kumz87 Posted December 12, 2012 Report Share Posted December 12, 2012 Hey guys, I appreciate the discussions that this board has and I am hoping you can help me out as well. I am a CSA who is faced with a few choices. Over the past 3 years I have developed an interest in 3 fields: IM+ICU, GP+ED and Anesthetics. I am hoping that you guys can give me some of your insights. I have done rotations or electives in all 3, enjoyed them and I can see myself working in all 3. In the next few months I have to make a decision -- the reason why is a bit complicated. GP+ED I liked working in the community and with a healthy population especially in a smaller city/town. Yes the 10th ambiguous MSK problem and the 15th head cold of the day got boring. But the pt interaction and knowing that I comforted my pt just by taking a serious look and giving them practice advice made up for the boredom. Also, alteast a dozen cases a day were intellectually stimulating and I learned something new everyday. And of course, ED was great. The flexibility to move, to have a varied practice and be able to work more or reduce hours on my own terms are huge attracting points for me. GP residency is probably the easiest residency to land for me. Not sure about getting that 1 year ED training though. IM+CC Everyday was problem solving in physiology which I enjoyed thoroughly. This is the career I wanted to have before I started medschool and every rotation/obsership I did made this rotation better. I actually enjoy the rounds and found the palliative aspect of ICU gratifying. The problem with this choice is that I can only pursue the route in US. There is very little chance of me landing IM residency in Canada. I will probably have little flexibility of where I want to live and how much I want to work in. Anesthetics This is the only rotation I have not done yet. I have logged quite a few number of hours during other rotations though. Another awesome experience, especially when the really sick patients came around. So many cool procedures. Gassing someone and then gaining their air control back has been such a great experience. I probably have no shot in this field right now. It's very competitive espicially for a CSA/IMG like me. However, I have a few options to delay my residency application to make my application strong for US including doing a rotating internship or doing a year of research. No chance of me getting into Canada at all either. Were any of you guys in a similar predicament? How did you decide at the end of your medical school? And i know this question has been asked to death - what is the role of GP/ED in the future in Canada? Would you say it's diminishing or increaseing in demand? Thanks so much guys! PS: I am in between 3rd and 4th year. I am in Aus/NZ (prefer not to say which one specifically). I have a full 4th year to go. Link to comment Share on other sites More sharing options...
NLengr Posted December 12, 2012 Report Share Posted December 12, 2012 I would not delay your application. Has the potential to red flag you. Critical care is very bloated right now. However jobs may open up in the future. But, as you said, you would likely not have much location flexibility. Link to comment Share on other sites More sharing options...
futureGP Posted December 12, 2012 Report Share Posted December 12, 2012 Hey guys, I appreciate the discussions that this board has and I am hoping you can help me out as well. I am a CSA who is faced with a few choices. Over the past 3 years I have developed an interest in 3 fields: IM+ICU, GP+ED and Anesthetics. I am hoping that you guys can give me some of your insights. I have done rotations or electives in all 3, enjoyed them and I can see myself working in all 3. In the next few months I have to make a decision -- the reason why is a bit complicated. GP+ED I liked working in the community and with a healthy population especially in a smaller city/town. Yes the 10th ambiguous MSK problem and the 15th head cold of the day got boring. But the pt interaction and knowing that I comforted my pt just by taking a serious look and giving them practice advice made up for the boredom. Also, alteast a dozen cases a day were intellectually stimulating and I learned something new everyday. And of course, ED was great. The flexibility to move, to have a varied practice and be able to work more or reduce hours on my own terms are huge attracting points for me. GP residency is probably the easiest residency to land for me. Not sure about getting that 1 year ED training though. IM+CC Everyday was problem solving in physiology which I enjoyed thoroughly. This is the career I wanted to have before I started medschool and every rotation/obsership I did made this rotation better. I actually enjoy the rounds and found the palliative aspect of ICU gratifying. The problem with this choice is that I can only pursue the route in US. There is very little chance of me landing IM residency in Canada. I will probably have little flexibility of where I want to live and how much I want to work in. Anesthetics This is the only rotation I have not done yet. I have logged quite a few number of hours during other rotations though. Another awesome experience, especially when the really sick patients came around. So many cool procedures. Gassing someone and then gaining their air control back has been such a great experience. I probably have no shot in this field right now. It's very competitive espicially for a CSA/IMG like me. However, I have a few options to delay my residency application to make my application strong for US including doing a rotating internship or doing a year of research. No chance of me getting into Canada at all either. Were any of you guys in a similar predicament? How did you decide at the end of your medical school? And i know this question has been asked to death - what is the role of GP/ED in the future in Canada? Would you say it's diminishing or increaseing in demand? Thanks so much guys! PS: I am in between 3rd and 4th year. I am in Aus/NZ (prefer not to say which one specifically). I have a full 4th year to go. we call it family physician in Canada and emergency medicine FP/EM is staying and demand is good but maybe not as good if you're planning a tertiary practice. have you looked at FP/A? if you don't mind living in rural areas it provides pretty much everything that you stated (anesthesia for low-risk cases, probably take care of all the intensive care patients with your extra anesthesia training, take over emergency whenever you want to (just need to learn extra MSK stuff). It's got a similar vibe and especially in a rural area youll be able to do anything you want (clinic + emerg + anesthesia). Plus +1 in anesthesia isn't as tough as +1 in emergency and FP isn't as hard as getting into IM Link to comment Share on other sites More sharing options...
kumz87 Posted December 13, 2012 Author Report Share Posted December 13, 2012 Thanks guys! I have been looking more into FP/Anes and it looks pretty awesome. Fits all my needs. But there arent many positions available except Alberta. Link to comment Share on other sites More sharing options...
Jochi1543 Posted December 13, 2012 Report Share Posted December 13, 2012 Just FYI, you don't HAVE to do an internal medicine residency to do ICU. I forget the full list of specialties I've seen employed in the ICU, but anesthesiology is definitely another route to ICU in addition to internal; I remember there was a doc who was neither from IM nor anesthesiology working in our ICU, as well, just can't think of his specialty off the top of my head. Link to comment Share on other sites More sharing options...
Satsuma Posted December 13, 2012 Report Share Posted December 13, 2012 Just FYI, you don't HAVE to do an internal medicine residency to do ICU. I forget the full list of specialties I've seen employed in the ICU, but anesthesiology is definitely another route to ICU in addition to internal; I remember there was a doc who was neither from IM nor anesthesiology working in our ICU, as well, just can't think of his specialty off the top of my head. Probably emerg or gen surg, those are the 4 common routes. Link to comment Share on other sites More sharing options...
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