Canadian/american Premed System Setup For Burnout

[StriveP]

Is it just me but doesn't it feel like the American and Canadian "premed" system is setup to burnout young physicians? Right now it takes the average Canadian 2.5 attempts to get into medical school including a 3-4 year degree. Most of us already feel burned out half way through our undergrad. On top of that you have to go through medical school where the first 2 years especially drains you (it doesn't get better according to my friends in med school). And then eventually you have to compete for residency spots along with board exams. Then once you finally match you pretty much still have no life... I'm just wondering doesn't this effect the quality of physicians we end up with? Seriously, most of us are burned out in the year 4 mark, then you have another 4-8 years depending on what you plan to do after medical school. Even though the Canada has one of the best healthcare systems in the world, it feels like the healthcare system needs to make some serious changes to tackle this burn-out issue in order to make it better. Is it just me who feels this way?

[rmorelan]

No not just you, although most of the literature on this is mostly focused on residency (probably because historically it was more brutal than medical school - recent thread on this for the various specialties with general thoughts that some residency programs are worse and some are better than medical school in terms of lifestyle etc). I though the 3rd year and up was more draining than the first two but there is some school variability.

 

Part of it is there are just some organization constraints - I mean it simply takes a long time to learn everything you need to know, and anything that reduces the work load impacts training time by increasing it (ha, you should see the surgeon fields with confronted with reduced work hours and thus reduced OR time - generally they want to have as much as possible). I don't think people want residency to extend out a "couple more years". Plus medicine in general as staff still has high work volumes (CMA posts information on that - some fields you can control it for reduced by but it still is a 60ish hour a week job for a lot of fields, plus keeping up with the field etc). Part of it is inertia as you are always starting from what was done before. 

 

How would you change it if you could?

[obi]

Honestly it's a pain in the ass that you have to get in after undergrad instead of highschool but the rest of the world is no different really.

 

Other countries generally have a 6 year program with an internship / community service (1-2 years) before they start residency. It all balances out in the end. You definitely shouldn't be feeling burnt out midway through undergrad though.. If that's the case then medicine is going to be a looong journey for you. I recommend really working on that life/work balance now so that you can find school enjoyable. The only people I know of who find medschool less busy than undergrad are the ones from UoT Even then, clerkship (M3) is MUCH more busy than pre-clerkship. It's infinitely more fun though.

 

Good luck!

[JohnGrisham]

No not just you, although most of the literature on this is mostly focused on residency (probably because historically it was more brutal than medical school - recent thread on this for the various specialties with general thoughts that some residency programs are worse and some are better than medical school in terms of lifestyle etc). I though the 3rd year and up was more draining than the first two but there is some school variability.

 

Part of it is there are just some organization constraints - I mean it simply takes a long time to learn everything you need to know, and anything that reduces the work load impacts training time by increasing it (ha, you should see the surgeon fields with confronted with reduced work hours and thus reduced OR time - generally they want to have as much as possible). I don't think people want residency to extend out a "couple more years". Plus medicine in general as staff still has high work volumes (CMA posts information on that - some fields you can control it for reduced by but it still is a 60ish hour a week job for a lot of fields, plus keeping up with the field etc). Part of it is inertia as you are always starting from what was done before. 

 

How would you change it if you could?

Solution?

 

Do what the rest of the world does and have 6 year programs. There is really no need to do a 4 year undergrad, especially now with people simply gaming it to get the highest gap's possible. Rarely are people there to critically think and expand their horizons. It's a futile task, and the outcomes would probably be more or less the same.

[Arztin]

Stripe P. Your friend is right. Preclerk = mostly more lists to memorize ad nauseam and at a faster pace than undergrad. It's frankly tiring.

[obi]

Solution?

 

Do what the rest of the world does and have 6 year programs. There is really no need to do a 4 year undergrad, especially now with people simply gaming it to get the highest gap's possible. Rarely are people there to critically think and expand their horizons. It's a futile task, and the outcomes would probably be more or less the same.

