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VOLUME 10, NO 1 January 2013

A word from the president

I would like to take this moment to wish you all a happy new year.

individual members.

The article written by Christopher Lemieux, Delegate of Services and Partnerships, will detail all of the services offered by the FMEQ.

We are glad to present the Fédération médicale étudiante du Québec (FMEQ) information letter: info-FMEQ. This publication contains articles that are of a concern to all medical students. Furthermore, here is an introduction to the federation that represents YOU.

In this first edition of info-FMEQ, let us demystify the terms PEM/PREM and AMP, which will have an impact on your choices of residence programs and future practice.

Moreover, there will be an exposé on admissions to medical school and our position on the subject.

Founded in 1974, the FMEQ represents all of the medical students of Quebec, which means over 3700 members (a third of all the medical students of Canada). The primary mission of the FMEQ is to unite and defend the collective interests of the students from all four faculties of medicine of Quebec in the areas of education, politics and society.

The other mission that the FMEQ holds is to develop the means for communication and collaboration between the medical student associations and their members. Lastly, the FMEQ offers a multitude of services to all of its associated and

If you have any questions or comments, feel free to write to us because we are here for you.

Dear fellow students,

Valérie Martel President FMEQ president@fmeq.ca

Best of luck,

VOLUME 10, NO 1 January 2013

You perhaps had the chance to see the faces of our new executive and administrative councils while flipping through the free FMEQ agenda. Below is a presentation of the FMEQ officers and administrators of 2012-2013, elected last spring.

C.E.

Valérie Martel, President Laurence Bernard, Vice-presidente Florence Grégoire-Briard, General secretary Jean-Philippe Blais, Delegate of political affairs Christopher Lemieux, Delegate of services and partnerships Claudel P-Desrosiers, Delegate of international affairs Anne-Catherine Rochette, Delegate of internal affairs Madeleine Plaisance, Delegate of educational affairs Jean-Simon Roch-Matte, Delegate of finance

C.A.

Marie-Pier Arsenault Maxime Lévesque François Rouleau-Fournier Sébastien Gagnon Benoît Bhérer-Simard

VOLUME 10, NO 1 January 2013

Editorial Are

we Admitting too Many

Students into Medical School?

At first glance, this question can be surprising.

Although the media is continuously highlighting the fact that there is a shortage of physicians in Quebec, the reality of the matter may change in the next few years.

Based on government statistics, in 2006 there were 798 admissions into Quebec medical schools. Since that time, the number of admissions has risen to 880 and should remain stable for years to follow.

The first problem that comes to mind with this increase in admissions is the repercussions on the quality of teaching to medical students.

One possible problematic area would occur during clinical exposure, since there will be more students for the same number of cases. The reality is that there is no real way to measure this outcome and therefore makes the situation hard to predict.

Nevertheless, there must be an assurance that medical training in Quebec remains the best possible.

Physicians Unemployed?

that

are

In the last few years, something troubling in the field of medicine has arisen: after finishing medical school education, physicians are having a hard time finding employment. Many specialties in medicine are training more physicians than Quebec can employ.

As a result, young professional physicians will need to contend with each other to have the right to treat their fellow Quebec citizens.

Furthermore, throughout

many residency programs, there is a decrease in the number of seats available for medical students. Even family medicine, a field that has become increasingly popular, will become problematic in the few years to come. A few months ago, the exMinister of Health, Dr Yves Bolduc had concluded that if the number of physicians continues to rise, there would be enough family physicians by 2016 to meet the population s demands. With the actual number of medical students today, and those of the future, there is a worry that the shortage of doctors yesterday will transform into the excess of doctors tomorrow.

The Government Avoiding the Situation According to a report by the 2011 Ministry of Health and Social Services, it would take 770 graduates from medical school to maintain the services already offered here in Quebec. Right now, there are 880 medical students being trained each year.

Furthermore, the situation in which the residents are not able to find employment in Quebec is troubling.

