Handsome88 Posted February 14, 2015 Report Share Posted February 14, 2015 How competitive is CCM in Canada? I'm doing IM in the states and would like to apply to fellowship in Canada (preferably ontario). Is it easily attainable or complicated an competitive (as Canada always is)? Also, since Pulm/CC double board is not available in Canada, would I be able to apply to a 2nd fellowship after CCM? Thanks. Link to comment Share on other sites More sharing options...
keith_015 Posted February 14, 2015 Report Share Posted February 14, 2015 How competitive is CCM in Canada? I'm doing IM in the states and would like to apply to fellowship in Canada (preferably ontario). Is it easily attainable or complicated an competitive (as Canada always is)? Also, since Pulm/CC double board is not available in Canada, would I be able to apply to a 2nd fellowship after CCM? Thanks. Critical Care is a very difficult area to get a job in, so keep that in mind. Looking at the match for the last 2 years, spots have gone unfilled in the first iteration, which I think is partially attributed to the poor job market. I think you must do your other fellowship before going back to do Critical Care if you choose to do both, not vice versa. Link to comment Share on other sites More sharing options...
Handsome88 Posted February 14, 2015 Author Report Share Posted February 14, 2015 Critical Care is a very difficult area to get a job in, so keep that in mind. Looking at the match for the last 2 years, spots have gone unfilled in the first iteration, which I think is partially attributed to the poor job market. I think you must do your other fellowship before going back to do Critical Care if you choose to do both, not vice versa. So is it easy for someone from the states to get CCM in Canada? I can't work as a GIM in Canada because in the states it's only 3 years. So I'm thinking of subspecializing in order to be able to work. Why do you think it's better to do another subspecialty and then do CCM? Is it just because of the job market or is there another reason? Also, assuming we do get a job. What's the compensation like in the field? I heard they work 1 week on 1 week off, is that true? Link to comment Share on other sites More sharing options...
rogerroger Posted February 14, 2015 Report Share Posted February 14, 2015 I can't answer all your questions. But I do know that finding a job in the ICU is very limmited. Especially in places where most people who are ICU trained would like to work, places which are not five bed rural center "ICUs"... The one week on model is popular from my limmited experience. Link to comment Share on other sites More sharing options...
keith_015 Posted February 15, 2015 Report Share Posted February 15, 2015 So is it easy for someone from the states to get CCM in Canada? I can't work as a GIM in Canada because in the states it's only 3 years. So I'm thinking of subspecializing in order to be able to work. Why do you think it's better to do another subspecialty and then do CCM? Is it just because of the job market or is there another reason? Also, assuming we do get a job. What's the compensation like in the field? I heard they work 1 week on 1 week off, is that true? In the current situation, if positions for CCM are left to second iteration, it may mean a good chance that you may be competitive. Having said that, again, the job market is limited and you would likely have to consider working in unfavourable locations to feed yourself. Subspecializing before CCM would definitely help you out. If you like GIM, you could try to match to the 2 year GIM fellowship which should qualify you to work in Canada. The pay is good for sure. I cannot comment on schedules, but from what I have seen in different communities, 1 on 1 off hasn't been the way they function. It may be one week on, 2+ weeks off depending on how many people help staff the ICU. Depending on location, some staff practice primarily in another field, and occasionally staff the ICU. Link to comment Share on other sites More sharing options...
Handsome88 Posted February 15, 2015 Author Report Share Posted February 15, 2015 In the current situation, if positions for CCM are left to second iteration, it may mean a good chance that you may be competitive. Having said that, again, the job market is limited and you would likely have to consider working in unfavourable locations to feed yourself. Subspecializing before CCM would definitely help you out. If you like GIM, you could try to match to the 2 year GIM fellowship which should qualify you to work in Canada. The pay is good for sure. I cannot comment on schedules, but from what I have seen in different communities, 1 on 1 off hasn't been the way they function. It may be one week on, 2+ weeks off depending on how many people help staff the ICU. Depending on location, some staff practice primarily in another field, and occasionally staff the ICU. I wouldn't mind working in a less desirable place with less beds (I may have a ROS contract anyways), however does that affect my salary (expect decrease or increase)? I have a question on behalf of several friends who are doing IM in the states with hopes of going back to Canada. How competitive is it to get a 2 year GIM position in Canada from the states? I would love to do a subspecialty before CCM in Canada but my interests lie in competitive fellowships (Cards, Pulm/CC) and so it might not be possible, which is why I'm looking to do CCM in Canada as a back up in case I don't get a Cards or Pulm/CC fellowship in US (or Cards in Canada). I'm now thinking of doing ID or Pulm in Canada then doing CCM in Canada though as it would be a nice fall back to do ID or Pulm on weeks where I'm not in the unit, plus ID/Pulm aren't competitive right? Also, is it possible to do a 1 year of chief resident or a fellowship in states (i.e Echo or heart failure) then do 1 year of IM in canada to get me to 5 years? Thanks Link to comment Share on other sites More sharing options...
A-Stark Posted February 16, 2015 Report Share Posted February 16, 2015 No, I don't think so. Link to comment Share on other sites More sharing options...
