Family Practice and Surgery?

[LukeWhite]

Hey all,

A quick question on family practice and surgery. Is it still possible to find a FP residency that will train in a full scope of basic surgeries?

I'm hoping to go into rural family practice/emergency med with an eventual shift to overseas missions work and would love to find a program that would give me plenty of practice being the primary surgeon for appendectomies, c-sections, hernias, etc. Is this possible anymore?

Thanks for all your help!

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[deleted6669]

ventura county fp residency in california is probably your best bet. they do c-sections, appys, etc

 

[droliver]

This topic has been touched on before & I think that in this era there is no indication for a non-surgeon attempting any elective surgery (this includes appendicitis) beyond cutaneous procedures. There are no real geographic areas in the country that you cannot temporize & get transport out of in almost any real-world scenario for surgical care by helicopter if needed. I'm not sure you could recieve enough training to handle any true general surgery emergency from your exposure during an FP residency (ruptured AAA, solid organ injury from trauma, arterial embolus, blunt/penetrating chest injury). What I think could be taught & would be valuable are a few emergent procedures which save lives - c-section, surgical airways, chest tubes, temporal burr holes, IV access, fracture reduction.

It would be hard to argue in court today that any elective surgery you choose to perform where you had a bad outcome would not be malpractice. We haven't even touched upon where you would get malpractice coverage or what hospital would imagine giving you privledges to perform them

 

[secretwave101]

Droliver is right that this issue has been touched upon before - and his response was basically an unhelpful and unsought opinion then, like it is now.

There are numerous FP residencies that focus on "full spectrum" medicine because a number of people are hoping to work OUTSIDE the US where TRANSPORT is not an option. Aside from that, there are still numerous FP's who are doing C-sections (in particular) as well as numerous procedures and even some surgeries.

Ventura is considered the top program in this area, but also THE most competitive (even though a county hospital - its a UCLA program). I emailed their director and asked about other programs he felt were on-par with theirs' in terms of emphasis. He listed programs in Salinas (Monterey County), Martinez
(Contra Costa County), Boise Idaho, Tacoma Washington and maybe Greeley Colorado as ones in the Western US.

I've also heard a great deal about a program in Ft. Worth, TX.

They all have websites and its fun reading about each program. They generally seem to work you pretty hard, but the residents often get enough procedures to gain some fairly expansive privledges at US hospitals. Then, of course, you can provide a very helpful and wide range of care to people in other countries who have few medical options.

Good luck! There are many who share your mindset, and many programs that can facilitate your interests.

 

[LukeWhite]

Thanks all for your responses! I understand that it's obviously better to let surgeons do their thing when at all possible; I've great respect for the inhuman amount of training required to be an expert in the art. I'm glad to hear, though, that there are programs that will train family practitioners who want to fill the gap when surgeons aren't available.

The residencies mentioned seem fantastic; the websites were very comprehensive. I'll post any others I come across in the search also.