What is surprising is that the Minister of Health and Social services in Quebec is the person who decides each year on the number of admissions into medical schools, the number of seats in the residency programs and the number of employment opportunities for physicians in Quebec(PEM/PREM, please see the article written by Florence GrĂŠgoire-Briard). Therefore, there is an inconsistency in the decisions being made by the Minister for the number of medical students

and the number of opportunities awaiting them when they graduate.

Today, there is already evidence that there is a problem beginning to occur: less spots in certain specialty programs, less employment opportunities for physicians of certain specialties like cardiac surgery, orthopedics or radio-oncology, and the need for physicians to leave the province to find employment. There is no doubt that if this problem continues to persist, future medical students will be in a worse situation.

The FMEQ Position Last spring, the FMEQ with a majority vote from its associative members, took a position to decrease the number of medical school admissions in Quebec to meet the health needs of the Quebec population. It should not be mistaken as a radical cut in the number of admissions but a methodical decrease that would be an advantage for future medical students; who would otherwise have a hard time to acquire an employment otherwise.

In addition, it would be a further advantage for the Quebec population to not have to pay for the education of medical students who will not be able to practice in Quebec.

Although this point of view may seem less popular in the public opinion and counter-intuitive, it would be in the best interest of the Quebec medical students and Quebec to truly look into decreasing the number of medical school admissions.

Jean-Philippe Blais Delegate of political affairs politique@fmeq.ca

VOLUME 10, NO 1 January 2013

Demystifying PREM and PEM !

What is a PREM? Every year, in Quebec, the Ministry of Health and Social Services determines a target number for the recruitment of doctors in every regional administrative areas (18 in total) of the province. This target represents the number of family physicians allowed per region. PREM stands for Plan régionaux d effectif médicaux , and it is mandatory to acquire one if a family physician wants to practice. The number of physicians recruited per region and per year thus represents the difference between the number of job available (number of PREM per region) and the number of jobs already taken by established physicians.

What is the difference between a PREM and a PEM? Although PREM represents the number of positions in a region, PEM, on the other hand, represents the number of doctors from every speciality that an establishment can recruit. The PEMs from all of the hospitals of a given region are added together to give the PREM reserved for the employment of specialists for that specific region and thus represent the overall number of jobs available. It is the number of PEM per establishment and per speciality that determines the number of positions available for specialist in a specific region.

How does the gover nment decide the number of PREM given for every region?

The number of PREM (and PEM) per region is reviewed by a committee whose purpose every year is to

manage the difference seen between the resources already available and the specific needs of that region. The committee also takes into consideration attrition of practicing physicians and the anticipate number of new doctors.

How are the PREM/PEM positions distributed?

Many rules and methods are applied to the attribution of PREM/PEM following criteria that depend on the type of practice, on the number of years of practice or on special circumstances.

Thankfully, all these criteria of attribution are easily accessible on the Website of the Ministry of Health and Social Services of Quebec.

How can we know the number of PREM available for each region?

Every year, the government allows accessibility to the public to a list of the number of PREM available per region and per field. To know this year s results and future predictions in the number of positions until 2015, visit: http://www.msss.gouv.qc.ca/sujets/ organisation/medecine/prem/ index.php? postes_disponibles_prem_specialiste

http://www.msss.gouv.qc.ca/sujets/ organisation/medecine/prem/ index.php? postes_disponibles_omnipratique

What is the reality of PREM/ PEM? In practice, although PREM/PEM have a lot of advantages, they still present some important flaws that are important to be discussed and should be addressed in future years by the government. In fact, one of the major flaws of this system is that it allows for an imbalance between the number of jobs available and the number of physicians graduating every year, the former being lower than the latter.

Furthermore, the management of PREM/PEM by hospitals is also problematic, as many hospitals decide to not fulfil every spot available in their programs to ensure full workloads to their already employed staff.

Finally, according to the actual system, many regions find themselves with a PREM/PEM that surpasses the maximal capacity of their installations and human resources. This phenomenon is mostly observed in the UMFs (unité de médecine familiale).

