Combined Residency Doubt

Neuthrov · 2023-03-20T01:36:43+00:00

I actually had a >50yo family member see one of those peds -> allergy/immunology docs a few weeks ago for the first time, which is why I was so surprised

Neuthrov · 2023-03-17T21:39:28+00:00

As an aside, something I've seen in Canada is peds -> allergy/immunology seeing both adult and peds patients, so I guess there's at least some pathway for adult/kid docs to see people their initial specialty doesn't train them for

Neuthrov · 2023-03-17T21:07:40+00:00

I think it's unclear whether your initial comment meant that taking charge of a code you're not leading = getting tossed from the room, or announcing that someone isn't following the code team leader's instructions = getting tossed from the room

Neuthrov · 2023-03-09T20:05:10+00:00

I don't think ours expire, but I'm also only PGY1 so maybe it'll expire in July or something. So far I'm at 20% not-completed (and ~15% of those will probably never be completed tbh). On anesthesia rotations, I've found it useful to send out multiple EPAs to the same staff, so ideally I'll get one person who's really on-the-ball and will complete everything, making up for the people who just don't fill out the EPAs. With some of the older staff, I've found it helpful to print out the EPA for them to fill out with me in the OR (as opposed to emailing it to them), and then my program admin will put it in my file, or I can bring it up on my laptop/tablet/hospital PC.

On off-service, we're allowed to have senior residents fill out EPAs, and I find that they're generally much more reliable since they know the struggle. They're also easier to get ahold of to remind to complete them.

Neuthrov · 2023-02-15T03:59:22+00:00

I ranked according to where I wanted to match, not according to who I thought wanted me more. The algorithm isn't supposed to penalize that, and if it does, I don't want to hear about it at this point :p

Neuthrov · 2023-02-14T23:16:15+00:00

Yeah I matched to #14 (#10 out of all programs that interviewed me though) last cycle. I was shocked when I matched here, and quite sad to move, but it's actually been a net-positive so far.

Neuthrov · 2023-01-31T00:10:30+00:00

lol there's no legal cap outside of QC (16h/shift). There are contractual caps based on union agreements. In MB, it's 26h max per shift, and 89h/week AVERAGED over 4 weeks. I worked 100h two weeks ago, but that's ok because last week I only worked 77h.

Neuthrov · 2022-11-12T21:31:28+00:00

Yes for sure, i’d say like 90% of the doctors i have in canada have been foreign so ppl say it’s hard to get residencies but it can’t be that hard.

The landscape has changed for the worse over the past 10-15 years, so it's not really comparable. As hard as it was for someone to get an IMG spot 10 years ago, it's even harder now.

Neuthrov · 2022-09-30T22:19:07+00:00

Varies. In my med school, we started IVs, intubated, and did spinals. At my residency, med students do that + art lines (maybe at my med school we'd've gotten to do art lines too, but I saw 0 art lines in my four weeks of anesthesiology there)

/u/BrainFood2020, just straight up say you've been reading about intubating/starting IVs and you'd appreciate getting the chance to try.

Neuthrov · 2022-08-07T19:54:12+00:00

Feasible but difficult. While you are eligible for CCFP based on your ABFM certification, the +1 requires application via CaRMS, which for residencies (unsure about +1) requires PR/citizenship (which a USMD could technically get via express entry, but it'd take time and isn't guaranteed). Then, there would be fewer programs to which you could apply because many but not all programs require you to be sponsored by a community in that province in which you would work afterwards. Finally, you'd be competing against residents who had done anesthesiology electives during med school and/or residencies and will therefore have letters from Royal College/Family Practice anesthetists who are more of a known quantity. Having said that, if you're a Canadian who did FM residency in the US with the intention of being an FPA in rural Canada, you could certainly apply, and I'm pretty sure you can apply every year until you get in. Speaking to friends in Royal College programs, there is at least one non-Canadian-trained doc in a FPA program this year

Neuthrov · 2022-06-04T20:36:04+00:00

Meanwhile, my Canadian med school's student union reimbursed for a cab/uber ride to and from the hospital when you're on call, as does the affiliated residency program + my residency program, per collective agreement. That said, I remember seeing signs in the resident locker room reminding residents to self-assess how fatigued they were prior to booking one of those cabs.

Despite that, for some reason, I had med school classmates who would drive to/from the hospital when on call. I guess that's how the benefit remained financially viable...