 

For the most part they still finish at the same time as a NA grad. They have extra years tacked on to their post-medical school training.

[Sit]

I somewhat agree that this system isn't really ideal from a student perspective. It's not the time or even the workload that make a premed's life hard- rather, I feel like it's the pressure. Pressure to get the grades, to get the EC's, etc. That pressure will multiply the amount of time most students will spend studying, volunteering, etc. It's sad that it's come down to jumping hoops, but there is room for enjoyment. Quite frankly, if you're burnt out in your ~4th year, then maybe you're not in the right concentration or perhaps you don't spend enough time on things you enjoy.

 

It's all about balance. Is the system balanced? Nah. But as students, we can try and balance ourselves.

[StriveP]

I somewhat agree that this system isn't really ideal from a student perspective. It's not the time or even the workload that make a premed's life hard- rather, I feel like it's the pressure. Pressure to get the grades, to get the EC's, etc. That pressure will multiply the amount of time most students will spend studying, volunteering, etc. It's sad that it's come down to jumping hoops, but there is room for enjoyment. Quite frankly, if you're burnt out in your ~4th year, then maybe you're not in the right concentration or perhaps you don't spend enough time on things you enjoy.

 

It's all about balance. Is the system balanced? Nah. But as students, we can try and balance ourselves.

Don't get me wrong, maybe you don't feel burned out but nearly everyone I know feels burned out at this point. My friends were having this conversation recently and I feel the whole "undergrad" prerequisite to get into medical school is ridiculous. It just deteriorates the quality of medicine patients gets since most people are defiantly burned out by residency, not to mention it effects the these "young" physicians psychological. I think a more effective way would be allowing students to apply after their 1st or 2nd year instead of a 3rd or 4th year degree which essentially is meaningless. Most medical school students I know could careless about their undergraduate degree as it didn't really teach them anything in relevance to medicine. And literally every country besides the US and Canada have this system where students out of high school can apply to medical school directly which obviously isn't ideal but I think finding an intermediate solution would be optimal.

[cookiemonster99]

Don't get me wrong, maybe you don't feel burned out but nearly everyone I know feels burned out at this point. My friends were having this conversation recently and I feel the whole "undergrad" prerequisite to get into medical school is ridiculous. It just deteriorates the quality of medicine patients gets since most people are defiantly burned out by residency, not to mention it effects the these "young" physicians psychological. I think a more effective way would be allowing students to apply after their 1st or 2nd year instead of a 3rd or 4th year degree which essentially is meaningless. Most medical school students I know could careless about their undergraduate degree as it didn't really teach them anything in relevance to medicine. And literally every country besides the US and Canada have this system where students out of high school can apply to medical school directly which obviously isn't ideal but I think finding an intermediate solution would be optimal.

 

I get where you're coming from with this but it raises a couple of issues if you are pushing towards the 6 year programs for medicine straight from high school. I personally don't think i am mature enough to be in clerkship when i'm 20 years old......Let alone treating patients when i'm 24 and doing surgical stuff(not sure if there's additional surgical residency for 6 year programs??). I know countries like the UK, Ireland, Australia allows their students to get into medical and dental school straight out of high school and quite frankly I just don't think they'll be ready for the profession. Granted I don't mean EVERYONE is not ready but I generally think having some university experience is extremely important before going into a professional program such as medicine as it'll make the work load lighter if you studied some of the subjects before and you'll be older and more mature to handle difficult situation. 

 

Can you imagine dealing with patients who are circling the drain when you are in your early 20s? Not sure i'll be mature enough or have gone through enough life experiences to handle something like that 

 

just my 2 cents

[rmorelan]

Plus part of the UG is to actually see if medicine is what you want to do. How many of the people that start out wanting medicine actually change their minds going through? I don't mean don't get the grades but actually figure out there are other things they would rather do. Really the entire system would have to change so that by the time you get to university you actually would have enough exposure to various fields that you would know you wanted to go into medicine - with all of the understanding of the benefits and costs of such a career. Remember too that in these 6 year programs quite often people don't make it all the way through - the system is set up to weed out a huge fraction of the class relatively early on. I would say only after you complete that step are you truly in medical school - and that is kind of a one shot deal. Our system is designed to pretty much make sure that once you get in you will become a doctor (it is cheaper that way in a sense as training a doctor is very expensive - you don't want people not making it routinely as you are flushing resources down the drain).

