A career path of a Physician specializing in emergency medicine

by Heidi Riley

Dr. Trevor Jain is an Emergency Room Physician at the QEH in Charlottetown and is also the director of UPEI’s Bachelor of Science in Paramedicine program. He is also the physician lead for admissions to the new UPEI medical school.

Dr. Jain started his career path at Acadia University by taking a Bachelor of Science in Biology with a minor in Computer Science.

He moved to PEI in 1994 to do a Master of Science in Pathology. “At that time, the only graduate work you could do at UPEI was at the Vet College.”

He attended the Dalhousie Faculty of Medicine from 1995 to 1999 and planned to specialize in plastic surgery as a facial reconstructionist.

In 1998 he was involved in the aftermath of the Swissair flight 111 airplane crash off Peggy’s Cove in Nova Scotia. “I was used by the military to design and set up a morgue and do autopsies on those victims. Subsequently, I changed my career path to emergency medicine.”

After medical school, he applied for a residency position and did two years of family practice residency. He went into practice, and then went back to school and took an extra year to study Added Competence in Emergency Medicine. He went on to do a specialization in emergency medicine, which took another two years.

Additional work in the military

During his time in medical school, Dr. Jain also worked 15 to 18 hours a week in the Reserves. He is still currently a member of the Reserves as a Trauma Team physician.

He leads a team of eight, including a critical care nurse, two advanced-care paramedics, and four combat casualty care personnel. “I fly in a Chinook helicopter to extract up to seven casualties at a time. We can resuscitate three critically injured at once and transport an additional four walking wounded.”

He has been to northern Iraq, Kuwait, and other locations in the Middle East. “That experience has been really good for my career, and my colleagues have been very supportive when I need to leave on a mission.

“My army training really helped me get through medical school. In the Reserves, I was used to being nauseous and tired, while still giving 100 percent. When I was first on call in the hospital for 34 hours at a time, those feelings were not foreign to me, but they were foreign to some of my colleagues.”

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The path to becoming a doctor

1. Four-year undergrad degree

2. Four years of medical school

3. Two to seven years of residency, depending on the specialty: Two years for family practice, and up to seven years for a cardiac surgeon.

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Life-long learning

“Physicians are life-long learners,” says Dr. Jain. “Every year, I have to do a certain number of credits to stay current in order to keep my medical license.” He has a Masters degree in disaster medicine and is currently finishing his PhD in disaster medicine.

“Being a doctor opens so many other doors. If I was not a doctor, I could not have approached the university to suggest the implementation of a degree program for paramedics. Now UPEI offers one of the first Bachelor of Science in Paramedicine degrees in Canada.

“Medicine is a journeyperson’s trade. You are highly supervised during your third and fourth year in medical school when you are working with patients. First year residents are somewhat supervised, year two are less supervised, and by year three you may be supervised by your chief resident.”

Choosing an undergraduate major

“There are some degrees that are viewed as being more difficult than others. A student who gets straight A’s in a certain program may not be rated as highly as another who gets A- in another program that is rated as being more difficult.

“For example, a Bachelor of Music is considered to be a very difficult degree. Many Humanity degrees are extremely difficult. One of the top hematologists in Toronto took his undergrad in religious studies, combined with science electives.”

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Tips to help qualify for medical school

• Take a full courseload in your undergrad years. “The hardest parts of medical school are getting accepted and the sheer volume of information you need to learn. You need to show that you are prepared for that by taking a full courseload during your undergrad and doing really well. Someone who does two courses at a time and gets A+ will not be rated as highly as someone who takes five courses and gets all A’s.”

• Score well on the MCAT (Medical College Admission Test). It is helpful to take a prep course before writing the test.

• Volunteer in an area that is client-based, dealing with patients at some level, such as soup kitchens or footcare for the homeless.

• References are key. Medical schools require one academic and one professional reference. Make sure the person you choose will give you a solid reference. Many schools send out a list of specific questions they want the reference to answer. The academic reference must be someone who has assigned you a grade, and the professional has to be someone who assigned your work. “It is important to forge relationships with academics and professionals who know who you are, can speak highly about you, and who you can trust to put the time and effort into giving a personal and valuable reference.”

• Extracurricular activities are always helpful.

“Most applicants do not get into medical school on their first try. I don’t want anyone to be discouraged if you don’t meet the criteria. For example, one candidate failed out of his undergrad program, and then he came back and got straight A’s their third and fourth year. That application stood out. That person was accepted into medical school, and now he is one of the top specialists in his field.

“It is a good idea to apply to more than one medical school. As an Islander, your best chance to get into medical school is to apply to the UPEI Faculty of Medicine, because of the residency requirements.”

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Choosing a medical school

“One of the reasons I championed the idea of a UPEI medical school is because we need more physicians,” says Dr. Jain. “By the year 2027, there will be 22 medical schools and 43 medical campuses in Canada.