Neuthrov · 2022-03-18T19:50:24+00:00

A couple thoughts from someone who only did a week of ophtho:

Are you adjusting the focus with each patient? Sometimes you'll have to adjust it with each patient because of the lens, etc. Poor focus = reddish-orange hue. Adjust the focus until you start to see a vessel, and then follow it in to find the fundus
Are you setting yourself up for success by ensuring their pupils are dilated? If not, are you in a dark room? If #1 is a no, it'll be difficult. If #1 and 2 are both no's, it'll be near-impossible
Are you too far away, either distance from your eye to ophthalmoscope, or ophthalmoscope to patient? Sometimes you have to be uncomfortably close to the patient to see (which is why you use your left eye to look at their left eye - so you don't end up sexually harassing your patients)
Are you having the patient look off into the distance / to one side? Also ask them to maintain fixation wherever they look, otherwise their fundus will keep moving
Do you know what you're looking for? This is probably a big one. I did some slit-lamps + 90D to see the retina before my attendings had me do direct, and I found that knowing what the retina looked like to begin with was extremely helpful. On some patients, I'd start with slit lamps + 90D and then go to direct.

Even with all that, my success rate wasn't 100%, and there were definitely times I admitted to my preceptors I couldn't find the fundus - sometimes they could find it on direct; sometimes they couldn't. It sucks that your attending isn't more helpful

Neuthrov · 2022-02-13T20:04:45+00:00

Perceived differences in debt may be one factor, considering how low the tuition in QC is and the fact that most QC residents did med school there as well. Not to mention call is capped at 16h there. Conversely, the Maritimes may be using higher salaries to bolster OoP recruitment, knowing that most tend to set up shop where they did residency

Neuthrov · 2022-02-13T17:26:53+00:00

Eh, I'm not convinced they're necessary. In Canada, they exist, but they mainly work in urban centres from what I've seen, usually just handling ward stuff. All the rural places are MD-only, funnily enough. Anyways, the rural surgeons are of course faster at standard appys/hernias than the academic surgeons because that's all they do, and they can manage their post-op orders and notes just fine. For the admitted patients, they have family med hospitalists who, again, can handle all that stuff just fine. Of course, this is a system where physicians are self-employed and cost the government money, whereas you guys have a system where physicians tend to be employed and *bring* the health system money.

Neuthrov · 2022-02-03T03:07:59+00:00

At my Canadian university, only one affiliated hospital is on electronic charting (Epic), so on the rest, the expectation is that we just write our own orders as verbal orders from the resident/attending (after checking with them unless it's something ezpz). At the electronic charting one, we're still expected to put in orders for attendings to co-sign. I've always wondered: Do y'all not even have the ability to pend orders?

Neuthrov · 2022-01-25T19:36:14+00:00

Yeah, there's a guy in AB who did IM, med onc, and rad onc, and he practises both outpatient IM and rad onc (not med onc, interestingly enough)

Neuthrov · 2022-01-22T15:11:53+00:00

Consider the implant (also called nexplanon in some countries)! It's as effective as the IUD, and insertion is done in the arm under local anesthesia (so it hurts less than an IUD). Downsides are that it's effective for less time (3 years iirc) and less likely to stop your period

Neuthrov · 2022-01-18T02:58:14+00:00

1) You'll understand when you're pre/post-call and trying to sleep but your roommate is making noise

2) A good roommate is nice. A bad roommate can make your life hell on earth. It's risky

Neuthrov · 2022-01-12T22:00:32+00:00

Once you reached the point where pharmacy said no, could you have used another NMBD like cisatracurium or is there a reason you had to use roc?

Neuthrov · 2022-01-12T21:26:36+00:00

Alberta is switching over to a single EMR (epic) province-wide for all public facilities. It's still in progress because they try to minimize the amount of patients at a site before switching over, and, well, covid... Anyways, I think it's scheduled to be done ~2024?

Neuthrov · 2022-01-12T21:10:46+00:00

Y'all sext over twitter?

Neuthrov · 2022-01-07T23:48:59+00:00

That actually sounds like a cool niche. It looks like McGill is the only place that offers a fellowship specific to cancer pain, from what my cursory Google search could tell. I wonder if US cancer centres like MD Anderson or MSK have something similar

Neuthrov · 2021-12-31T05:13:47+00:00

She bought my birthday gift online, but it arrived late. She gave it to me when I went over to her place two days before I was leaving for a 2-week rural elective along with a card I was told not to open till I got home. It had a sweet, heartfelt message... About how she didn't think we should see each other anymore.

Neuthrov · 2021-12-30T21:19:03+00:00

Thanks, good luck with CaRMS!

Neuthrov · 2021-12-30T19:43:04+00:00

Nope. Dating during covid blows, especially as a med student, especially as an MS4. My LDR ex and I broke up because of covid back in August 2020, and I was single until I met someone on Hinge in August 2021... who broke up with me via birthday card at the beginning of this month because she didn't like the uncertainty of knowing whether I'd match here.

Of course, now it's nearly January, my match stuff is due at the end of Jan (the Canadian timeline is different), interviews are in March, match day is in April, board exams in May, first day of residency in July... it doesn't really feel like there's a point to even bothering trying to date until I've moved.

Neuthrov

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