going home

Now... I have not lived with my parents for about 2 years. The summer between my third and fourth years of undergrad was the last time I co-habitated with them for more than a few days maybe a week over Christmas at the most. I am moving home next week for the summer. Med school is weird because it's what, for me, comes AFTER grad school. I did not go home and stay with my parents over the summer in grad school ( nevermind the fact that I was living in Scotland at the time, with my boyfriend ). So, this seems like a regression somehow. And it seems like it might be a difficult adjustment. Not just for me, but for the parental units as well. See, the problem is, I talk A LOT. I have always talked a lot and I have difficulty with silence. My parents on the other hand don't really talk a lot to each other. I mean, they do the usual hi how was your day stuff and they talk when there's something to talk about, but they don't babble on incessantly like I do. I am trying to work on this, but sometimes I slip up. I think those times are my parents' personal hell. They're always very glad to see me, bless their hears, but by 5 or 10 minutes into a visit they remember that their daughter is a loud mouth and start to go slightly green. By 20 minutes in to the visit they've just stopped answering when I speak. By 30 minutes in they're about ready for me to leave. I just can't help it, I like human interaction, I like to know what other people think about things. Meghan and I get along well because we both like to talk a lot. We have conversations. With my parents, all of my conversations are one sided. This is no fun. Once Ben comes atleast I'll have him to talk to and him to tell me when to shut up, but that's after a whole month and a half of being home alone with mom and dad. I think they might kill me.

Oh, and on another note. Exams are done, yay! I start my job a week yesterday. I had a meeting on Friday with my boss and chose my research project. I think it's going to be cool. A little bit of CT, a little bit of ophtho and a bit of biomechanics. Everything I like in the world of research. I really need to get on writing those two papers too. I have drafts I just need to put them in the correct formats for the publications I'm going to submit them to. Then hopefully they don't get flamed. I'm also going to Perth Ontario tomorrow to start my "week in the country". My time will be split between an internest and a family/emerg doc. I'm excited because I haven't tried internal or emerg on for size yet. You never know what could take my fancy!

The Impending Doom

So,
I have my first exam of 2 tomorrow and I'm feeling the impending doom. I am lying in bed trying to go to sleep but can't and don't feel like I can cram any more information into my head so I thought I'd just blog for a minute. Blog about feeling hopeless. Blog about not knowing all of the antibiotics. Blog about not knowing the virulence factors for all of the bacteria known to man. I am completely fu*ked for this exam and the one tomorrow. Atleast this one is multiple guess so I can fake my way through it. The long answer is going to be another story. What ARE the complications of right sided endocarditis. Death? Yeah, I thought so too.

To All Those Who Just Don't Understand

Sometimes when you're a med student it's difficult to explain to the rest of the world that, yes, you really do have to study THIS MUCH!!!!

A friend of mine and I had very similar experiences lately. They went like this:

Non Med Student Friend: Wanna come to my BBQ tonight?

Med Student: Nah, I gotta really study, I didn't study to day to come to this thing we're currently at and I have to hit the books tonight... sorry.

NMSF: Study? You don't have to study. Your exams aren't for another 2 weeks. You've never studied this far in advance before. You'll be fine. It's only one night.

MS: Look, I'm really sorry, but this is the only exam we have on this material and it's the accumulation of 4 months of lectures. I used to cram in undergrad and then forget everything I've learned but I feel like I actually need to REMEMBER this stuff and it's a lot to memorize. I really do need to study tonight. I'm not the only one doing it. Everyone in my class is studying now.

NMSF: You'll look back on this time in your life and really regret missing my BBQ and all of the other good times you could have had while you were studying.

MS: Better that than standing watching someone die because I didn't study hematology. (Ok, maybe I didn't say this, but I wanted to!)

See, everyone else graduates university and goes on to a job where they go to work, come home, then sit on their patios/couches/arses and drink wine and eat dinner and laze the night away. Yes, there's the occasional weekend or evening work but that's not the norm and that work is productive, not sitting staring at a book trying to memorize the prodromes of all of the febrile exanthems. I, however, left my undergraduate degree, got a masters, and then entered this hell. It's a whole different ball game and I'm starting to realise that there are things about my life that non-medics will never really comprehend. I guess I'd better become OK with that.

