medigeek Posted February 20, 2013 Report Share Posted February 20, 2013 I just mean for well informed med students applying to residencies, is it even worth it to consider surgery/most specialties (anything that needs to do procedures as its core). All of this considering the major employment/job market issues. I think the frustration of unemployment as a surgeon/specialist is magnified to an extreme extent because of that sheer length of time (prime lifetime) spent in school and training (intense school/training) along with money invested and likely a good amount of debt. As in, you're a neurosurgeon who finished residedy at age 35 after doing a couple years research too, now you're stuck doing a fellowship.. and another fellowship and you'll be 40 before finally getting into your career. Seems frustrating. Link to comment Share on other sites More sharing options...
ellorie Posted February 20, 2013 Report Share Posted February 20, 2013 I guess it depends how much you love to cut. Link to comment Share on other sites More sharing options...
rmorelan Posted February 20, 2013 Report Share Posted February 20, 2013 I just mean for well informed med students applying to residencies, is it even worth it to consider surgery/most specialties (anything that needs to do procedures as its core). All of this considering the major employment/job market issues. I think the frustration of unemployment as a surgeon/specialist is magnified to an extreme extent because of that sheer length of time (prime lifetime) spent in school and training (intense school/training) along with money invested and likely a good amount of debt. As in, you're a neurosurgeon who finished residedy at age 35 after doing a couple years research too, now you're stuck doing a fellowship.. and another fellowship and you'll be 40 before finally getting into your career. Seems frustrating. I actually think a lot of residents in neruo surg think they start their careers at the start of residency or there about - I mean that is where they start the research that defines them I guess is my point. The road is so long (8-9 years with the phd if they don't have it, plus fellowships) the ones I talked have just merged all that into the mental picture of their career - maybe in some sense as a self defence system. They all seem to love what they do though. Link to comment Share on other sites More sharing options...
rmorelan Posted February 20, 2013 Report Share Posted February 20, 2013 I guess it depends how much you love to cut. Yeah some people just cannot see themselves doing anything else - and you probably don't want those people doing some other field in medicine, because they would be grumpy and bored. Doesn't sound like a nice combination Link to comment Share on other sites More sharing options...
medigeek Posted February 20, 2013 Author Report Share Posted February 20, 2013 I actually think a lot of residents in neruo surg think they start their careers at the start of residency or there about - I mean that is where they start the research that defines them I guess is my point. The road is so long (8-9 years with the phd if they don't have it, plus fellowships) the ones I talked have just merged all that into the mental picture of their career - maybe in some sense as a self defence system. They all seem to love what they do though. Makes sense. But being stuck doing fellowships and research until someone finally retires... seems painful. Link to comment Share on other sites More sharing options...
nosuperman Posted February 20, 2013 Report Share Posted February 20, 2013 There's also some degree of futility in attempting to gauge the job market 7+ years (assuming you started narrowing it down in third year) ahead of time. Also when talking about people who can't find work, you have to clarify whether they mean "anywhere", "in Canada", or "in Vancouver/Toronto". If you're willing to move or write the USMLE it opens up more options. There's also usually a bit more flexibility in career paths than most people acknowledge pre-carms. The people who are doing multiple fellowships have every right to stick it out until they find a job that meets their desired criteria (specialty, location, etc.) but if they were particularly concerned about their finances they could "settle" for something that allows them to address that. Many love what they do, however, and waiting for that ideal job is the lesser evil of making more money doing something else. Link to comment Share on other sites More sharing options...