PREM/PEM are thus predictions, not always realistic, of the number of doctors desirable per region, but do not necessarily consider the region s realistic expectations and resources.

Florence Grégoire-Briard Secrétaire secretaire@fmeq.ca

VOLUME 10, NO 1 January 2013

What about the AMP ?

According section 360 of the act respecting health

If the emergency services in that region are complete,

services and social services, Specific Medical

activities that must be within a 40 km radius of the

Activities (AMPs) are mandatory for all family physicians of Quebec.

Every family doctor starting

their practice must get into contact with the regional department of general medicine (DRMG) to acquire a list of AMPs available in that region. Afterwards, the physician must select an AMP from that list and make a demand of adherence with the DRMG.

At

the beginning of a physician s family practice, they have two trimesters to make their demand to the DRMG and begin to offer the AMPs under the consequence of a 30% reduction in pay for all activities carried out in a private office.

The time

allocated for the AMPs performed by a physician depends on the numbers of years of practice. From 0 to 15 years of practice, the physician must allocate 12 hours a week towards these AMPs. The number of hours diminishes to 6 hours for physicians with 15-20 years of practice. Finally, for a physician with more than 20 years of practice,

the physician no

longer is obligated to perform these AMPs unless

the physician must choose one of the following physician s primary practice location and region:

2. Delivery of care to users admitted for short-term care;

3. Delivery of medical services involving on-call availability in a long-term care facility (CHSLD) or rehabilitation centre, or within the framework of a CLSC home maintenance program;

4. Delivery, in the obstetrics department of a centre operated by an establishment (CHSGS), of medical services in obstetrics; If the last four sectors presented above are well maintained and the DRMG has determined that the emergency services in a 75Km radius from the primary practice location are sufficient, the physician can perform the following:

5. Continuity of care with respect to vulnerable

there is still a need of these services in that area. In

clientele;

that case, AMPs are adjusted on the basis of the

6.

physician s ability to deliver this type of service and their type of practice. The number of hours outlined above is subject to change for physicians who work

Participation in any other priority activity determined by the agency and approved by the Minister to the extent and under the conditions determined by the latter.

part-time. Furthermore, there exist six categories of AMP:

1. A physician must deliver medical services in the emergency department of a local CLSC. This activity must be performed within a 75 km radius of the physician s primary practice location and must be in his region. The volume of activity that must be accomplished by the physician is 16 shifts of eight hours every trimester of the year.

Madeleine Plaisance Delegate of educational affairs pedagogique@fmeq.ca

VOLUME 10, NO 1 January 2013

Services 2012-2013 The FMEQ is proud to present its services offered to medical students for the 2012-­‐2013 year. Also, there will most probably be more services offered throughout the year. To keep up to date, visit our website for ongoing and new deals (www.fmeq.ca/services).

Lexi-comp is in partnership with the FMEQ with the goal to offer members access to nonbiased information, free from the influence from pharmaceutical companies. information that we can qualify as evidence based.

Lexi-Comp offers

Here are the details of their offers: Lexi-Complete (reg. price for one year $285) -One year $275 -Two years $280 -Three years $350 Lexi-Clinical suite (reg. price for one year $175) -One year $99 -Two years $158 -Three years $198 Lexi-Drugs and interact (reg. price for one year $150) -One year $60 -Two years $96 -Three years $120 To have access to these great deals, please go to our website and click on the Lexi-Comp hyperlink.

Are you always on the look-out for interesting applications? Skyscape offers a 25% discount on medical applications for your smart phone or tablet. These include applications from Washington Manuel, Merck, Harrison, Stedman dictionary, Netter and many more!

For more details and a complete list of applications offered, please visit the FMEQ website.

VOLUME 10, NO 1 January 2013

Services 2012-2013 For the last 40 years, Kaplan Medical offers complete services on preparation material for the USMLE (the licensing exam in the United States). Right now, Kaplan Medical has made a deal for FMEQ members to save 10% on these preparation services.

