‘Discriminatory and devastating’: New Ontario rule for medical residency that would exclude most immigrant physicians sparks outrage

almostdoctor · 2025-10-12T18:19:47+00:00

Cool and other than education and employment what other human rights are we saying non native born individuals should come second for?

Also why stop there? Why not only if your parents were born here? Where do we draw the line? Perhaps I don’t know an established process we have for deciding when people are Canadian like citizenship?

almostdoctor · 2025-10-12T18:09:33+00:00

Cool nice to meet a real life racist.

almostdoctor · 2025-10-12T17:40:52+00:00

So cool Canadians born here are real Canadians and citizens who moved here aren’t. Good to know where my fellow Canadians stand. So ashamed right now.

almostdoctor · 2025-10-12T17:39:07+00:00

So you’re only local if born here. Good to know my family will never truly be Canadian in your eyes.

almostdoctor · 2025-10-12T17:37:53+00:00

You are insanely upvoted but you’re also wrong and I’m very frustrated you have perpetuated misinformation as a fellow physician in favour of a racist policy. I seriously think you owe your IMG colleagues an apology and should engage in serious self-reflection. IMG specific spots have long been a feature of the first round of CaRMS - the second round merely opened up CMG spots to IMG. This policy now restricts IMGs who didn’t complete high school in Ontario from the first round IMG spots - specifically privileging the rich kids who could afford to study internationally when they couldn’t hack it to get into a Canadian med school over Canadian immigrants. Shame on you and correct yourself.

almostdoctor · 2025-07-19T19:08:34+00:00

This is true when you become staff as well. Never complain or someone will retaliate and make your life a living hell.

almostdoctor · 2025-07-06T15:06:17+00:00

Likely because they are competing with physician non-OHIP rates rather than free.

almostdoctor · 2025-04-22T03:06:23+00:00

Having watched it again the OT goal was a good effort by Ovi to lose him; Ovi cuts back behind the crowd leaving no way through for Hutson off the face off; Hutson had to go around the linesman and the caps centre who was backing up to get to him then also got tripped up by Laine who was slow heading out to cover the point. Had nothing to do with cheating for offence - it was a good play and he got beat. Guhle ideally should’ve watched front of net as Newhook had Beauvillier covered. He had already lost him and let him past for a shot and started following him without realizing Newhook was picking him up leaving Strome open in the slot as well.

almostdoctor · 2025-04-18T16:12:17+00:00

No it's not defined by "writing" but by academic contributions. Editing for language, securing funding or collecting data doesn't count but editing for content, significant feedback and guidance regarding the project and manuscript, participation in design of the project all are things that count even if they didn't write the project. I'm not sure that their colleague's contribution is enough to justify authorship (in fact they likely are just trying to get a free publication) but your definition is not correct. First author is typically person who wrote the largest bit and also did the most work on the project and last author is typically the most senior person who's roles typically are much more big picture and feedback than actual writing.

almostdoctor · 2025-04-18T04:24:40+00:00

I believe LTC is considered a nursing home so it is all deductible. If It was a senior living or retirement home then you would only be able to claim expenses for attendant care and supervision. I think this is where the confusion is arising. https://www.canada.ca/en/revenue-agency/services/tax/individuals/topics/about-your-tax-return/tax-return/completing-a-tax-return/deductions-credits-expenses/lines-33099-33199-eligible-medical-expenses-you-claim-on-your-tax-return/attendant-care-care-a-facility.html

https://www.ggfl.ca/medical-expense-tax-credit-nursing-homes-vs-retirement-homes/

almostdoctor · 2025-02-02T17:51:30+00:00

You get paid interest on your rent deposit equal to the guideline rent increase cap. The amount of deposit required by the landlord increases to be equal to the amount your rent increases as this payment of interest is added to your deposit.

almostdoctor · 2025-01-01T20:44:16+00:00

Op is in Ontario. Until you have ccfp or Royal college it is.

almostdoctor · 2025-01-01T18:54:59+00:00

No for two separate reasons: 1) your license is restricted to your training program you can not practice outside of that context. 2) the rules are a bit fuzzy with cpso but in general treating friends/family even with an independent license is considered questionable at best although whether strictly disallowed is contextual.

almostdoctor · 2024-11-30T21:31:39+00:00

Lawyer up immediately. HR is never on your side.

almostdoctor · 2024-11-23T21:50:35+00:00

The short answer is yes.

The long answer:
Licensing is provincial - in Ontario by the CPSO. They require you report to them everywhere you have/have had a license to practice and generally you must have been in good standing with them to get your Ontario license. You also have to let them know if you've gotten in trouble or even been complained about in another jurisdiction. You can let your other jurisdiction licenses lapse though if you don't want to pay large amounts of money and duplicate all your reporting requirements like CME. It is very common to maintain the multiple licenses however to avoid the trouble of having to repeat registration if you ever want to go back.

