

 

At the end of the day, people who still REALLY need doctors are in rural and remote areas....and the only way to encourage people is incentives $$$ and recruiting people from those areas. I don't think they're doing enough of that.

[Robin Hood]

Yeah I mean the market COULD always look better, but I agree, if it's not going to look better for at least 5 years (Which CAN be predicted by what's happening now), you have to decide what you are going to do with all this debt.....

 

And the rotating intership, wouldn't that "Steal" jobs away from family doctors (through 2 year residency program) and then the GP market gets saturated? Although I guess good for patient care?

 

At the end of the day, people who still REALLY need doctors are in rural and remote areas....and the only way to encourage people is incentives $$$ and recruiting people from those areas. I don't think they're doing enough of that.

 

Quebec med schools are increasing exposure to FM for med students, and doing valorization mesures, and that seems to be working, we have 384 new FM residents this year, a 11% increase from last year (347).

[moo]

Moo:

 

Question if you don't mind...

 

What do you think about someone doing a 2+1 (FM+EM) and trying to a 1yr trauma fellowship afterward?

 

I'd I'd like to do this because I'd prefer to live/practice in a smaller centre that has a small community hospital. MAYBE even into a rural'ish area.

 

Do you think this opens up a person to be multi-employable through both private practice and community practice in a hospital setting - splitting time between both to keep from being bored? Lol

 

Not sure if you can do a trauma fellowship with a CCFPEM. Those are usually done after gen surg. The CCFPEM is a good route to take because you can still do FM after, even if there are no emerg jobs after or if you get burned out. The FRCPC in emerg is overkill IMO, and you're restricted to mostly big centers with no out to family medicine unless you retrain. And as for research, if you wanna do research, do an MHSc or MPH. you will learn way more Epi skills that way and can still land an academic position (really, anyone can get a clinical appointment to do research so this whole thing about how the FRCPC lends you to do more research opportunities is BS. After you get your clinical appointment, just apply for grants and salary awards. Or you can still work in the dept of family med or emerg depending on the institution and still get a salaried position.

[aaronjw]

Yeah I mean the market COULD always look better, but I agree, if it's not going to look better for at least 5 years (Which CAN be predicted by what's happening now), you have to decide what you are going to do with all this debt.....

 

And the rotating intership, wouldn't that "Steal" jobs away from family doctors (through 2 year residency program) and then the GP market gets saturated? Although I guess good for patient care?

 

At the end of the day, people who still REALLY need doctors are in rural and remote areas....and the only way to encourage people is incentives $$$ and recruiting people from those areas. I don't think they're doing enough of that.

 

Money as incentive is not working. It's been proven. Sure, it works for a period of time for new grads and IMGs but then they leave.

 

Doctors are motivated by things other than money. Again, initially they will be because they have debt to pay off and want to start living like a human for once but after a period of time, money no longer becomes that motivating factor.

 

Rural physicians often work longer hours than non-rural physicians amd without sufficient backup which increases stress and pressure on them to provide for their patients jn an ever increasing manner especially since rural populations tend to have less healthy people than urban populations.

[Robin Hood]

Money as incentive is not working. It's been proven. Sure, it works for a period of time for new grads and IMGs but then they leave.

 

Doctors are motivated by things other than money. Again, initially they will be because they have debt to pay off and want to start living like a human for once but after a period of time, money no longer becomes that motivating factor.

 

Rural physicians often work longer hours than non-rural physicians amd without sufficient backup which increases stress and pressure on them to provide for their patients jn an ever increasing manner especially since rural populations tend to have less healthy people than urban populations.

 

IMGs will have to reimbourse the gov't for their residency if they don't stick to their RoS, no?

[aaronjw]

IMGs will have to reimbourse the gov't for their residency if they don't stick to their RoS, no?

 

ROS is 3 or 5 yrs - can't recall 100%.

 

There is also a non IMG-ROS contract based on financial incentives to grt people to practice in rural areas.

 

Once these contracts are up they are free to move wherever.

 

IMG-ROS simply want to get their training so ROS works but few stick around.

 

Financial incentives, again typically target new grads which is great, initially, but then they leave.

 

The point should be to develop LOMG-TERM physicians in these areas. Not one and done. Two-tier healthcare in Canada has always existed. It's called rural vs urban healthcare.

[Robin Hood]

ROS is 3 or 5 yrs - can't recall 100%.

 

There is also a non IMG-ROS contract based on financial incentives to grt people to practice in rural areas.

 

Once these contracts are up they are free to move wherever.

 

IMG-ROS simply want to get their training so ROS works but few stick around.

 

Financial incentives, again typically target new grads which is great, initially, but then they leave.

 

The point should be to develop LOMG-TERM physicians in these areas. Not one and done. Two-tier healthcare in Canada has always existed. It's called rural vs urban healthcare.

 

But they sometimes have to train in a rural area, and they stick with it for an equal time. So the IMG will probably be there for 10 years. The thing also is, that you can't force them to stay there for ever, that would be too harsh (until now, because it will still be politically feasable as no one cares about IMGs).