 

Someone was talking of balance - that is very important here. Simply because it doesn't really get better at any magical point I suppose - you are not working towards some future utopia. I have staff doctors telling me that residency was better than than their roles because the residency union had protections that they don't have (limits on call etc. The concept of a post call day doesn't exist for staff. The huge stress when the buck stops with you - and the mistakes you will make, and living with the consequences. Plus working long hours but also with all of the rest of living now there - kids, spouse.....Things you can put off in residency now you can't. Trying to keep up with a rapidly changing field, only now you have to do it on your own). UG is hard, medical school is hard, residency is hard, and being a staff doctor is no walk in the part either If you are going through medicine waiting for things to get easier then you have to be careful because that day may not come.

 

Not to be doom and gloom - because I love this field and the amazing impact we have on people lives. There is of course a cost.

[Aetherus]

I get where you're coming from with this but it raises a couple of issues if you are pushing towards the 6 year programs for medicine straight from high school. I personally don't think i am mature enough to be in clerkship when i'm 20 years old......Let alone treating patients when i'm 24 and doing surgical stuff(not sure if there's additional surgical residency for 6 year programs??). I know countries like the UK, Ireland, Australia allows their students to get into medical and dental school straight out of high school and quite frankly I just don't think they'll be ready for the profession. Granted I don't mean EVERYONE is not ready but I generally think having some university experience is extremely important before going into a professional program such as medicine as it'll make the work load lighter if you studied some of the subjects before and you'll be older and more mature to handle difficult situation. 

 

Can you imagine dealing with patients who are circling the drain when you are in your early 20s? Not sure i'll be mature enough or have gone through enough life experiences to handle something like that 

 

just my 2 cents

Although I think there are problems in the system, I personally think the 4 year bachelor degree is a good thing for medicine. First of all,it means that you are selecting for people who can take the pressure since it only gets worse from here. Also having a prior degree gives diversity to the skill set of physicians. I have engineers, English PhD, a music masters etc in my class, and I feel that it gives different perspective to class discussions therefore enriching everyone.

 

Finally, if you want a system closer to the rest of the world, simply look at Quebec. They do two years of cegep before going into Med. There have been studies showing that the burnout rate is greater in these younger students. So this goes against what you are saying and I believe it is because these younger students have not had the chance to develop the necessary techniques to cope for the Intense amount of stress and material that comes with a program such as medicine.

[ralk]

1) All competitive fields have a stressful component to them. Medicine is, in some ways, rather uniquely competitive, but the stress you're under isn't unique to being a pre-med. Many pre-anythings are under the same sort of pressure.

 

2) As tempting as it is to blame the medical system, or even more specifically the admissions process, they're not really the ones responsible for the high pressure - we are. Schools have to have some sort of metric for admissions. Whatever that metric is, students vying for medicine will attempt to do their absolute best on those metrics and because there are so many people doing this, what's necessary for admission to medicine will be very high. These high standards will in turn cause stress for those trying to live up to them. Medical school admissions got rid of extra-curriculars, pre-meds would simply stress more about their GPA and MCAT. If we moved to a direct-entry from high school, we'd see a whole bunch of stressed out high school students instead of a whole bunch of stress out undergrads (though let's face it, there are already a ton of stressed out high school students).

 

Residency applications have already seen this. We got rid of grades in med school and now the focus (and stress) have moved to other considerations, such as doing research or networking.

 

I think Emotocon has it right. If you don't want to be stressed, you have to learn to manage the pressure on you and find your own balance, because no change to the system will remove that pressure. I know it's tough, I know it feels overwhelming at times. But this is part of life, especially in medicine, and learning to deal with it capably and early on will make you stronger as you progress in your career.

