Jump to content
Premed 101 Forums

How To Shorten The Pathway Of Becoming A Doctor In Canada


Recommended Posts

Currently, I think it is taking way too long to become a specialist in Canada.

 

Let's see ..... 4 years of undergrad + 4 years of med school + 5 years of residency ........ and that is IF things work out as planned & you get into med school on your first try ...... no gap years during school .......no extra fellowships to find work.

 

Do you think this pathway needs to be shortened or not ? 

 

And if you think it does need to be shortened, where do you think we should make the cut ?

Link to post
Share on other sites
  • Replies 66
  • Created
  • Last Reply

Top Posters In This Topic

Top Posters In This Topic

Popular Posts

I don't personally think it needs to be shorter. Undergrad isn't just killing time; for a lot of premeds, it is a time of significant personal growth. I really think it is a good thing med students ar

As someone who got in out of third year and goes to a third year school, I kind of dislike the assumption that by shortening any stage of the process, we will get immature and lower quality physicians

I think the cut should be made to undergrad .......... med schools should drop the undergrad degree requirement and allow competitive applicants to apply directly from high school.   If it still bec

I don't think it's that simple. In the 90s, there were many factors (mainly governmental) that lead to the doctor shortage.

 

Yes, there is still a shortage. But what does that mean? There are many fields of medicine, especially in the large cities/tertiary care centres, that are saturated. The majority of doctors needed are family physicians in rural areas. Shortening the number of years of training won't solve this problem. Sure, you may have some converts, but someone who is set on being a neurosurgeon in Toronto probably won't change their mind due to the fewer years of training and won't help with the shortage.

 

Structural changes made by the government is the key to the shortage. In the short term, practice incentives, like those given to rural physicans, help, but in my opinion changing the number of years of study won't.

 

That's not to say people don't already have the same idea. All you have to do is look into the reason QuARMS was started.

Link to post
Share on other sites

I do think it's a fair point to consider shortening training to ease debt load/make the field more friendly to older applicants. :)

 

Undergrad: In high school I thought undergrad was just a means to an end and didn't understand this requirement when many places around the world accept applicants straight out of high school. However now that I've completed undergrad,  I personally think undergrad is invaluable. This is when most people change their minds about pursuing medicine/gain maturity and life skills. Undergrad was the 4 most important years of my life (so far). Without it I really think I would not have the life experience/perspective/resilience/soft skills to excel in medicine. 

 

Medical school: There are already 3 year medical schools. Perhaps the 4 year ones should be converted to 3 years to put everyone on a level playing field when it comes to clerkship/electives, otherwise people may opt for the 4 year degree for this reason. There was recently a journal article suggesting that MD programs should be shortened to 3 years.

 

Residency: An option is to shorten residency training to be on par with the States where for example psych is only 3 years compared to 5 here. A lot of residencies are shorter in the States as an example.

Link to post
Share on other sites

I agree with thatonekid that it is very systemic and the problem of shortages needs to be resolved by redistribution. I don't think shortening the length of schooling should happen because there is a chance for quality of care to dip (if that's the case) and that just because people don't want to take longer in school doesn't mean we should change it. Yes, I would personally like to rip through these next few years by hoping I got into UofC med and doing family medicine so 9 years total, but it didn't work out that way. 

Link to post
Share on other sites

3 year undergrad -> Mac Med -> Family Med Residency

 

8 years.

 

A move towards skills based residency training could accelerate the process. I am finding through my clinical experience that there is a lot of "grunt work" that slows things down. Sure, it keeps the system going. But if residents weren't caught up with it, they could accelerate their training. Perhaps too the undergraduate component could be shortened to 2 years, but there is a question of maturity. At times I do feel like the additional years are an advantage in terms of knowing what you want from life. However, at other times I feel like I am killing time. And maybe, if the pathway was shortened, I wouldn't have the small time I have now to relax and enjoy life outside of school.

