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Any point to do an EM fellowship after FM residency

Discussion in 'Family Medicine' started by ajagr68, Jan 5, 2012.

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  1. ajagr68

    ajagr68 2+ Year Member

    Dec 4, 2011
    Is there any reason to do a fellowship in EM after completing Family Medicine Residency. I know FM docs can work in rural EM's automatically. With the fellowship are they viewed as equal to EM residents if wanting to work in the ER in a more urban setting? Is there any financial benefit after doing a EM fellowship after FM residency?
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  3. Nevis

    Nevis 2+ Year Member

    Feb 25, 2010
    Nope, unless you want to work in a rual ER I don't see much point. Personally, I thought about this route, but how do I know that the fellowship will offer training that is equivalent to an ER residency? Your teachers are likely other FM docs who lack formal EM training and who probably made more then one mistake while learning on the job. I decided that if I went this route the day i encountered my first real trauma pt. who dies on me I would always wonder if I had had better training, say in a real EM residency, could I have done something more. There is an argument to be made that even a poorly trained ER doc in a rual area is better then no ER doc at all...but I don't want to be that poorly trained doc always wondering if i could have done something more. Do you?
  4. montessori2md

    montessori2md Member 10+ Year Member

    Oct 1, 2005
    On the Road Again
    There are quite a few FM attendings in my ED who have done EM fellowships. You do an EM fellowship b/c you want to do EM, and the hospital won't let you unless you do the fellowship. If you're in a larger hospital, odds are you have a trauma service, and if you're in a rural hospital, a lot of the trauma will be flown to a level I, you'll never see them.
    It also depends on your residency and how able they were to prepare you as far as procedures, etc. If you have done a ton of intubations, lines, feel comfortable managing acutely ill patients, and documented your numbers, you may not need a fellowship to get a hospital/EM group to take you, especially if they really need the help.
  5. OneLeven

    OneLeven 2+ Year Member

    Jan 16, 2012
    In a rural setting, does an EM fellowship allow you to earn more when moonlighting in an ER or Urgent Care Clinic?
  6. cabinbuilder

    cabinbuilder Urgent Care Physician 10+ Year Member

    Nov 21, 2005
    No, Moonlighting pay is by the hour. Urgent care is so bare bones (I am working that today). It's mostly folks with bronchitis, sprains, back pain, ear infections, smal lacs. Folks who don't have a doctor or are uninsured.

    I am FP trained and have been doing rural medicine for the last 3 years in TX, CO, MT, and OR. I have covered the ER in small hospitals and as the above poster stated, it is very rare that you would have any major trauma come through the door as the local ambulance folks know what the staff is capable of and almost no one is admitted who has any type of surgical needs. The only class I was asked to have is ATLS for some of the hospitals.

    My advice is if you plan to do rural medicine be sure you do some of your third year electives in trauma ER at a larger hospital and get comfortable with chest tubes, central lines, and stabilizing trauma. Learn how to do a fasciotomy for compartment sydrome. Odds are you will never use it but at least you can say that you did the rotation and have self confidence before going out there by yourself.
  7. EdibleEgg

    EdibleEgg Member 7+ Year Member

    Jan 24, 2008
    You may make a bit more money with a fellowship, but not much. Several of the mid sized hospitals in my area will pay a 10-20 dollar an hour bonus to EM boarded or fellowship trained docs. It will make you a bit more palatable to some hospitals (our new director is FP+ fellowship trained). It will not make you equivalent to EM boarded physicians in the eyes of most administrators or EM boarded docs.
  8. andwhat

    andwhat Senior Member 10+ Year Member

    Nov 14, 2003
    United States

    One thing popped up that I do not understand too well. Certain hospitals prefer Family Practice certification without a fellowship to work in the ER, meaning someone without a fellowship has a higher chance of landing the job than someone fellowship trained. This does not make sense.
    Last edited: Jan 29, 2012
  9. Seafood

    Seafood 2+ Year Member

    Sep 1, 2009
    How competitive are these fellowships?

    I know there is one in TN, are there any others?
  10. EdibleEgg

    EdibleEgg Member 7+ Year Member

    Jan 24, 2008
    I've never heard of this... I'm not sure why this would happen.
  11. ztaw15

    ztaw15 5+ Year Member

    Oct 5, 2007
    There are actually two ER fellowships in TN, maybe a third that is not very "official" - I don't know much about it. Then there are three operative OB fellowships too.
  12. emedpa

    emedpa GlobalDoc 10+ Year Member

    Aug 25, 2001
    Taking an Away team....
    there are 7 "official" em fellowships for fm boarded physicians on the aafp fellowship website.
  13. tcp03

    tcp03 Tcp03 2+ Year Member

    Mar 14, 2008
    1. Can FM work in a Peds ER?
    2. We've discussed FM's role in rural EDs....how bout a FM working in an suburban non-trauma center ED (adult or peds)?

    Thank you all in advance!
  14. ztaw15

    ztaw15 5+ Year Member

    Oct 5, 2007
    I'm in a city that may be a little different in terms of its practice patterns, but it is a very large urban area and there is only one trauma center. Aside from in the trauma center and one Stroke/Cardiac center that occasionally takes some GSWs when the trauma center is on overflow, the other ~6 places seem to be staffed by more IM/FM guys than EM guys. I think this is mainly a function of not having an EM program here, though there is an FM-EM fellowship program in the city, and another about an hour outside. As far as the pediatric facility, I think it is staffed entirely by peds/pedsEM people.

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