Discussion in 'Family Medicine' started by Angry Mouse, 03.22.04.
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One of the most important things for you to do is try to envision what you want your practice to be like after training. If you are going to a rural area, you will probably need more procedural experience than if you stay in the city. Honestly, the specialty is so broad, no program can excell in every area. Ask the residents what they fell capable of handling, and what they have to refer b/c of lack of experience. For me personally, I'm interested in sports medicine and OB, and not so interested in Peds, so I interviewed at programs that were relatively stronger in the areas I liked. Anyway, good luck to you
i couldnt agree more with pepe! it wasnt easy sitting down and deciding which fp programs to apply to, which ones to accept interviews at and not to mention the anxiety driven rankings!
but, i wanted a program with lots of inpt/IM exposure, procedures, atleast 2 ICU months, and moonlighting opportunities. why? because i want to not only do outpt fp but also take care of my pts inpt as well. and this is still very common contrary to popular belief so dont let anyone tell you other wise. i also may end up in not so urban area where i will very possibly be covering an E.R. and even deliveries. so you want a program thats strong in those areas as well. every program has weaknesses though.
the main thing is... are the residents happy? if there not something is wrong. either they are worked too much and arent learning or the program just sux. the residents (aside from some of the chief residents) wont screw you around and will give it to you straight so talk to them! make sure the program has good didactics too...lunch conferences, speakers, academic half days..something! programs that have dedicated procedure clinics incorported into the curriculum are always good..you make money and keep your skills up by doing...doing procedures!
hope this helps. as far as opposed and unopposed you get mixed answers. this was a big question i had, but ended up at an opposed program. but, the fp inpt service was a very busy service so i dont have to worry about internal medicine taking pts or anything like that. always ask who and how many docs admit to your fp service.....the more the better in my opinion. more path, more sick pts, more youll learn.
This is all great advice. More specifically for your inpatient learning, you'll get better experience if the patients on your hospital service (and many of those will be from your clinic service) are more complicated medically. On a related note, I think its important to see how good the relationships are between FP and the other departments/services. I got the impression at some places that patients (at least, those that weren't clinic patients) that got admitted to the FP service only had 1 or 2 diagnoses--in other words, they were pretty heavily screened before being assigned to the FP service. Its better to be somewhere where 1. You get the chance to really develop the chops to handle the complicated inpatient stuff and 2. the other departments recognize your skill level and are thus not leery of giving your service more complicated patients. Some will say that the only way to handle this issue is to go straight unopposed. You can probably find this kind of experience also at academic programs and at 'hybrid' type programs, you just need to evaluate carefully. Personally, I think it doesn't hurt to have your inpatient service in a hospital where you are the only residents tho'
Mouse, looking on Freida I see programs that have January/July as start dates. Then I see some with July/negotiable. I graduate in January and would like to start sooner than July (like yourself).
Do you know what that "negotiable" covers? Ever hear of anyone starting in March, for instance?
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