Handsome88 Posted February 16, 2015 Author Report Share Posted February 16, 2015 No, I don't think so. Sorry, that's an answer to what question exactly? Link to comment Share on other sites More sharing options...
keith_015 Posted February 16, 2015 Report Share Posted February 16, 2015 I wouldn't mind working in a less desirable place with less beds (I may have a ROS contract anyways), however does that affect my salary (expect decrease or increase)? I have a question on behalf of several friends who are doing IM in the states with hopes of going back to Canada. How competitive is it to get a 2 year GIM position in Canada from the states? I would love to do a subspecialty before CCM in Canada but my interests lie in competitive fellowships (Cards, Pulm/CC) and so it might not be possible, which is why I'm looking to do CCM in Canada as a back up in case I don't get a Cards or Pulm/CC fellowship in US (or Cards in Canada). I'm now thinking of doing ID or Pulm in Canada then doing CCM in Canada though as it would be a nice fall back to do ID or Pulm on weeks where I'm not in the unit, plus ID/Pulm aren't competitive right? Also, is it possible to do a 1 year of chief resident or a fellowship in states (i.e Echo or heart failure) then do 1 year of IM in canada to get me to 5 years? Thanks Less beds = less billing = less income. This can be offset by being on the schedule more if the community is underserviced for CCM. 2 year GIM is becoming more popular in Canada. Currently it is competitive. It might change if they broadly roll out the 2 year program and not allow the 1 year option, meaning more spots created. ID and Pulm are still competitive. Check out the Carms statistics area for matching outcomes. I am not sure there is a funding model available for your last question. I would probably guess that wouldn't be equivalent experience and would not be doable. Link to comment Share on other sites More sharing options...
Handsome88 Posted April 2, 2015 Author Report Share Posted April 2, 2015 In the current situation, if positions for CCM are left to second iteration, it may mean a good chance that you may be competitive. Having said that, again, the job market is limited and you would likely have to consider working in unfavourable locations to feed yourself. Subspecializing before CCM would definitely help you out. If you like GIM, you could try to match to the 2 year GIM fellowship which should qualify you to work in Canada. The pay is good for sure. I cannot comment on schedules, but from what I have seen in different communities, 1 on 1 off hasn't been the way they function. It may be one week on, 2+ weeks off depending on how many people help staff the ICU. Depending on location, some staff practice primarily in another field, and occasionally staff the ICU. You mention 1 week on 2 weeks off. What is the average income for this type of schedule if you don't work during those 2 weeks? What's the hourly rate for CCM? Link to comment Share on other sites More sharing options...
ploughboy Posted April 2, 2015 Report Share Posted April 2, 2015 You mention 1 week on 2 weeks off. What is the average income for this type of schedule if you don't work during those 2 weeks? What's the hourly rate for CCM? I don't know a whole lot about critical care billing (yet), but ballpark for a medium-to-large ICU is $30k per week. In a small-ish unit you might only make $10k per week, but you might have enough time during that week to run a clinic etc. Technically it's not an hourly rate but a per diem, at least according to the OHIP fee schedule (see pages J24 and J25 here: http://www.health.gov.on.ca/english/providers/program/ohip/sob/physserv/j_diagth.pdf ). As with a lot of other things, some groups (especially in academic centres) have alternative ways of being reimbursed but I don't know enough details to comment further. Link to comment Share on other sites More sharing options...
Handsome88 Posted April 4, 2015 Author Report Share Posted April 4, 2015 I don't know a whole lot about critical care billing (yet), but ballpark for a medium-to-large ICU is $30k per week. In a small-ish unit you might only make $10k per week, but you might have enough time during that week to run a clinic etc. Technically it's not an hourly rate but a per diem, at least according to the OHIP fee schedule (see pages J24 and J25 here: http://www.health.gov.on.ca/english/providers/program/ohip/sob/physserv/j_diagth.pdf ). As with a lot of other things, some groups (especially in academic centres) have alternative ways of being reimbursed but I don't know enough details to comment further. 10k per week? That's really bad actually...So woking week on week off all year in the ICU would just be around 240k? Not worth it! Link to comment Share on other sites More sharing options...
ploughboy Posted April 7, 2015 Report Share Posted April 7, 2015 10k per week? That's really bad actually...So woking week on week off all year in the ICU would just be around 240k? Not worth it! That's a 6 or 8 bed unit where you finish rounding mid-morning and run your respirology clinic during the afternoon, dealing with any clinical changes over the phone and occasionally ducking out if there's a procedure or an admission. Link to comment Share on other sites More sharing options...
Handsome88 Posted April 18, 2015 Author Report Share Posted April 18, 2015 That's a 6 or 8 bed unit where you finish rounding mid-morning and run your respirology clinic during the afternoon, dealing with any clinical changes over the phone and occasionally ducking out if there's a procedure or an admission. Respirology unit? Are we speaking about Canada here or the US? I thought in Canada most just do critical care without pulm...unlike US where it's pulm/cc. Link to comment Share on other sites More sharing options...
ploughboy Posted April 18, 2015 Report Share Posted April 18, 2015 Respirology unit? Are we speaking about Canada here or the US? I thought in Canada most just do critical care without pulm...unlike US where it's pulm/cc. Or your "weak and dizzy" clinic, or your "probably low risk chest pain" clinic or whatever. Link to comment Share on other sites More sharing options...
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