Cardiac Residency for BC Minister's Son Stirs Debate

On chat board, some med students see club for 'old rich boys and girls,' others see no big deal.

By Andrew MacLeod 18 Jun 2013 |

Andrew MacLeod is The Tyee's Legislative bureau chief in Victoria. Find him on Twitter or reach him here.

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Cardiac surgeons at work: Who gets a chance? Operating room photo: Shutterstock.

A Tyee story about the awarding of a University of British Columbia training position to the son of two prominent Vancouver doctors, one of whom is a former cabinet minister and current MLA, generated intense debate on an Internet chat board for medical students.

The May 24 story described the case of Kevin Lichtenstein, who got a residency position in cardiac surgery through UBC after studying medicine in the United Kingdom. His father happens to be Sam Lichtenstein, who heads the division of cardiovascular surgery at UBC.

His mother is Moira Stilwell, a radiologist and nuclear medicine physician who has been the minister of advanced education and of social development. She was left out of Premier Christy Clark's post-election cabinet.

In 2011 Stilwell wrote a report for the health minister about how difficult it is for Canadians who study medicine abroad to get residency positions and complete their training. The minister at the time, Michael de Jong, said he was unaware Stilwell had a son in that situation until The Tyee brought it to his attention.

The day The Tyee's story about Lichtenstein ran, someone going by Amadeus89 posted a link to it and opened a discussion thread on the vBulletin website for students at Canadian premed and medical schools.

Some saw nothing remarkable in a student perhaps making use of family connections and pointed out cardiac surgery positions often go unfilled. Others criticized what they said looked like nepotism and argued people in medicine should be held to a high ethical standard to match how the profession presents itself.

Spirited debate

Following is the discussion, lightly edited:

future_doc: If you don't believe this is outright patronage due to connections in the highest places, well you believe in the tooth fairy. Due to the optics alone, this should have never been allowed to occur.

There needs to be a transparent investigation and not a whitewash.

Lactic Folly: [Six] unfilled spots in cardiac surgery this year. What were the odds to beat?

A-Stark: Well I just hope he's actually a good fit for the position. Often they'd rather leave positions empty in a field like CV surgery than fill them with candidates who weren't serious.

leviathan: It is obviously fishy but at the same time, the kid might have been a very strong applicant. Also it's for cardiac surg which typically is not a competitive field. For all we know he did deserve the spot and his dad just helped seal the deal. I would be pretty pissed if he got the spot only because of connections though, because I wasn't even eligible to apply to UBC for their spots and would have loved to match back home.

rmorelan: and the cardiacs in particular do not accept people without obvious skill. I mean surgery program in general don't but cardiacs are famous for it -- leaving spots open rather than fill them with people they don't want, and taking the long view -- they only want the best.

KLM: and the best would not be someone who could not get into a Canadian med school.

Doritos: oh because people cant improve? so thats your opinion about people studying abroad, they are not good enough and STAY not good enough?

morelan (responding to KLM): Potentially in individual cases - because their criteria is not the same as getting into medical school itself. For instance last summer I ran into a Canadian trained overseas with the pretty impressive surgery ability for clerk -- very impressive. Wasn't exactly rocking the VR section though.

NutritionRunner: Some of these doctors' kids go straight overseas from high school, they don't even bother doing an undergrad in Canada. They rely on mom and/or dad's ability and connections to get them back to Canada. Actually heard one of them bragging about it and their parents' connections to program directors. This individual was laughing at all the Canadians doing undergrad programs while he was going straight into med school after high school.

Amadeus89: Ah, nepotism is alive and well. Horribly unfair to those without the same kinds of connections.

future_doc: Making, having connections is a very important part of life.

nauru: Sadly true. People, you are dreaming if you think Canada isn't rife with corruption and nepotism. Medicine is no exception.

deadlybutterfly: Odds were pretty low for him. Wouldn't be surprised if his parents did hook him up. I would be disappointed, though.

leviathan (responding to KLM): If you ever get into medical school in Canada, you're going to be in for a big shock when you discover some international students are much brighter and more capable than you. Not all of them, but definitely some of them.

KLM: I am in an Ontario med school.

leviathan: Congrats on your acceptance. Just be careful when you make comments like that. You never know where the residents or staff you're training under went to medical school. They might take you seriously and develop much higher expectations of your abilities.

masterb: This stuff is always going to happen, unfair but lets be real. I just think that its a stupid move to connect your son within your own department. Cardiac surgery probably is a small club and you must know important people at other schools, can you not get your son discretely matched into programs elsewhere?

