FP Programs with good OB

[PACtoDOC]

I am a third year and have decided on FM. I have been researching for months now the many programs and have found only a few that seem to fit what I am looking for. My priorities are getting enough C-sections to be able to go do them in a rural location when I am done. I am not willing to do a 4th year in some OB fellowship to accomplish this. Next, I prefer a place where they treat residents well and are truly concerned for their learning. I would prefer a community based unopposed program but would consider an academic program if there was enough separation to make it community oriented. I want lots of procedures without the overkill that comes from programs like JPS in Fort Worth.

The programs that seem to have uniquely carved niches in this area thus far that I have found are

Ventura County, Ca
Salinas, Ca
Contra Costa, Ca
JPS Fort Worth
Anchorage, Ak

Please let me know if you know any more programs like this. Appreciative.

Matt

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[bmickelsen]

Matt
There are programs in Pocatello Idaho, Spokane Washington, and the two in Wyoming that seem to fit your description. I'm looking for the same sort of residency. Below is a a link to programs that send more than 50% of their graduates in rural locations for fP when they are done.

http://www.unmc.edu/Community/ruralmeded/member/database/morehalf.htm

 

[PACtoDOC]

Wow, that is one of the best pieces of information that I have been given thus far!! Thank you very much. I am seriously considering sending out a letter to all the rural programs to see if they will reply to me and tell me if they can provide me with the minimimal number of C-sections to do them rural when I am done. My guess is that they will not reply if they cannot provide a high number. I'll probably drop in a copy of my transcript and scores to get them to pay me some attention, since it is not every day that they get people applying with top grades and scores. Maybe I am crazy for wanting to do FP but it is what I love. Thus far the program in Ventura seems to be the best fit, but it would be nice to find a place similar that is also in a beautiful place but has homes for rent less than the Ventura average of about $1,800 month!!! It is painstaking to go through all these program's homepage's on the web and often the info is limited. I am just trying to figure out where I am going to do my first few rotations in 4th year so that I can visit the places I want to go to. Keep the good info coming!!

 

[Willamette]

You'll probably be interested in this too...

http://www.unmc.edu/Community/ruralmeded/student.htm


I have a HEALTHY interest in rural FP, but I don't think I can afford it (i.e. too much $$ to pay back...between my wife and I, it'll be ~$350K after residency). In fact, if I could get someone else to pay for our loans, I'd seriously consider going home and being a rural doc. As it is, I think I'm headed for EM. This is not to say that I don't like EM, I think it's really cool. It's just that sometimes I feel like I'm more the FP type, you know? It sucks that $$ plays such a big role. I'm not talking about the income, I'm talking about the income/debt ratio. Oh well, now I'm just jabbering. I hope that you (and whoever else looks) finds the link useful. Best of luck.

Willamette

 

[flighterdoc]

You'll probably be interested in this too...

http://www.unmc.edu/Community/ruralmeded/student.htm


I have a HEALTHY interest in rural FP, but I don't think I can afford it (i.e. too much $$ to pay back...between my wife and I, it'll be ~$350K after residency). In fact, if I could get someone else to pay for our loans, I'd seriously consider going home and being a rural doc. As it is, I think I'm headed for EM. This is not to say that I don't like EM, I think it's really cool. It's just that sometimes I feel like I'm more the FP type, you know? It sucks that $$ plays such a big role. I'm not talking about the income, I'm talking about the income/debt ratio. Oh well, now I'm just jabbering. I hope that you (and whoever else looks) finds the link useful. Best of luck.

Willamette

There seem to be a number of rural FP groups that will pay your loans for you. You might check them out.

 

[PACtoDOC]

I am on the NHSC scholarship and thus I will have about a grand total of 50K in loans when I graduate. Thus, FP is very inviting to me. I can understand the money issue, as I would not be going into FP if I owed 350K either!! Thanks for the link.

Matt

 

[Willamette]

There seem to be a number of rural FP groups that will pay your loans for you. You might check them out.

Help me get rid of $350K in debt?! How much help? And who? I've seen all sorts of propaganda talking about the "opportunity" for debt relief, but I'm reluctant to tighten our belts to the brink of destitution (for many many years) on the hopes that "someone" will help give me the "opportunity" for debt relief. This is in NO WAY intended as a swipe at you flighterdoc. If you or anyone else has got some concrete info, I'm all ears...

Willamette

 

[flighterdoc]

Help me get rid of $350K in debt?! How much help? And who? I've seen all sorts of propaganda talking about the "opportunity" for debt relief, but I'm reluctant to tighten our belts to the brink of destitution (for many many years) on the hopes that "someone" will help give me the "opportunity" for debt relief. This is in NO WAY intended as a swipe at you flighterdoc. If you or anyone else has got some concrete info, I'm all ears...

Willamette

You've probably seen the same ads in the back of the journals as I have. All I can say is check them out. Also, the California Medical Board has a loan repayment program (up to $105k), if you qualify. Other states may have loan repayment programs as well. There are NHSC loan repayment programs for primary care, and I'm sure others.

