Happy November! 🍂 Also — happy last week of pretending it’s an hour earlier! 😎

Hate daylight saving time as much as we do? (Probably not, if you’re in YT, or SK, or somewhere else with permanent DST 🤷🏾.) As the song goes: Blame… us 🇨🇦. Or, rather, Thunder Bay — formerly Port Arthur & Fort William — the first municipality in the world to implement daylight saving. And now we can’t get rid of it, even though Ontario voted for permanent DST in 2020, and the US Senate last year. Oh — also in the ‘70s. Here’s to that extra hour of sun in the morning? 🥴 🤔 🥱

Time for some stories!

• FM Residencies Go Under the Knife 🔪

• Taking the Pulse 🫀

• “Black licorice is to die for!” (said no one ever) 🙊 

• 🌱 Land you might want, peppers you might not. 🥵

• Our 🆕 Postcall med-themed crossword puzzle! ⛳️

Driving these numbers: Bitcoin is still rising on expectations of a Bitcoin ETF approval, but markets are in waiting mode. There are two events happening this week:

1. AAPL’s earnings report is coming out this week. This comes on the tail of their M3 chip announcement last week.

2. The Federal Reserve will be announcing their own interest rate changes this week, with experts expecting a pause in US rate hikes.

FM Residencies Go Under the Knife 🔪

What happened: The College of Family Physicians (CFPC) wants to add an extra year to family medicine residency programs, with the first 3-year program set for 2027. This change aims to address evolving healthcare challenges, including an aging population, complex social issues, addiction and mental health concerns, and a shortage of admin support for doctors.

Dr. Nancy Fowler, family physician (FP) and executive director at CFPC, consulted seasoned FPs & med schools and surveyed the international healthcare scene. CFPC’s verdict? 2 years are insufficient for teaching core skills and subjects. 

Fowler stresses this extension isn’t a criticism of current training but a response to changing healthcare demands. CFPC’s plan includes:

1. Expanding training to prepare FPs for service across Canada, from big cities to rural areas.

2. Enhancing skills in virtual care, AI, interdisciplinary teamwork, and equipping FPs to set up practices.

Why it’s interesting: Extending FM residencies stirs controversy. Dr. Nicholas Pimlott, a professor at University of Toronto, believes 3 years is just what the doctor ordered. He feels his 2-year program in 2000 failed to fully prepare him for comprehensive generalist practise, leading to a steep learning curve through on-the-job experience.

As for Dr. Zeke Blumenkrans, that extra year doesn’t add up — especially when an estimated 6.5 million Canadians lack a regular FP. With COVID-19’s toll, many burnt-out FPs are eyeing retirement. Blumenkrans believes options to add specialized skills and continuing ed already exist — and that no length of residency can ever fully prepare FPs. Dr. Paul Dhillon adds, “At the end of the day, I’ve never had anyone say, ‘my doctor hasn’t had enough education or hasn’t spent enough time in school before they start treating me’” 🩺. 

As the CFPC delves into cost modelling and feasibility, Fowler hopes for finalized provincial commitments by March 2024. The goal: to ensure fair pay and reduce admin burdens for FPs while pursuing "slow, gradual, and incremental change” to avoid disruptions. 

Yash Verma, a first-year med student from the class of 2027, will be among the first affected by this change. His class's consensus: "If the third year were to happen, they would not become family doctors."

RDoc and CFMS (who weren’t invited to Fowler’s consultation 😬) worry the extra year may deter aspiring FPs — since early surveys indicate nearly half of med students would reconsider. OMA has called for a timeout, stating the focus now shouldn’t be extra training but addressing the FM crisis. 

Bottom line: So… the jury’s still out. There are other solutions, too, like SFU’s upcoming medical school with a dedicated FM program (which we covered last month).

What do Postcallers think? Keep on scrolling… 👇

Taking the Pulse 🫀

Want to share your thoughts on CFPC’s proposed 3-year residency program? 🤔 Have a personal experience to share? Email us at [email protected] and we'll include your anonymized comments in the next issue!

Here’s how you, Beloved Readers, responded to last week’s poll:

What patients might say this week 🙊 

1. “What’s the best valve replacement surgery, doc?”

Transcatheter aortic-valve replacement (TAVR) or TAVI is a minimally invasive procedure for heart valve replacement. A new study from NEJM has shown that there is no difference in outcomes between TAVR vs. surgery in low-risk patients with severe, symptomatic aortic stenosis. For patients who may not be candidates for a big operation, TAVI represents a game-changer. 