For more information on these offers, please visit the following website: kaplanmedical.com/ifmsa

Although Sogemec offers insurance programs for the Federation des medecins specialistes du Quebec, they offer great deals on insurance plans created especially for medical students.

For more information, please visit the following website: www.fmeq.ca

weekends starting at 6pm -2500 outgoing text messages and unlimited incoming test messages -100 long distance bonus minutes -Company calling

Rogers is offering greats deals to FMEQ members on cell phone plans and on cell phones, when you sign a contract with them. Company Code: N3FR Voice plans

-Monthly fee -$30 (-12% discount) -Included airtime -250 anytime local minutes -Included Features -Call display -1000 incoming minutes -Detailed billing -Call waiting -2500 minutes of call forwarding -Basic voicemail -Unlimited nights and

Data Plans

-6 Go -$30 -500 Mo -$25

Discounts when you sign a contract for 3 years with Rogers

-Amount -$300 (Voice and Data plans) -$150 (Voice plan only) -Offer Validity -November 1, 2012 to January 31, 2013

VOLUME 10, NO 1 January 2013

Services 2012-2013 The CanadaQBank is a database of more than 4000 questions which include multiple choice questions, clinical questions and their answers with explanations. The questions offered by CanadaQBank all respect the criteria outlined by the Medical Council of Canada. The usual cost of these services offered by CanadaQBank range from $20$45 a month.

For more information on the CanadaQBank, please visit http:// canadaqbank.com/faq.php .

To have FREE access to this database:

1. Register online at the CanadaQBank website

2. When registering your account be sure to use your university email, which means to use the email ending with: @mail.mcgill.ca, @ulaval.ca, @umontreal.ca or @usherbrooke.ca 3. Once the account has been made, to have free access to questions, you need to log into the CanadaQBank database by the FMEQ website.

The CanadaQBank is useful not only for second year clerks preparing for the LMCC, but also for all the clerks who are doing their rotation stages. What makes this a great tool is that the questions are divided into specific sections such as family medicine, pediatrics, obstetrics and gynecology, surgery, psychiatry and preventative medicine and community medicine.

Strom spa is glad to offer great deals to FMEQ members: -15% off the entrance to the thermal experience -15% off all massages and treatments -Offer is always valid, no restrictions -Offer is for student members of the FMEQ and one accompagnying visitor -The student member of the FMEQ must be present with the visitor -The student member of the FMEQ must be prepared to present their student identification card from one of the four faculties of medicine members of the FMEQ (This includes Université de Montreal, McGill University, Université Laval or Université de Sherbrooké) -15% off the Nights under the Stars -10% off gift certificates

VOLUME 10, NO 1 January 2013

Services 2012-2013 The FMEQ is proud to partner with McGraw-Hill and offer its members a 25% discount and FREE SHIPPING within Canada on over 500 titles. Search over 500 titles including the popular Case Files and Tintinali s emergency manual as well as Harrison s Principles of Internal Medicine.

For more information, please visit the following website: www.fmeq.ca

Christopher Lemieux Delegate of services and partnerships services@fmeq.ca

Nos partenaires

VOLUME 10, NO 1

Facebook event : http://www.facebook.com/events/39890375018

Registration : www.fmeq.ca

January 2013

Why a Wellness Day? Because in 2011, clerks from all medical faculties of QuĂŠbec filled out a FMEQ survey and the answers the federation got back could not be ignored. The survey in fact clearly demonstrated that stress levels were high among clerks and that it was more or less well-managed by respondents.

These results led to the development of a Wellness Day for clerks, which held its first edition in 2012. The FMEQ has renewed its efforts, again this year, in developing this day specially designed for you and in making sure that every student wishing to take part in the event gets released from clerkship obligations.

contest - contest - contest - contest

Rename the info-FMEQ The FMEQ is looking for a new name for its journal.

Send us your many ideas at :

info@fmeq.ca contest - contest - contest - contest