Untrained And Unemployed: Medical Schools Churning Out Doctors Who Can't Find Residencies And Full Time Positions

[ploughboy]

http://news.nationalpost.com/health/untrained-and-unemployed-medical-schools-churning-out-doctors-who-cant-find-residencies-and-full-time-positions

[JohnGrisham]

http://news.nationalpost.com/health/untrained-and-unemployed-medical-schools-churning-out-doctors-who-cant-find-residencies-and-full-time-positions

I'm not at all sad that the guy who only applied to FM in GTA, didn't match. Sorry, but that is something you need to think and plan ahead as being an eventuality - doing your residency at any point in the country. Does it suck? Yeah, but that is nothing new that was easily missed in planning.

[JohnGrisham]

Also reading many of the comments on the article - hurts my head, as so many of them are so unaware of how the medical system works here. The blaming foreigners and blah blah. 

[Organomegaly]

People use this as evidence of there not being a "doctor shortage" all the time. I find that designation misleading.

 

Canada still has one of the lowest physician per capita rates of all the OECD nations. We need more physicians, as evidenced by our gratuitous wait-times. But the public nature of our healthcare system, coupled with a lack of HR planning and appropriate infrastructural investments from government, leaves those physicians unable to fill a niche.

 

In my opinion, the solution for aspiring specialists who can't see themselves doing anything else is to write the USMLE and head down south to a private system which will gladly take them.

[LittleDaisy]

I feel bad for the ENT who couldn't find a full time job though after 4 years.I mean getting into ENT is super competitive, I already know a bunch of people who are very keen on ENT at my school for 2 spots

And for the guy who only applied to FM In GTA, he should have been aware that all the residency spots are popular at UofT. I believe that UofT is the only medical school in Canada who fills out all their spots during the 1st round. Even family medicine is not a guarantee anymore, it is safe to apply everywhere; there is always the risk of no-match

I'm not at all sad that the guy who only applied to FM in GTA, didn't match. Sorry, but that is something you need to think and plan ahead as being an eventuality - doing your residency at any point in the country. Does it suck? Yeah, but that is nothing new that was easily missed in planning.

[JohnGrisham]

People use this as evidence of there not being a "doctor shortage" all the time. I find that designation misleading.

 

Canada still has one of the lowest physician per capita rates of all the OECD nations. We need more physicians, as evidenced by our gratuitous wait-times. But the public nature of our healthcare system, coupled with a lack of HR planning and appropriate infrastructural investments from government, leaves those physicians unable to fill a niche.

 

In my opinion, the solution for aspiring specialists who can't see themselves doing anything else is to write the USMLE and head down south to a private system which will gladly take them.

Going to the US is almost always an option, but it comes with a whole host of different problems. I mean, i guess being employed and with problems - is better than being unemployed.

[makingfetchhappen]

I'm not at all sad that the guy who only applied to FM in GTA, didn't match. Sorry, but that is something you need to think and plan ahead as being an eventuality - doing your residency at any point in the country. Does it suck? Yeah, but that is nothing new that was easily missed in planning.

From the article saying he applied every where from Hamilton to Oshawa, this to me tells me he applied to Mac, U of T, and for the Queens spots in Oshawa? I wonder what it means where it says his wife and child live in Toronto. Is he stuck there because she works there? It doesn't explain why they would not move.

[JohnGrisham]

From the article saying he applied every where from Hamilton to Oshawa, this to me tells me he applied to Mac, U of T, and for the Queens spots in Oshawa? I wonder what it means where it says his wife and child live in Toronto. Is he stuck there because she works there? It doesn't explain why they would not move.

Yeah not sure exactly on specifics, but either way - only applying to spots in one specific area is his own problem and not something to use to evoke emotion in some attempt to garner sympathy. 

 

 

 

 

[indefatigable]

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[Wartortle]

The article shows two things. 1) Planning is important, like Gohan said. 2) Don't gun for one residency, spread your interests, b/c sh** happens.

[Organomegaly]

It's really easy to apply our early 20 vantage points to a 37 year old man with a wife and a child, but applying across Canada can be hard for some people . I would do it married or not, but its worth acknowledging how these particular cases are more complicated (familial obligations in the first case, surgical speciality in the second case with lack of accommodating infrastructure).

 

The reason this scares me is that eventually people will push from surgery to family/internal, and then these fields will be saturated too.

 

What then?

[JohnGrisham]

The article was also about the unmatched FM - who was not an aspiring specialist.  I don't think it's unreasonable for him to have aimed for the GTA, given possibly family commitments.  But I guess he should have cast a broader net.  On the other hand, if the Toronto market is really to some extent "saturated" at the residency level (regardless of the reasons), should there be more seats added to schools like nosm?

It's fine to aim for an area of preference, but its your due diligence to apply broadly if you want to ensure you match. Not everyone gets to do their specialty of choice in the location of their choice at the program of their choice. Nothing new in life.

 

 

As for familial obligations, thats why you talk about these possible scenarios and eventualities BEFORE it gets to that point. But perhaps that is exactly what they did, and they made the decision as such.

 

Maybe 4 years ago, when he applied to medical school, he sat down with his wife and had that honest talk: What happens if I can't get into a Toronto residency? 

