Would you go to US medical school if money was no issue?

[Life_Sci_Guy]

Since US grads are considered equivalent as Canadian grads for residency matching, I cannot see any other downfalls.

 

If you were accepted into a US medical school, and money is no issue, would you go attend instead of wasting more years applying to Canada?

 

 

Please give reasons why.

[cookiemonster99]

Since US grads are considered equivalent as Canadian grads for residency matching, I cannot see any other downfalls.

 

If you were accepted into a US medical school, and money is no issue, would you go attend instead of wasting more years applying to Canada?

 

 

Please give reasons why.

 

yes

saves time

I could be making money faster

 

all the post below will follow the same three principles

[Birdy]

Nope. I have no desire to live in the US at all. Services for my son are unavailable or crappy in most public school systems. The schools just kind of suck in general and my kids likely would not be able to be educated in French, which matters to me.

 

I also don't want to work in a system where healthcare is approached as a business instead of a right. Even if it is just for my training.

 

Canada is my home. I will train here or I will pursue a backup plan.

[cookiemonster99]

Nope. I have no desire to live in the US at all. Services for my son are unavailable or crappy in most public school systems. The schools just kind of suck in general and my kids likely would not be able to be educated in French, which matters to me.

 

I also don't want to work in a system where healthcare is approached as a business instead of a right. Even if it is just for my training.

 

Canada is my home. I will train here or I will pursue a backup plan.

 

One outlier

Srry

[rmorelan]

One outlier

Srry

 

ha Loaded question of course - waste time OR move forward on your dreams. You can dispute the "wasted time" aspect of that statement right away.

 

and you using your money argument is cheaper in the long run to "waste" one more year and actually get in than pay back the difference in costs you would pay going to the US when you factor in the increased tuition, interest payments, up front large guaranteed payments. loss of things like OSAP, they potential risk of having to do residency down there at a lower income rate, and likely higher living/transportation expenses over the time. The difference in costs is in the 100s of thousands and you can compute the salary requirements for that vs average doctor income (and it would be illogical to pluck the highest income salaried doc to do that math, which seems to be common - I would argue at best with average income it would take at least a year to pay that off. More likely of course it would be longer of course. ). I know someone said money was no object in all of this but really money is ALWAYS an object - creatively removing it creates an unrealism.

 

All this ignores the advantages long term in your career an extra year in a masters degree for instance can provide. You want to get a job now in some of the more competitive specialties now a masters really helps both at CARMS and at getting the job in the long run, particularly at major centres. There is a reason people take years off during residency to go get them. Good chance I will be taking some time to complete a phd in my residency.

 

So the decision either way is a calculated risk. I am just trying to paint a much more grey image of the options here than originally stated sometimes going to the US is the logical next step to advance you dreams based on what you have done to point. Often it is not though as well for equally logical reasons.

[JohnDakota]

Money isn't an object for me, at the moment, so this isn't theoretical in any sense.

 

I wouldn't. I want to study somewhere my wife can work and be happy too. She can't really work in the US. She loves her job and I would hate to take that away from her. Her career is as important to me as my dream of becoming a medical doctor.

 

Furthermore - 1-2 years working out the kinks to study in Canada will translate in to significantly less indebtedness and therefore more financial stability in the long run. Even if that means I become an MD later in life. I'm quite pessimistic and I don't believe anyone from our generation is reasonably going to retire at 60 or possibly even 65. I'm fairly certain our generation is going to get stuck with the tab to support the Boomers, and those just after the Boomers, while not benefiting from any of their social support programs (ie. pensions @60 years old). So, if I'm going to work until i'm ~70 years old, I don't see the need to rush in to it. Hell, if you start as a full time Family Doctor (post PGY2) at 40 years old, you're still working for 30 years before retirement.

 

I've never understood the desire to rush through life stages. We all get to the same end point eventually - death. Just enjoy each stage as it presents itself.

[Teflon Don]

Nope. I have no desire to live in the US at all. Services for my son are unavailable or crappy in most public school systems. The schools just kind of suck in general and my kids likely would not be able to be educated in French, which matters to me.

