Finding a Job in Quebec baillargeon.jpg

David Baillargeon, M.D., CM, FRCSC
Laval, QC

For a little more than two years now, I have been working as an orthopaedic surgeon at the Cit de la Sant de Laval on the outskirts of Montreal. We are fortunate to be able to welcome senior orthopaedic residents on an elective basis to perfect their knowledge in arthroscopy. As of this writing, we have a surgical fellow training at our hospital.

The decision to work at Cit de la Sant de Laval was the result of several coincidences. During my third year of residency, I had already received a number of offers from different hospitals where I had completed my practicum. But I wasn't ready to make any commitments (or false promises), so I decided to pursue what interested me most, sports medicine. I thought, even if hospitals had other needs, I would do what I felt passionate about, rather than accommodate the market and quite possibly become unhappy about my choice. I applied to a number of American universities for a fellowship in sports medicine because I was quite intrigued about practicing medicine in the United States.

Once I was accepted into sports medicine at the University of California, San Francisco, several Canadian hospitals reiterated their interest in recruiting me, although there was no formal job offer. A few months before leaving for the fellowship, I contacted one of my former senior residents who had specialized in sports medicine. He was now working at Cit de la Sant de Laval and seemed to have developed an excellent practice. Although I had always pictured myself practicing at a downtown university hospital centre, I found myself really inspired by the surgeons I had met at Laval. I came to the realization that I would probably be better off and happier working there. The hospital made me an offer, and, on the strength of a handshake, I accepted.

I went to San Francisco for the fellowship, where I learned a lot about the American health care system. When I started and, again, when I finished my fellowship, I received numerous job offers (in both university and private clinical settings) from several states. Salaries are much more attractive in the US, but that has to be weighed against the administrative aspects of the job, because the big insurance companies have a stranglehold on the delivery of orthopaedic services. Also, the long working hours made family life next to impossible. In the end, these factors greatly influenced my final decision. Thus, for personal, but most of all, for professional reasons, I decided to return to Canada to practice.

Even though it may be quick and easy to get information about available jobs from journals or through placement agencies, I would still highly recommend talking to your network of colleagues (former senior residents, etc.). The reality of practicing in a hospital may be altogether different than the picture painted by an agency or in a journal posting or even in an hour-long interview. It's also important to be honest when looking for a job and not give in to the temptation of saying yes to every hospital that makes you an offer, thinking that this will make the end of your residency easier. The orthopaedic community in Canada is a small world, and news travels fast. If you make promises to a few hospitals at the same time, believe me, they will find out and your reputation will be tarnished.

Better by far to base your career choice on something for which you have a passion. Ask questions. Take advantage of conferences and other events to talk to residents and managers from various hospitals to understand how they run things. I would also advise hospitals looking for surgeons not only to advertise in journals but also to send their most recent recruits to conferences where they can meet residents and give them a real feel for how a particular hospital runs its orthopaedic practice. Also, provincial associations might consider reserving a few minutes during their scientific programme to allow surgeons from hospitals that are recruiting to talk about their practices.

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