% outpatient during FP residency?

[kcrd]

I was wondering if some of the current FP residents could tell me what proportion of their residency training is in outpatient clinics vs inpatient. Also, a lot of the programs in my area list 60 hours/week as the average for first year residents. Is this a ridiculously low estimate, or does it sound about right to you? Thanks in advance.

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[edfig99]

the 60 hrs per week sounds about right...it may be a little more or less depending on the rotation...sometimes it can get to 80 or a little more above it. NYS has had work hour laws since the mid-80s, and we're pretty good about sticking to them in our program

in terms of %time outpatient, that does vary by year and by rotation. Our interns do one half day a week in continutity clinic, second years do 3 and third years do 4. about 7 or 8 months of our pgy 1 yr is inpatient based, versus 3.5 mo 2nd and 2.5 mo in 3rd year. as a third year, i have spent the bulk of my time in outpatient settings, working about 40 hrs/wk (on paper anyway -- i do enjoy what i do, so i eek out a few more hours here and there)

hope this helps.

 

[kcrd]

very helpful - thank you, ed!

 

[CHICA17]

This is an outshoot from the original topic, but I really need an answer from those that can help, please! I'm in the process of applying to residency, and I'm going Family Practice and possibly Preventative Medicine (possibly dual). Emphasis on the FP portion of the program.

In terms of a FP residency, do you know of any that are mainly outpatient-based? I know that most programs have inpatient as part of them, but I'm really looking for a program that is heavily outpatient, since it fits my interests better. I'm willing to move anywhere, but would prefer TN/OH if possible. If not, that's fine. I can live anywhere, in terms of small/large hospitals/towns.

Also, do residencies really adhere to the 80 hour rule, or do most of them go over it? I'm on a rotation and I'm beginning to wonder......if any of them stay under 80 hours. LOL. If they did, that would also be a great one to suggest to me! please!

Any comments/suggestions are greatly appreciated!!! Thanks so much for your time and understanding in advance

 

[MedicineDoc]

In my opinion: Inpatient is a continuation of outpatient and they go hand in hand. By Trying to separate one from the other during your training you would be doing yourself and your learning process a disservice. A FM/IM doc knows what he/she can deal with outpatient and what needs to be admitted to the hospital.

 

[Leukocyte]

In terms of a FP residency, do you know of any that are mainly outpatient-based? I know that most programs have inpatient as part of them, but I'm really looking for a program that is heavily outpatient, since it fits my interests better. I'm willing to move anywhere, but would prefer TN/OH if possible. If not, that's fine. I can live anywhere, in terms of small/large hospitals/towns.

Pretty much all FM residency programs are heavy on the out-patient continuity clinic. All programs have to adhere to a minimum # of out-patients seen, but many exceed it. The in-patient adult and peds experience varies from program to program, but there is also a minimum standard that needs to be met.

Beside, your FM residency program will be MORE THAN HAPPY to schedule you for more days in the clinic if you REALLY wanted to as your specific rotation allows (not too many residents are trilled about this).

When I did my residency, PGY-1s where in clinic for 2 half days per week with 4 months of in-patient. PGY-2s where in clinic for 4 half days per week with 4 months of in-patient. PGY-3s where in clinic for 6 half days per week (sometimes more depending in the rotation) with 5 months of in-patient.

Also, do residencies really adhere to the 80 hour rule, or do most of them go over it? I'm on a rotation and I'm beginning to wonder......if any of them stay under 80 hours. LOL. If they did, that would also be a great one to suggest to me! please!

Overall, most stay under the 80 hour rule, but it depends on the specific rotation that you are doing. For example, in-patient service can be demanding and could cause one to stay over 80 hours. Same goes for OB service. Also please note that there will be TONS and TONS and TONS of paperwork, charts, and dictations that need to be done often out-side the official scheduled work hours. So in reallity, if you consider ALL that paperwork stuff, it is more than 80 hours. The only advice to to work quickly and methodically (have a system in place) so that one can do the dictations, charts, paperwork within the scheduled work hours. But often, this can be difficult.

This is an outshoot from the original topic, but I really need an answer from those that can help, please! I'm in the process of applying to residency, and I'm going Family Practice and possibly Preventative Medicine (possibly dual). Emphasis on the FP portion of the program.

I am currently going a Preventive Medicine fellowship. I am not aware of any "official" combined FM-PM residencies. If you are interested in PM, you can do it after your FM residency. Some programs say that they can accomidate residents who want to do a MPH during there residency...But just getting a MPH is NOT like doing an official Preventive Medicine residency. So if you are seriously considering a career as a federal or state public health physician (medical officer / medical epidemiologist), then I would reccommend doing an official accredited Preventive Medicine residency. The PM residency will give you real life experience in applying what you learn in MPH classes to work as a public health physician / preventive medicine consultant.

Good Luck.

 

[raptor5]

For continuity clinic it is all about the magic number. 1650. The number of patients you must see over 3 years. Sometimes it amounts to quantity over quality where experience in other specialties is scavenged for that number.

 

[Richie Truxillo]

(Note these are averages)
We had 1/2 day clinic per week as an intern
2nd year was 1 full day of clinic weekly
3rd year was 1.5-2 full days of continuity clinic weekly.

I had no problem, even when only doing 1.5 days/week as chief resident (had half day off for administrative time), reaching my magic 1650 patients.

Much of this is also dependent on the volume at your clinic site as well, as those who have higher volume have an easier time meeting their numbers generally.

 

[cabinbuilder]

My residency was run by an Internist so we really did more internal medicine than family practice which was fine because I learned a huge amount an am confident in a lot of my IM problem management skills.

Our FP clinic did not do PEDS or OB/prenatal.

Each year had three 1/2 clinic days
Our Intern year had 5 inpatient hospitalist service months. Some with the FP guys some with the Internists.

2nd year had 3 hospitalist months.
3rd year had 2 hospitalist months.
We also covered ICU as well.

I don't think it's wise to try to sell yourself short about what you think residency should be for you. Just embrace what you love and tolerate what you don't. Get through residency and then practice how you like. You never know where you will end up in the future and you may need those inpatient skills to make money or fill in some locums spot that you never dreamed you would do as a med student. You may find that you really like it when early on you have this notion of not wanting to do it.

I felt that way about clinic initially - just HATED it. Found it very monotonous and just irritating all the non-compliance. Now I don't mind it and I found over the three years in residency it came to grow on me as I started having some favorite patients and we bonded as a team.

IT WILL BE OK..