Canada?

[Undecided22]

Do any of you have experience with working in Canada? If so how does one get to work in Canada after training in the US?

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[Old_Mil]

I have actually looked into this with the understanding that if the ACA is not repealed that in another decade or so Canada/New Zealand/Australia will all be more attractive places to practice than here in the Republic of North Zimbabwe. Canada seems to be the toughest of the three. Their stance is that our residencies are three years and theirs are five so you have to undergo 1-1.5 years of "supervision" at a hospital willing to sponsor you. All of these seem to be in Ontario. There may be some opportunities in the frozen tundra of Manitoba. BC and Alberta look at you and say, "Eh? You want to do what?"

Everything is quite a bit different there, I spoke to a fellow who saw 5-6 widgets an hour. Asked him how, essentially it sounded like they had to do next to no charting (one page, one sided t-sheet equivalent per patient). Course lawyers are nearly extinct under that system as opposed to here.

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[gro2001]

I have actually looked into this with the understanding that if the ACA is not repealed that in another decade or so Canada/New Zealand/Australia will all be more attractive places to practice than here in the Republic of North Zimbabwe. Canada seems to be the toughest of the three. Their stance is that our residencies are three years and theirs are five so you have to undergo 1-1.5 years of "supervision" at a hospital willing to sponsor you. All of these seem to be in Ontario. There may be some opportunities in the frozen tundra of Manitoba. BC and Alberta look at you and say, "Eh? You want to do what?"

Everything is quite a bit different there, I spoke to a fellow who saw 5-6 widgets an hour. Asked him how, essentially it sounded like they had to do next to no charting (one page, one sided t-sheet equivalent per patient). Course lawyers are nearly extinct under that system as opposed to here.

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How about Australia?

 

[alpinism]

I have actually looked into this with the understanding that if the ACA is not repealed that in another decade or so Canada/New Zealand/Australia will all be more attractive places to practice than here in the Republic of North Zimbabwe. Canada seems to be the toughest of the three. Their stance is that our residencies are three years and theirs are five so you have to undergo 1-1.5 years of "supervision" at a hospital willing to sponsor you. All of these seem to be in Ontario. There may be some opportunities in the frozen tundra of Manitoba. BC and Alberta look at you and say, "Eh? You want to do what?"

Everything is quite a bit different there, I spoke to a fellow who saw 5-6 widgets an hour. Asked him how, essentially it sounded like they had to do next to no charting (one page, one sided t-sheet equivalent per patient). Course lawyers are nearly extinct under that system as opposed to here.

Sent from my A110 using Tapatalk 2

Mother of God.

Canada here I come!

Eh!

 

[med2UCC]

Where I am if you are working on a "defined license" i.e. under supervision you get paid as much as the fellow next to you who is not on a defined license. Once you pass your exam the defined license goes away. When I was moonlighting as a family medicine resident in emerg, I got paid $150.00 per hour. The guy supervising me got $185.00 (the base rate at the time). Generally speaking the Atlantic Provinces in Canada are easier to get into to work than anywhere else, and actually nice places to live generally, No big cities, but if you're not into big cities that's not a problem. And yes, generally for a simple complaint I do a one page chart, dictate notes on the more complicated cases or anyone I admit, and it speeds me up. Other things like our chronic overcrowding slow me down. Cheers,
M

 

[GeneralVeers]

Where I am if you are working on a "defined license" i.e. under supervision you get paid as much as the fellow next to you who is not on a defined license. Once you pass your exam the defined license goes away. When I was moonlighting as a family medicine resident in emerg, I got paid $150.00 per hour. The guy supervising me got $185.00 (the base rate at the time). Generally speaking the Atlantic Provinces in Canada are easier to get into to work than anywhere else, and actually nice places to live generally, No big cities, but if you're not into big cities that's not a problem. And yes, generally for a simple complaint I do a one page chart, dictate notes on the more complicated cases or anyone I admit, and it speeds me up. Other things like our chronic overcrowding slow me down. Cheers,
M

Interesting. Do you have any of the following BS that we have to deal with:

1. Door to doc times pressure by admin (preferably less than 30 minutes)
2. Patient satisfaction
3. Patient complaints for BS nonsense
4. Not able to send away non-emergent patients. (do you have a nurse at the front desk screening out the minor crap so you don't have to see it?)
5. RVU-based system requiring you to see an unsafe amount of patients

I'd like to hear your thoughts, because those things are commonly discussed.

 

[med2UCC]

Interesting. Do you have any of the following BS that we have to deal with:

1. Door to doc times pressure by admin (preferably less than 30 minutes)
2. Patient satisfaction
3. Patient complaints for BS nonsense
4. Not able to send away non-emergent patients. (do you have a nurse at the front desk screening out the minor crap so you don't have to see it?)
5. RVU-based system requiring you to see an unsafe amount of patients

I'd like to hear your thoughts, because those things are commonly discussed.

So, at our shop, in order, we have:
1) Door to Doc time pressure of a sort - we are trying to get down our left without being seen rate, but generally a 2 hour wait for non-emergent complaints is considered reasonable and there is an acceptance that it can be much longer. We try to see our true emergencies right away. Everything else can sit for a little while if necessary. So no, no true pressure.
2) Patient satisfaction - they can always try the frivolous college complaints (generally dismissed) or badmouth you around town (generally not listened to by anyone serious) or hospital complaint (usually dealt with in minutes by chief saying "So I have to talk to you about this - consider it done). No surveys. Really no problem as long as you try to be moderately polite and responsive to their complaint.
3) Oodles of BS and people without PCP's. We're an underserved area with an elderly population with a high level of comorbid conditions. Ireland has BS too. Everywhere in the Western world gets silly people with BS complaints. Sorry, that's just the way it is.
4) Sadly, we're not allowed to send anyone away without being seen by a doctor. The nurses will sit them out in the waiting room for a therapeutic wait though, and the more non-acute and obnoxious they are, the longer the wait. Sometimes they leave, which is tragic! Sometimes they see the doctor for 5 minutes, sometimes less. Depends on the complaint. We always try to be polite,even with the drug seekers.
5) At all the shops in our area we are paid by the hour. At the tertiary centre we also have a bonus fund which is paid out once it gets to a set amount, and this is split according to our shadow billing (at the end of each shift we submit the back sheet of the quadruplicate chart with the diagnosis and any procedures scribbled on it and someone shadow bills for us, to prove that we actually do work on our shifts). It's a nice little bit of extra money that usually goes on my mortgage or helps pay for roofing shingles or something for the money pit.
We have a pretty sweet deal really. We rarely get sued and when we do we are vigorously defended. The college is slow but generally reasonable. We do have a problem with overcrowding, and occasionally someone arbitrarily decides something is too expensive for us to have anymore (skin glue at one point) but we are pretty resourceful and finding what we need through other routes (i.e.stealing from the OR - with the help of the OR nurses and security!).
Cheers,
M

 

[tkim]

Canada also has the only EM Waiting Room Fellowship:

http://www.cjem-online.ca/v9/n1/p71