medigeek Posted February 20, 2013 Author Report Share Posted February 20, 2013 There's also some degree of futility in attempting to gauge the job market 7+ years (assuming you started narrowing it down in third year) ahead of time. Also when talking about people who can't find work, you have to clarify whether they mean "anywhere", "in Canada", or "in Vancouver/Toronto". If you're willing to move or write the USMLE it opens up more options. There's also usually a bit more flexibility in career paths than most people acknowledge pre-carms. The people who are doing multiple fellowships have every right to stick it out until they find a job that meets their desired criteria (specialty, location, etc.) but if they were particularly concerned about their finances they could "settle" for something that allows them to address that. Many love what they do, however, and waiting for that ideal job is the lesser evil of making more money doing something else. Well you have to realize that pretty much any subspecialty whether in medicine or surgery needs a certain population to create that job spot. You'll never have a neurosurgeon or interventional rads working in a small town.. Hell any specialty outside of general things needs a city. So as far as the job market is concerned, yes getting a job in most subspecialties is next to impossible at any specific given time. Naturally, the biggest concentration of these jobs are also in big cities. Hamilton won't have many subspecialists... nor will windsor have many. The US is certainly an option of course and probably a reality for many future surgeons/specialists graduating. I personally don't think many students really dig deep into the job market before going down that road. At least not until they're a PGY-4 or something And about the whole 'love what you do" thing.. well you have to wonder, what if the person just wants to work as a surgeon in the community. Or just wants to work in x specialty in the community. Not everyone is interested in superspecializing and/or doing so much research, at least not past a certain point! Link to comment Share on other sites More sharing options...
rmorelan Posted February 20, 2013 Report Share Posted February 20, 2013 Makes sense. But being stuck doing fellowships and research until someone finally retires... seems painful. I hear they actually cut the positions in neuro surg this year from 19 to 12. They are responding to the over supply I guess. Link to comment Share on other sites More sharing options...
nosuperman Posted February 20, 2013 Report Share Posted February 20, 2013 They are responding to the over supply I guess. I was surprised when I found out that this type of thing isn't the norm. Link to comment Share on other sites More sharing options...
NLengr Posted February 20, 2013 Report Share Posted February 20, 2013 I hear they actually cut the positions in neuro surg this year from 19 to 12. They are responding to the over supply I guess. Smart. This should be a regular thing. Link to comment Share on other sites More sharing options...
future_doc Posted February 21, 2013 Report Share Posted February 21, 2013 When CaRMS comes for me, I hope I have interest in more than one field as it is essential to be flexible. Link to comment Share on other sites More sharing options...
tooty Posted February 21, 2013 Report Share Posted February 21, 2013 Some go in knowing about bad job prospects in Canada and plan to go to the states. Link to comment Share on other sites More sharing options...
rmorelan Posted February 21, 2013 Report Share Posted February 21, 2013 Some go in knowing about bad job prospects in Canada and plan to go to the states. not that going that route is getting easy for some of the specialties. Link to comment Share on other sites More sharing options...
NutritionRunner Posted February 21, 2013 Report Share Posted February 21, 2013 All specialties need to be cut, and the general license needs to return. That would be nice. Unfortunately, I don't see it happening anytime soon. Link to comment Share on other sites More sharing options...
uwomedhopeful Posted February 21, 2013 Report Share Posted February 21, 2013 All specialties need to be cut, and the general license needs to return. What do you mean by that?? (sorry if i sound very uninformed... i only recently decided to pursue medicine so i am still a rookie ) Link to comment Share on other sites More sharing options...
rmorelan Posted February 21, 2013 Report Share Posted February 21, 2013 What do you mean by that?? (sorry if i sound very uninformed... i only recently decided to pursue medicine so i am still a rookie ) What is now effectively a long time ago I guess you did an internship year as your first year as residency and that allowed you to act as a general practitioner. That changed when family medicine became its own specialty. The move had strengths and weaknesses of course - on the issue side now you have to decide what specialty you want to do much earlier, we cannot all act as GPs so if you cannot find work in your specialty there is no backup you can fall to - less of a problem if you can say work case work part time as a GP and part time as a X waiting until you can fully move over. Link to comment Share on other sites More sharing options...
rmorelan Posted February 21, 2013 Report Share Posted February 21, 2013 I was surprised when I found out that this type of thing isn't the norm. Yeah it is really rare - there are powerful reasons to want to have the same number of residents. Maybe even some of the "you cannot predict the job market in 8 years" thinking is going on with the programs as well. Thing is you can predict the job market 10 years from now - It isn't like most of the variables are out there. The only thing that can really mess you up is huge tech leaps or the economy completely getting trashed. Neither of those however would increase the demand for doctors - and the later one is really short term in any case (guess what - the stock market crash of 2008 has completely recovered. Still don't see mass retirings though ) . Hard to see an scenario where the demand for neuro surgeons will double in ten years. Link to comment Share on other sites More sharing options...