Link to post
Share on other sites

Residency: An option is to shorten residency training to be on par with the States where for example psych is only 3 years compared to 5 here. A lot of residencies are shorter in the States as an example.

 

There's the general intern year though. The residencies in the states are maybe like 1 year shorter. Some are longer, such as family medicine.

Link to post
Share on other sites

In Quebec, you can get in to (QC) med without undergrad. After grade 11, it'd be

 

2 year cegep -> med school (4-5 years depending on whether you have to do a year of premed or not) -> residency (basically can get their MD as young as 22-24, when most people *start* med school)

 

Some schools (like Mac and UBC) outside of Quebec will take you after 3 years of UG. Mac is a 3 year program so that speeds things up a bit more.

 

Overall, there are speed-ups, under certain conditions. Problem is the field is so competitive that filling the bare minimum (i.e. just finishing cegep or 3rd year UG) doesn't make you competitive enough against all those more mature people with their bachelor's or master's or PhDs, and loads of life experiences.

 

The current nature of competition in the field only makes it especially hard for older applicants if they did not get good grades in their first UG (if they did a UG at all). But if you have a good enough GPA from before you started thinking about med, it's possible to get in without jumping through hoops of doing a master's or second UG before applying.

Link to post
Share on other sites

I have rephrased the question to broaden the scope of this discussion.

 

I think the pathway really needs to be shorter ....... at least for the sake of doctors if not for patients.

 

And if the pathway needs to be shorter, med school & residency years need to remain untouched or else we risk the quality of patient care going down.

 

Therefore, the cut should be made to undergrad.

 

Personally, I don't see how learning calculus will be of any use to a future doctor .......... and as far as I know only USA and Canada have this system in place ........ in everywhere else people go straight into med school without having to do undergrad.

 

And we could have the internship year back to give time to med students to breathe and really explore what they like in medicine.

 

The only real problem here is how are med schools going to evaluate applicants who apply straight from high school ............ probably they will all look the same ......... but med schools all over the world are doing it so I imagine it can't be impossible.

Link to post
Share on other sites

I have rephrased the question to broaden the scope of this discussion.

 

I think the pathway really needs to be shorter ....... at least for the sake of doctors if not for patients.

 

And if the pathway needs to be shorter, med school & residency years need to remain untouched or else we risk the quality of patient care going down.

 

Therefore, the cut should be made to undergrad.

 

Personally, I don't see how learning calculus will be of any use to a future doctor .......... and as far as I know only USA and Canada have this system in place ........ in everywhere else people go straight into med school without having to do undergrad.

 

And we could have the internship year back to give time to med students to breathe and really explore what they like in medicine.

 

The only real problem here is how are med schools going to evaluate applicants who apply straight from high school ............ probably they will all look the same ......... but med schools all over the world are doing it so I imagine it can't be impossible.

I think it's pretty irresponsible to take people right out of highschool in to medicine. At 17-18 years old (graduation age of highschool), people are barely recovering from puberty. The maturity simply isn't there to deal with healthcare needs.

 

It is not only Canada and US that require a bachelor's before applying to med, other countries have the same system. In those countries that do take students right out of highschool (i.e. European countries), the program is usually 6 years rather than 4. In addition, it is traditional in Europe to take gap years after highschool, internships are usually longer than Canada/US. So it's not really saving any time.

 

As a mathematician, I do feel compelled to defend math in medicine. It is used in ways that are not immediately obvious. This is from the pov of nursing, http://work.chron.com/nurses-use-math-jobs-10475.html. I recommend just googling math and medicine and see. You might think it's just propaganda, but I actually got a math question during my interview so it was useful in at least getting me in to med school.

Link to post
Share on other sites

I just want to  mention that in Québec, around 50% of med spots are reserved for cegep students (grade 11+ 2 years of health science concentration). I don't think that it makes you less competitive for med school in Québec, since there are quotas dedicated to cegep students. I don't think that cegep students are filling the bare minimum (IMO). We do have 1 additional year of premed at UdM and at McGill. At Laval, a lot of cegep students do their preclerkship in 3 years.. 