 

[PACtoDOC]

Will,

There are some great programs that offer debt relief but nothing is going to put a dent in that 350K. The medical education process in our country is to blame and you have no reason to feel bad about taking a specialty position. NHSC could get you about a total of 80K or so off your loans, but that is not very much. If I owed 350K, I would not even consider EM either though. I would be doing ortho, ophtho, plastics, etc.... Even as an EM doc you will still have to tighten up for awhile on 3500 dollar a month loan payments!! I honestly feel that there should be a better federal program that encourages primary care medicine, and I am not talking about NHSC. There are only about 200 medical students a year graduating with NHSC scholarships annually and that is not a drop in the bucket. Plus, you have to go to places they think are underserved. And if you have ever seen how the government tries to run anything, they routinely leave good places off the list. There should simply stated be a program to encourage students to go into primary care on graduation, which provides 1) an extra 10K stipend in residency annually, 2) no interest accrual on loans during residency, and 3) annual decremental loan cancellation for every year you provide primary care medicine without regard to area. To attract docs to rural or underserved areas, there should be an additional 30K added to their salary for going there during each year of loan cancellation. NHSC only puts a drop in the bucket, but a big program like this could put an extra 20% of grads into primary care nationwide. Then people like Will could live out their true desire to become a rural smalltown doctor.

 

[Willamette]

Will,

There are some great programs that offer debt relief but nothing is going to put a dent in that 350K. The medical education process in our country is to blame and you have no reason to feel bad about taking a specialty position. NHSC could get you about a total of 80K or so off your loans, but that is not very much. If I owed 350K, I would not even consider EM either though. I would be doing ortho, ophtho, plastics, etc.... Even as an EM doc you will still have to tighten up for awhile on 3500 dollar a month loan payments!! I honestly feel that there should be a better federal program that encourages primary care medicine, and I am not talking about NHSC. There are only about 200 medical students a year graduating with NHSC scholarships annually and that is not a drop in the bucket. Plus, you have to go to places they think are underserved. And if you have ever seen how the government tries to run anything, they routinely leave good places off the list. There should simply stated be a program to encourage students to go into primary care on graduation, which provides 1) an extra 10K stipend in residency annually, 2) no interest accrual on loans during residency, and 3) annual decremental loan cancellation for every year you provide primary care medicine without regard to area. To attract docs to rural or underserved areas, there should be an additional 30K added to their salary for going there during each year of loan cancellation. NHSC only puts a drop in the bucket, but a big program like this could put an extra 20% of grads into primary care nationwide. Then people like Will could live out their true desire to become a rural smalltown doctor.

Agreed. I know that some folks'll think it's selfishness or greed that drives someone like me into a higher-paying specialty, but they'd be wrong. I just want something that will allow us to be comfortable. Granted, we could do the rural-thing if we both worked full-time, but we don't want to count on my wife's salary while we have little ones at home (we're gonna start during residency). That said, the salary of a rural doc just doesn't get it done, and I didn't go to medical school just so that I'd have to worry about $$. As for pursuing something like ortho or opto, I'm on a wait-and-see pattern with that. I've always subscribed to RAH's dictum that "specialization is for insects," so it makes the broad-based fields (FP, EM) most appealing.

Willamette

 

[deleted6669]

tacoma family medicine/rural track
klamath falls/ohsu rural track

 

[stoic]

Will,

There are some great programs that offer debt relief but nothing is going to put a dent in that 350K. The medical education process in our country is to blame and you have no reason to feel bad about taking a specialty position. NHSC could get you about a total of 80K or so off your loans, but that is not very much. If I owed 350K, I would not even consider EM either though. I would be doing ortho, ophtho, plastics, etc.... Even as an EM doc you will still have to tighten up for awhile on 3500 dollar a month loan payments!! I honestly feel that there should be a better federal program that encourages primary care medicine, and I am not talking about NHSC. There are only about 200 medical students a year graduating with NHSC scholarships annually and that is not a drop in the bucket. Plus, you have to go to places they think are underserved. And if you have ever seen how the government tries to run anything, they routinely leave good places off the list. There should simply stated be a program to encourage students to go into primary care on graduation, which provides 1) an extra 10K stipend in residency annually, 2) no interest accrual on loans during residency, and 3) annual decremental loan cancellation for every year you provide primary care medicine without regard to area. To attract docs to rural or underserved areas, there should be an additional 30K added to their salary for going there during each year of loan cancellation. NHSC only puts a drop in the bucket, but a big program like this could put an extra 20% of grads into primary care nationwide. Then people like Will could live out their true desire to become a rural smalltown doctor.

Kansas has a program setup that is attempting to do just this. It's not as extensive as what you've suggested, but it does provide extra cash during residency (to the tune of 26k over the final two years of a three year FP or IM residency). The state board of regents also has loan forgiveness programs setup for both DO and MD students (they are only open to students, however). For these programs you can literally go anywhere in the state except for 5 counties. The MD program is for students in the state school and provides tution, books, and housing cost... in the end it's free medical school. The DO program is good for about 20k a year to a total of 80k. The DO program also includes EM as a primary care profession.

I don't know what kind of deals other states have setup.

