Looking for info regarding EM/FP rotation in Sells, AZ

[Prncssbuttercup]

Hi all, looking ahead to set up a selective through UAZ-Tuscon in Sells, AZ. It is "Emergency Room/Family Physicians in Community Hospitals" and I am wondering if anyone has done this rotation, and if so what they thought of it!

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[Winged Scapula]

I don't know anything about the rotation but it's on the Tohono O'odham rez and in the middle of nowhere. I'd expect a fair bit of poverty, diabetes, and wild dogs running around (rez dogs).

 

[Prncssbuttercup]

Yep, knew it was in the middle of nowhere, wondering more if it is a good rotation for someone who wants to do family med, but might want to do rural EM on the side (which is the goal of the rotation). I worked for a CHC so I'm fairly comfortable with the poverty thing, just not sure if I'll get decent experience out of it. I am not sure if it's possible to find other students who have done it previously, which is why I thought I'd ask here! Hopefully the feral dogs aren't a problem, because I'm a dog lover, and I don't need to try to adopt any dogs while on a rotation... but it could be an excuse to get the rabies vaccine

https://oasis.medicine.arizona.edu/public/view_course.html?yid=2015;did=FCM;cid=891P

 

[styphon]

In rural areas, family medicine/internal medicine are often the ER providers, as opposed to EM boarded physicians.

I do not know the hospital, or its distance to larger hospitals- but a rural hospital will ship out most if its complex patients to a tertiary care hospital after stablization. These include MI's, sepsis, CVA's, horrible trauma, etc. Rural hospitals with long transport times will do more "stabilization" as opposed to a hospital 45 minutes from a Level I trauma center. In addition, a native american population is special niche that has a higher rate of DM and its complications, frequent substance abuse issues, and poor health literacy.

I would think - if you want to see how it is to deal with an underserved population in a rural setting, this would be a great opporunity. If you want "cool" multi-system trauma with everyone running around and chest tubes flying everywhere - I am willing to bet this isn't the place.

 

[Prncssbuttercup]

I am not sure that I need chest tubes flying etc, just looking for solid rural EM work. It's ~90 minutes by road to Tucson, which I would think would be the nearest major hospital. Although that is a guess on my part. I guess one of my thoughts is learning how to and what to stabilize and ship out. A friend of mine made a point once about knowing what you can and cannot handle, and knowing ASAP is important. Either way, your comments are helpful, thankfully I have a fair amount of time to decide as my electives aren't scheduled until next year.

 

[Winged Scapula]

I think it sounds pretty cool if you like that sort of thing. Sells is only about 60 miles from Tucson and with posted desert speed limits up to 75 mph, it doesn't take that long, but that would be the closest Level 1 trauma center. You should be able to get some census data from the Indian Health Service as to number of ED visits, ICD codes, etc. so you can see how many and what you could expect to see in a typical month.

Rez dogs are cute but I'm not sure they're adoptable; they're lone wolves. http://en.wikipedia.org/wiki/Rez_dog

 

[Prncssbuttercup]

I have 3 dogs currently, my husband doesn't want three dogs after my oldest one dies, so it's better for them to not be cute or adoptable!!!

Good ideas on the census info!

 

[styphon]

To add to my post:

I am employed at an IHS (indian health services) site. We deal only with native americans, and you need a "tribal certificate" before you can even register your name in the EMR. I have worked in suburban, urban, and rural sites before coming to this - and the IHS has some of the sickest patients on average of any of the places I have been at. Being white - there is also a high level of mistrust, and it takes a while before you are accepted. Our resources are limited - I do not have the specialists I had available in the inner city, nor the newer medications available at places like rite aid. We use a local rural hospital - which is limited in services - and often our patients are shipped to the innercity for further treatment. The clinic itself is nice - we have our own lab, pharmacy, xray, Ultrasound, optho, and dentists.

 

[Prncssbuttercup]

As a student, I would expect them not to trust me, and I would be surprised if I could get into the EMRs, I've heard from several classmates that it is highly dependent on which place you're working with. You would know more than I do!

 

[xuehighbiger]

me too,I'm a dog lover, and I don't need to try to adopt any dogs while on a rotation... but it could be an excuse to get the rabies vaccine.thanks