[LeBronto2019]

I feel like the statistic of 2.5 tries to get accepted is a bit skewed. Look at the applicant pool vs. successful admission pool. Applicant averages are obviously much lower and if only 10% of students get accepted each year, of course a ton of students will need to keep trying to get accepted. But if you consider a school and you have, at the very least, above average GPA and MCAT scores, you may not need that many tries to get in. And most people will take the M.Sc. route or continue with more undergrad years to boost their GPA if they don't get accepted anyways, so they have something killing time. 

[codebar]

Finally, if you want a system closer to the rest of the world, simply look at Quebec. They do two years of cegep before going into Med. There have been studies showing that the burnout rate is greater in these younger students. So this goes against what you are saying and I believe it is because these younger students have not had the chance to develop the necessary techniques to cope for the Intense amount of stress and material that comes with a program such as medicine.

Do you know where I can find those studies? Ive always been interested about the consequences of beginning medschool younger. So far, I havent read anything bad against this system.

[Slashsev]

Serious, a 22 he olds burn out vs 35 yr old with a family is different.

[GrumpyMoriarty]

I don't agree with the 6 year system starting after high school. I didn't really have a clue as to what I wanted to do until after grade 11 and I highly suspect I am not the only person with this problem. If the undergrad medical system was in place, i would not be in a good position to go into medicine since I basically did nothing remotely science-related until grade 12. 

[StriveP]

Serious, a 22 he olds burn out vs 35 yr old with a family is different.

 

I don't know what courses you've been taking but try taking a full course load with upper year molecular biology courses and labs then come back and judge. I can't believe how some of you guys are quick to judge about "burning out" too fast. It depends on the courses people are taking, it's a fact some of us are taking much more difficult courses than others and obviously we'll burnout faster than the kid who takes just Kine courses. Anyways, try thinking before posting or you'll just look like an idiot.

 

 

And I'm not saying there should be a 6 year system straight out of high school. I strongly feel that undergrad has prepared me for handling stress and has allowed me to mature. But having to complete 3-4 years of undergrad before applying is a waste of time. it would have been more efficient if we can apply after 2nd year of undergrad. This gives us enough time to finish the major pre-requites and saves us 1-2 years of our lives. It's simply a more efficient system.

[rmorelan]

The other related issue with the European system is that everyone has to therefore have the same background in medicine - there are  no engineers, business majors, psychologists, math majors.....or people like me with a software/computer science background among other things. Now I don't we need half the class with non-traditional backgrounds but it is amazing how limited parts of medicine really are because no one understands important aspects of things. I often feel like that one eyed man in the land of the blind - by default I am the best computer scientist there is around. You become the go to guy for everyone - and I mean everyone. When you see the mistakes that were made because insight simply wasn't there you understand the issues involved. Same with other key areas. Without joking I can say we are 20-30 years behind in some things - and a lot of major advances are made by people pushing from outside the norm.

 

Diversity is strength.

[Dermaholoic]

I dont think it's set up for burnout at all actually. The problem is that the field attracts neurotic/stress-out type-A personalities. If you just say, "I dont care" and go with it, medicine is pretty enjoyable. 

[thsc]

The other related issue with the European system is that everyone has to therefore have the same background in medicine - there are  no engineers, business majors, psychologists, math majors.....or people like me with a software/computer science background among other things. Now I don't we need half the class with non-traditional backgrounds but it is amazing how limited parts of medicine really are because no one understands important aspects of things. I often feel like that one eyed man in the land of the blind - by default I am the best computer scientist there is around. You become the go to guy for everyone - and I mean everyone. When you see the mistakes that were made because insight simply wasn't there you understand the issues involved. Same with other key areas. Without joking I can say we are 20-30 years behind in some things - and a lot of major advances are made by people pushing from outside the norm.

 

Diversity is strength.

Mind elaborating on what some of these things that you're referring to are? I'm interested to know. 