 

I also don't want to work in a system where healthcare is approached as a business instead of a right. Even if it is just for my training.

 

Canada is my home. I will train here or I will pursue a backup plan.

 

healthcare is NOT a right.

there are a limited number of healthcare workers, they have limited time, equipment is limited etc. you are not entitled to these things which come at a cost to others.

[aaronjw]

healthcare is NOT a right.

there are a limited number of healthcare workers, they have limited time, equipment is limited etc. you are not entitled to these things which come at a cost to others.

 

Is education a right?

 

Is access to clean drinking water a right?

 

Is access to quality food a right?

[rmorelan]

Money isn't an object for me, at the moment, so this isn't theoretical in any sense.

 

I wouldn't. I want to study somewhere my wife can work and be happy too. She can't really work in the US. She loves her job and I would hate to take that away from her. Her career is as important to me as my dream of becoming a medical doctor.

 

Furthermore - 1-2 years working out the kinks to study in Canada will translate in to significantly less indebtedness and therefore more financial stability in the long run. Even if that means I become an MD later in life. I'm quite pessimistic and I don't believe anyone from our generation is reasonably going to retire at 60 or possibly even 65. I'm fairly certain our generation is going to get stuck with the tab to support the Boomers, and those just after the Boomers, while not benefiting from any of their social support programs (ie. pensions @60 years old). So, if I'm going to work until i'm ~70 years old, I don't see the need to rush in to it. Hell, if you start as a full time Family Doctor (post PGY2) at 40 years old, you're still working for 30 years before retirement.

 

I've never understood the desire to rush through life stages. We all get to the same end point eventually - death. Just enjoy each stage as it presents itself.

 

plus do you really want to retire at 65? I mean collectively as a society? We pegged that age a long time ago when you only lived a very short time after that. Now we have people routinely living into their 90s. The idea that we should structure things so that people retire that early now seems odd to me - and of course the cost of it would be huge long term.

[JohnDakota]

healthcare is NOT a right.

there are a limited number of healthcare workers, they have limited time, equipment is limited etc. you are not entitled to these things which come at a cost to others.

 

I'm unsure how you can reasonably expect people to exercise their inalienable fundamental rights outside of having a reasonable level of physical/mental health. For the reason that exercising fundamental rights is predicated on good health of the individual, access to healthcare is also a right. We are fortunate to be citizens of countries that can afford to supply it.

 

Yes healthcare resources are finite and they all come at costs.... generally high costs. But that doesn't make it less of a right.

 

Here's the World Health Organization's position; http://www.who.int/mediacentre/factsheets/fs323/en/

[JohnDakota]

plus do you really want to retire at 65? I mean collectively as a society?

 

Personally... I don't want to...although I don't think I"ll want to be working 60+ hours a week at that age either.

 

As a society... I believe Boomers need to swallow part of this sour pill too. Although I doubt they will. We're still letting Federal workers retire with 'full pensions' at 25 years service. Many of my parent's friends have retired at 55 with unreal pensions/health benefits. By the time they die, these people are going to be retired longer then they worked.

 

I blame public service unions for much of this mess and for the life of me I don't even understand why government workers need unions. Compared to their private industry counterparts, public service has always had great benefits (ie job security/health/pension). The trade off with taking a public job was you understood you were getting paid less.. which is no longer the case due to union negotiations.

[Life_Sci_Guy]

So how about premeds without wives/kids haha.. like the person above said, those are definite outliers.

 

The only issue seems to be the money issue, which as I stated was not a problem. If that is the only issue, then it seems like a good option. You have to consider the strain/agony of going through the Canadian cycle all over again too, and how would you use that 1 additional year? I have all my pre-reqs and a good GPA, so I would do nothing in that year. I don't want to waste a year of my life doing research lol.. better things for my time than that.

 

Edit: nevermind the fact that being competitive for a Canadian school doesn't mean you will get in. You could be applying 2-3 additional years!

