Specialty Profile

Medical Biochemistry GENERAL INFORMATION (Source: RCPSC and Pathway Evaluation Program) The primary role of the medical biochemist is to study and measure the biochemical abnormalities in human disease. The medical biochemist is trained in the operation and management of hospital biochemistry laboratories and acts as a consultant in all aspects of their use. As an academic specialist, the medical biochemist develops and integrates a basic medical science research programme with clinical practice in a field of biochemical interest and maintains an active role as a teacher of clinically-applied biochemistry. Technology-driven specialties such as medical biochemistry require the physician to have a broad awareness of the field at the time of completion of formal training. But the physician must also be prepared for major changes during the ensuing years of practice that are inevitable and the residency period is the time to acquire skills for life-long learning. In medical biochemistry, role learning must be supplemented by skills in self-directed learning. It requires ability in problem solving, formulation of hypotheses, the ability to do directed information searches and also the ability to critically appraise data. Medical biochemistry involves pathophysiology (requiring a thorough knowledge of normal and abnormal biochemistry and physiology, and the ability to apply this knowledge to the understanding of human disease.); consultation; interpreting results (understanding the principles and limitations of biochemical analyses and applying these concepts to the interpretation of test results); analytical methods; and instrumentation. Once you have completed medical school, it takes an additional 5 years of RCPSC-approved residency training to become certified in medical biochemistry. This residency training must include the following:

• 1 year of basic clinical training (including rotations in medicine, pediatrics, obstetrics and surgery)

• 2 years of RCPSC-approved residency in medical biochemistry, preferably spent in one university centre (at least one of these two years must be spent in the biochemistry laboratory of a general hospital)

• 1 year of residency that may be either in internal medicine or in pediatrics. For more specific training requirements go to: http://rcpsc.medical.org/information/index.php?specialty=225&submit=Select There are currently 89 medical biochemists practicing in Canada. Of these, 2% are under the age of 35, 41% are 35-54, 35% are 55-64 and 18% are age 65 and older. A total of 77% of practicing medical biochemists are male and 23% are female. (Source: 2008 CMA Masterfile).

DETAILED INFORMATION The remainder of the data contained in this specialty profile has been extracted from the 2007 National Physician Survey (NPS), unless otherwise stated. All percentages are for respondents only. A total of 30 medical biochemists responded (for a response rate of 37%). Complete data tables for medical biochemistry from the 2007 NPS are available at: http://www.nationalphysiciansurvey.ca/nps/2007_Survey/Results/physician3.3_sp-e.asp For an index to all specialties, go to: http://www.nationalphysiciansurvey.ca/nps/2007_Survey/2007results-e.asp Choosing medical biochemistry (2004 NPS Data) In 2004, nearly a third of medical biochemists (30%) reported that they decided on this specialty as a career choice during their residency, 23% decided during their clerkship year (i.e., the last year of medical school) and 17% decided after a period of time in practice. More than three-quarters of medical biochemists (77%) said they chose this specialty for the intellectual stimulation/challenge it provides, 67% chose it for the research opportunities and 47% for the workload flexibility and/or predictability. From these factors, intellectual stimulation/challenge of the specialty was cited as the single most important career decision-making factor (43%). Practice Setting Nearly three quarters of medical biochemists (74%) work in an academic health sciences centre. A further 44% work in a university/faculty of medicine and 25% are in a research unit. Only 21% work in a private office/clinic. Practice Profile (based on 2004 NPS data) Nearly half of medical biochemists (47%) work in a solo practice and 30% are in a group practice where on-call duties, equipment, office space and/or staff are shared amongst the physicians. Half of medical biochemists (50%) serve mainly an urban/suburban population. Under half (40%) of medical biochemists do on-call for hospital in-patients, 20% do on-call for non-hospitalized patients by telephone only and just 10% are available by telephone and see patients as required. One fifth (20%) of medical biochemists do no call at all.

Income Just under half (44%) of medical biochemists receive 90+% of their income from fee-for-service, 22% receive 90+% of their income from a salary and 19% are remunerated through a blended source (i.e., made up of a combination of 2 or more payment methods like fee-for-service, salary, capitation, sessional, contract, benefits/pensions, on-call remuneration or some other form). Unfortunately, the Canadian Institute for Health Information’s Average Gross Fee-for-Service Payment Report 2005-2006, does not contain income information for this specialty. To protect their income, physicians take out medical liability coverage in the event that a patient is harmed in a medical misadventure. According to The Canadian Medical Protective Association’s Fee Schedule for 2009 the annual cost for insurance for a medical biochemist is:

Quebec Ontario Rest of Canada $ 2,459 $ 2,448 $ 1,092

Satisfaction Most medical biochemists (84%) report that they are very or somewhat satisfied with their current professional life. A total of 84% are very or somewhat satisfied with their relationship with other specialist physicians and nearly three-quarters (74%) with their relationship with family physicians. They are less likely to be very or somewhat satisfied with finding a balance between personal and professional commitments (64%). ADDITIONAL INFORMATION Additional information on this specialty can be found from the: Canadian Association of Medical Biochemists: http://www.camb-ambc.ca/