[osteon]

I don't know what courses you've been taking but try taking a full course load with upper year molecular biology courses and labs then come back and judge. I can't believe how some of you guys are quick to judge about "burning out" too fast. It depends on the courses people are taking, it's a fact some of us are taking much more difficult courses than others and obviously we'll burnout faster than the kid who takes just Kine courses. Anyways, try thinking before posting or you'll just look like an idiot.

 

 

And I'm not saying there should be a 6 year system straight out of high school. I strongly feel that undergrad has prepared me for handling stress and has allowed me to mature. But having to complete 3-4 years of undergrad before applying is a waste of time. it would have been more efficient if we can apply after 2nd year of undergrad. This gives us enough time to finish the major pre-requites and saves us 1-2 years of our lives. It's simply a more efficient system.

Congrats on your fancy-pants undergrad molecular bio courses - you are like the majority of med applicants (oh how taxing work it is!)! Sorry for the sarcasm, but the program/school you're in is just a small part of difficulty and stress so your statement strikes me as naive. For instance, I personally find engineering courses way easier than any english course I've ever taken. To me, writing a 10 page essay on god knows what book or author is WAY more stressful than any mechanics project I've had to do, probably because I enjoy what I'm doing. Just chill out - school is a whole lot worse if you spend your time worrying about whether you get an A or A- in a particular course. If you're planning a career in medicine, undergrad is probably as easy as it gets, so enjoy it!

 

I also disagree about the early entry med school. In fact I hope that more schools adopt the requirement to have a completed degree first. As others have said, it brings a lot of diversity to the field of medicine, which is important. But also, finishing the degree just gives the student some more time to mature, and develop extra skills through extracurriculars and stress management. I also think that it's important to experience the field of medicine to some degree before committing $200K and your life to the profession. In the long run, you won't notice the extra 1-2 years for completing the undergrad. I actually like a more holistic approach. I think the skills that can be developed through ECs are vastly more important than the difference between a 3.7 and 3.9 GPA.

[older]

Seems that there is a lot of misinformation here about how medical education is structured in Europe. To clarify this, here are details about UK system vs. Canadian system. Which is better? There are pros and cons.

 

In  UK, you can (but that's not the only way, see further below) enter med school straight from high school. It will not work in Canada  in the current state of secondary education. There is huge disparity in quality in education between provinces and schools themselves. 

 

In UK, you must take 2-steps standardized tests (GCSE -  8-10 subjects,  and A2 - min 3 subjects two years later). You have to have minimum 3 A's  (out of 4 A-levels taken) to be considered by any of  med schools . Recently, the bar is rising to A+. In contrast, Canada has no standardized country-wide tests -  Ontario does not have standardized graduating tests at all. There is no objective way to compare a student with 95% average from one school to another, so the very competitive medicine application process would be intrinsically unfair.  Btw, the best Canadians grads from academic-oriented schools (e.g. those loaded with AP or IB classes) easily compare to UK students with 3As, but many schools would simply not provide the basics needed in med school. 

 

In addition to GCSE and A2,  entrance exams count heavily in admission process. Most med schools use UKCAT,  a 4-part test  not based on science (somewhat comparable to LSAT or GMAT). Four med schools, including Oxford and Cambridge, use BMAT,  (science-based plus essay part), similar to our MCAT.  Some med school do not have entrance exams, but very few. Those require stellar GCSE and A-levels. All schools require Personal Statement, conduct interviews, and use EC, work experience and volunteering  to a various degree in the admission process.  Applications are limited to 4 schools, plus the 5th, non-med choice.

 

Once admitted, you do a 5 or 6 year medical course. While some schools have 6-year program, other have 5-year but most of those allow to intercalate. Intercalation is taking a year off medical course after  2nd, 3rd or (rarely) 4th year in order  to complete another degree, at the same or different university. Your bachelor course is based on first 2 yrs of med school where you learn mostly science.  You can choose in accordance with your interests, e.g. neuroscience, genetics, but also more general courses such as ethics and law, or global health.  After 6 years of school you  have both 3-yr Bachelor Degree and Medical degree. Since NHS pays your med school tuition for the 5th and 6th year, you get your "free" bachelor degree with just one year of extra work. 