Nothing to be concerned about, everything is going to be brushed under the carpet and as much as we hate it all our powerless voices will be silenced. This is such a small scale scandal, B.C. politicians need to take a page out of the Ontario politics book, from ehealth to ornge to power scandal to crack cocaine and getting away with all of it.

Anfield: I wonder what's going through this kid's mind. Will he look at himself in a few years and be proud, trying to convince himself he truly deserved it?

Either way, this should only motivate normal folks like us to do our best and hope for the best.

masterb: Entitled kids/parents never feel guilty, they just feel more entitled. Some of us are just dealt a bad hand in life to begin with, some us just have to be grateful we even manage to be able to be concerned about applying to med school and be able to come to premed 101. There are kids out there in the world that are hiding in caves trying to avoid being bombarded by allienoid looking aircrafts for whom premed 101 probably even isn't the last thing on their mind. Be grateful and work smart. I'll keep my fingers crossed for legit IMGs and CMGs to match in appropriate programs so they can take good care of my family when they are sick.

Lactic Folly: I don't know any more about this story than the rest of you, but we don't have evidence that he was not a qualified applicant on his own merits. 

I imagine there are university policies to deal with potential conflicts of interest - not sure what was done in this case, if anything, but it shouldn't require barring someone from applying to their hometown if they would have otherwise been eligible to do so.

A-Stark: A cardiac surgery residency isn't exactly a walk in the park. If this guy succeeds in it, he will have well proven his abilities.

masterb: He better, after his parents spent half a million dollars on his education...

fred245: Why are people acting like this is such a big deal? Is anyone actually naive enough to believe that this kind of thing doesn't happen every day in every single part of the world? Connections matter...hence why there is such a strong emphasis on NETWORKING these days.

May sound unfair, but it is what it is, and it's never going to change.

KLM: It is never going to change if we the little people do nothing about blatant nepotism. I am all for networking but not nepotism. Sure the latter exists everywhere but I was hoping in Canada it would not be so obvious.

Like another poster said you think the father would have found his son another cardiac residency with a buddy of his instead of right in his department. Guess entitlement knows no boundaries.

telomerase: This kind of thing happens all the time...there are many unqualified people in medicine and even more in dentistry, thanks to their hefty connections!! Of course, there are far more people who actually deserve to be there. Not sure what happened here, but he better be qualified...cardiac surgery is no joke!

Fortunately, mommy and daddy won't be able to pull any strings when their ass gets sued for failing to provide standard care later on...

future_doc: Skill and malpracitce, as the case may be, are great equalizers.

Lactic Folly (responsing to telomerase on "unqualified people"): I understand people find this story inflammatory, but this is quite a statement -- are there any citable examples in the medical realm?

telomerase: Do you want me to name the people? I don't think there is research lab dedicated to this topic of "who got into medical school with connections"...wish there was though....

I think perhaps unqualified is not the right term....undeserving would be a better term! You can be qualified and still undeserving....

FML.: Every single field out there is like this. What did you expect, that medicine was flawless, transparent and so pure and honest?

telomerase: Are you asking me? Cuz i agree with you lol But to answer your question, I expect medicine to be different because of their whole emphasis on "ethics" should preach what you teach...also, i expect more because it is impacting people's health....

FML.: Yeah I understand what you mean. Personally I just think that's bullsh*t for the interviews and the public. Disappointing.

telomerase: Yup I agree!

brooksbane: Medicine is, and always has been, an old rich white boys (and girls) club. 

Even though there are visible minorities in medicine, and quite a lot of them, you can bet that the rich white guys and girls on top, absent political pressure or blatantly obvious racism, pick other rich white guys and girls to succeed them.

But in this guy's case, cardiac surgery isn't even remotely competitive. You can't really decide whether nepotism was involved until you find out what kind of competition the guy had, if any.

inthesticks: so all we know is that this person got a residency spot, which was unfilled by north american applicants and was then open to international applicants (which he is). No one can speak to his academic and clinical capabilities but since he is born into a family which have the potential to create these 'opportunities', he is automatically cited as being a recipient of those opportunities?


masterb: Brooksbane, you took the words right out of my mouth. I'm glad I'm not the only one who sees it this way. Out of curiosity, are you speaking from a specific experience? If your comfortable sharing, I'm really interested in finding out what led you to this conclusion. 

Also, I am quite confident in the pool of IMGs this year that there are non-white folks that can blast the sh*t out of this residency program better than the guy they accepted and who have stronger track records.

Case in point: is a former non-white IMG resident of UBC's program Dr. Srivastava (mentioned this in a different thread), the guy performed the first robotic endoscopic quadruple bypass graft.  [Tyee]

Read more: Health, BC Politics

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