2. “Speaking of valves, how’s that pig heart doing?”

For over a month, the pig heart transplant showed no sign of rejection. Unfortunately, yesterday, the second person to receive a genetically modified pig heart has died. The donor pig heart underwent 10 gene edits in an experimental procedure to optimize it for human use. Cardiac xenotransplant chief Dr. Muhammad Mohiuddin said the team will analyze what happened with the heart as they continue studying pig organs.

3. “Death by black licorice?”

Back in 2017, the FDA issued a now deleted warning about black licorice. In a 2022 statement from the American Health Association, eating too much can deplete your body of potassium. One case report from NEJM even describes a man passing away from cardiac arrest… from eating too much black licorice. But chances are, you’ll be fine if you eat it in moderation.

🍔 Quick Bites

1: 👩‍⚖️ A Federal Court judge has approved landmark $23 billion settlement to compensate First Nations children and families for Ottawa’s racial discrimination and chronic underfunding. The result of a 16-year legal battle, this covers approximately 300,000 First Nations children, youth, and families. As part of the agreement, Prime Minister Justin Trudeau is being asked to issue a formal apology.

2: 🏦 After 10 back-to-back rate hikes, the Bank of Canada has finally opted to hold its benchmark interest rate steady at 5%. While it’s good news for variable-rate mortgage holders, it can take as long as 18 months for the impact of rate moves to be fully felt, so it may be some time before we make headway on recent runaway inflation.

3: 💊 A new Internal Medicine Residency Program is launching at Surrey Memorial Hospital in July 2024. The partnership between Fraser Health and UBC will start with an intake of 5 residents.

4: 📈 Bitcoin’s price is surging again to ~$47.8k CAD (35k USD) — a value not seen since May 2022. The mood around crypto is optimistic, and investors believe the SEC will approve a bitcoin spot ETF in the next few months. 🤷‍♀️

5: 🚘 Think a vehicle safety inspection means your vehicle is, like, safe? 🥴 Despite getting the green light from Canadian Tire, a Winnipeg resident’s SUV broke down 20 minutes after she paid for it. If we can’t trust provincial safety inspections, what can we do? Unfortunately, exclusively buying from dealerships may be the answer. 🤷🏻‍♂️

6: 👾 A new artificial intelligence software boasts a 100% detection rate for melanoma. (Also — 99.5% of all skin cancers and 92.5% of pre-cancerous lesions.) In the study, the high-accuracy of the new AI model meant less face-to-face consultations — and more time for patients that need urgent attention.

Postcall Picks ✅ 

💵 Buy: land for $10? The Town of Cochrane, in a bid to build more housing and attract families and skilled workers, has cleared the selling of land for as low as $10. And if you’re curious - we’ve saved you a click; here’s the Google Maps for Cochrane, ON.

🌶️ Eat: or not! 🔥 Pepper X, a new variety, has shattered the record previously held by the Carolina Reaper as the world’s hottest chilli pepper. Coming in at a scorching 2.69M Scoville heat units, its three times hotter than the previous record. And in case you’re curious, Scoville is chemically linear, but perception is logarithmic. 🪵 

📺 Watch: this montage of Chandler Bing 😢, played by the late actor Matthew Perry on Friends for 10 seasons. A master of comic timing, Perry was recently remembered by Canadian PM and high school classmate Justin Trudeau. Could we be any more sad? 🥺

Match Day! 🎉🎊

And finally…. 🥁 today is Match Day 🎉 🎊 for medicine subspecialities! Good luck to everyone who is involved, and may the odds be ever in your favour!

🕹️ Game ⛳️

Our med-themed crossword puzzle guarantee: fun or your money back! 🤑

Last week’s fastest time: 1:51

This week’s first question: What is inflammation of the gallbladder?

If you had fun playing our puzzle (and we know you did), please share! (Our crosswords are small batch, handcrafted, and made with love 🥰!)

Job Opportunities 💼 

Role: General Surgeon

• Where: Victoria Hospital (Prince Albert, SK)

• Salary: $452,449

• Learn more

Role: Cardiac Intensivist

• Where: Hospital for Sick Children (Toronto, ON)

• Salary: $266,000 to $380,000

• Learn more

Role: Family Physician

• Where: Nelson’s Place Medical Clinic (Halifax, NS)

• Salary: $250,000 to $300,000

• Learn more

Role: Physician Assistant 

• Where: Rockyview Medical Clinic (Calgary, AB)

• Salary: 48.27 hourly (32 hours per week)

• Learn more

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