VLOG My Plan To Be SUCCESSFUL As A New Family Doctor... (And Not Go Bankrupt)

[@nxtgenmd]

Hey everyone, I hope you enjoyed the video / found it helpful :) If you did, feel free to hit the like button and definitely feel free to ask any questions in the comments below. For those of you looking for an itemized list of things to do in residency before graduating to set yourself up for success, here you go: 1. Contract negotiations: Remember that the Canadian national overhead is 27% for family medicine. It is your job to keep your overhead as close to (or even below) this number as possible. If you're going to be signing with a clinic that's quoted you at 40% overhead, then personally, I would probably shop around a bit more first and/or consider moving to a less expensive area. Remember that you can stay firm but cordial during negotiations - especially if you are friends with the other partners. But you need to advocate for yourself. Look up rent/real estate values and ask other doctors about office supplies, employee salaries and overhead for your area 2. Learn how to be a better biller! I will be bringing a professional billing agent onto the channel in a few weeks to share their tips for new staff. Take advantage of time based billing codes where appropriate and don't downplay the value of applicable "out of basket" codes. For areas of billing uncertainty, consult the schedule of benefits and/or ask a billing manager. Remember that the government will NOT chase you if you miss out on your billing... but they will reject your codes if you don't bill properly. So this will take months for you to streamline. 3. Review your contracts and overhead costs with your lawyers and accountants. We get free accountant support during residency through our school, but I don't know if this applies to other programs - be sure to check with your co-residents 4. Try to sign somewhere with a signing bonus. Having an extra $50,000 on hand will be necessary to help with initial start up fees and your college dues which will be very expensive. Good luck and see you next week!

[@NeValaiDuraka]

Man, I just want to say a huge thank you for all the videos you've made, I'm so inspired by your story!!🙏

[@nxtgenmd]

I'm really glad to hear that the videos have been helpful. All the best with your own studies! :)

[@azkairfan5738]

Great content! Could you pls do a video of what clinical skills you have learnt during your FM residency & which skills you consider an independent family practitioner cannot survive without in Canada? It’ll be very helpful for internationally trained physicians hoping to work in Canada. Training programs in different countries may focus on different areas depending on the population needs. It’ll be great to have a comparison and to prepare in advance for those who are looking to immigrate and take the PRA path to practising FM in Canada. I love how you simplify relatively complex topics, would love your take on this! :)

[@nxtgenmd]

Glad the videos have been helpful :) I will definitely talk about this within some of the VLOG content that I'll be putting out in my first year of independent practice. Thank you

[@ovimed]

I'm from Quebec and I'm currently in my 4th year of med school in Ireland and as an IMG I can't even come back home for residency unless I wait 1-2 years, which ofc is not possible due to huge interest on student loans and other factors (same thing for Alberta). In addition to this, they have between 50-100 unfilled residency spots every single year in FM. I actually want to do rural FM and this is really mind boggling to me the amount of barriers and hoops we have to jump through. Most of my classmates don't even want to bother with Canada and just go to the USA where they are welcome with open arms, no return of service, and are given generous loan forgiveness programs... They need to make it easier for Canadians studying abroad to come back in the future, especially those from Ireland/UK/Australia where even the CFPC recognizes fully the residencies and board certifications! They are loosing thousands of talented doctors to other countries. There's more demand of Drs than there is supply so naturally they will go wherever they have the best conditions.

[@nxtgenmd]

I'm always looking for more data on this to hopefully do a video on it in the future :) Feel free to reply if you'd like. I personally know many Ireland based IMGs and IMGs from other countries that did successfully match into family medicine in Canada this last cycle. What barriers do you feel have been limiting you from returning? In speaking with a few of my IMG colleges, it seems like usually the LMCC test score / NAC OSCE is one of the biggest hurdles that IMGs need to do well on to secure a spot. One misconception that many students have is that all unfilled spots must be filled by programs - but the truth is, they would rather keep these spots open then fill them with candidates that they did not rank. As a 4th year student, why would you need to wait 1-2 years to return?

[@ovimed]

@@nxtgenmd I will be making a video on this once I match next year, rather not say anything yet. You need to wait for AB and QC because unlike the rest of North America they want you to have your diploma equivalence before being able to apply to the match which results in at least 1 year wait, then QC has its own delays and burocracy.

[@AbdulAli-ku9he]

Thanks for the useful info. and all the best!

[@nxtgenmd]

Same to you and thanks!

[@СнежанаОсипенко-е9и]

You inspire! Thank you so much! 😊

[@nxtgenmd]

You are welcome :) Good luck!

[@joannaigo5635]

Thank you so much for this! I enjoy seeing the transition from residency through your lens. More videos please! Do you have any resources on billing?

[@nxtgenmd]

Thank you :) There will definitely be more videos once I get a better handle of the current work schedule. I have many resources on billing and will be bringing a billing expert onto the channel to discuss their best tips with students and new doctors. If there's anything that you'd like to know specifically, let me know

[@chuksezeike3183]

Thanks a lot for this video. What happens when the clinic receives excess money from the doctors? Take for instance a clinic with 6 doctors paying 25% overhead, the clinic will certainly have some change after paying the overhead. What happens to the extra money?