 

There is also an option of 4-year graduate med course - if you already have an undergraduate degree. This option is equivalent to US/Canada system. But the advantage of UK system is that you can do it either way. If you know what you want to do, you can apply straight from high school. If you don't , or you make up your mind about being a doctor while taking another course, then  graduate entry program (GEP) is your way to go. GEP  is very competitive, but it is much less insane than in Canada - people do not do second undergrad degree in order to get in, and they compete only with other GEPs, while the majority of the doctors-to-be go through 5 or 6 year program.  Additional advantage for GEP applicants is that you can wipe out your poor high school scores - your degree GPA, entrance exam, PS  and EC get you there, just like in Canada.

 

The last 3 years of  medical degree (regardless of which program you take) are the clinical training years where you spend a lot of time on placement in hospitals. Some Med programs, those heavy on PBL (Problem Based Learning)  have a pre-clinical contact with patients also during the first two years. There is a lot of time to learn your way around patients. 

 

After graduation  you do 2 Foundation Years (previously known as the junior doctor years), during which you rotate through various specialties - during this time you are being paid as you train. As an FY doctor you are not yet fully trained, and only have provisional membership of the GMC - full registration depends on passing your FY exams.

 

In your FY2 year you decide which specialty you would like to apply for. You have to compete for your preferred specialty with everyone else who wants it, this is based on your performance in your med school and as an FY doctor.

 

You then train in your specialty - at this point you are a registrar in that specialty. This stage of training can take 5 to 10 years depending on the specialty that you chose. If you pass all your training while working as a registrar doctor you can become a consultant in that specialty. This is not automatic - you have to apply and there has to be a position.  As a  consultant you still need to continue updating your knowledge, and are encouraged to do additional training to improve your knowledge and skills and/or further specialize within your specialty.

 

Doctor's training in UK does not take any less time than in US/Canada, actually it can take more. It's just structured different way. Importantly, the system gives fair chance to get in and receive excellent education without burnout and stress of 4 undergrad years. 

[Edict]

Seems that there is a lot of misinformation here about how medical education is structured in Europe. To clarify this, here are details about UK system vs. Canadian system. Which is better? There are pros and cons.

 

In  UK, you can (but that's not the only way, see further below) enter med school straight from high school. It will not work in Canada  in the current state of secondary education. There is huge disparity in quality in education between provinces and schools themselves. 

 

In UK, you must take 2-steps standardized tests (GCSE -  8-10 subjects,  and A2 - min 3 subjects two years later). You have to have minimum 3 A's  (out of 4 A-levels taken) to be considered by any of  med schools . Recently, the bar is rising to A+. In contrast, Canada has no standardized country-wide tests -  Ontario does not have standardized graduating tests at all. There is no objective way to compare a student with 95% average from one school to another, so the very competitive medicine application process would be intrinsically unfair.  Btw, the best Canadians grads from academic-oriented schools (e.g. those loaded with AP or IB classes) easily compare to UK students with 3As, but many schools would simply not provide the basics needed in med school. 

 

In addition to GCSE and A2,  entrance exams count heavily in admission process. Most med schools use UKCAT,  a 4-part test  not based on science (somewhat comparable to LSAT or GMAT). Four med schools, including Oxford and Cambridge, use BMAT,  (science-based plus essay part), similar to our MCAT.  Some med school do not have entrance exams, but very few. Those require stellar GCSE and A-levels. All schools require Personal Statement, conduct interviews, and use EC, work experience and volunteering  to a various degree in the admission process.  Applications are limited to 4 schools, plus the 5th, non-med choice.

 

Once admitted, you do a 5 or 6 year medical course. While some schools have 6-year program, other have 5-year but most of those allow to intercalate. Intercalation is taking a year off medical course after  2nd, 3rd or (rarely) 4th year in order  to complete another degree, at the same or different university. Your bachelor course is based on first 2 yrs of med school where you learn mostly science.  You can choose in accordance with your interests, e.g. neuroscience, genetics, but also more general courses such as ethics and law, or global health.  After 6 years of school you  have both 3-yr Bachelor Degree and Medical degree. Since NHS pays your med school tuition for the 5th and 6th year, you get your "free" bachelor degree with just one year of extra work. 