For people coming from less privileged families, doing a 4 year undergrad and writing MCAT could be a huge sacrifice to their family and socio-economic status. Having a shorter path of med school would allow some exceptional candidates to get in med school earlier. In my personal case, I am very happy that I could get into med school after cegep. Simply because my family circumstances won't allow me to do a 4 year undergrad and hoping to get into med school after a science undergrad. Probably cegep students and 3rd UG are less mature and have less life experiences, but after 5 years of med school, we acquire the same competencies as all other Canadian counterparts.  :)

I just think that opening more spots of 3rd UG in English Canada could allow some great, academically gifted candidates to save one year of undergrad, hence one year less of student loans lol

Probably you meant something else, Oshaku. I am sorry if I misinterpret your message.

In Quebec, you can get in to (QC) med without undergrad. After grade 11, it'd be

2 year cegep -> med school (4-5 years depending on whether you have to do a year of premed or not) -> residency (basically can get their MD as young as 22-24, when most people *start* med school)

Some schools (like Mac and UBC) outside of Quebec will take you after 3 years of UG. Mac is a 3 year program so that speeds things up a bit more.

Overall, there are speed-ups, under certain conditions. Problem is the field is so competitive that filling the bare minimum (i.e. just finishing cegep or 3rd year UG) doesn't make you competitive enough against all those more mature people with their bachelor's or master's or PhDs, and loads of life experiences.

The current nature of competition in the field only makes it especially hard for older applicants if they did not get good grades in their first UG (if they did a UG at all). But if you have a good enough GPA from before you started thinking about med, it's possible to get in without jumping through hoops of doing a master's or second UG before applying.

Link to post
Share on other sites

i think the length of undergrad, med school, and residency isn't a huge issue. i think they offer a series of check marks - meaning opportunities to take a step back and reflect on your goals. not everyone knows that they want to pursue medicine straight from the womb. for a lot of people, myself included, it's a real journey. i think the biggest issue is how difficult it is to find jobs once you're done residency +/- fellowship. once you're in med school/residency, you don't feel quite as rushed. you're learning tons, you're having amazing (and not so amazing) experiences. you're networking and making connections, and you're learning in a safe(ish) environment. i wouldn't be looking to cut back on years. for those who are essentially born doctors, there are shortcuts in place. like others have mentioned, in QC, you can skip undergrad and do med-p and in most provinces you can be accepted after 3rd or even 2nd year undergrad. why rush? enjoy the journey. 

Link to post
Share on other sites

I don't personally think it needs to be shorter. Undergrad isn't just killing time; for a lot of premeds, it is a time of significant personal growth. I really think it is a good thing med students are, on average nearly mid-twenties. Not that 20-somethings are the peak of maturity either but I saw very significant differences in the maturity of my classmates in third year relative to first year of undergrad.

 

As well, undergrad permits those who were poor students in high school time to grow up and do better. This was the case for me. My average in grade 12 was 76% (82% for my top six.) Sufficient to get into university, but insufficient for any professional programs. I was rejected from nursing twice. I'd have never gotten into medicine right out of high school if our system were based on high school grades. My thoroughly mediocre grades weren't due to a lack of ability, it was a lack of desire to attend class because I was shortsighted and dour, a typical teenager.

 

Beyond that, look at how many people are extremely strong academically in high school and crash and burn completely on entry to university. It is a not insignificant portion of the first year class who just can't handle university despite success in high school. Would you really want to see this happening in med schools?

