Canadian/american Premed System Setup For Burnout

[coastalslacker]

Don't think of it as "burning out", think of it as "weeding out". 

 

The stress doesn't magically end when you finish your training and become an attending.  All of a sudden the buck stops with you.  Even consenting a patient for surgery is an entirely different process - something you do a thousand times as a trainee - because now it's your name at the end of the chart.  Thankfully, you've progressed through a rigorous training program and stress, while still unpleasant, is something you are equipped to deal with.  My 4 hour case turned into a 6 hour case yesterday through a somewhat predictable but entirely unpreventable event....drop a quick f-bomb, tell anaesthesia you need 2 more hours, and then fix it.  Thank you to all the stressful situations I've had before.     

 

I think there are, and, always will be, improvements that can be made in the process of selecting who gets to become a physician and then training those people.  However, at the end of the day the job is the same, so trying to smooth out the process may actually be counterproductive.

 

An aside - people should stop complaining about how hard their degree is.  Nobody thinks you're smarter because of it, you just sound like a whiner.  Put on your big-boy pants if you want to go into medicine. 

[NLengr]

Don't think of it as "burning out", think of it as "weeding out". 

 

The stress doesn't magically end when you finish your training and become an attending.  All of a sudden the buck stops with you.  Even consenting a patient for surgery is an entirely different process - something you do a thousand times as a trainee - because now it's your name at the end of the chart.

 

I had this conversation with one of my friends from residency who I was operating with yesterday. He's now an attending. He apologized to me because he felt he was being anal and picky during the case (he wasn't really). He commented how he isn't happy go lucky at work like when he was a resident. I told him something similar to what you said. Basically the buck stops with you so don't worry about seeming picky when I'm doing something during your case. You are the one who has to answer to the patient in the future, so you need to be happy with the operation.

[older]

Don't think of it as "burning out", think of it as "weeding out". 

 

The stress doesn't magically end when you finish your training and become an attending.  All of a sudden the buck stops with you.  Even consenting a patient for surgery is an entirely different process - something you do a thousand times as a trainee - because now it's your name at the end of the chart.  Thankfully, you've progressed through a rigorous training program and stress, while still unpleasant, is something you are equipped to deal with.  My 4 hour case turned into a 6 hour case yesterday through a somewhat predictable but entirely unpreventable event....drop a quick f-bomb, tell anaesthesia you need 2 more hours, and then fix it.  Thank you to all the stressful situations I've had before.     

 

I think there are, and, always will be, improvements that can be made in the process of selecting who gets to become a physician and then training those people.  However, at the end of the day the job is the same, so trying to smooth out the process may actually be counterproductive.

 

An aside - people should stop complaining about how hard their degree is.  Nobody thinks you're smarter because of it, you just sound like a whiner.  Put on your big-boy pants if you want to go into medicine. 

 

[older]

 

Don't think of it as "burning out", think of it as "weeding out". 

 

The stress doesn't magically end when you finish your training and become an attending.  All of a sudden the buck stops with you.  Even consenting a patient for surgery is an entirely different process - something you do a thousand times as a trainee - because now it's your name at the end of the chart.  Thankfully, you've progressed through a rigorous training program and stress, while still unpleasant, is something you are equipped to deal with.  My 4 hour case turned into a 6 hour case yesterday through a somewhat predictable but entirely unpreventable event....drop a quick f-bomb, tell anaesthesia you need 2 more hours, and then fix it.  Thank you to all the stressful situations I've had before.     

 

I think there are, and, always will be, improvements that can be made in the process of selecting who gets to become a physician and then training those people.  However, at the end of the day the job is the same, so trying to smooth out the process may actually be counterproductive.

 

An aside - people should stop complaining about how hard their degree is.  Nobody thinks you're smarter because of it, you just sound like a whiner.  Put on your big-boy pants if you want to go into medicine. 