Satsuma Posted February 21, 2013 Report Share Posted February 21, 2013 Hamilton won't have many subspecialists... nor will windsor have many. You realize that Hamilton has 4 teaching hospitals right? For example, HHS is a regional stroke centre, lead trauma hospital, regional cancer centre etc with an catchment area of over 2 million people,stretching from Niagara up to Guelph. They aren't exactly small community hospitals. Link to comment Share on other sites More sharing options...
AtomSmasher19 Posted February 27, 2013 Report Share Posted February 27, 2013 I hear they actually cut the positions in neuro surg this year from 19 to 12. They are responding to the over supply I guess. Too little too late Link to comment Share on other sites More sharing options...
medigeek Posted February 27, 2013 Author Report Share Posted February 27, 2013 You realize that Hamilton has 4 teaching hospitals right?For example, HHS is a regional stroke centre, lead trauma hospital, regional cancer centre etc with an catchment area of over 2 million people,stretching from Niagara up to Guelph. They aren't exactly small community hospitals. Yea bad example with hamilton, though it should be mentioned they have limited attendings (again, due to lack of $$$). Link to comment Share on other sites More sharing options...
rmorelan Posted February 27, 2013 Report Share Posted February 27, 2013 Too little too late they usually are - public policy is really hard to turn around once started. It will take a bit to apply the breaks. Link to comment Share on other sites More sharing options...
rmorelan Posted February 27, 2013 Report Share Posted February 27, 2013 You realize that Hamilton has 4 teaching hospitals right?For example, HHS is a regional stroke centre, lead trauma hospital, regional cancer centre etc with an catchment area of over 2 million people,stretching from Niagara up to Guelph. They aren't exactly small community hospitals. Pretty important centre at that - they do excellent research there. Link to comment Share on other sites More sharing options...
A-Stark Posted February 27, 2013 Report Share Posted February 27, 2013 Yea bad example with hamilton, though it should be mentioned they have limited attendings (again, due to lack of $$$). No, they don't. What the hell are you talking about? Link to comment Share on other sites More sharing options...
apache Posted February 28, 2013 Report Share Posted February 28, 2013 yes sir, imagine practicing for 3-4 years instead of getting coffee in clerkship before you choose the next 30 years of your life... what a ****ing crazy idea All specialties need to be cut, and the general license needs to return. Link to comment Share on other sites More sharing options...
NLengr Posted February 28, 2013 Report Share Posted February 28, 2013 Yeah it is really rare - there are powerful reasons to want to have the same number of residents. Maybe even some of the "you cannot predict the job market in 8 years" thinking is going on with the programs as well. Thing is you can predict the job market 10 years from now - It isn't like most of the variables are out there. The only thing that can really mess you up is huge tech leaps or the economy completely getting trashed. Neither of those however would increase the demand for doctors - and the later one is really short term in any case (guess what - the stock market crash of 2008 has completely recovered. Still don't see mass retirings though ) . Hard to see an scenario where the demand for neuro surgeons will double in ten years. A problem is if you reduce the numbers of residents in a program, you have to offload the work to other residents (not like they aren't already worked to the max) or the staff. No staff is gonna want to cut resident numbers in their program if there is a risk they will have to do more scut, paperwork, calls and consults (not just reviewing them with the resident). On top of that less residents means less people doing the legwork on your research, which you need to do at an academic center. It's not hard to see why academic staff have little drive to reduce resident numbers in their program, even if residents aren't finding work at the end. Medicine eats its young.... Link to comment Share on other sites More sharing options...
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