[JohnDakota]

Original post

 

If you were accepted into a US medical school, and money is no issue, would you go attend instead of wasting more years applying to Canada?

 

 

Please give reasons why.

 

Note "please give reasons why."

 

So how about premeds without wives/kids haha.. like the person above said, those are definite outliers.

 

The only issue seems to be the money issue, which as I stated was not a problem. If that is the only issue, then it seems like a good option. ....

 

Edit: nevermind the fact that being competitive for a Canadian school doesn't mean you will get in. You could be applying 2-3 additional years!

 

We're giving you reasons... you're just saying those reasons are 'outliers' and refocusing all attention on the money aspect even though you fixed it as a non-issue.

 

So let me move my real situation to a theoretical;

- I no longer have a wife

- I'm 32... so there's extra pressure to complete everything more quickly.

- Money isn't a problem.

 

I still wouldn't go to the US. I want to practice in Canada because to me, life is more than just what I do. It's who I'm with and I want to be close to family and friends.

 

Furthermore, it's important to develop your professional network to seamlessly transition from training to employment. Training in the US would make it difficult to develop a Canadian professional network.. at least more difficult than training in Canada. I'd easily sacrifice a year or two working out my Canadian application to save a year or two when I'm older trying to return to Canada. As a theoretical single male I can more easily cope with the uncertainty then as a future, married with children medical doctor trying to return to Canada.

[Life_Sci_Guy]

Original post

 

 

 

Note "please give reasons why."

 

 

 

We're giving you reasons... you're just saying those reasons are 'outliers' and refocusing all attention on the money aspect even though you fixed it as a non-issue.

 

So let me move my real situation to a theoretical;

- I no longer have a wife

- I'm 32... so there's extra pressure to complete everything more quickly.

- Money isn't a problem.

 

I still wouldn't go to the US. I want to practice in Canada because to me, life is more than just what I do. It's who I'm with and I want to be close to family and friends.

 

Furthermore, it's important to develop your professional network to seamlessly transition from training to employment. Training in the US would make it difficult to develop a Canadian professional network.. at least more difficult than training in Canada. I'd easily sacrifice a year or two working out my Canadian application to save a year or two when I'm older trying to return to Canada. As a theoretical single male I can more easily cope with the uncertainty then as a future, married with children medical doctor trying to return to Canada.

 

So you're saying the issue is networking with Canadian health professionals? Aware me on the importance of this. I figured I would always just start my own clinic like most pediatricians do (i guess this is dependent on the residency though).

[JohnDakota]

So you're saying the issue is networking with Canadian health professionals? Aware me on the importance of this. I figured I would always just start my own clinic like most pediatricians do (i guess this is dependent on the residency though).

 

I'm not even in medical school so I'm not going to try to inform anyone on the nuances of starting your own practice. I think that would just make me.... a jackass.

 

But from a professional standpoint - I can only assume that networking in your private practice plan is somewhat less important than someone in a specialty that normally involves working in a hospital, for example. However, I'm fairly sure that being part of the pediatrician community in Canada, and specifically the geographic region you want to eventually practice in, will let you access certain important information that wouldn't be easily accessible to outsiders (ie. US trained MDs). But maybe that information is freely available in public forums and you become aware of these datasets when you're in residency. Maybe a resident here can inform us of this? I've been looking for this data already.

 

The kind of information you would be interested in would be birth rates of local populations as a ratio to existing pediatric practices. Basicallly, you wouldn't want to set up shop in an area where there's a very low birth rate and many pediatricians. That's just basic small business economics.

[Teflon Don]

Is education a right?

 

Is access to clean drinking water a right?

 

Is access to quality food a right?

 

nope, none of that is a right. who grows the food? a farmer does. are you going to go up to a farmer and demand that he give you some food because you feel entitled to the literal fruits of his labour? will you arrest him if he denies your request? will you demand that he give you his produce at whatever cost you desire or else he is denying you your "right"?

you shouldn't.