 

 

 

You are missing the point. Nobody denies that medical  profession requires hard work and the work will be stresfull. Also, it is not that undergraduate degree is "stressful" as such.  The burnout is due to enormous pressure faced by young undergards working towards insanely competitive med school admission. This is what can make the whole undergarduate experience a nightmare.  Some bad classess and exams can ruin your GPA, thus denying  your dream of becoming a doctor. The pressure  for grades is  too much for many people - they cannot enjoy their university life, bacause they always feel compelled  "to do more" in order to achieve higher grades and increase their chances. And even if you have stellar GPA, you may still not get in. So many people never get in, even if they worked very hard for 4 years. And this is where ridiculous solutions come to play, such as doing a 2nd, useless but "easy" degree for sole purpose to improve grades, just to get  competitive edge.  

 

It is true that  Admissions don't care about your undergard degree but it is beside the point. There is a GPA cutoff and you may  never get to the next stage. It is not that high GPA is not achievable - it is.  But for many, it comes at a very high price.

 

The concern is that many people who would be great doctors never make it through this undergraduate barrier - despite very good academic ability. Some will  burn out, many will be left with useless degree. You are right,  this  is "weeding out" but are there really just weeds left behind?  The  system where people go to med school straight from high school is fairer.  Those who change their mind, those immature and those with no real committment to the profession will be weeded out in the  first years of medical school -   for right reasons.  But no one is forced to study for 4 years just to have a chance (slim chance!) to get to med school.

 

Once you are "in" , it is different kind of stress. You still need to work hard, but you are not balancing on the edge of being out of  the game for 4 long years.

[A-Stark]

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)

 

[...]

 

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).

 

All too true. I had my program OSCE two weeks ago, with Royal College-style questions and stations. It was difficult, and if I did manage to do about average for my year, it still gives me something of a sinking feeling about the actual exam in a few (not very many...) years. 

 

As for being a senior, it's very true. More responsibility means more work - albeit different work. I'm way, way more efficient than I was as an intern, but it's even harder to know everyone on a list of 20 and manage interns and clerks. Though currently our team is eerily calm. 

 

You are missing the point. Nobody denies that medical  profession requires hard work and the work will be stresfull. Also, it is not that undergraduate degree is "stressful" as such.  The burnout is due to enormous pressure faced by young undergards working towards insanely competitive med school admission. This is what can make the whole undergarduate experience a nightmare.  Some bad classess and exams can ruin your GPA, thus denying  your dream of becoming a doctor. The pressure  for grades is  too much for many people - they cannot enjoy their university life, bacause they always feel compelled  "to do more" in order to achieve higher grades and increase their chances. And even if you have stellar GPA, you may still not get in. So many people never get in, even if they worked very hard for 4 years. And this is where ridiculous solutions come to play, such as doing a 2nd, useless but "easy" degree for sole purpose to improve grades, just to get  competitive edge.  

 

It is true that  Admissions don't care about your undergard degree but it is beside the point. There is a GPA cutoff and you may  never get to the next stage. It is not that high GPA is not achievable - it is.  But for many, it comes at a very high price.

 

The concern is that many people who would be great doctors never make it through this undergraduate barrier - despite very good academic ability. Some will  burn out, many will be left with useless degree. You are right,  this  is "weeding out" but are there really just weeds left behind?  The  system where people go to med school straight from high school is fairer.  Those who change their mind, those immature and those with no real committment to the profession will be weeded out in the  first years of medical school -   for right reasons.  But no one is forced to study for 4 years just to have a chance (slim chance!) to get to med school.

 

Once you are "in" , it is different kind of stress. You still need to work hard, but you are not balancing on the edge of being out of  the game for 4 long years.

 

I don't really agree with this. I understand that some people go through undergrad working only for the "med school" goal, but you can enjoy your time and do well if you have some semblance of natural ability and a good work ethic. It's still not comparable to anything that comes after, though, because no one in undergrad works anything close to a full work week or deals with the kind of BS that occurs in a hospital. 

 

For example, I had a fairly normal day today. We rounded as a team in the morning, and our usually micro-manager staff then left us to our own devices for the day. A bit of discharging, note writing, clerk-wrangling, and consultant-calling followed. My day ended off with pronouncing a patient who'd been expected to pass away. In undergrad, a typical day might have been a couple morning or afternoon classes, maybe a lab (though not generally since I didn't do a lot of bio or chem), and then lots of time to study, do assignments or readings, write papers, and attend to the rest of my life. Even with all that time I procrastinated a lot, and could generally get away with writing most of a paper the night before it was due. 

