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well, no wonder there is a shortage in rural care...
Started by ThinkTooMuch
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deleted87716
Probably because everyone out in the boonies is still on dial-up. 😉
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Depends on your circumstances. If you are still relatively young a early to mid 20s do MD/DO. MD schools will be harder to get into than DO. They both cost about the same in terms of tuition. If you are older, above 27-28, with a family I'd go nurse practioner or PA route. Forget about CSP. For disclosure I am an attending MD working in the rural midwest for one year before going off to fellowship.
Just my $0.02.
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The DO/MD route will allow for more choices in location, especially if you go into FM. You can play around with this website to get an idea of the opportunities available for different specialties: http://nhscjobs.hrsa.gov/ Its the job listings that NHSC scholars and loan repayment people use for the various health fields that NHSC applies to. You'll notice the most opportunities by far are for FM docs.
This is exactly what I am doing. Very excited to get back into rural life. Got a great contract, no weird clauses. great benefits, no overhead, guaranteed salary and only FP's in the community so no one is telling you "you can't do that since you are FP". My kind of place, loan repayment, good environment for my kids, lots of outdoor activities.
I'm interested in underserved medicine and am looking for suggestions on where I can volunteer to gain experience in this.
I'm a working professional in the Washington DC area and wouldn't mind dedicating some time after work to help out those in need.
I'm specifically targeting activities that medical schools focusing on underserved medicine (i.e. Howard University Medical School) would find appealing.
I've volunteered at a hospital before in the ambulatory surgery department and was a member of AmeriCorp caring for minority kids from single parent homes in an after school youth club.
But all this was years ago, so I'm trying to get back in.
Any suggestions?
I'm a working professional in the Washington DC area and wouldn't mind dedicating some time after work to help out those in need.
I'm specifically targeting activities that medical schools focusing on underserved medicine (i.e. Howard University Medical School) would find appealing.
I've volunteered at a hospital before in the ambulatory surgery department and was a member of AmeriCorp caring for minority kids from single parent homes in an after school youth club.
But all this was years ago, so I'm trying to get back in.
Any suggestions?
You can go work in some clinic in WV, that's not too far from the DC area and they are definitely in need of heath care and they qualify as rural. There is a DO school in WV try to help withthe shortage there.
I was interested in rural practice and/or underserved....
Unfortunately, from a surgical provider perspective, the conditions are concerning from an ethical standpoint. I am a trained subspecialty surgeon. The communities I looked at have 100-200k referral rural base. The CEOs of the hospitals want more general surgeons.... that basically dabble in the subspecialties.
They told me, "we are currently loosing the patient volume and business because the patients are being sent to trained specialists at the university....". In essence, for the non-emergent high end care, they have a system to transfer to well trained specialists. The CEO's hope is to block this referral with "What I want is a general surgeon that can do a little of this work and keep the business here....".
It troubles me to think that the recruitment practice is geared towards blocking underserved patients from receiving high-end, subspecialty care.
JAD
Unfortunately, from a surgical provider perspective, the conditions are concerning from an ethical standpoint. I am a trained subspecialty surgeon. The communities I looked at have 100-200k referral rural base. The CEOs of the hospitals want more general surgeons.... that basically dabble in the subspecialties.
They told me, "we are currently loosing the patient volume and business because the patients are being sent to trained specialists at the university....". In essence, for the non-emergent high end care, they have a system to transfer to well trained specialists. The CEO's hope is to block this referral with "What I want is a general surgeon that can do a little of this work and keep the business here....".
It troubles me to think that the recruitment practice is geared towards blocking underserved patients from receiving high-end, subspecialty care.
WV is a prime example area in which I looked at some hospitals and spoke with some CEOs... all conversations similar to what I said above.
JAD
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That's not "blocking" patients from high end care. That's offering more services locally. I work in a rural area, and trust me... the patients that want "high end" care are going to go anyway. I doubt outcomes are better overall. In fact, if providers know their limits, they are probably better.
There are some inner city free clinics in Baltimore and Washington...
I hadn't seen this reply previously. I can not speak for your community practice.
However, outcomes are better in numerous areas, particularly cancer and particularly when comparing someone specialized in a field as opposed to a dabbler. There are numerous general surgeons in the community performing "cancer" operations. I have seen both the patients/end results and the published literature on what this produces. These rural hospitals are often looking for someone to do vascular surgery (carotids, peripheral, etc...), general thoracic (lobectomies/pneumonectomies, esophagus), etc... in addition to bread and butter general surgery. In surgery, it is quite common for the community surgeon not to accept any limitations.
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deleted87716
Not sure what you mean by "less breadth." It's four years vs. three, and a whole lot more time spent rotating through specialty services rather than doing the sort of ambulatory care you'll likely be doing in a rural practice. Plus, the added fun of two board exams...plus, two board recertifications for the rest of your career.
To the OP, I too am slightly confused as to your goals in reference to rural care... I think MedPedes has its place as does FP. MedePedes opens up possibility for more subspecializing fellowships, etc.... It can/does also serve an important role in primary care. However, even if you have no intention to practice obstetrics, medpeds, IMHO, provides you with less women's health type training then FP. It (medpedes) will also shortchange you on some of the procedural training/experiences that may be advantageous in a rural/underserved community, again IMHO.
Ultimately, you need to decide what path you want and what you really envision your role in a rural community setting. There may be some advantages on either side.
why combined med and peds when you can do both in FM to the degree necessary to bring those skills to rural practice? IMHO both would be fairly interchangeable in that setting and so it really depends on whether you want an in-pt or out-pt based residency training experience.
What rural areas are actually screaming for is psychiatry. So combine family medicine and psychiatry and do in and out pt. medicine, as well as psychiatry where it's really needed. Just another idea...
What rural areas are actually screaming for is psychiatry. So combine family medicine and psychiatry and do in and out pt. medicine, as well as psychiatry where it's really needed. Just another idea...