 

I realize a lot of premeds look at undergrad as wasted time, a means to an end, but I think it's much more than that and I'm glad of the three years of undergrad I had. I will be 31 when I finish med school, so at the very least I'll be 33 when I start practicing, and that's doing med the shortest way possible in Canada - 3 years of undergrad, 3 year med, 2 year FM residency. I'm okay with that. I'll be nearly 40 before I have a positive net worth, but that's still better than a lot of Canadians.

Link to post
Share on other sites

For me, I think the timing was perfect. In fact, I chose a 4-year school over a 3 year and that was a factor in my decision. I didn't really have medicine in mind until part way through university, and if it was the norm to apply before an undergraduate degree, I might have been discouraged (I'm already a bit older than most undergrads in my year). One thing I would like to have access to is the old system where you got licensed after internship year and could practice as a GP before specializing. My dad did this and it worked out well for him. I'm sure there are good reasons not to have it, but anyway...

 

That said, I know a few people who were champing at the bit for medicine for as long as they can remember. Everyone probably has a slightly different idea of the ideal system.

Link to post
Share on other sites

Shortening anything will just lead to a favor of quantity over quality. Our system is far from perfect, but shortening training without addressing anything else will make things worse.

I think the 4 years of UG are great for personal growth and maturity, like Birdy said. There is a particular medical school in Canada where a student got in after 2 years of UG and the last I heard was he repeated first or second year 3 times because he wasn't sure he wanted to do medicine. This isn't common, but shows a weakness of shortening UG.

The problem with 3 year med schools is that some students don't have enough time to decide what area they want to get into. And if you change your mind at some point after discovering you have a strong passion for ROAD or any other competitive specialty, you will probably not match to it, leaving you unhappy with your job.

As for shortening residency, if you look at 5 year programs there is usually huge knowledge gaps between R1, R2... R5, and staff. Why shorten it? You still get paid as a resident and by R5 it's pretty decent.

I'm not familiar with the American system so I don't know what they're leaving out of their programs.

Link to post
Share on other sites

As someone who got in out of third year and goes to a third year school, I kind of dislike the assumption that by shortening any stage of the process, we will get immature and lower quality physicians.

 

Also, I think lots of the people speaking to the problems of three year schools didn't go to one. Most people I've met are pretty happy with their decision. All it means is that you have to take some personal responsibility for choosing a specialty and not wait till your clerkship rotations.

 

I get that lots of people wouldn't have been ready for medicine at an earlier stage, or wouldn't have gotten in. But who said everybody has to get in earlier? Couldn't we have a system like elsewhere in the world where there is direct entry and graduate entry? (PS 6 year programs abroad end up as the same number of years as my personal track to medicine)

 

I'm not sure if the length of training needs to be shortened, but I definitely think it would be possible to do so.

Link to post
Share on other sites

As someone who got in out of third year and goes to a third year school, I kind of dislike the assumption that by shortening any stage of the process, we will get immature and lower quality physicians.

 

Also, I think lots of the people speaking to the problems of three year schools didn't go to one. Most people I've met are pretty happy with their decision. All it means is that you have to take some personal responsibility for choosing a specialty and not wait till your clerkship rotations.

 

I get that lots of people wouldn't have been ready for medicine at an earlier stage, or wouldn't have gotten in. But who said everybody has to get in earlier? Couldn't we have a system like elsewhere in the world where there is direct entry and graduate entry? (PS 6 year programs abroad end up as the same number of years as my personal track to medicine)

 

I'm not sure if the length of training needs to be shortened, but I definitely think it would be possible to do so.

I find it very difficult to understand how someone can choose a specialty before clerkship.

 

Can you tell me how that works ?

Link to post
Share on other sites

I find it very difficult to understand how someone can choose a specialty before clerkship.

 

Can you tell me how that works ?

Most people have basically chosen a specialty or at least narrowed it down to 1-2 by clerkship. You can shadow, talk to people in the field, etc. Just like every profession!