“The doctors who trained at a medical school in the Caribbean are awesome. They took their training in the Caribbean because they got tired of waiting to be accepted in Canada. They worked hard to get into a residency program in Canada and are fantastic physicians.

“The UPEI medical school program will be the same as the one at Memorial in Newfoundland. The program trains you to get your medical doctorate, and after that, it opens up all the specialties for you to apply to for your residency.”

Residency

After graduating medical school, the next step is to apply for a residency position. For example, if you want to be a cardiovascular surgeon or an ophthalmologist (eye surgeon), ENT, or a family doctor, you apply to all the academic centres around Canada for a residency spot. After an in-person interview, the medical schools will rate you and you will rate them. “It is quite exciting in fourth year – everyone across Canada is informed of their match on the same day.

“During residency, you do rotations in departments such as obstetrics, emergency, and many more. Residency is like boot camp. You work 60 to 80 hours a week. Some surgical services require a 90-hour week. But it does come to an end.

“Residency is the last time you will be supervised by senior staff. It is important to absorb as much information and knowledge as possible from those around you. I learned how to deliver babies from a nurse who got me to deliver 40 babies in three months. A pharmacist taught me about drugs. An administrator taught me how to handle processes. It is a team environment.”

The best things about being a physician

“Becoming a physician is a long road, but it is awesome! It is one of the best jobs in the world. You will meet some amazing people in medical school who will become your life-long colleagues and friends. The most incredible people I know I met in medical school.

“You are your own boss, and you have choices as to where you want to set up practice and shifts. You have the independence to orchestrate time off.

“Emergency medicine is awesome. You get to help people on their worst day. I have done some cool things in emergency medicine. I fly in a helicopter to go to a scene to provide emergency care at car accidents or an IDE (improvised explosive device) explosion or a bus crash. Doing critical care in the air is pretty awesome. The way you are trained to think to save people on their worst day is a pretty cool job.

“Emergency medicine involves shiftwork. When I do a night shift at the QEH I am by myself and may have 37 patients in the waiting room waiting to be seen and ambulances coming in. By eight in the morning, I am done, and it takes me two or three days to recover. That is why emergency physicians have a bit higher rate of burnout. The way to counteract the exhaustion is to do it part-time. Teaching at UPEI has allowed me to do other things.”

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Financing your medical education

A host of funding sources are available, including the George Coles Scholarship. For a list of scholarships available on PEI, visit https://employmentjourney.com/?s=scholarship

“When I graduated from med school, I had thousands of dollars in debt. But banks are eager to lend money to medical students. You can live well within your means.

“Although students pay tuition, it costs the taxpayer about $250,000 to $350,000 to train one medical student. It is a privilege to become a physician.”

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Disadvantages to being a physician

“It’s more than a job – it is a way of life. You are always on call. The community will look at you a bit differently because you have expertise that everyone will want to use.

“It is a lot of hard work, and there is a lot of sacrifice. I missed a lot of things with my daughters that I really regret. I missed a lot of anniversaries and holidays with my family. If you have a partner, they have to be understanding. Because the hours are so long while in residency, your friends will not understand why you can’t spend more time with them.”

Most physicians receive no government pension, paid vacation, disability insurance, or dental coverage. “Unless you work for a university or in a system that pays a salary, you are your own business, and you have to set up health plans yourself. You are an independent contractor whose business it is to provide medical services.

“People who enter medical school are used to being the cream of the crop. But it is very humbling to suddenly be surrounded by people who are all the cream of the crop. You are competing with top-tier people. They are all high achievers who want to do great things.”

Dr. Jain says there is a lot of delayed gratification to becoming a physician. “People in other professions start their careers much earlier. They get a car and a house, and you at 32 have not even started yet. That is why physician compensation is the way it is – to help with your debt and to acknowledge your expertise. To become a family doctor takes a minimum of 10 years of university. That is 20,000 supervised clinical contact hours.

“Some of my happiest, best times in education was in medical school. I got to go to school with and hang out with incredible people. Those connections cannot replace material things. I wouldn’t trade those for the world.”

Salary According to the Physician Service Agreement between the Medical Society of PEI and the Government of PEI and Health PEI, in 2023, family physicians earned between $172,806 and $199,047 per year. Specialists earned between $227,119 and $398,500 per year.

“If you go into medicine to make money, choose a different career,” says Dr. Jain. “We are very blessed to earn that income, but to train a cardiovascular surgeon in Canada takes 17 years of university.”

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Advice to prospective physicians

“Self-care is really important: hydration, eating well, and exercise. The ability to get along with people and collaborate is a key skill. A sense of humour and the ability to have fun is also important when you need to blow off some steam.

“The biggest piece of advice I would give medical students is to enjoy the journey. Take three minutes every day to look around and realize you are being trained as a physician – how cool is that!”