 

In retrospect I have no idea how I did that because as a med student and *certainly* as a resident I simply don't have time for that. Your life becomes much more circumscribed - as it does for, ya know, basically all adults - and you will NEVER have the kind of freedom that you have in undergrad ever again. 

 

I'd also say that the vast, vast majority of 18 year olds (and I was barely 18 when I started undergrad) lack the maturity and experience needed. What's more, high school grades and performance at that level generally don't really reflect how many people do in undergrad let alone afterwards. Big fish, small ponds, and all that. Undergrad is the first time many students are living on their own, and in university they will have to work independently. I sometimes wonder whether all the griping about places like UofT are more about students having difficulty with the transition, but then I didn't go there. But I have tutored a lot of first-year calculus students in the past who struggled because they were unwilling or unable to put in the work necessary. I do think that the desire for direct-entry from high school has more to do with the perceived ease. However, if you can't hack it in undergrad (where a single course will never make or break you), I have no idea why you think you'd do well in med school. Or pass your Royal College exams. 

[rupchatt]

I feel "this whole diversity b.s is not needed" i couldnt care less if my doctor is a musician or dancer, i just wanna make sure i get the right meds, i feel the schools put too much emphasis on that stuff, i feel there should be undergrad gpa req but it should only be health science or biomed (2 years max). A 4 year degree is utterly unnecessary and a waste of time, energy and money. People dont even remember what they studied and whats the point if they wont ever need that in medschool and note:maturity is not just limited to age, you can have a 19 year old man or a 49 year old boy. It depends on the person.

[A-Stark]

Allowing for individual variation, the vast, vast majority of 19 year olds do not exemplify maturity. 

[Edict]

I feel "this whole diversity b.s is not needed" i couldnt care less if my doctor is a musician or dancer, i just wanna make sure i get the right meds, i feel the schools put too much emphasis on that stuff, i feel there should be undergrad gpa req but it should only be health science or biomed (2 years max). A 4 year degree is utterly unnecessary and a waste of time, energy and money. People dont even remember what they studied and whats the point if they wont ever need that in medschool and note:maturity is not just limited to age, you can have a 19 year old man or a 49 year old boy. It depends on the person.

 

Maybe 30 years ago Canada operated on a similar system McGill is still operating on that system with their Med-P program today a program of 2 years undergrad followed by 4 years of medical school. Queens recently experimenting with this system again.

 

Knowing today's students, they are incredibly mature for their age. I'm not sure what most people mean by immature but if you mean cow tipping, or drinking wildly then that is definitely not a lot of the pre-med students you'll meet. The ones I know in QuARMS were publishing articles in the news in Gr. 5. Not a single party picture to be found either.

 

The burnout isn't actually caused by undergrad its caused by the competition, people really can't enjoy their undergrad lives. I also don't understand why people think that medicine requires too much maturity for a 19 year old to handle. The first 2 years are spent learning in the exact same way that an undergrad would do just in a different subject and with proper training by the time they are doing their clinical training they will be fine.

[coastalslacker]

Older, (I don't know how to quote)

 

It's not that I'm missing the point, I just don't agree. 

 

Life is inherently unfair.  Some people are born smarter/prettier/insert adjective of choice/harder-working than others.  Some people can do very little work and do well in university - well enough to get into medicine.  Some people have to work extremely hard, to the exclusion of all else, in order to achieve the grades and CV to get into medicine.  If an individual falls into the latter group then it comes down to a choice - are they willing to work that hard, or, should they pursue one of the myriad other careers that are available.  Unfortunately, for those in the latter group, this is often perceived as "failure" instead of an honest assessment of one's abilities.  The culture of 10,000 hours, in which enough work will get anyone to their goal, encourages people to keep at it - study all night for their exams, forgo enjoyable life experiences because it will take time away from studying, or, fluffing up their med school CV. 

 

Someone said above:  "It is not that a high GPA is not achievable - it is. But for many it comes at a very high price."  Well.....duh.  Not everyone is smart enough to be a doctor.  Some people (lots of people) are just barely smart enough....that's a hard position to be in - do you want to always be panting to keep up, or, do something different?  One girl in my medical school class remembered everything she read after reading it once.  We all envied her incredibly.  Some people read the same thing over and over again and never remembered it.  We all wondered how exactly they had gotten in and hoped none of our loved ones were their patients.  I don't want to put medicine on a pedestal, but not everyone is cut out for this business.  In the same vein, and more to the point of my previous comment, not everyone can manage stress adequately to get through medical training and become a physician.  Failing to deal with stress in undergrad (a fraction of what one will encounter in residency and beyond) might be a sign. 

