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[indefatigable]

58 minutes ago, 649 said:

What is the root cause of the problem? Medical school sizes haven't changed significantly in the past 5-10 years so is it because:

1. Med students are all going for a few specialities with few residency spots, so people are unmatched due to their own choices

2. Residency spots were somehow reduced meaning there might be 1000 people in medical school but only 900 residency spots so 100 people are guaranteed to be unmatched

3. IMGs are good and are taking the spots of CMGs

 

Potential Solutions:

1. Make a deal with Quebec to accept 50-60 fam med residents

2. Reduce medical school class sizes

3. Ban IMGs from round 2, making another round for CMGs

4. Ban IMGs from certain countries to reduce their numbers

5. Increase funding to med schools so they can hire more attendings and create more residency spots

6. Contracts to get 100% match rate to rural med for 3-5 years but guaranteed job afterwards

re: Problems

Combination of 1-2. 3. I would agree with that IMG matching contributes to the problem in 2.  

re: Solutions

1 - big problem is language barrier.  Québec's anglophone population is relatively small and concentrated in Montréal.  It would essentially mean transferring regional francophone FM positions to an urban location, which I don't think would go through.  Plus even in Montréal, the majority of patients are francophone.  

2 - Yes .. to me the one that makes the most sense and is the most promising

3,4 - doesn't work from a legal point of view.. court cases are what allowed IMGs to match in first round, would run into discrimination problems..

5. compared to option 2 costs $$ - ex: ON reduced residency positions why would they increase them?

6. not unfortunately practical - who would guarantee the contracts, not to mention continuity of care?  would create similar problems that ROSs have currently.   

[GrouchoMarx]

1 hour ago, 649 said:

What is the root cause of the problem? Medical school sizes haven't changed significantly in the past 5-10 years so is it because:

1. Med students are all going for a few specialities with few residency spots, so people are unmatched due to their own choices

the match should not be as restrictive as it is and there shouldnt be a stigma

2. Residency spots were somehow reduced meaning there might be 1000 people in medical school but only 900 residency spots so 100 people are guaranteed to be unmatched

harebrained government tinkering

3. IMGs are good and are taking the spots of CMGs

the only people whining about this are the "CSA"s which itself is a prejudiced term because it is considering Canadian citizenship as a criterion for a better quality resident despite attending offshore forprofit schools. They are IMGs like every other IMG. i denounce the term CSA

 

Potential Solutions:

1. Make a deal with Quebec to accept 50-60 fam med residents

impossible since most of the unmatched are English and do not speak enough French. moving those positions to English canada will never happen.

2. Reduce medical school class sizes

there is still a physician shortage, particularly in primary care, so this is not in the best interest of society

3. Ban IMGs from round 2, making another round for CMGs

i agree

4. Ban IMGs from certain countries to reduce their numbers

i agree. add to that banning saudi residencies, or instead allowing canadians to self fund positions. right now the saudis get better residency prospects than canadians in some ways

5. Increase funding to med schools so they can hire more attendings and create more residency spots

i agree

6. Contracts to get 100% match rate to rural med for 3-5 years but guaranteed job afterwards

return of service agreements do not work. 

 

the best solution would be to get back to general internship and license but there are too many fragile egos at play to make this happen.

 

[jlkhhylyiluh6]

increase compensation to needed specialties (fam med, psych) and decrease compensation in ridiculously overpaid specialities (derm, optho). Money talks.

[GrouchoMarx]

18 minutes ago, beeboop said:

increase compensation to needed specialties (fam med, psych) and decrease compensation in ridiculously overpaid specialities (derm, optho). Money talks.

will never happen. they lobby and have money and connections. its the pareto distribution at work. the only way to change the game is to flip the table.

[JohnGrisham]

Edited.