[@nxtgenmd]

Glad it helped 🤙 not necessarily unfortunately - at a certain point, you cannot get the costs to go any lower and each new doctor coming in will start to become more and more expensive to the office. This is because as you see more people, the cost of your overhead will need to increase (example: I will need more syringes, lidocaine, etc. with a large roster than a doctor who will only have a roster of 800 patients). In a true partnership, your overhead reflects the true costs and there is no additional money left over to give to anyone. On the other hand though, there are instances where a more senior doctor will charge you a percentage of your billings just to work at their office in addition to the cost of overhead. In that case, they keep this money for themselves and are making money off of you.

[@Manuel78]

How was your step 3 usmle ? Would you like to do another specialization in USA next match season ?

[@nxtgenmd]

The exams are this week - I feel pretty good but I should have the VLOG up next week when they're done 🤙 Not at all. I only applied to family medicine and am not looking to transfer out. My reasons for wanting to have all the steps done are to keep in my back pocket in case I ever need to relocate for family reasons

[@Manuel78]

@nxtgenmd thanks. I currently studying for step 3 and waiting the match next week. Good luck bro.

[@nxtgenmd]

@@Manuel78 Best of luck with it too bro and thank you

[@nadeenm]

Congrats on completing your residency. Will you be setting up in the Niagara Region? My husband, daughter and I are looking for a family doctor.

[@nxtgenmd]

Thank you very much :) yes, my office is in Welland - 5 Plymouth Rd by the hospital. Feel free to come by and grab an application if you would like. All the best!

[@nadeenm]

@@nxtgenmd Fantastic! Just filled them out today 😁😎

[@HINTS190]

Hey, love your videos as always. I was curious about two things. (1) Whats your motivation to do the USMLEs as it seems youre setting up practice in Ontario? (2) Other than the USMLE, whats required to practice in the states from our 2-year vs their 3-year program

[@nxtgenmd]

Hey, glad to hear it 🤙 1) I want to have them in case I ever need them in the future and I would hate to subject myself to this level of studying in my 40s. There are no negatives to having the 3 steps completed regardless of your specialty and I actively encourage any students who have any interest in them at all to get them done. Also, I believe that they have actually made me a better clinician and have really pointed out a few holes in the curriculum that I think are seen with the Canadian medical education - with step 3 specifically, a lot of this stuff is directly applicable to me since I am training to be a generalist. 2) For the purposes of working in the US, you are better off looking at licensing on a state by state basis for your specialty. Many states do not even require Canadian doctors to have the step exams - however it is very possible that this changes in the next 5 years according to some rumors. Some states will have specialty specific transfer exams that you will need to write as well in addition to a few other requirements Hope this helps

[@jeanetteraichel8299]

Too bad that the provinces don't cover overhead expenses. They could give tax credits for your equipment abd supplies and a percentage of the rent/mortgage. It would mean more would follow in and take family medicine because the province will help. All the no match for other specialties should be OK with family medicine because it what they went to school for to practice medicine

[@nxtgenmd]

I'd love for more incentives to be directed towards family medicine - both in big cities where rent is prohibitively expensive and in rural communities where we really need more people to work. On the other hand, as a family doctor, I don't want people to end up "stuck in family medicine." If you don't want to be here, I don't think it benefits the patients or the profession to force medical students into the specialty. I'd rather we show people how great the job can/should be and have the right people find their way there :) Just my 2 cents

[@messimagisterial4216]

Hey Gianluca I haven't studied for the mcat yet but how do u think it compares to the step exams?

[@nxtgenmd]

I will definitely do a video in a few weeks ranking each of the different "medical journey exams" in terms of difficulty :) In my opinion, the MCAT is the easiest from a content perspective by a large margin - although it may also be one of the most stressful because it goes a long way towards determining whether or not you get into medical school. Good luck with studying

[@gourabsarker9552]

Sir when will you graduate from residency program? Plz reply. Thanks a lot.

[@nxtgenmd]

4 months

[@mairajamal4953]

Hello sir, can you please guide as an IMG from Pakistan do we even stand a chance to get into FM residency in canada after taking exams ... If possible can you please make a detail videos ... I havent seen many img graduates coming to canada as for USA

[@Zacs1993]

Do you work with UK trained FM Drs? Im a newly qualified GP working in the UK looking to move to Canada

[@nxtgenmd]

Yes I do 🤙 the 2 that I know went to medical school in the UK and completed a Canadian residency

[@Zacs1993]

@@nxtgenmd awesome! 👌 are there major practice differences?

[@nxtgenmd]

@@Zacs1993 yes, from what I've been told the Canadian system does seem "foreign" to doctors who have trained elsewhere - unfortunately I wouldn't be able to highlight specific differences as I've only ever worked in Canada

[@gourabsarker9552]

Sir how much do you expect to earn as an attending family physician after residency program? Plz reply. Thanks a lot.

[@nxtgenmd]

please see this video to better understand family medicine salary: kzbin.info/www/bejne/jqrOYouvqdONr6c all the best

[@messimagisterial4216]

I want to be a Canadian family medical doctor Inshallah.