Path to Medicine Becoming a Physician Who Why

Path to Medicine – Becoming a Physician Who, Why and How Dr. Mim Fatmi Naman Siddique

Outline - Who should do medicine What should be the motivation The fun stuff - Different specialties Different career options as an MD - Life as a Medical Student Life as a Resident Life as an Attending Physician - Medical School in canada Medical School in US Medical School internationally

Should I Choose a Career in Medicine? 4

Should I Choose a Career in Medicine? • Service : Most important aspect - you SERVE your patients - treat physically, mentally, emotionally, etc. • Knowledge : Very interesting multidimensional material - but learn continuously • Action : allows you to be around others, make decisions and make things happen Respect : your work and contributions are valued- **careful** • Security : provides for a consistent and secure future- **careful** • Mobility : Medicine allows you to move almost anywhere in the world • everyone needs doctors • Flexibility : offers you lots of career options from the same knowledge base 5

Mythbusters Medicine is all patients, all the time. Reality: Sometimes you do 4 times as much paperwork as you spend doing clinical work. Medicine is always rewarding. Reality: Sometimes it is a thankless job! You’ll make, like, a zillion dollars. Reality: A lot of doctors spend >30% of their income on overhead and pay >50% in taxes, so they may walk away with very little. It’s okay to completely devote myself to this career. Reality: Everybody needs balance; you need to make a conscious effort to find it, but it’s important to always take time for yourself.

Questions to Ask Yourself 7

Questions to Ask Yourself 1. What is your motivation to pursue a healthcareer? 2. Are you fit for medicine? 3. How are you going to obtain the education and training? 4. How will your career impact your personal life in the longterm?

Now for the Fun Stuff ○ Your patients will trust you and connect with you on a personal level ○ You will not only help with their health but your impact can be bigger socially and mentally ○ You can contribute to research with so many uncovered mysteries in medicine and science ○ You’ll be ballin’ ○ You get to be your own boss ○ You’ll never get bored ○ Opportunities within medicine are endless

Specialties Anesthesiology Cardiac Surgery Dermatology Diagnostic Radiology Emergency Medicine Family Medicine General Surgery Hematology Internal Medicine Medical Genetics Neurology Neurosurgery Nuclear Medicine Obstetrics and Gynecology Ophthalmology Orthopedic Surgery Otolaryngology Pathology Pediatrics Physiatry Psychiatry Radiation Oncology Urology 10

Life as a Medical Student Class Days: - 8: 00 am - leave for school - 8: 30 a - 5: 30 pm - Lectures, small groups, anatomy, studying - 5: 30 pm - come home sleep for an hour or two - 6 pm - 11 pm or 12 am - eat then study till I pass out Clinic Days: - 8: 00 am - leave for school - 8: 30 a - 5: 30 pm - Lectures, small groups, anatomy, studying - 5: 30 pm- 9 pm - help preceptor see patients, do PE’s, order tests - OR 5: 30 - 8: 30 pm - other extracurriculars/interest groups/etc. - 9: 30 pm - 12 am - eat then study till I pass out - Rinse and repeat x 5 - Holidays and weekends - catch-up time

Life as a Resident On inpatient psychiatry: 9: 00 am - print lists, paper rounds 9: 30 am - start seeing patients assigned to you 10: 30 am - coffee break : ) 10: 45 am - finish up and review patients with staff 12 pm - lunch, self study or attend lectures 5 pm - 11 pm - workout, make dinner, live your life, sleep On internal medicine: 7: 30 am - come in early, check labs on your patient, print lists 8: 00 am - morning teaching 9: 00 am - touch base with staff, plan for the day 9: 15 am - start seeing patients assigned to you, WRITE A LOT OF NOTES 12 pm - lunch (maybe) 12: 30 pm - consult necessary specialties, order tests, review with staff 5: 00 pm - paper rounds 5: 00 pm - prepare for call shift, if on call 7: 00 pm - get home and live your life before doing it all again

Things to consider- Residency • Work hours usually 7: 30 am to 6 pm • You may work 2 weekends every month plus 26 hour call every 4 days (very little time): less with family medicine and more for surgical specialities • Expectations: very high to perform in all areas in terms of clinical, teaching and research • Most residency programs require “extra training” even when you are done the clinical work

Life as an Attending Physician

Disclosures - I am not an admissions officer - I am only speaking from my own experience and that of my colleagues