 

For all we know this was their agreed upon outcome: First attempt, apply geography restricted and hope to match. If unmatched, second try apply broadly. 

 

We don't know the thought process, but if my giving him the benefit of the doubt is true(it was a conscious decision to apply 1st round restricted, knowing the risk) - then there shouldn't be an article about it.

 

If its the case where they DIDN'T have the conversation, and just said "Don't worry honey, i'm a rockstar and i'll get into Toronto" then that's his own decision to bear with, as is the case where he will continually only apply to that region for subsequent matches.

 

 

 

[Wartortle]

It's really easy to apply our early 20 vantage points to a 37 year old man with a wife and a child, but applying across Canada can be hard for some people . I would do it married or not, but its worth acknowledging how these particular cases are more complicated (familial obligations in the first case, surgical speciality in the second case with lack of accommodating infrastructure).

 

The reason this scares me is that eventually people will push from surgery to family/internal, and then these fields will be saturated too.

 

What then?

That's very true and I really don't know the solution to the position you brought up as I am no where near there. But the only thing we can do about the high and lows of residency spots, etc. is to ride it out. There honestly isn't much we can do but prepare for the worst and hope for the best

[Organomegaly]

Personally, I will be writing the USMLE, and this is coming from someone who at least right now wants primary care. The medical job market is too precarious here. It is wise to keep as money doors open as possible.

[JohnGrisham]

Personally, I will be writing the USMLE, and this is coming from someone who at least right now wants primary care. The medical job market is too precarious here. It is wise to keep as money doors open as possible.

Kudos to you, to commit to the USMLE in a 3 year program... Your sir/madam are a scholar

[Organomegaly]

Lol me and standardized testing are friends...at least so far we have been

[indefatigable]

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[JohnGrisham]

Sure - he should have cast a broader net - why not southwestern Ontario for example?  On the other hand, I think he should have reasonable expectation of being able to match in the geographic area of graduation.  I don't think his best choice should be Thunder Bay - if it is then it means nosm is likely not producing enough graduates (clearly he would prefer not to be in Thunder Bay ).  I doubt many nosm graduates are matching into Toronto for various reasons.  

I guess we agree to disagree, looking at data, yes it is "likely" to match in the geographical area of graduation. But should not be a reasonable expectation at all - it depends on what your threshold is.  My threshold of likely is at 50% haha.  

 

I don't follow the thunderbay part, perhaps I missed that part of the article/discussion? If there are extra spots in thunder bay, it could also mean that NOSM graduates don't necessarily want to match in that area. Or a myriad of other factors, such as training offerings, and the likes. I don't think that line of thinking holds much weight about not enough graduates.  That's the beauty of portability - you are not regulated to have to commit to a specific geographical area for residency -and as well as practice as a licensed physician. To do so, would open up a can of worms that was long since closed w.r.t freedom of mobility. 

[3change]

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[indefatigable]

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[sleeping_sickness]

 On the other hand, I think he should have reasonable expectation of being able to match in the geographic area of graduation.  

He's from McGill, not an Ontario school. Although I suspect he did most of his electives in the GTA to be able to spend time with his family. 

 

It was not unreasonable for him to apply to a handful of Ontario FM programs to be near his family. Maybe there were red flags in his interview?

[Panacea]

"When Brandt graduated in 2010 from Western University as an otolaryngologist, he says, he and his wife were willing to go anywhere in the country for work.

But he couldn’t find a position, and instead did a year of sub-specialty training in the U.S. Despite learning reconstructive facial plastic surgery from the physician who literally wrote the textbook, as well as having published 30 medical-research papers himself and won various awards, the 37-year-old returned to face six months of unemployment."

 

Ouch...if this guy can't find a job lol, I can't imagine who does. 

[indefatigable]

.

[Organomegaly]

Beast

 

hahahaha a freudian slip for sure 

[武田信玄]

People use this as evidence of there not being a "doctor shortage" all the time. I find that designation misleading.

 

Canada still has one of the lowest physician per capita rates of all the OECD nations. We need more physicians, as evidenced by our gratuitous wait-times. But the public nature of our healthcare system, coupled with a lack of HR planning and appropriate infrastructural investments from government, leaves those physicians unable to fill a niche.

 

In my opinion, the solution for aspiring specialists who can't see themselves doing anything else is to write the USMLE and head down south to a private system which will gladly take them.

Your solution is just going to saturate the US market eventually.

 

Also, to quote "the number of physician per capita in Canada" as a support to the notion that we need more doctors is very one-sided. You have to take into account that a significant portion of Canadians live in rural areas where the population density is comparatively low. Some, if not many, of these residents may also lack means of effective transportation (either due to economic or cultural factors). Therefore, in order for a doctor to set up a clinic in such areas and to provide health care to enough patients so that the clinic can become financially sustainable, the doctor will most likely have to do all the travelling to see the patients, which is simply not feasible in today's day and age, especially when you take into consideration of the sparcely-distributed population in these areas as mentioned before. Therefore, under the current remuneration system, we will continue to have this problem of low physician-to-patient ratio in these rural areas and these rural population groups will continue to deflate our national "number of physician per capita".