[aaronjw]

But they sometimes have to train in a rural area, and they stick with it for an equal time. So the IMG will probably be there for 10 years. The thing also is, that you can't force them to stay there for ever, that would be too harsh (until now, because it will still be politically feasable as no one cares about IMGs).

 

Physician levels in rural areas have been declining for well over 10 years. During this time we've had IMG-ROS and financial incentives. It does not work long-term thus REAL solutions are required, not band-aid ones.

 

I loathe first-order problem solving. It does not address the root cause of the problems therefore you're ALWAYS left trying to address the problem and sadly, its the most widely used type of problem solving, especially in health care.

[lostintime]

IMGs will have to reimbourse the gov't for their residency if they don't stick to their RoS, no?

 

It's 5 years and I think there SHOULD be a rule that they can NOT buy-out unless it's for very compelling reasons (personal illness, difficult personal situations, NOT just because someone is super rich and wants to live by the CN Tower or Parliament). If that's what they are here for, i.e. IMG specific track that CMG's can't even compete for spots in order to "fulfill this need" then why in the world are they allowed to buy out? They have the option of not applying in the first place. A contract is a contract. OR maybe state that they CAN buy out (personal rights blah blah) BUT they are not allowed to practice in Canada anywhere else.

 

I don't think it's too harsh, we have enough CMG's right now without jobs, why are you introducing IMG's who are NOT fulfilling a need?

[Robin Hood]

It's 5 years and I think there SHOULD be a rule that they can NOT buy-out unless it's for very compelling reasons (personal illness, difficult personal situations, NOT just because someone is super rich and wants to live by the CN Tower or Parliament). If that's what they are here for, i.e. IMG specific track that CMG's can't even compete for spots in order to "fulfill this need" then why in the world are they allowed to buy out? They have the option of not applying in the first place. A contract is a contract. OR maybe state that they CAN buy out (personal rights blah blah) BUT they are not allowed to practice in Canada anywhere else.

 

I don't think it's too harsh, we have enough CMG's right now without jobs, why are you introducing IMG's who are NOT fulfilling a need?

 

I said it would be harsh to stick them there for ever.

[dokrbb]

It's 5 years and I think there SHOULD be a rule that they can NOT buy-out unless it's for very compelling reasons (personal illness, difficult personal situations, NOT just because someone is super rich and wants to live by the CN Tower or Parliament). If that's what they are here for, i.e. IMG specific track that CMG's can't even compete for spots in order to "fulfill this need" then why in the world are they allowed to buy out? They have the option of not applying in the first place. A contract is a contract. OR maybe state that they CAN buy out (personal rights blah blah) BUT they are not allowed to practice in Canada anywhere else.

 

I don't think it's too harsh, we have enough CMG's right now without jobs, why are you introducing IMG's who are NOT fulfilling a need?

 

This, and all previews comments where the word "IMG" is mentioned, gives me an impression that ALL your (as CMG) Problems are caused by those 8-10% spots theo'retically (you know why I am using "theo'retically") are given to IMGs only,

 

It's just ridiculous, really...

 

edit: more than, you are far, far away from the topic of this thread; Does someone want to complain about the IMGs and the unfair life ?, send a message to MCC or elsewhere, at least your words wouldn't be just words...

[lostintime]

Legally it is impossible to have a contract without exit clauses outside of the military.

 

Can't the exit clause be repayment of training and not allowed to work elsewhere in Canada? I think that will be enough deterrent. Money isn't enough because you have rich people buying their way out of anything they want.

[lostintime]

This, and all previews comments where the word "IMG" is mentioned, gives me an impression that ALL your (as CMG) Problems are caused by those 8-10% spots theo'retically (you know why I am using "theo'retically") are given to IMGs only,

 

It's just ridiculous, really...

 

Previous? Right, talking about A and B within the same thread automatically means they have a cause-effect relationship. Right.

 

I didn't say they have to stay there FOREVER, but I think 5 years is fair.

[Robin Hood]

Physician levels in rural areas have been declining for well over 10 years. During this time we've had IMG-ROS and financial incentives. It does not work long-term thus REAL solutions are required, not band-aid ones.

 

I loathe first-order problem solving. It does not address the root cause of the problems therefore you're ALWAYS left trying to address the problem and sadly, its the most widely used type of problem solving, especially in health care.

 

The thing is: we have been proposing solutions, but none seem to work. It seems that the only way to get physicians in rural areas would be using force (not physical force). (no, I don't suggest some people should be stuck there, but it seems to be the only solution)

But the question will be: who will have to pay the price?

It seems the IMGs will be the best candidates, they are treated like second-class grad, they didn't study medicine in Canada so Canada has no obligation to them, and it's the most politically feasable because no one cares about them, and they are even despised.

[dokrbb]

...It seems the IMGs will be the best candidates, they are treated like second-class grad, they didn't study medicine in Canada so Canada has no obligation to them, and it's the most politically feasable because no one cares about them, and they are even despised.

 

Is it a kind of canadian pre-med arrogance that speaks out there?

 

Am I right, Robin Hood?