 

so why should you expect to go up to a doctor who has spent years of his life developing his skills and sacrificing other opportunities and demand that he give you healthcare because you feel you are entitled to it?

 

farmers and doctors are not slaves of society and you are not entitled to their property or services.

[JohnDakota]

nope, none of that is a right. who grows the food? a farmer does. are you going to go up to a farmer and demand that he give you some food because you feel entitled to the literal fruits of his labour? will you arrest him if he denies your request? will you demand that he give you his produce at whatever cost you desire or else he is denying you your "right"?

you shouldn't.

 

so why should you expect to go up to a doctor who has spent years of his life developing his skills and sacrificing other opportunities and demand that he give you healthcare because you feel you are entitled to it?

 

farmers and doctors are not slaves of society and you are not entitled to their property or services.

 

... except the government subsidizes MD training significantly as well as food production because the government understands it's imperative that the population has access to good food and healthcare... ergo it's not an entirely free market as you are suggesting.

 

So there is an element of cost control put in place by the government on both regulated/subsidized foods and healthcare to ensure the population can have confidence in the quality of good/service as well as access these goods/services at reasonable costs.

[TheBoss]

Hmm, so is the assumption that if you don't take the acceptance to US, you're sure you'll get into the med school in Canada in a couple years, and at the school of your choice, plus matching to residency at the same school further down the road? Seems family/geography is commonly being cited as the reason not to go the US, as well as not practicing in the US long-term, but unless you got into your local med school, you're gonna have to move at least once. Outside that, matching back to Canada for residency after US med school doesn't really have more barriers than doing so from a Canadian med school.

[Teflon Don]

... except the government subsidizes MD training significantly as well as food production because the government understands it's imperative that the population has access to good food and healthcare... ergo it's not an entirely free market as you are suggesting.

 

So there is an element of cost control put in place by the government on both regulated/subsidized foods and healthcare to ensure the population can access these goods/services at reasonable costs.

 

its not an entirely free market as im suggesting? DUH im suggesting that it ought to be not that it is. and i do believe government should stop subsidizing MD training and agriculture. do you think people would stop growing food or medical schools would stop producing doctors if government decided to stop robbing workers and corporations with ridiculously high taxes in order to subsidize these sectors?

NO.

 

do you think government is keeping healthcare costs down by imposing severe restrictions on who can practice and who can train doctors?

if so then why are there no private medical schools in canada? surely if government run medical schools were producing the best doctors who were then providing the best care at the lowest cost then they would have nothing to worry about.

 

and btw government does not provide these services for free, they just rob one segment of society (the young and healthy) in order to subsidize care for the old and weak. this in and of itself has the effect of misallocating capital in the economy, stifling economic growth and hurting the very people who think they are benefiting from these government programs and subsidies.

 

oh but its okay because its a democracy so if the majority vote to rob the rest then its not theft at all.

[mrewmrew]

 

and btw government does not provide these services for free, they just rob one segment of society (the young and healthy) in order to subsidize care for the old and weak

 

The old and weak were once young and healthy.

[Leon]

and btw government does not provide these services for free, they just rob one segment of society (the young and healthy) in order to subsidize care for the old and weak. this in and of itself has the effect of misallocating capital in the economy, stifling economic growth and hurting the very people who think they are benefiting from these government programs and subsidies.

 

oh but its okay because its a democracy so if the majority vote to rob the rest then its not theft at all.

 

What would be your preferred alternate model?

[Hockeynut]

its not an entirely free market as im suggesting? DUH im suggesting that it ought to be not that it is. and i do believe government should stop subsidizing MD training and agriculture. do you think people would stop growing food or medical schools would stop producing doctors if government decided to stop robbing workers and corporations with ridiculously high taxes in order to subsidize these sectors?

NO.

 

do you think government is keeping healthcare costs down by imposing severe restrictions on who can practice and who can train doctors?

if so then why are there no private medical schools in canada? surely if government run medical schools were producing the best doctors who were then providing the best care at the lowest cost then they would have nothing to worry about.

