see everything in univ prog, or do everything in unopposed?

[Dr McSteamy]

university programs always get the toughest, most interesting cases.

although a lot of good pts are taken away from opposed FM programs, I would assume you can observe the interesting cases from other services anyway????


So I think you could potentially learn more crap from a univ program than some unopposed community program.

am i thinking right?

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[sophiejane]

university programs always get the toughest, most interesting cases.

although a lot of good pts are taken away from opposed FM programs, I would assume you can observe the interesting cases from other services anyway????


So I think you could potentially learn more crap from a univ program than some unopposed community program.

am i thinking right?

I have been amazed at the weirdness I've seen here in this community of 150K. Stuff I never saw in a big city hospital. Don't assume only the university hospitals get weird and interesting things. The difference is, we see the interesting cases, essentially diagnose them, and send them off to tertiary care centers if we don't have the specialists or the facility to treat them. Which is exactly what you will be doing as a family doc anyway.

I can't tell you the number of times I've consulted Pedi specialists in the DFW area who say they hardly ever see some of the weird things we see here. Of course we sometimes (not always) send them there for treatment, but by then, the fun part (the diagnosis) is done.

I know people will disagree with me, but I really can't see any advantages to going to an opposed or university program, unless you want to end up on the faculty at one. If you want to practice in the real world, learn how to do the things you will do in practice, you should go unopposed/community.

 

[DrJosephKim]

There are obviously pros and cons to opposed vs. unopposed. Think about what type of family physician you want to be after you finish.

 

[deleted87716]

In a typical academic center, the so-called "interesting" cases that get transferred in are probably more likely to end up on an IM, peds, or subspecialty service rather than the FM service.

 

[cali-ob]

well at my program (opposed univeristy affiliated county hospital) cases from
Ed are not assigned by the complexity of the patient. They are assigned based on who the patient sees in the out patient setting. If they see an FP as their primary (even if the last visit was years ago) then they come to our service. If their primary is an IM doc then they go to IM. Thats it, that's all. So I think our services are about equal in complexity, and as far as patient volume, the FP service is actually a lot busier than the IP medicine service.

the same goes for peds...if the child sees a pediatrician as their primary they go to peds, if they see an FP, they come to us, no matter how interesting or complex. Anyone really sick goes to the Unit of course, where they are managed by ICU attending. OB patients who come in to Triage or in labor if they see an FP for their prenatal care, the ob residents just page the FP resident on call for OB. THey are there for back up at all times of course but we see them from beginning to end.
So in my situation I like being "opposed" though I don't think we are opposed by anyone at all from doing what we want to do

 

[deleted87716]

Ed are not assigned by the complexity of the patient. They are assigned based on who the patient sees in the out patient setting. If they see an FP as their primary (even if the last visit was years ago) then they come to our service. If their primary is an IM doc then they go to IM.

I was referring to unassigned patients. There are lots of local factors that may come into play, of course, but institutional politics at most academic centers typically does not favor family medicine departments. I'm sure there are exceptions.