 

Man....I'm sure I've offended lots of people.

 

I don't see how direct entry from high school improves things.  You just transfer the stress from one part of life to another.  High school is great because you don't have to worry about grades.  Some people do, I respect that.  The two years you "save" is negligible in the grand scheme of things and many people (myself included) value the time they got to spend in undergrad before medical school.  I got to read hundreds of books totally unrelated to medicine, take some years off between undergrad years to travel the world, have fun and learn and wouldn't trade those experiences for getting to be a doctor two years sooner.  Who cares, you only live once - do other stuff besides medicine.  Study something that interests you in case you don't get into medicine.  I think the "maturity" card is overplayed as I would agree there are vast differences in the maturity levels between different individuals.  The benefit of using university GPA versus high school performance is the heterogeneity of high school education in Canada, without common tests such as in the UK.  Until there is a way to compare apples to apples, direct high school entry will not happen in Canada.  Undergrad is also not apples to apples, but it is better, and MCAT smooths things out abit.  Yes, I know  Queen's is admitting a few kids out of high school, but it seems like a publicity stunt more than an honest reappraisal of how they choose doctors.    

 

I truly wish the best of luck to all those applying to medical school.  It's a great career.   Most people who are up to snuff do make it in.  Be honest about yourself and your abilities.  Don't beat your head against a wall.  If you find the process of getting in so terrible, you won't hack it when things actually get stressful.   

[rmorelan]

I feel "this whole diversity b.s is not needed" i couldnt care less if my doctor is a musician or dancer, i just wanna make sure i get the right meds, i feel the schools put too much emphasis on that stuff, i feel there should be undergrad gpa req but it should only be health science or biomed (2 years max). A 4 year degree is utterly unnecessary and a waste of time, energy and money. People dont even remember what they studied and whats the point if they wont ever need that in medschool and note:maturity is not just limited to age, you can have a 19 year old man or a 49 year old boy. It depends on the person.

 

that is probably because as a patient your main focus is on the medical expert role - getting the right pills as you say

 

The field as a whole has had long standing problems exactly because the absolute focus has been on what is exactly in front of you - helping the one person you are seeing right now. Of course that is the major focus so that is understandable - it wouldn't matter if you were good at the rest and but be killing people with medical incompetence. 

 

Still because of that focus we tend to not step back and work on system issues that would improve things longer term. We as a field have long acknowledged there is a lot more to medicine than just dealing with one patient at time.

 

As for the degree being unimportant - I don't think that is completely true. I am a resident doctor at this point and I still use my computer science training regularly to make improvements in the hospital and spend up access to care/improve resource management. I am already starting to make sure we have the right systems in place, can access the right data, and track the right things. I would hate people to think that you won't be using parts of your UG in the medical field, that all that you have done is pointless regardless of the underlying degree. I have been very surprised over the years just how often I am pulling things out of background in economics, psychology, computer science, and yes the more traditional biology training I have (I am a bit weird of course in the number of degrees I have). Doctors are in charge of a lot of the major components of health care, and it is quite useful I think to have some people inside that actually have broad enough understanding to actually run things effectively.

[rupchatt]

I am not criticizing the system. I am just trying to look at it from a different perspective. I am sure diversity helps but I feel the medschools put overemphasis on that stuff. Also, GPA is very difficult to standardize. Anyway everything is fair in life.

 

Cheers

[older]

Allowing for individual variation, the vast, vast majority of 19 year olds do not exemplify maturity. 

 

And why should they? They are not treating patients at 19. They have several years of training before they do - enough time to mature.  Allowing for individual variation, most people at 19 are mature enough to decide what profession they are interested in.  And they still can change their mind if they chose wrong.

 

The lenght of medical  training is more or less the same  regardless whether one takes 6-year program after high school or goes through undergrad, and that's all that matters.  

[older]

Older, (I don't know how to quote)

 

It's not that I'm missing the point, I just don't agree. 