 

[X20pilot]

Take a look at the Brazos Family Medicine Residency in Texas. I will be starting there in another week. The residents there can choose to do an ob track that will allow them to get enough numbers to perform c-sections. The program is rural focused and procedure oriented.

 

[PACtoDOC]

I think that Brazos Valley Program needs a few more years to show it has fixed the problems of the past. Just 2 years ago it matched 0% and if you read what Scutwork says it seems a bit in flux. I'll look into it next year when I am applying and see if it sounds like it is getting better. Keep us all informed. But in all honesty, I am from Texas and cannot wait to leave this hot place. That is why SoCal is so inviting even if it does cost a black market kidney to live there!!

 

[X20pilot]

I understand your caution. I looked at the scutwork website, and I proceeded with lots of skepticism. I first rotated here 2 years ago (in my 3rd year) when the resident who wrote that evaluation was in his 3rd year. During the past year (my 4th year), I have rotated over 14 weeks either directly or indirectly with the program. My experience has been nothing but positive. In fact, I didn't originally want to go into Family Medicine. I despised the idea of becoming just a pill pusher. That isn't the kind of training they provide here. The program is unopposed, and I have seen first hand residents performing c-sections, endoscopies, central lines, BTL's, multiple derm procedures, colposcopies, etc. This program's bad reputation is unwarranted in my opinion.

Your caution is completely understandable though, and if you don't like the heat then this area of TX is definitely not for you. If you change your mind, I would be glad to answer any questions you might have. I have a classmate who matched at a program in Kansas (Via Christi I think?) that is supposed to have excellent OB and procedural training, and I have also heard good things about a program in Colorado for rural experience. You may also want to check out the website I posted a link for below. I think that the info is a little outdated, but it might still be helpful.

http://www.psot.com/PREREAD.HTML

 

[r90t]

PACTODOC,
I had 2 classmates go to the Idaho program to become a rural doc with the surgical skills necessary to fly solo in the OR. One left the program to do an OB/GYN residency in TX after internship year. The other is still there and will be an R3 in a couple of days. If you are interested, I can give him a call to see if the resident procedures are high enough to do C-sections in the rural setting.

 

[Pepe]

Pactodoc,
I matched into the FP program in Washington, PA. and you should probably look into it. The program will give you the opportunity to do ~50 c-sections by the time you leave. The advantage is that you aren't forced to do heavy OB, but the opportunity is there if you want it. The guy from my school who is going there now wants to do rural FP and did enough c-sections to be granted priveliges at his local hospital. Anyway, good luck with your decision.

 

[Newdoc2002]

PACtoDOC,

Dont's put all your eggs in one basket when looking for OB C-secs in a FP program. If you like a particular program, see how they can meet your need to get c-section numbers.

Before I decided I will not likely be doing OB, I came to a program not known for numbers although some residents had done it in the past. My solution was going to be available for c-sections "on-call" and do an elective(s)
at another program in OB (like JPS, why kill yourself for 3 years when you need the experience of 2 months?). I could even "precept" with other docs for C-section numbers once I got out.

At last I knew, Cox in Springfield, MO. had a very strong OB experience, a well rounded FP program, good moonlighting and good benefits in a great city.

Keep in mind that residency is just not about numbers and rotations. It's about life.

See ya later;
Newman

 

[DDuncan]

I am a third year and have decided on FM. I have been researching for months now the many programs and have found only a few that seem to fit what I am looking for. My priorities are getting enough C-sections to be able to go do them in a rural location when I am done. I am not willing to do a 4th year in some OB fellowship to accomplish this. Next, I prefer a place where they treat residents well and are truly concerned for their learning. I would prefer a community based unopposed program but would consider an academic program if there was enough separation to make it community oriented. I want lots of procedures without the overkill that comes from programs like JPS in Fort Worth.

The programs that seem to have uniquely carved niches in this area thus far that I have found are

Ventura County, Ca
Salinas, Ca
Contra Costa, Ca
JPS Fort Worth
Anchorage, Ak

Please let me know if you know any more programs like this. Appreciative.

Matt

Having just finished 4th year, will be starting FP residency next month, I can understand your situation.

First you must start with:
http://www.psot.com/Documents/Oscars.doc

Browse around the psot web site, and read all you can by Dr Rodney.

Second - You should go to the AAFP conference for medical students and residents in Kanas City (early August?). You can talk with residents from nearly every program. By far my most valuable time spent in the search process.

I can share my experience with residency search around the midwest. Places where C-section training is the norm include:
Via Christi - Wichita KS
Greeley CO
Muncie IN
Terre Haute IN
Rockford IL
Baraboo WI - (Rural Track of the Madison program)

Places where a few residents learn C-sections:
Peoria IL

GOOD LUCK

 

[kaisa]

Don't think AK is good Ob site, but know Wisc (madison) has good OB training.

 

[Vukken99]

wyckoff heights Medical center in Brooklyn NY FP residents can do one year of fellowship and since their OB Gyn residency is in shortage of residents. you pretty much can do a lot...

The other one is Franklin hospital in Maryland I think
they have OB track too....