Now, back to my febrile exanthems. First exam on Wednesday! Eek!

Oh, and we had our OSCE on Thursday. It went fine. If only all of our exams were that easy.

Oh! and Happy 80th Birthday Granny!

Sadness

Earlier this semester a mother came to talk to us about her twin sons. One born severely disabled and one born healthy. Her disabled son lived for a few tumultuous years and then he died. She comes in every year to talk about her family's illness experience and share what it is like to be the mother of an ill child who spent most of his life in hospital. She touched me deeply. She left us with a truly inspiring sentiment:

"I understand why I had been given two boys. What better gift for a brother who cannot see than a brother who never stops talking."

Human resilience astounds me.

the tale of CaRMS

So,
There has been a very surprising development in the canadian residency matching system in the past day. It's got so many pairs of panties in so many knots I can't even begin to count them. So this is the story:

International medical graduates (IMGs) used to match only in the second round of CaRMS so that gave Canadian graduates first pick at residency spots. There history have been a few provinces that have set aside parallel match spots just for IMGs but this was by far the minority. To qualify the term IMG, these are usually people who are Canadian born but went to medical school in other countries because they could not get one of the very limited spots here and now wish to practice in Canada. There are also a handful of people who are landed immigrants in Canada and wish to convert their training in another country over to be a doctor here but they are in the minority.

What has happened now is that a bill was passed without anyone knowing about it stating that IMGs will now be able to participate in the first round of the CaRMS match. The reason everyone is in a snit about it is that the CaRMS ratio for spots to Canadian medical students will now be reduced to 1:1. This means that there will be one spot allocated for each graduating medical student.

A majority of these spots will be family spots. Traditionally family medicine spots go unmatched because there are far more family spots than people who want to do family. This is by in large because they are the cheapest spots for the government to fund, being only 2 year programs, and so all of the "new" spots they've created over the past few years have been family spots. If the residency match goes to a 1:1 it means that there will be a lot of people matched to family spots who do NOT want to do family medicine as a specialty. It also means that once you're in a residency there will be no way to switch programs unless it's within the same institution and you can convince the program directors to re-direct your funding. You may be saying to yourself "well, there's a doctor shortage, people should be forced to do family". Yes, there is a doctor shortage, that isn't limited to family doctors. There is also a specialist shortage in Canada. And the reality is, people who do not want to do primary care don't make good primary care physicians. These people will not do justice to a specialty that takes lots of time, effort and dedication.

Furthermore, there is a rumor that it's going to be a parallel match. This means that we will not be directly competing with IMGs for spots but there will be a certain number of residency spots allocated to the IMG CaRMS match and a certain number allocated to the Canadian grad carms match. There has been no strategy reveiled for how these spots will be allocated. If there's only one derm spot at a school, which stream will it be allocated to? If there are 2 ob/gyn spots, will one go to IMGs and one to Cangrads eventhough there are going to be way more cangrads than IMGs accepted into spots? Or will it be proportional? These are questions that need to be answered in the days to come.

From what I see this is really going to fuel resentment on the part of Canadian grads against foreign grads. I have no problem with foreign grads being funnelled back into the Canadian system. What I do have a problem with is the 1:1 ratio. I think the ratio should be atleast 1.2:1 which is approximately what it is now. Just adding IMGs into the additional .2 of the ratio to make the cangrad match 1:1 does NOT make sense. The biggest problem I feel is that the general public doesn't understand how residency works so the 1:1 ratio probably makes total sense in their minds. I mean, we all get to be doctors, right? It's going to be a hard task to explain adequately to the public what this new system will mean for the quality of their health care in the future.

Oh, and why did this all come about? A class action lawsuit! of course. A group of IMGs are threatening to sue every medical school in Canada because only letting IMGs match in the second round is, in their opinion, against the charters of rights and freedoms.