 

Life is inherently unfair.  Some people are born smarter/prettier/insert adjective of choice/harder-working than others.  Some people can do very little work and do well in university - well enough to get into medicine.  Some people have to work extremely hard, to the exclusion of all else, in order to achieve the grades and CV to get into medicine.  If an individual falls into the latter group then it comes down to a choice - are they willing to work that hard, or, should they pursue one of the myriad other careers that are available.  Unfortunately, for those in the latter group, this is often perceived as "failure" instead of an honest assessment of one's abilities.  The culture of 10,000 hours, in which enough work will get anyone to their goal, encourages people to keep at it - study all night for their exams, forgo enjoyable life experiences because it will take time away from studying, or, fluffing up their med school CV. 

 

Someone said above:  "It is not that a high GPA is not achievable - it is. But for many it comes at a very high price."  Well.....duh.  Not everyone is smart enough to be a doctor.  Some people (lots of people) are just barely smart enough....that's a hard position to be in - do you want to always be panting to keep up, or, do something different?  One girl in my medical school class remembered everything she read after reading it once.  We all envied her incredibly.  Some people read the same thing over and over again and never remembered it.  We all wondered how exactly they had gotten in and hoped none of our loved ones were their patients.  I don't want to put medicine on a pedestal, but not everyone is cut out for this business.  In the same vein, and more to the point of my previous comment, not everyone can manage stress adequately to get through medical training and become a physician.  Failing to deal with stress in undergrad (a fraction of what one will encounter in residency and beyond) might be a sign. 

 

 

Oh boy, I bet you are in the "smart" group.  But saying that "not everyone is smart enough to be a doctor" is very condescending. Firstly, we are not talking about "everyone", we are talking about individuals with good or very good academic ability who do well at the university, but they are just not "smart enough" to beat the competition to the med school. 

  

Most of all, do not equate high GPA and "book-smarts" with a good doctor.  While ability to grasp scientific concepts is necessary, the med school curriculum isn't that hard.  The material is huge but concepts are not difficult. There is so much involved in medicine besides academics. Med schools recognized it some time ago when they started producing doctors with 99% average who could not communicate with patents, or even didn't care much about them. This is when many med schools changed admission criteria and started looking at a person behind the transcript. The  abilities and qualities other than academic ability ultimately play the most important role in  shaping good doctors.  

 

Even a no-genius can be "smart enough to be a doctor".  However, med schools must have admission critera, and GPA is most often the make-or-break. And this is what makes undegrard experience unnecessarily stressful. But some med school wisely use minimum academic critera (not low, but reasonable), and once you meet this minimum, the field is open  to show abilities that matter more. You are right that "not everyone is cut out for this business", but this cutout is not academic smarts.   

[NLengr]

i feel the schools put too much emphasis on that stuff, i feel there should be undergrad gpa req but it should only be health science or biomed (2 years max).

 

 

That would be the worst med school class ever. A bunch of stereotypical overly anxious type AAA no real world experience biochem grads....

 

In all seriousness, the most useful undergrad for most med students/residents/staff would be a B. Comm or BBA focused in "small business". Med school can teach you the science. What nobody gets taught, and everyone needs, is the skills and knowledge to run your small business (aka your practice) when you are done. EVERYONE I know felt unprepared for the business side of things when the time came to start practice. That stuff makes up a significant portion of your life when you are done.

[A-Stark]

Even a no-genius can be "smart enough to be a doctor".  However, med schools must have admission critera, and GPA is most often the make-or-break. And this is what makes undegrard experience unnecessarily stressful. But some med school wisely use minimum academic critera (not low, but reasonable), and once you meet this minimum, the field is open  to show abilities that matter more. You are right that "not everyone is cut out for this business", but this cutout is not academic smarts.   

 

I think this is already reflected in how many schools structure the admissions process. For example, at Dal, there is a certain number of points awarded for GPA and the MCAT. But this actually maxes out, so that over a certain point there are no additional points awarded (e.g. an MCAT over 34-35 doesn't help). 