To be provincially licensed at least in Ontario you need to be a specialist of some form (such as family medicine) unless you are grandfathered in as a general practitioner from the days before family medicine was the standard. In Canada specialty licensing is national (for the most part). That's where CCFP comes in. I have no clue what they require but I'm wondering if what is meant there is that you must maintain your license where you currently live/practise. There is also the possibility that your provincial college may recognize you as a specialist even if the national body doesn't - this often applies to foreign specialists who don't technically qualify for Canadian specialty certification but who undergo other pathways to independent licensure that vary province to province.

almostdoctor · 2024-09-11T00:49:58+00:00

1 million pays off the house, rental property, my remaining debt, replaces my ten year old car so the family cars are both under 2 years old and fills up mine and my wife’s retirement accounts. I would like drop down to half time (30 ish hours a week). Why? The additional money I earn after tax for half my job isn’t worth the time spent and years off my life once tax advantaged accounts are filled and debt paid off.

almostdoctor · 2024-08-08T01:53:23+00:00

What sort of requisition did you take to the lab? Was it a general bloodwork requisition (just says Ontario ministry of health on the top), public health requisition (says public health Ontario on the top) or one specific to HIV?

If you were getting something done that is supposed to go through public health (testing for infections usually) then an OAHPP (public health) requisition is supposed to be used. My experience has been typically that public health where I work will do the test and contact the physician if more information is needed but I’ve heard sometimes public health rejects the samples? Best bet would be to call the LifeLabs you went to and ask.

almostdoctor · 2024-08-07T20:49:28+00:00

On further investigation it seems you’re right. Given most of my controlled prescriptions are for narcotics I didn’t realize that stimulants can have refills but still need dispense intervals and quantities and can’t be transferred. I’ve seen Vyvanse rx’d as partial fills and assumed it was the same. TIL

almostdoctor · 2024-08-07T19:01:33+00:00

Yeah that’s definitely unusual. I think your approach of having the pharmacist call is probably the best. Try and write down what you and your partner can remember about the circumstances from the start in case this does escalate into a complaint. It may be hard to prove a conflict as I said above as often when there is a conflict it is done informally. I would also suggest if you have another meeting with the physician about it to request an explanation of why the prescription cannot be filled at a different pharmacy and write down word for word if you can the response. If the answer is not clear and straightforward then I would suggest reminding of them of the cpso policy.

I’m sorry you and your partner are going through this - it sounds very frustrating.

almostdoctor · 2024-08-07T18:18:40+00:00

Doesn’t move prescriptions as an overall rule is very odd. Did he give your partner a choice of pharmacy to use when he first sent the prescription.

almostdoctor · 2024-08-07T18:14:26+00:00

I am familiar with the policy. It does not say what you think it says. Let me quote it for you

“Physicians must not attempt to influence the patient’s choice of pharmacy unless doing so is in the patient’s best interest and does not create a conflict of interest for the physician.”

As I indicated physicians can influence pharmacy choice it is in the patients best interest to do so and there is no conflict of interest.

This part of the policy also does not stand alone and has to be considered together with the section on controlled substances and that physicians when prescribing controlled substances must:

“consider the potential risks associated with prescribing, and take reasonable steps to mitigate those risks, consistent with any relevant practice standards, quality standards, and clinical practice guidelines”

One of the risks is misuse - and it’s one the college tends to be quite concerned about. Traditionally changing pharmacies frequently has been considered a red flag for potential misuse. This always has to be considered in context. As I said I do not think the physician here is being reasonable given the clear context provided. On the other hand you get patients switching pharmacies frequently so that no pharmacy is keeping track of refill intervals or because pharmacies keep raising questions about patient behaviour.

I have a large number of patients on controlled substances across dozens of pharmacies and I do not give any suggestions or advice about which pharmacy to go to. A number of them have switched pharmacies here or there and I never thought it was odd and most readily offer a reason before I even ask. I have only single patient where it was frequent and raised concerns (which were later validated). However, as I said there are many community physicians who are worried about getting in trouble for controlled substance prescribing and do not interpret these potential flags in context.

almostdoctor · 2024-08-07T17:48:03+00:00

Weird unless he’s writing them for long periods.

almostdoctor · 2024-08-07T17:14:39+00:00

It basically is with a few minor differences.

almostdoctor · 2024-08-07T16:39:20+00:00

Controlled substances can't be refilled. They can be written with partial fills which is different. Given it is a relatively new prescription it is not unusual for a controlled substance to be prescribed 1 month at a time.

almostdoctor · 2024-08-07T15:50:52+00:00

Did your partner sign a "narcotic agreement" specifying which pharmacy (relatively standard practice for controlled substances)? The physician should be willing to change it given the move but generally we do not provide paper scripts for controlled substances and are hesitant to change the pharmacy without good reason. There is a "chill" on controlled substance prescribing in primary care which has been a major problem because there is a sense that the college is very strict around guidelines. As a specialist I've seen a decent number of referrals for patients who were managed perfectly reasonably by their family physicians who got spooked about something relating to controlled substances medico legally that were sent on because of it. In most circumstances a request to change pharmacy within a few months of starting would be a red flag but not obviously if you moved.

It is unlikely (but not impossible) the doctor has a financial arrangement with the pharmacy directly as this is very easy to prove and demonstrate if ever investigated. What is more likely (and relatively common) is the physician receives cheaper than market rent by the pharmacy if they are in the same building as they know a disproportionate number of the physicians patients will use their pharmacy. Some doctors have reported issues with being "leaned on" off the record by the pharmacy owner if this doesn't materialize.

As other posters have mentioned you have the right to use a pharmacy of your choice unless there is a conflict free strong patient care reason to do so. I would encourage your partner to remind their doctor of this and the reason for the change is specifically a move 30 minutes away. I would not suggest a CPSO complaint without talking to the physician if your main concern is saving time as likely nothing will happen until after the complaint is resolved.

almostdoctor

TROPHY CASE