 

There is also an option of 4-year graduate med course - if you already have an undergraduate degree. This option is equivalent to US/Canada system. But the advantage of UK system is that you can do it either way. If you know what you want to do, you can apply straight from high school. If you don't , or you make up your mind about being a doctor while taking another course, then  graduate entry program (GEP) is your way to go. GEP  is very competitive, but it is much less insane than in Canada - people do not do second undergrad degree in order to get in, and they compete only with other GEPs, while the majority of the doctors-to-be go through 5 or 6 year program.  Additional advantage for GEP applicants is that you can wipe out your poor high school scores - your degree GPA, entrance exam, PS  and EC get you there, just like in Canada.

 

The last 3 years of  medical degree (regardless of which program you take) are the clinical training years where you spend a lot of time on placement in hospitals. Some Med programs, those heavy on PBL (Problem Based Learning)  have a pre-clinical contact with patients also during the first two years. There is a lot of time to learn your way around patients. 

 

After graduation  you do 2 Foundation Years (previously known as the junior doctor years), during which you rotate through various specialties - during this time you are being paid as you train. As an FY doctor you are not yet fully trained, and only have provisional membership of the GMC - full registration depends on passing your FY exams.

 

In your FY2 year you decide which specialty you would like to apply for. You have to compete for your preferred specialty with everyone else who wants it, this is based on your performance in your med school and as an FY doctor.

 

You then train in your specialty - at this point you are a registrar in that specialty. This stage of training can take 5 to 10 years depending on the specialty that you chose. If you pass all your training while working as a registrar doctor you can become a consultant in that specialty. This is not automatic - you have to apply and there has to be a position.  As a  consultant you still need to continue updating your knowledge, and are encouraged to do additional training to improve your knowledge and skills and/or further specialize within your specialty.

 

Doctor's training in UK does not take any less time than in US/Canada, actually it can take more. It's just structured different way. Importantly, the system gives fair chance to get in and receive excellent education without burnout and stress of 4 undergrad years. 

 

Spot on. Speciality is actually 3-8 years with 3 for GP and 8 for Neurosurgery. However this can usually take much longer as people take years out to do research, do extra degrees and otherwise improve their applications for consultant positions. 

 

Not knowing much about burnout in Canada, I can at least say that my experience in the UK system leads me to believe it is a great system. Because our program is 6 years long we don't have as high of a workload as Canadian medical students, on a week by week basis. I think this spreading out of the workload leads to less burnout and from my experience and my friends experience the vast majority are satisfied with their decisions to enter medicine and those who weren't easily switched to a different subject.   

 

Competition is also much less since the competition doesn't really pick up again until the later clinical years and foundation years for speciality training. 

 

Lastly this goes without saying but if you know you are interested in the human body and medicine it makes sense to have the option to study what you want in university. Instead of having 90% of undergrads in the biomedical sciences course wanting to be in medical school, biomedical science professors in the UK know that more of their students actually wish to pursue biomedical science degrees. 

 

Also, by no means are graduates excluded from the 5 year or 6 year programs, we have several non-trads in our class. Many schools also have 4 year GEM programs that are more similar to the US/Canadian system. 

[A-Stark]

Don't get me wrong, maybe you don't feel burned out but nearly everyone I know feels burned out at this point. My friends were having this conversation recently and I feel the whole "undergrad" prerequisite to get into medical school is ridiculous. It just deteriorates the quality of medicine patients gets since most people are defiantly burned out by residency, not to mention it effects the these "young" physicians psychological. I think a more effective way would be allowing students to apply after their 1st or 2nd year instead of a 3rd or 4th year degree which essentially is meaningless. Most medical school students I know could careless about their undergraduate degree as it didn't really teach them anything in relevance to medicine. And literally every country besides the US and Canada have this system where students out of high school can apply to medical school directly which obviously isn't ideal but I think finding an intermediate solution would be optimal.