Link to post
Share on other sites

it's tough to choose a specialty before clerkship but, like amichel said, you need to take some personal responsibility. you need to shadow and talk to upper year students, residents, and staff in order to get a good feel for things. i personally prefer the 4 year program. i kind of let a specialty choose me. i followed the path of least resistance and just followed opportunities where they arose. i'm pretty happy with where i ended up. i'm not sure that would've worked out for me in a 3 year program since i was still hedging bets until the end of third year even though all the cards seemed to be pointing me in one particular direction. 

Link to post
Share on other sites

it's tough to choose a specialty before clerkship but, like amichel said, you need to take some personal responsibility. you need to shadow and talk to upper year students, residents, and staff in order to get a good feel for things. i personally prefer the 4 year program. i kind of let a specialty choose me. i followed the path of least resistance and just followed opportunities where they arose. i'm pretty happy with where i ended up. i'm not sure that would've worked out for me in a 3 year program since i was still hedging bets until the end of third year even though all the cards seemed to be pointing me in one particular direction.

And lots of people here still hedge their bets until right before Carms. You'd be surprised. The way people run into trouble is if they decide late on a competitive speciality, but honestly, that can happen in 4 year programs as well, since lots of people start in first and second year if they want something super competitive.

Link to post
Share on other sites

you don't need, and are not expected, to have experienced everything that the specialty entails. once you've found something that you like, you stick with it unless something completely blows it out of the water. there's no way to explore everything that medicine has to offer before carms, or ever, for that matter. it's stressful because we always want to make sure that we've made the right decision. i think with regards to specialty selection for many people, there are many right decisions. plus, you can always transfer once you start if you find something that calls to you above and beyond what you had chosen. it's so stressful and you feel like carms is going to determine the rest of your life, but there are always things you can do to change course if you're not happy. it is your life after all. 

Link to post
Share on other sites

This is the burden of a three year program. I HATE the fact that I had to figure out what specialty. It's stressful and you are honestly gambling a lot on limited experience.

 

I'm going through carms this year, and while I have made a decision (and like the specialty I'm applying too) I was really stressed to do so and I know that I have not physically experienced everything that the specialty entails.

Sorry, what I meant is that most people have narrowed it down even in 4 year programs. Also, don't forget that there are lots of specialties you never do a core rotation in anyways, so same boat.

Link to post
Share on other sites

As someone who got in out of third year and goes to a third year school, I kind of dislike the assumption that by shortening any stage of the process, we will get immature and lower quality physicians.

 

Also, I think lots of the people speaking to the problems of three year schools didn't go to one. Most people I've met are pretty happy with their decision. All it means is that you have to take some personal responsibility for choosing a specialty and not wait till your clerkship rotations.

 

I get that lots of people wouldn't have been ready for medicine at an earlier stage, or wouldn't have gotten in. But who said everybody has to get in earlier? Couldn't we have a system like elsewhere in the world where there is direct entry and graduate entry? (PS 6 year programs abroad end up as the same number of years as my personal track to medicine)

 

I'm not sure if the length of training needs to be shortened, but I definitely think it would be possible to do so.

 

Quebec is a system where there is direct and grad entry. It seems to work out okay for them but I know some people in the med-P program who complain about lack of maturity in their peers. Obviously, there are some applicants who are mature enough even from high school but it's not the majority. However, there is a chance that over the course of training, they will mature by the time they have any real responsibility.

When I was younger I wished training was shorter but I'm glad I took 4 years to do a bachelor and have 4 years for med. I think the system is okay the way it is because there's multiple ways to shave off a year here and there, making shorter training the norm might make people feel pressured to start earlier. This was just me, so I can't speak for others, but coming from a competitive high school and high pressure family, I was wondering if I should have applied to the UK like some of my classmates because at the time, I wanted to be a doctor as early as possible. Even in undergrad I regretted not being prepared to apply as a 3rd year and give it a shot. 

 

Just curious, OP, if you had the power to change the length of schooling, where would you make the cut? 

Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...

×
×
  • Create New...