 

Now, perhaps I wasn't all that stressed in undergrad because I wasn't actually thinking about medicine at the time. There are definitely courses I could have done better in or avoided completely - and I certainly would always recommend NOT taking a creative writing class because you might end up with a B! - but I really don't think undergrad *should* be all that stressful for anyone capable of getting a strong GPA. It's true enough that some will need to work harder to get it - I worked pretty hard in retrospect even if I wasn't especially aware of it at the time. And I got involved in different activities because I was in interested in them (and for social reasons!). 

 

Having been on the admissions interviewing side several times now, I can say that a variety of experience is always a plus, as is evidence of long-term extracurricular commitments that show creativity and dedication. I don't think that's difficult to do if you have the ability. But it's not condescending to say that some are not "smart enough". What is unfortunate is that many end up just on the cusp of getting in - sometimes more than once - but there's no shortage of strategies to deal with that. It's important to take those undergrad courses seriously, but the best way of doing well is to take a program that interests you, and avoid the typical biochem degree or the like. 

[rupchatt]

That would be the worst med school class ever. A bunch of stereotypical overly anxious type AAA no real world experience biochem grads....

 

In all seriousness, the most useful undergrad for most med students/residents/staff would be a B. Comm or BBA focused in "small business". Med school can teach you the science. What nobody gets taught, and everyone needs, is the skills and knowledge to run your small business (aka your practice) when you are done. EVERYONE I know felt unprepared for the business side of things when the time came to start practice. That stuff makes up a significant portion of your life when you are done.

I disagree with you. This is how it is done in New Zealand and they have fantastic doctors! I don't think a bachelors of commerce is needed to be a doctor.  I don't think the patients could care less about whether their doctor studied business, pottery, geography, history or computer science. A health science or Biomed degree with a public health focus is way better than overemphasizing diversity.

[rupchatt]

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. 

atleast you dont have deal with the uncertainty of getting accepted and go through years of stress and debt. Once they are in medicine, they have a comfort zone. Also, it is way easier to accepted in the UK compare to US or Canada and its a fact.

[rmorelan]

atleast you dont have deal with the uncertainty of getting accepted and go through years of stress and debt. Once they are in medicine, they have a comfort zone. Also, it is way easier to accepted in the UK compare to US or Canada and its a fact.

 

well high school doesn't exactly sound fun with intense pressure to achieve the grades required.

 

I wonder what the drop out rate is during the 5-6 year period?

[rupchatt]

hahaha 

[rupchatt]

well high school doesn't exactly sound fun with intense pressure to achieve the grades required.

 

I wonder what the drop out rate is during the 5-6 year period?

ahahahaha

[NLengr]

I disagree with you. This is how it is done in New Zealand and they have fantastic doctors! I don't think a bachelors of commerce is needed to be a doctor. I don't think the patients could care less about whether their doctor studied business, pottery, geography, history or computer science. A health science or Biomed degree with a public health focus is way better than overemphasizing diversity.

Provide some evidence that New Zealand doctors are better than Canadian doctors or else you aren't making any point.

 

You are exactly right, patients don't care about undergrad. That's exactly why it doesn't matter what you do. Again, if you want to argue that diversity is overemphasized and the public would benifit from health science or biomed graduates only, provide evidence that staff physicians with those undergrads outperform their peers with a different background.

 

I've finished med school. I'm well aware that your type of undergrad matters very little. Biochem and health science grads struggle through, just the same as everyone else. The B.Comm/BBA point was that you don't get taught business in medical training. A huge part of being a doctor is running the business side of your practice. If you do it poorly you can really negatively impact your practice and your finances. Most people in medical training and in practice agree it's an area that is neglected. Doing some business work in undergrad might help fill that gap (hence the value of the degree to a doctor)

[Edict]

Provide some evidence that New Zealand doctors are better than Canadian doctors or else you aren't making any point.

 

You are exactly right, patients don't care about undergrad. That's exactly why it doesn't matter what you do. Again, if you want to argue that diversity is overemphasized and the public would benifit from health science or biomed graduates only, provide evidence that staff physicians with those undergrads outperform their peers with a different background.

 

I've finished med school. I'm well aware that your type of undergrad matters very little. Biochem and health science grads struggle through, just the same as everyone else. The B.Comm/BBA point was that you don't get taught business in medical training. A huge part of being a doctor is running the business side of your practice. If you do it poorly you can really negatively impact your practice and your finances. Most people in medical training and in practice agree it's an area that is neglected. Doing some business work in undergrad might help fill that gap (hence the value of the degree to a doctor)

 

So many small business owners are able to run their own business without a degree, i'm sure having a degree is useful in that area but can that not be learned when you need it?