Time Line • Highschool (4 yrs) University (2 -4 ys) Application Cycle (1 yr)- concurrent with university or after Medical School (3 -4 yrs) Residency (2 -6 yrs) - paid job Fellowship (1 -3 yrs) - not always needed 17

Application example: U of C 1. GPA- 20% 2. MCAT- CARS- 10% 3. Global assessment of academic merit- 10% 4. Attributes (60%) - 10% of this is intellectual curiosity and research - So roughly 50% Extracurricular and 50% academic or academic related

Other Schools - AFMC Admission reqs for Faculties of Medicine - $25 - generally all schools looking for same thing - might have personal essay requirements as well

1. Grade Point Average (GPA) • • 20% of your application If full degree, can drop worst year Can be any degree program General recommendations (varies): • Biology - 1 year • General Chemistry – 1 year • Organic Chemistry – 1 year • Physics - 1 year • Biochemistry – 0. 5 year • **Anatomy + Physiology** • Social Sciences – 1 year • **Pharmacology**

Competitive Grades • Maintain good grades in high school for admission to an undergrad program at University • Undergrad selection based on: degree program, proximity to home, scholarships, opportunities, **NOT PRESTIGE** • Only your university’s GPA that counts towards med school admission 21

Courses in University • 5 courses per semester is mandatory for most, but not all, medical schools in Canada. • It would be a good idea to balance your semester with core and optional courses (this is your time to explore your interests in university and optional courses will help you obtain a competitive GPA) 22

Global assessment of academic merit- 10% - Will look at trends, courses, full MCAT - Can you succeed in the rigorous academic environment of the MD program

Things to do at this point: – Discover what interests you academically and nonacademically. – Pick a university program that interests you (if the medical school of your choice doesn’t require a particular one). – Research medical schools in Canada and US to get an idea about their criteria (these vary) in order to plan your undergrad accordingly. – Decide on undergrad - doesn’t have to be biggest or best university 24

2. Attributes • Extracurricular activities, work experience, life experience • 3 letters of reference • Each letter asks the referee to comment on 2 of the 6 attributes • Chose referees wisely • “Can you write me a STRONG letter? ” • Other universities across Canada require 2 letters • Ontario schools may have essay questions - take your time and edit with friends and family

Extracurricular Activities • Medical Schools want people who are well rounded + learn from activities 26

Attributes (10% each) - Communication Skills - Intercultural, empathy, conflict, different backgrounds, breaking barriers - Collaboration - working within groups from different backgrounds - Maturity and Insight - values (honesty, integrity, etc. ) + ethics (how to deal with hard situations) + big picture thinking - Advocacy and Commitment to Communities - to authority for changes that impact individuals and a community - Intellectual Curiosity, Research, and Scholarship - research - Leadership and Organizational Management - improve groups your working with, management of resources, take on responsibility as you progress

Extracurricular Activities • They should show commitment - long term - better from high school or junior high • Something that interests YOU. • Start at an entry level position and move up from there • Want long term commitment, variety, and personal growth 28

Extracurricular Activities • Leadership • Advocacy • Research • Sports • Diversity of experience • Professionalism/Employment • Volunteer Work - Islamic or not • Awards 29

Tips Get involved in extracurricular activities: Community (cross-community), sports, school/university clubs, employment, etc Steer away from activities where you are stagnating (i. e. hospital volunteering) Get involved in student clubs and off-campus groups Do something you’re passionate about and improve the group you’re working with Keep time in mind 30

3. MCAT • 4 sections: – Critical Analysis and Reasoning Skills (CARS) – Chemical and Physical Foundations of Biological Systems – Biological and Biochemical Foundations of Living Systems – Psychological, Social, and Biological Foundations of Behavior • Total score centered at 500, ranging from 472 - 528 • Each section centered at 125, ranging from 118 -132

Good MCAT Score: (Cont) – These days medical schools are putting more emphasis on CARS (ie. some school will only look at CARS scores). – To prepare, you can take a prep course (will find out more once they start to attend university) or self study, but PRACTICE is the KEY! – Block off some time 32

Stats Uof. C - MCAT - 127. 4 CARS, GPA -3. 78 Uof. A - MCAT - 128. 16 avg, GPA - 3. 81 UBC - MCAT - 513. 4 TS, GPA - 88. 62% Uof. T - MCAT - N/A , GPA - 3. 95 Mc. Master - MCAT - 128. 9, GPA - 3. 84 USask -MCAT-98 th% TS + 128 CARS , GPA - 88% Uof. M -MCAT 522, GPA - 4. 39 Others (AFMC)