 

and btw government does not provide these services for free, they just rob one segment of society (the young and healthy) in order to subsidize care for the old and weak. this in and of itself has the effect of misallocating capital in the economy, stifling economic growth and hurting the very people who think they are benefiting from these government programs and subsidies.

 

oh but its okay because its a democracy so if the majority vote to rob the rest then its not theft at all.

 

Finally someone who takes (relatively speaking) my side on things! +100

[JohnDakota]

do you think people would stop growing food or medical schools would stop producing doctors if government decided to stop robbing workers and corporations with ridiculously high taxes in order to subsidize these sectors?

 

Obviously not.. but the segment of society that will be able to access medical training will be much more limited to those who can afford it.

 

20k+ per year in tuition/books plus living expenses is already pretty hard to soak up. If you want to know what the real cost of education is today, look at what international students pay. In the US that's anywhere between 40-85k per year, WITHOUT living expenses. The cost isn't much different here in Canada. So let's split the difference - call it 62.5k/yr in tuition. From my experience it's about 15k/yr in living expenses. So 77.5k/yr to attend medical school and live. After medical school you're 333k in debt (including compounded 3% interest per year). As a resident you're taking home ~30k/yr, less 15k to live. So let's say you put everything on your debt, after a 2 year family med residency you're still 323k in debt. As you can see, this level of indebtedness eats up half of your max possible payment at our currently ridiculously low interest rates. Wait till after 2015 and these rates go up by 1% per year for sequential years.

 

Clearly, at that price point, only people from relatively wealthy backgrounds will be able to access that education.

 

As a society it's in our best interest to have professional populations that can properly empathize with the general public. It helps that they've had diverse experiences from diverse backgrounds... which means not just wealthy people.

 

do you think government is keeping healthcare costs down by imposing severe restrictions on who can practice and who can train doctors?

 

No.

 

surely if government run medical schools were producing the best doctors who were then providing the best care at the lowest cost then they would have nothing to worry about.

 

?

 

and btw government does not provide these services for free, they just rob one segment of society (the young and healthy) in order to subsidize care for the old and weak. this in and of itself has the effect of misallocating capital in the economy, stifling economic growth and hurting the very people who think they are benefiting from these government programs and subsidies.

 

This is an incredibly narrow perspective. People are more free to spend as they wish because there is an understanding that if they become sick that healthcare will be there for them. Yes.. even if what they can spend is slightly less because of higher taxation.

 

Consider what Americans pay for health insurance. With the ACA the risk pool now includes heavy users, and thus rates have gone up for everyone. Young, healthy (low users) are still being expected to pay 600+/month for bronze/silver packages. That's 7200/year. Do you honestly think that someone making ~40-50k/yr in Canada is paying ~7200 in taxes that's going directly to healthcare costs? No.. obviously there are better models and I think what we have here isn't perfect, but it's better than the more free-market model the Americans have.

[Life_Sci_Guy]

Hmm, so is the assumption that if you don't take the acceptance to US, you're sure you'll get into the med school in Canada in a couple years, and at the school of your choice, plus matching to residency at the same school further down the road? Seems family/geography is commonly being cited as the reason not to go the US, as well as not practicing in the US long-term, but unless you got into your local med school, you're gonna have to move at least once. Outside that, matching back to Canada for residency after US med school doesn't really have more barriers than doing so from a Canadian med school.

 

These are my thoughts exactly. I wanted to make sure that I wasn't missing anything when I made this post.

 

Inevitably, I will leave my family/friends to go somewhere since there is no medical school anywhere close to my hometown (even if there was, I could never guarantee I'd get acceptance there); no IMG status as a US grad and can apply to Canadian residencies which will also probably be not at home.

[rmorelan]

The old and weak were once young and healthy.

 

there were also at one point young and weak as well. It takes 20-25 years of training in total to create a doctor - all highly supported by the governments as just the most basic example. Society is paying the price up front for all of us. There is an inherent fairness for lack of a better term in that being returned at some point.

 

I also have to question this "old and weak" aspect but that is an entirely different debate