[Birdy]

Provide some evidence that New Zealand doctors are better than Canadian doctors or else you aren't making any point.

You are exactly right, patients don't care about undergrad. That's exactly why it doesn't matter what you do. Again, if you want to argue that diversity is overemphasized and the public would benifit from health science or biomed graduates only, provide evidence that staff physicians with those undergrads outperform their peers with a different background.

I've finished med school. I'm well aware that your type of undergrad matters very little. Biochem and health science grads struggle through, just the same as everyone else. The B.Comm/BBA point was that you don't get taught business in medical training. A huge part of being a doctor is running the business side of your practice. If you do it poorly you can really negatively impact your practice and your finances. Most people in medical training and in practice agree it's an area that is neglected. Doing some business work in undergrad might help fill that gap (hence the value of the degree to a doctor)

Or at least get some experience with the business side of medicine. My current job is in healthcare administration, and while I work for government, not a small business, I'm still getting very valuable experience. I work with a lot of independent healthcare providers and I frequently have to work with one of the largest private insurers in the country. I'll get plenty of clinical exposure in med school, but I won't get much, if any, training in medical billing in med school, or resource allocation, or how to hire and manage employees, or public health fiscal policy, which will impact me as a doctor. As it is, I'm already building contacts (including physician mentors) and that alone is valuable. I'd certainly recommend other students look for a job in healthcare administration as a way to get some exposure. It's not exactly what I'll be doing, but many skills and a lot of knowledge will be transferable.

[rmorelan]

So many small business owners are able to run their own business without a degree, i'm sure having a degree is useful in that area but can that not be learned when you need it?

 

ha, well considering the failure rates of small businesses I am not sure that is actually that useful of a point Plus even if you are just punting along that doesn't mean the business is optimal or that stress factors are minimized.

 

You can of course learn on the fly but it is like anything else - you are going to make a lot of unneeded mistakes that way and it is going to be unnecessarily painful.

 

I actually think that the lack of training in running a practise is a major weakness in our training systems. Considering the extra requirements on a doctors office - recording keeping, patient charts, confidentiality......

[sprite]

I feel "this whole diversity b.s is not needed" i couldnt care less if my doctor is a musician or dancer, i just wanna make sure i get the right meds, i feel the schools put too much emphasis on that stuff, i feel there should be undergrad gpa req but it should only be health science or biomed (2 years max). A 4 year degree is utterly unnecessary and a waste of time, energy and money. People dont even remember what they studied and whats the point if they wont ever need that in medschool and note:maturity is not just limited to age, you can have a 19 year old man or a 49 year old boy. It depends on the person.

 

i definitely agree with this. 

maybe expand it to at least having a certain bsc with certain pre reqs, like biochem, physio anatomy etc, things that are relevant to medicine. If youve done those in undergrad then you can spend more time reviewing and expanding your knowledge in medical school instead of starting from scratch.

Taking two or three years worth of medically relevant subjects does not equal studying for the mcat for a couple of months in the summer. 

 

http://www.ouac.on.ca/statistics/med_app_stats/

 

additionally, having set pre reqs narrows the application pool. instead of having a 4300 applications like mcmaster, you can narrow it down to 2600 applications like ottawa - which actually has pre reqs. I am sure out of 2600 application there is more then enough diversity to go around, and you know these people are generally on the same page. It'd be interesting to see what the application data would be like if ottawa used the mcat, perhaps even less applications. OR atleast use the mcat like western, as a barrier. If you don't know your basic sciences, then c ya, you can take your diversity elsewhere lol. 

 

additionally look at the jump of applications between 2008 and 2009 to queens medicine. i am under the impression that queens used to have pre-reqs but abolished them around that time no? I could be wrong. But what purpose did abolishing pre-reqs serve haha ? 

 

having a 4 year degree prior to medicine is absolutely useless, the whole diversity thing is so over-exaggerated too. Like many said, i want my doc to be a competent physician , not "diverse". Maturity comes with age not finishing a bachelors degree.