Colleagues - During your exposure, you may work with clinical clerks, residents, fellows, and attending physicians. Clerks are senior medical students in their third or fourth year of medical studies. Residents have graduated from medical school, and are undergoing training in their chosen specialization in order to become licensed to practice. Residents in their first year of postgraduate training were formerly called interns. After completing residency, physicians can choose to pursue further specialization in a fellowship program. Attendings are physicians who have completed their postgraduate training (residency +/- fellowship) and are hired on as staff.
Working Conditions - The typical workday is 6-12 hours long, Monday to Friday. Exchange students are expected to be present for the entire 4 weeks. Some departments, such as Emergency Medicine, may require students to do shift work (night- and day-shifts) with sufficient time off to rest, or to be on-call overnight and/or on weekends with their team. Specific information relating to working conditions is usually sent directly to students by the respective departments or university's visiting electives office prior to arrival. Students are mandated to familiarize themselves with the material provided by departments and university administration, and to comply with any additional instructions prior to their arrival.
The extent of what you do will be dependant on the preceptor's confidence in you and your own ability to articulate your own skills and interests (ie. make sure to make it clear that you want to be challenged and that you have the training to do a good job!) You should be sure to tell the preceptors you want to do overnight call if that is an option, while it is tiring it can be a fantastic learning experience and way to distinguish yourself as a motivated student.
Health care in Canada is delivered through a publicly-funded health care system under the provisions of the Canadian Health Act (CHA). Medicare policies for each province differ slightly. Each province is in control of their own health care system, with the government providing the majority of the funding, provided that the provinces follow the guidelines outlined in the CHA. Some services are not covered or not completely covered by Medicare, such as most dentistry services and some medications.
The key features of the CHA include:
1. '''PUBLIC ADMINISTRATION''' - Health insurance plans must be "administered and operated on a non-profit basis by a public authority, responsible to the provincial/territorial governments and subject to audits of their accounts and financial transactions." (Section 8).
2. '''COMPREHENSIVENESS''' - Health care insurance plans must cover "all insured health services provided by hospitals, medical practitioners, or dentists" (Section 9).
3. '''UNIVERSALITY''' - All insured persons must be covered for insured health services "provided for by the plan on uniform terms and conditions" (Section 10).
4. '''PORTABILITY''' - Because plans are organized on a provincial basis, provisions are required for covering individuals who are in another province. The conditions attempt to separate temporary from more permanent absences by using three months as the maximum cut-off. As the above-mentioned summary clarifies, "residents moving from one province or territory to another must continue to be covered for insured health care services by the "home" province during any minimum waiting period, not to exceed three months, imposed by the new province of residence. After the waiting period, the new province or territory of residence assumes health care coverage."
5. '''ACCESSIBILITY''' - The insurance plan must provide for "reasonable access" to insured services by insured persons "on uniform terms and conditions, unprecluded, unimpeded, either directly or indirectly, by charges (user charges or extra-billing) or other means (age, health status or financial circumstances)" (Section 12.a). This section also provides for "reasonable compensation for [...] services rendered by medical practitioners or dentists" and payments to hospitals that cover the cost of the health services provided. Note that neither reasonable access nor reasonable compensation are defined by the CHA, although there is a presupposition that certain processes (e.g. negotiations between the provincial governments and organizations representing the providers) satisfy the condition. The CHA allows for dollar-for-dollar withholding of contributions from any provinces allowing user charges or extra-billing to insured persons for insured services.
There are 17 medical schools across Canada, 14 of which are considered English-speaking institutions represented by the CFMS, and 3 of which are Francophone, represented by the FMEQ/IFMSA-Québec. Entrance requirements for each school differ slightly, but all schools require a minimum of 3 equivalent years of undergraduate study with prerequisites in English and the life sciences. Selection of students for medical school is rigorous and generally depends on their performance in the pre-admission interview, undergraduate grades, and their score on the North American standardized exam, the Medical College Admissions Test (MCAT). The average entrance age to medical school is between 22 - 24 years old.
The majority of our medical education programs are 4 years long (with summer breaks between years 1 and 2, and 2 and 3), except for the programs offered by University of Calgary and McMaster University that are 3 years in length (without summer vacation).
After we graduate from medical school, we receive our medical doctoral degree (MD), but are not licensed to practice until we complete postgraduate training in the form of a residency, which, depending on the specialty, will take between 2 (general practitioner/family doctor) to 5 (specialists) years. In all residency programs, there are options to further specialize, which can take 1-3 additional years.
Local transportation options depend on the host city. The following is the most up-to-date alphabetical list of transit websites:
Calgary, AB - http://www.calgarytransit.com/
Edmonton, AB - http://www.edmonton.ca/transportation/edmonton-transit-system-ets.aspx
Halifax, NS - http://www.halifax.ca/metrotransit/
Hamilton, ON - http://www.hamilton.ca/CityServices/transit/
Kingston, ON - http://www.cityofkingston.ca/residents/transit
London, ON - http://www.ltconline.ca/
Ottawa, ON - http://www.octranspo1.com/
Saskatoon, SK - http://www.saskatoon.ca/DEPARTMENTS/Utility%20Services/Saskatoon%20Transit/Pages/default.aspx
St. John's, NL - http://www.metrobustransit.ca/
Toronto, ON - http://www.ttc.ca/
Vancouver, BC - http://www.translink.ca/
Winnipeg, MB - http://winnipegtransit.com/en
In terms of national transportation, students can cross Canada by either bus (e.g. Greyhound, MegaBus), train (e.g. Via Rail), car rental (multiple options), or plane (major airlines include Air Canada, Porter Airlines, and WestJet) depending on personal references and financial considerations. Keep in mind that Canada is an enormous country comparable in size to the continent of Europe so ground transportation is a pretty slow way to get around within the country.