Ideal Training Grounds

[Guest Kirsteen]

Hi there,

 

I'm wondering... I've read here and there that certain locations in Canada are "better" than others for certain residencies, for example, one post today mentioned Alberta as a hot spot for opthalmology. Is there some sort of resource available that provides some guidance as to the ideal places to go for a given residency?

 

Also, what do you guys think would factor in with respect to a "good" place to go for residency? (Aside from specific research facilities, equipment, etc.)

 

Last question on residencies... once you actually begin your undergraduate medical training, does it behoove you to seek international opportunities in your ideal field, especially if this field is competitive? That is, if you had the opportunity to spend 6 weeks in X country embroiled in a certain area of medicine, for which that facility was known to have excellent resources, would it be more or less beneficial or irrelevant to your residency future than finding a similar posting on Canadian soil?

 

Cheers,

Kirsteen

[Guest Ian Wong]

Word of mouth. That information simply isn't available on the internet.

 

As far as good places for residencies, "good" means different things. U of T is a "good" med school in a different way than Mac is a "good" med school, for example. Because of that, residencies really need to be fit to the individual. For example, I've heard that some of the smaller ENT programs are good because you get more hands-on exposure. If there are less residents and less fellows, then you will get more patient exposure, you'll start managing your own cases earlier, and this will serve you well to have seen those additional cases if you are planning on working as an ENT in the community.

 

However, if you are interested in a particular part of ENT, say in neuro-otology, then U of T or UBC will be a better fit. These residencies should (I think), give you much more freedom to really branch into a subspecialty of the ENT specialty. You'll also have an easier time getting a neuro-otology fellowship from UBC or U of T, because you'll have had more opportunities to work with those academic and practising clinicians during your five years of residency.

 

Finally, just like med school, personal comfort has to be considered. Do you like the hospitals, residents, doctors, the city, etc? Will you have friends and such there already, or will it feel like you've been dropped into a foreign city. And so on.

 

As far as getting into a residency, that's a bit of a nebulous thing. From my perspective, I think I'd rather spend that time working in the ENT department of the university that I'd hoped to match into. I think that familiarity time is really important as an "audition" to see whether you are a good fit for the program and vice versa. However, you'd definitely have some amazing experiences going the other route, and that definitely has advantages of its own, particularly when applying to all of the other ENT programs across Canada.

 

Who knows?

 

Ian (who will know in T minus 20 months!)

UBC, Med 3

[Guest Kirsteen]

Thanks for your insight, Ian.

 

What about international versus domestic medical experience? Is there any advantage/disadvantage to pursuing international medical electives? There is at least one program that I'm quite interested in, in Scandinavia, that I would be quite happy to pursue as a scheduled elective or in any of the free time (ur, wot?) when medical school actually begins.

 

Is it far more important to spend the time in front of the people with whom you think you would prefer to work? That is, if I wished to pursue a residency in Toronto, for example, should I spend as much of my medical undergrad time in Toronto hospitals/research facilities?

 

Thanks again,

Kirsteen

[Guest Ian Wong]

I don't know the answer to this. My personal belief is that it would be better to spend the time with people you want to match with. Whether this is a good answer or not I think would be dictated by a whole bunch of other factors, including the facilities and training available at both locations, the staff itself, etc, etc, etc.

 

I don't know that there's a dividing line here, except perhaps at which place you think you'll gain the most experience. I think that for a lot of the competitive specialties that it's probably best to get as much familiarity with the people who will ultimately decide whether they want you as a resident (and be stuck working with you in future years). I think it's always an advantage to know your future colleagues, unless you suck , in which case you probably weren't going to get in there anyway.

 

Finally, the "auditioning" is reciprocal. This is also your opportunity to discover whether you would be a good fit at that institution, and whether you like the program. This is something that you can only discover by spending time at that specific institution, and not during an international experience.