Applying to Medical School • Overall academic record • Scores on the MCAT • Volunteer experience, leadership positions, extracurricular activities + HOW YOU WORD THEM • Reference Letters • Interview skills - apply the skills you have learned and be a good human/Muslim 34

More information – Each University has their own website with information – There is also: http: //www. premed 101. com/forums/ Take this information with a grain (read brick) of salt - Better to ask the office of MD admissions or talk to a medical student/resident 35

Canadian Medical Schools Prerequisites Summary Sample 36

Cost of Medical School Tuition Canadian Students Tuition International Other Compulsory Fees Alberta $11, 714 N/A $1, 043 UBC $15, 457 N/A $208 -$865 Calgary $14, 600 N/A $793 Dalhousie $13, 818 $21, 078 $908 Laval $3, 240/$8, 879 $25, 317 $714 Manitoba $7, 499 N/A $984 Mc. Gill $4, 825/$13, 224 $37, 705 $2, 553 Mc. Master $20, 831 $108, 546 $737 Memorial $6, 250 $30, 000 $1, 140 Montréal $3, 102/$8, 501 $24, 239 $1, 355 Ottawa $18, 117 N/A $902 Northern Ontario $17, 200 N/A $1, 750 -$2, 050 Queen’s $18, 228 N/A $912 Saskatchewan $12, 276 N/A $697 Sherbrooke $3, 170*/$9, 494 $25, 582 $1, 081 Toronto $18, 424 $51, 051 $1, 509 Western $17, 722 N/A $973 37

Cost of Medical School (cont) Fees $15, 012 Books $1000 -2000 (if even that) Living Expenses + food $21, 756 Other $6, 000 - last year Total: From $36, 770 to $42, 770 38

Options of medical schools OCanada OUSA OInternational 39

SPECIALIZATION CARMS, CARMS: CANADIAN RESIDENCY MATCHING SERVICE 40

What’s different about the US? • Central Application through Association of American Medical Colleges (AAMC) – – – Enter Transcript Enter Extracurricular Essay: General theme ‘Why do you want to become a doctor? ’ Reference Letters (upto 5) Select Universities (i. e. Canadian friendly schools) • Universities send secondary application – Essay: specific to university • Interview offer (rolling admission): • VERY EXPENSIVE 41

What about the Caribbean? - options available in different Caribbean Countries - some have clinical rotations in the US - difficult to come back to Canada to practise - VERY EXPENSIVE $$$

YOUR LIFE IF YOU CHOOSE A MEDICAL CAREER BRIEF SNAPSHOT

Average timeline to complete your training: 13 years before you can practice as a consultant 10 years for family medicine Pre-medicine Average 3 -5 years Medical School Normally 4 years Except Calgary ad Mc. Master Residency 2 - only family Others: 5 -8 years Be prepared to work and when you are done there will always be work to be done

Things to consider - realities • Expect to be put on the spot to answer questions daily: it doesn’t matter if you did not sleep • You will have to show to work even if you are sick sometimes because patients must be seen • You will have to break bad news- watch people die or tell them that they will

Things to consider- realities • There is lots and lots of paperwork • And more paperwork • You will have to move at some point in your training and you may not choose where you end up • There is a crunch for healthcare jobs so you may not get the location or speciality that you want • You have to be business minded in most specialities

Chairman: Dr. Mukarram Ali Zaidi

VISIT: www. thinkforactions. com for more information @thinkforactions

References • http: //fmignet. aafp. org/online/fmig/index/premed/career. html • http: //healthcareers. about. com/od/whychoosehealthcare/tp/Before-You-Start-Your-Career. htm • http: //www. ivyglobal. ca/MCAT/mcat_test. asp • http: //www. afmc. ca/pdf/2013_ad_bk. pdf • http: //www. oxfordseminars. ca/MCAT/mcat_profiles. php • http: //www. canadiancareers. com/meds. html • http: //www. ouac. on. ca/omsas/ • http: //www. science. mcmaster. ca/scce/files/forms/students/job-search-resume/medicalschool/Applying_to_Medical_School_in_Canada. pdf • http: //www. premed 101. com/ • 49

