Friday, December 25, 2009

What they don't tell you before med school: Choosing where you work

Each year medical schools in Canada are flooded with more and more hopeful applications from students who are praying for the chance to wear a white coat and introduce themselves as "Doctor". These students have put forward superhuman efforts to achieve: they have great grades and solid MCAT scores; they have resumes polished with extracurricular activities showing their leadership, determination, and compassion; and they have spent hours on end crafting essays describing exactly why they want to enter the field of medicine. The competition is so steep in Canada that thousands of students are rejected time and time again, causing many to go off to international schools in the Caribbean, Australia, and Ireland.

Unfortunately there are many negatives to being a doctor that you just don't hear about when you are applying to medical school. One major drawback is the limitations placed on where you can live when you finally graduate. Medicine is touted as a very stable profession in Canada, one that is "recession proof". This stability is due in part to the major physician shortage we have in Canada. However, this shortage is not ubiquitous in location or profession.

If you want to be a family doctor, you're set, you can basically work in any city and you will be able to find patients and establish a practice. However, if you are a heart surgeon, you may complete your residency without a job available. Imagine that, finishing 4 years of med school and 6 years of residency without a job to show for your efforts. The lack of employment is simply because there are only so many facilities that can offer cardiac surgery and there are more graduates than there are retiring surgeons whose spots need to be filled.

Even if you are interested in a specialty that does provide employment opportunities for its graduates, you may still have little say in where you are employed. For instance, I was talking to an ENT surgical resident who was complaining that he will definitely not find work in Vancouver when he graduates because everyone wants to work here; thus, only the most experienced and capable surgeons are hired (good news if you have an ENT problem in Vancouver).

Some may argue that this problem is not unique to medicine because many occupations force people to relocate to where work is available. However, this is especially unfortunate in medicine because many people go into med school without being aware of this reality. Going tens of thousands of dollars into debt, slaving through med school and then residency, to realize that you have to move far away from your family and friends to find work can be a rough fact to deal try to deal with it before you apply to med school. Either that or be comfortable entering a specialty with more flexible options...