 

Ian

UBC, Med 3

[Guest strider2004]

Kirsteen,

 

I believe all 4-yr schools give students at least the first summer off to do whatevery they want. There's an interntional student elective program that some of my friends participated in. You get to go to a different country and experience their medical system. You also get to meet other students from different countries because its basically a worldwide exchange program. However, spots are limited so it would be impossible to guarantee a particular program in Scandinavia with you apply. At least it would get you close

[Guest Kirsteen]

Hey strider2004,

 

The program that I'm interested in is available through UT and Mac (they have a reciprocal arrangement with the insititute in Stockholm). Therefore, if I end up matriculating in either of those two schools chances may be decent that I could secure the elective position in Stockholm. However, if I ended up attending another school it may be tougher.

 

What I was originally concerned about though, was the value of the international experience versus spending the time at home in a similar elective. It seems to be that the more face time you can put in with those doctors/hospitals where you'd like to end up working, the better. Ideally though, if I can, I'd like to supplement my "standard" elective time with some extra time in my area of interest in an international facility whose strengths in that area are well-renowned. I think if you can rack up the time in both, it can't possibly hurt.

 

Cheers again,

Kirsteen

[Guest fahhotguy]

Dear discussion participants,

 

I read the above discussion with interest. I finished Ophthalmology at UWO last year, and I I'd like to offer these observations about electives.

 

If you are interested in "competitive" programmes such as dermatology, ophthalmology, ent, plastics, etc. I feel that an international elective is not as useful as if you go to as many Canadian institutions as possible during electives to "audition". We at UWO looked favourably on students who we liked on electives. In Med I and II, summer research is an excellent way to show interest in a competitive field. It is most important to decide early in your medical training what field appeals to you most as options become more limited if you have not shown an interest in a competitive programme by say Med III.

 

If you are interested in family practice, internal, psych, and other fields, I am convinced that you can spend your summers and electives at more interesting electives, perhaps overseas or in the USA. It is hard to get time off again once you get into residency, so try to make your free time count.

 

Sincerely,

Frank MD FRCSC

[Guest Ian Wong]

Hi Frank,

 

Welcome to the forums! Thank you for adding in your viewpoints; it's great to get some opinions from people who have already been there, done that.

 

I'd like to ask you a few more questions, if I may:

 

This is a fairly young site being one of the first premed sites in Canada. Now that a number of its readership is in medical school, hopefully it will become the first medical school website in Canada that links med students from East to West. As a result however, most of the medical students in this discussion forum are either entering Med 1 or Med 2. You've mentioned that many of the competitive programs look for applicants who show an interest, and that starting early in the Med 1 and 2 summers can be of use.

 

How important do you think it is for most of these students to devote work in Med 1 and Med 2 summers towards research/projects in those specialties? I ask this because as a former resident, you've obviously spent a great deal of time working with both the Ophtho faculty as well as with the medical students rotating through. I'd guess that you know the other residents extremely well, and can probably shed some light as to what makes a good resident.

 

My big question is that many students still don't know what areas they wish to pursue until Med 3, when they finally have the free time to work with doctors in the hospital. Myself, I am very interested in ENT, and will be putting full effort into that specialty alone starting this fall. However, it wasn't until this summer when I spent time shadowing many different ENT's and doing an elective at UBC that it really piqued my interest.

 

Before this time, I'd waffled through several different specialties, including Ortho, Gen Surg, Pediatrics, and Ophtho. If I had committed to doing research before this time period in the summer of Med 1, it would have been in one of those areas, and would now constitute less useful work (a reference letter from an orthopod doesn't ring many bells with the ENT folks)

 

Funnily enough, I spent some time with a local ophthalmologist, who had a certificate that allowed him to work as an EENT. He explained to me that he firmly believes that Ophtho got the better half of that split, and it was at that time that I started looking into ENT. Head and neck anatomy always fascinated me, but it took a wisecrack by an ophthalmologist to let me see the light!

 

Anyway, do you have any suggestions for those students who don't yet know what they would like to study? Do you think that research is essentially mandatory now for a successful application to a very competitive specialty like Ophtho?

 

Ian

UBC, Med 3