 

That is not at all correct. I would also say that admissions committees do not care about undergraduate degrees insofar as they might be "relevant" to medicine, but rather what they say about experience. It's about maturity, diversity of experience, and varied activities and accomplishments. As an interviewer recently, I can say that the applicants who simply followed the usual biochem degree pathway didn't impress much unless they could speak to experience. Maturity matters and, frankly, most 21 year olds don't have it. Those that do didn't treat undergrad (and beyond) as a chore or burnout on "ECs"; they transitioned to being young adults who can parlay their experience into their motivation for medicine. 

 

And all that aside, most premeds don't really have any idea what day-to-day life in clerkship let alone residency or independent practice is. In my program we actually have several former nurses - and I'd say their training and experience absolutely informs their work now. 

 

I don't know what courses you've been taking but try taking a full course load with upper year molecular biology courses and labs then come back and judge. I can't believe how some of you guys are quick to judge about "burning out" too fast. It depends on the courses people are taking, it's a fact some of us are taking much more difficult courses than others and obviously we'll burnout faster than the kid who takes just Kine courses. Anyways, try thinking before posting or you'll just look like an idiot.

 

And I'm not saying there should be a 6 year system straight out of high school. I strongly feel that undergrad has prepared me for handling stress and has allowed me to mature. But having to complete 3-4 years of undergrad before applying is a waste of time. it would have been more efficient if we can apply after 2nd year of undergrad. This gives us enough time to finish the major pre-requites and saves us 1-2 years of our lives. It's simply a more efficient system.

 

I did an honours double major in political science and math. In my last year of undergrad, though, I finally got around to taking organic 1 and 2, such that some of the last exams I wrote were organic 2 and partial differential equations. Around the same time I also wrote an open book real analysis exam. Try taking those! The year before that I wrote my honours thesis - it was 100 pages of political theory. 

 

Of course, in the end undergrad was something of a breeze. You have so much time to study - even with labs, your class time commitment doesn't even remotely approach a full time work week. And it's frequently possible to get away with only a few days of studying for a final. In med school, we studied hard for days and days (usually at least two weeks) for a single exam, and usually one that was weighted as 100% of our final mark. The volume of information is far greater. By clerkship you're "working" full-time and have to fit in studying around that. You think your molecular bio exams were hard? Ever seen an NBME final? 

 

By the time CaRMS approaches you'll be making decisions that will to a great extent determine the path of your career. Oftentimes I've seen the younger, less mature students make riskier decisions and wind up disappointed. 

[NLengr]

 The volume of information is far greater. By clerkship you're "working" full-time and have to fit in studying around that. You think your molecular bio exams were hard? Ever seen an NBME final? 

 

I'd kill for an NBME final. The thought of my Royal College Exam gives me palpatations!

 

The reality is the farther you advance in training, generally the harder things become.

 

Undergrad: Pretty decent. Not other responsibilities except school. Can tailor courses. Courses are on average not too hard (unless you are stupid like me and do something like engineering)

 

Pre-Clerk: Much more volume than undergrad, but still lots of study time.

 

Clerkship: Still lots of volume, but now you need to do work as a clerk (daytime at the hospital plus some call). Generally, you don't have any real responsibilities when you are working though, it's much more about learning.

 

Junior Resident: Ton of work (scut, clinics, emerg etc.). You have actual responsiblity. Lots of call. Still need to learn the basics of your field, plus pass the LMCC +/- Surgical foundations. So there is some studying to do too.

 

Senior Resident: Tons of work, just not scut stuff. Managing other residents, running a team of residents, admin work etc. Learning how function at the staff level for clinic/consults. Learning how to really operate (if you are a surgical specialty). Oh and studying for the Royal College, which consumes most of your life. (for example the go-to text for my specialty is 4800 pages, all fair game for the exam, plus any new information that has come out since the exam is also fair game).