Do residents / fellows ever train in private practice settings?

[deleted1058816]

M2 here considering dermatology. Given that dermatology is such an outpatient—and private practice—dominated specialty, do dermatology residents / fellows ever work in private practice? (i.e., rotate to a private practice for a few months during training)?

Or is all residency / fellowship only at the teaching hospital sponsoring the residency? I'm just thinking it doesn't really make sense to learn non-invasive cosmetic surgery, in the hospital, when most of it is practiced in private clinics

Sorry for the silly question. We don't begin rotations until M3 here! Would appreciate both general and dermatology specific responses!

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[collegestud2013]

Some community programs in some specialties may be closely affiliated with a private practice group, or a groups that is PP-academic hybrid. So yes it's possible to rotate as resident/fellow. However, as a resident it would likely be more of an elective rotation where your clinical responsibilities are less than when on a core rotation covering primary services in your specially. So it may not give enough exposure to start your own PP straight out of residency if that's what you're aiming to do.

 

[deleted1162863]

M2 here considering dermatology. Given that dermatology is such an outpatient—and private practice—dominated specialty, do dermatology residents / fellows ever work in private practice? (i.e., rotate to a private practice for a few months during training)?

Or is all residency / fellowship only at the teaching hospital sponsoring the residency? I'm just thinking it doesn't really make sense to learn non-invasive cosmetic surgery, in the hospital, when most of it is practiced in private clinics

Sorry for the silly question. We don't begin rotations until M3 here! Would appreciate both general and dermatology specific responses!

It isn't really too early to reach out to dermatologists at your medical school who might make good mentors to ask about this.

 

[eteshoe]

I remember way back yrs ago as an M1 reaching out to the dermatology lecturer and shadowing her (academic generalist) and she put me in contact with some of her colleagues in the area (PP and academic MOHS) so I got to get a better idea of how they practiced. Most dermatologists tend. to be pretty happy to let you shadow, work on projects, etc.

 

[voxveritatisetlucis]

I would argue that community hospitals are like pp in that a lot of docs there have no interest in teaching and see med students/residents as a burden

 

[aldol16]

Many programs have private practice rotations where they send their residents to different practice settings. Some programs are even privademics models where they are mostly private but are affiliated with large academic centers. It depends on the program.

 

[SurfingDoctor]

Yes they do. HCA/Kaiser have the market on those for-profit programs.

 

[esob]

I'm at an academic program and we complete several months of training in private practice. The experience is immeasurably helpful for learning about the insurance side of the industry.

 

[operaman]

We had a short PP exposure in our pgy3 year that was very helpful and eye opening after spending so much time at the mothership. We also had optional rotations with various PP facial plastics docs if we were interested in the cosmetic side of things.

I think they can be very valuable, especially to learn about billing and coding. I actually learned much of this at the VA of all places when two of our former grads came back from PP to work the VA. One started coding visits like she did in PP and suddenly ours was the busiest ent clinic in the national VA system and we got millions of dollars in equipment, midlevels, more nurses, etc. She was a master of coding and documenting well and I still use much of what I learned and am now 98th percentile for physician productivity at my shop!

The other advantage is to see how regular surgeons operate. Academic surgeons are hyper specialized and tend to be ridiculously good in their little area, but most of us will never be that good unless we too do a fellowship and spend 10-20years doing that one thing. Seeing a good PP generalist is good for seeing how a safe surgeon approaches complex cases. Also good to see what they refer out since in academia you never really refer out at all since you’re the end of the line.

Drawback to PP is the hit rate for interesting cases is usually much lower. That said, if you’re set on being a community PP doc, training in that environment may be great preparation. You prepare for and do many major complex things in an academic program, but truth is you will never do most of those again in practice. Some people don’t mind that and enjoy the learning and the challenge while others would rather focus their time learning what they will actually be doing.

 

[PikminOC]

This is a good question. In medical school I had one rotation in family practice that was private practice

 

[Lem0nz]

At my community general surgery residency 80-85% of all of our attendings were private practice hospital affiliates and not employed by the hospital. Was great. They treated us fantastic and we were apart of the culture. We were not considered a burden and none of them had any issues with teaching.

 

[DarkHorizon]

I trained at a community program. 2/3 of my attendings were private practice. The other 1/3 were hospital employed group that also functioned more or less as community surgeons.