References • http: //en. wikipedia. org/wiki/Medical_school_in_Canada • http: //donalda 13. tripod. com/medschool. html • http: //www. medaholic. com/canadian-medical-schools-prerequisites-summary/ • http: //healthydebate. ca/2011/03/topic/politics-of-health-care/why-are-so-many-canadians-goingabroad-to-study-medicine • http: //www. doctorstarter. ca/ • http: //www. ucalgary. ca/pubs/calendar/current/md-5 -3. html • http: //www. dartmouth. edu/~nss/nav/pages/advice/junioryearforward. html • http: //www. cmaj. ca/content/179/11/1228 • http: //www. inquarta. com/medical-school-admissions-consulting/ 50

References Allied health • http: //en. wikipedia. org/wiki/Health_care_provider • http: //www. ama-assn. org/ama/pub/education-careers/careers-health-care. page • http: //library. thinkquest. org/15569/car 1 a. html Md specializations • http: //www. royalcollege. ca/portal/page/portal/rc/credentials/accreditation/arps • http: //www. med. uottawa. ca/postgraduate/eng/residency_training_programs. html 51

References Cost • http: //www 2. macleans. ca/2010/09/16/how-much-they-pay-for-it/ • http: //med. ubc. ca/students-learners/md-undergraduate-resources-support/financial-assistanceinformation/cost-of-an-md-student/ • http: //omsbf. oma. org/student/factsheet. htm • http: //registrar. mcmaster. ca/calendar/2012 -13/pg 1276. html • http: //www. md. utoronto. ca/admissions/finance/Current_Fees. htm • http: //schulich. yorku. ca/client/schulich_lp 4 w_lnd_webstation. nsf/page/MBATuition+Fees+and+Co st+of+Living? Open. Document • https: //www. bcma. org/news/facts-cost-becoming-doctor • • http: //www. ilwindia. com/canada-education-cost. php • http: //www. md. utoronto. ca/admissions/finance/Current_Fees. htm http: //www. utoronto. ca/student. exchange/incoming/cost. html • • http: //umanitoba. ca/student/ics/finances/estimate. html • http: //www. apexstudent. com/overview/expenses 52

References • http: //en. wikipedia. org/wiki/Medical_school_in_Canada • http: //donalda 13. tripod. com/medschool. html • http: //www. medaholic. com/canadian-medical-schools-prerequisites-summary/ • http: //healthydebate. ca/2011/03/topic/politics-of-health-care/why-are-so-many-canadians-goingabroad-to-study-medicine • • • http: //www. doctorstarter. ca/ http: //www. ucalgary. ca/pubs/calendar/current/md-5 -3. html http: //www. dartmouth. edu/~nss/nav/pages/advice/junioryearforward. html http: //www. cmaj. ca/content/179/11/1228 http: //www. inquarta. com/medical-school-admissions-consulting/ • http: //en. wikipedia. org/wiki/Health_care_provider • • http: //www. ama-assn. org/ama/pub/education-careers/careers-health-care. page http: //library. thinkquest. org/15569/car 1 a. html 53

References • http: //en. wikipedia. org/wiki/Health_care_provider • http: //www. ama-assn. org/ama/pub/education-careers/careers-health-care. page • http: //library. thinkquest. org/15569/car 1 a. html • http: //www. royalcollege. ca/portal/page/portal/rc/credentials/accreditation/arps • http: //www. med. uottawa. ca/postgraduate/eng/residency_training_programs. html • http: //www 2. macleans. ca/2010/09/16/how-much-they-pay-for-it/ • http: //med. ubc. ca/students-learners/md-undergraduate-resources-support/financial-assistanceinformation/cost-of-an-md-student/ • http: //omsbf. oma. org/student/factsheet. htm • http: //registrar. mcmaster. ca/calendar/2012 -13/pg 1276. html • http: //www. md. utoronto. ca/admissions/finance/Current_Fees. htm 54

References • http: //schulich. yorku. ca/client/schulich_lp 4 w_lnd_webstation. nsf/page/MBATuition+Fee s+and+Cost+of+Living? Open. Document • https: //www. bcma. org/news/facts-cost-becoming-doctor • http: //www. ilwindia. com/canada-education-cost. php • http: //www. md. utoronto. ca/admissions/finance/Current_Fees. htm • http: //www. utoronto. ca/student. exchange/incoming/cost. html • http: //umanitoba. ca/student/ics/finances/estimate. html • http: //www. apexstudent. com/overview/expenses 55