Actually I agree to what you're reporting about the Australian post-grad training bottlenecks.
I would post the same anecdotal observations (or 'experience').
I mean..hmm.
I wrote a few drafts then discarded them.
having felt that medanon falls under the bracket (that you've observed) - of 'has made up their mind to go to Australia for school', and *potentially only wants to see the positives. Nothing else said will change that. But more than that, I don't think they're wanting to hear more at this particular point or they're still trying to wrap their head around what's already been divulged to them.
But if the cat's out of the bag.
I will say that in my cohort at least, the Canadians were all pretty self-aware of whether or not we had a competitive application for CaRMS.
Nowadays, most current medical students are 'self-aware' by the time they get to 3rd or 4th year, that applies to both people applying to the US or Canadian match. As in, the processes are very involved, requiring advanced planning. Premeds and pre-clinical years won't get a real sense of it until they get through a couple of milestones. Regardless, it's hard to maintain a level of commitment to studies outside of medical school once med school starts. It's hard to predict how that will all unfold until you get closer to the end. I've seen both success and disappointments to that effect. And everything in between.
I have (or had) friends/classmates in #2 as well.
It's not many...but they're a) unemployed (but at home), b) employed - but not at home (i.e. working in Australia and trying again to match at home, or Singapore - yes Singapore despite not being Singaporean), c) working in a field they did not want (i.e. they wanted med, they now have psych, it's the only one that would take them or rural FM). It's so easy to say it's a rare occurrence (which it is - making it to point of applying and not have it work out), but it was very devastating for a few. I take it for granted, but not everyone wants to just get a job anywhere, it has to be home after 4 years because they have a spouse unable to move or sick parent etc. Others just carried on, and it wasn't such a huge deal. It doesn't have to be, if you don't want it to be.
# 3 internship - actually the CMIs have always been 'undersubscribed', with the exception of one year, since their creation. they're very stringent about eligibility, which partly accounts for it. whether that will continue - no idea. things fluctuate a lot in this country. I've discussed in other threads, not really going to rehash too much unless it's specifically asked again. Will you get an internship? if you're a final year med student probably, even 3rd year that's asking, beyond that I'm never confident of speculating. when I started med school there was no CMI, because there was no need for any - there were enough state internships for the numbers of 'serious' applicants. And now we have up to 80-100 'extra' interns each year that are purely international students. I've no idea how long this will last, because overall student class sizes are still increasing based on MDANZ numbers, they haven't been static. There's still students who currently leave for home after, which is another variable. similarly, this year's batch of new med students had to adjust themselves to new VISA changes that will affect them on grad - hopefully this may cause more to concentrate on going off-shore (to offset the increase in class sizes), but I don't know.
there's been some criticisms levelled against CMIs as well, as it's purely private or rural hospital based, but that's for another day/another thread/time. it's another subjective topic. Regardless, it's an internship. it gets you registration.
# 4 - bottlenecks.
a) peds - yep, have friends/coworkers who have given up on peds and are now GP registrars with upskilling in peds. they gave up applying to peds after PGY3 or 4. in every state there's only 1-2 hospitals that train peds trainees, so it's tough getting a foot into those doors.
c) (anecdotal) - hard to get a FACEM (ED attending) position at a tertiary site or one that offers trauma.
depending on state - hard to get a job that isn't rural or private. So, it's less appealing if you really wanted trauma. Requires flexibility. but yes, generally easier to get onto the training program if you do their entrance exams, gain enough points, have completed PGY2. There's bucketloads of UK ED registrars.
d) would be lucky to even get on for PGY 5 or PGY 6. provided you meet their points system.
e) a lot of young med subspecialty consultants will have to work as rural gen med physicians, that happen to be certified in doing scopes or doing echocardiograms & MIBIs. already know more than a few in this category. Anecdotal to be sure, but that's where some will end up, others, end up in private practice or do crazy amounts of research and fellowships overseas..and what have you in order to work at a tertiary site.
exception (I think) is geri, geri is like the one growing field.
BPT spots fluctuate every year, it really depends on how popular it is within a class or year group. *Interest tends to drop after BPT1 too, to no surprise. Some will realize it's not for them and get out while they can. or they get disillusioned by what's potentially waiting for them - they realize it's ridiculously hard to be an interventional cardiologist (you have to pass those ridiculously hard BPT exams, get onto cardio AT and then if lucky, get cardio fellowships) and they definitely don't want to end up in gen med if all that fails (as a fake example). because that's exactly what awaits if plan A fails. it's really hard to start over in another subspec.
Rural med is the only thing that isn't competitive.
Because we actually desperately need more rural practitioners.
we (as in, in general as thread) hadn't touched on it earlier, but for the more competitive fields, you have to do research now to even get have a shot at them.
which means having access to sites that offer rotations in those fields, and consultants capable of supervising. they usually need you to be connected to their home hospital, because almost always, they need someone with immediate access to patient data.
It's not unusual now to hear about people doing research masters or PhDs to get into ATs (or just be consultants at a competitive hospital site).
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I've nothing against anecdotal things, I do the same, so long as it's been made clear (for the sake of premeds) and is within context or has substance.
statements that aren't like..oh deakin's dodgy because it's world ranking is non-existent. every school has it's special focus, if it's a rural school it's about practical skills and pumping out rural generalists for Australia. it won't have as much research so the rankings are not going to be high.
. I guess it'll lucky if ATs end up as consultants in the subspecialties they trained in.