Family/Wilderness Med vs. ER

[La Fiera]

Hello,
I can't decide between Family Medicine and ER. I was hoping you guys could give me some insight to this problem.
I would really like to work in a small mountain town somewhere in Colorado, Alaska, or Montana or elsewhere. I know there are FP wilderness residencies out there that teach residents more than the average FP residency, but I was hoping to hear more specific details. My idea of the perfect job (romantisized of course) is to work as a small town doc, who does everything, from delivering babies to sewing up wolf bite wounds to taking care of pts with pneumonia. Maybe this is the doctor of 50 yrs ago, but I can still hope!
I was reading a post about IM vs. ER and a lot of people mentioned that FP weren't suited to doing alot of the work that comes through the ER. Are there any fellowships where one can expand family med to be more competent in the ER? Would you advise becoming an ER doc instead to work in a small town with my ideals in mind?
Thanks!

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[dr.smurf]

you bring up an excellent and popular topic. i think alot of people go into fp for that diversity you speak of. thats exactly why i went into fp, because you can do so much when your done. if you want to do the things you mentioned in a small town you should definitely do FP. EM is geared toward just that...the ER. they dont manage pts up on the floors or do the ob or medicine to the extent fp's do. fps make great er docs because they are trained in everything. and if the ER is something you know you will do as an FP there are fellowships in rural medicine and emergency medicine which were started for that very reason. go to aafp.org and look at the fellowships they list under "other".

dont forget that there are lots of courses like ATLS (advanced trauma life support), ALSO (advanced life support obstetrics), ACLS, PALS, NALS that you can take and stay current on. these will allow you to initiate and manage care of very acute pts in the er until they can be transfered out to a higher level trauma center or er. hope this helps. good luck!

 

[La Fiera]

Thanks so much for the info!
Does any one have any recommendations for which are the best FM/rural/wilderness medicine residencies?

Thanks again!

 

[deleted6669]

in no particular order:
klamath falls,oregon
tacoma family medicine, wa
natividad medical ctr, ca
spokane family medicine(rural track), wa
ventura county,ca(not rural, just great training in full scope fp)
contracosta county, ca(same as above)
good luck

 

[flighterdoc]

Well, if you REALLY want a wilderness FP program, check out Alaska - the only residency in Alaska at all, and some serious wilderness/remote work.

It's a PGY1-3 program, 10 positions per year and usually doesn't fill all 10.

Besides, Alaska is just beautiful.

 

[Silvertip]

Check out the Montana Family Practice Residency in Billings, MT, as well. They have a website.

http://www.mfpr.org/

Look at the photos (Fun in Montana)- looks like these residents have a great time in the outdoors during residency.

 

[drsarah04]

The FM residency in Greeley, CO, is another program where you can learn lots of procedures, and there is TONS of OB. At their rural site in Wray, CO, the residents even learn how to perform hysterectomies, appys, etc. They focus on training residents to practice in a rural area.

At UCSF-Fresno, I was told that their ER program has affiliations with the Nat'l Park Service and that FM residents can get experience in wilderness medicine that way. However, I did not get the impression they were open to residents' doing international rotations.

I second everything the above posters wrote, and have specifically heard that the MFPR in Billings has a strong wilderness medicine/rural emphasis. I too feel that FM is a great field if you're interested in rural/wilderness/international medicine for the reasons that others posted. (Many docs told me surgery is another good field, for what it's worth.)
Hope this helps!