Med School Admissions
(Source: Wikipedia)

Generally, medical students
begin their studies after
receiving a bachelor's degree in
another field, often one of the
biological sciences. However,
not all medical schools in
Canada require a bachelor's
degree for erobiology, ethics,
and epidemiology. This
instruction can be organized by
discipline or by organ system.
Teaching methods can include
traditional lectures,
problem-based learning,
laboratory sessions, simulated
patient sessions, and limited
clinical experiences. The
remainder of medical school is
spent in clerkship. Clinical
clerks participate in the
day-to-day management of
patients. They are supervised
and taught during this clinical
experience by residents and
fully-licensed staff physicians.
Typical rotations include
internal medicine, family
medicine, psychiatry, surgery,
emergency medicine, obstetrics
and gynecology, and pediatrics.
Elective rotations are often
available so students can
explore specialties of interest for
residency training.

Some medical schools offer
joint degree programs in which
a limited number of interested
medical students may
simultaneously enroll in M.Sc.
or Ph.D. programs in related
fields. Often this research
training is undertaken during
elective time and between the
basic science and clinical
clerkship halves of the
[edit] Post-graduate medical

Students enter into the
Canadian Resident Matching
Service (CaRMS) in the fall of
their final year. Students rank
their preferences of hospitals
and specialties. In turn, the
programs to which they applied
rank each student. Both sets of
rank lists are confidential. Each
group's preferences are entered
into a computerized matching
system to determine placement
for residency positions. 'Match
Day' usually occurs in March
[8], a few months before
graduation. The length of
post-graduate training varies
with choice of specialty. Family
medicine is a 2 year program
accredited by the College of
Family Physicians of Canada
(CFPC), and third year programs
of residency training are
available in various areas of
practice, including Emergency
Medicine, Maternal/Child, Care
of the Elderly, Palliative Care or
Sports Medicine. All other
medical specialty residencies
are accredited by the Royal
College of Physicians and
Surgeons of Canada; most are 5
years long. Internal medicine
and pediatrics are 4-year
programs in which the final year
can be used to complete a
fellowship in general internal
medicine or general pediatrics,
or used towards a longer
fellowship (e.g., cardiology). A
few surgical residencies,
including cardiac surgery,
neurosurgery, and some general
surgery programs, last 6 years.
Subspecialty fellowships are
available after most residencies.
Family medicine programs
often offer an optional third year
of training in such fields as
emergency medicine and care
of the elderly (as opposed to
Geriatrics, which is a
subspecialty of internal

There are subtle differences
between how residency training
is organized in Canada as
opposed to the United States.
For example, M.D. graduates
proceed directly into their
residencies without the
intermediate step of internship.
However, this difference is
somewhat superficial: for many
residencies, the first
postgraduate year (PGY1) in
Canada is very similar to a
rotating internship, with 1-2
month-long rotations in diverse
fields. On the other hand, in
Canada the graduate is often
committed to a subspecialty
earlier than a similar American
a u s c u l t a t i o n    t u t o r
Aortic regurgitation and systolic flow murmur

The classic example of a semilunar insufficiency murmur is aortic regurgitation. The murmur of aortic
insufficiency is caused by turbulence of blood regurgitating through an incompetent aortic valve from the
aorta to the left ventricle. This produces a high-pitched decrescendo murmur, which begins with the
second heart sound (S2), lasts through some or all of diastole and declines in intensity as the aortic
pressure falls. It tends to equilibrate with the left ventricular pressure. Large volume aortic valve
regurgitation is accompanied by a wide aortic pulse pressure and with a rapid rising and collapsing
systemic pulse.  
t h e     h e a r t
Aortic regurgitation is diagnosed by
Doppler - most efficiently by Color
Doppler Imaging. The regurgitant jet
occurs during diastole toward the left
ventricular cavity. From the 4 chamber
or apical views, the color signal is
primarily displayed as red-yellow, since
its direction is toward the transducer
and the jet can be distinguished from
the mitral diastolic inflow.

The long axis view can show the
difference between mild regurgitation,
which has a narrow base and short jet,
compared to severe with broad base
and long jet extent. The force in the
latter may show presystolic closure on
M-mode tracing.
Normal Cardiac Cycle
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