Calif - FM program with Inpatient heavy training

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cyahwheniseeyah

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Sorry to start a new thread, but to be honest it was hard to swift through the tons of threads to look for my particular quesiton. I'm looking for FM programs that have great inpatient training with great FM friendly electives that cater torwards in patient training, critical care etc.

Would like to also get success stories of FM trained graduates landing hospitalist jobs. Thanks.

Particular looking into california. To be blunt I don't want to differentiate unopposed versus opposed because both are great in their own rights. Thanks alot guys

*** edit- i feel like I'll get a lot of backlash for not doing my own research. Sorry guys, tried my best to get concrete info. ***
 
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cabinbuilder said:
why does your status say pre-med? If you are not in medical school yet, not sure why you are worrying about residency that is 4-7 years away?
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haha I have no idea to change it... I'm a MS4 though. I've seen you around the forums alot cabinbuilder and admire your locum spirit. Just trying to pave my own career in California. Just trying to get help to chose programs to apply to out there. Thanks though.
 
cyahwheniseeyah said:
haha I have no idea to change it... I'm a MS4 though. I've seen you around the forums alot cabinbuilder and admire your locum spirit. Just trying to pave my own career in California. Just trying to get help to chose programs to apply to out there. Thanks though.
Click to expand...
go into your account under personal details. In the center there are status options. Change yours to medical student.
 
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If you tried your best, you should be able to get most of it 🙂

Just go to each program's website and read through their curriculum
https://nf.aafp.org/Directories/Residency/Search

Ventura and Contra Costa are probably the two most inpatient heavy. UCSF doesn't post their curriculum, they aren't full-spectrum but they do all their inpatient at SFGH and I've heard it's rigorous but not sure how many months.
 
[You could say something like "hey guys, I admit I haven't read through all 66 pages of topics, maybe just the first 5 or 10 pages, but I'm looking for this particular type of program, and so far I've heard of these programs X, Y, Z, can you recommend any others?" because otherwise it does come off sounding a little lazy, not like you actually "tried [your] best"]

You can get some sense of what the inpatient training is like from a program's website, but beyond the number of months on inpatient medicine or ICU (+/- inpatient peds, inpatient surgery) there is also the question of how intense the rotation is, what is your patient load / size of your team, what is your mix of inpatient/outpatient responsibilities, are you doing accessory/extraneous work vs the real work that makes the hospital run, how much responsibility do you have at what level of training when you're on call, how many people do inpatient work after graduating, etc. Many of those things are hard to judge from a website. Hard to gauge overall, but particularly just by looking at the number of months on this or that rotation.

We do a lot of inpatient. So does Contra Costa. Other places in California that do: Santa Rosa, Natividad/Salinas, maybe Northridge, maybe Merced, maybe others I don't know about.

Did you go to the AAFP conference in Kansas City this past month? Tons of programs there, and a great way to get details about all kinds of places before submitting applications.
 
VenturaResident said:
[You could say something like "hey guys, I admit I haven't read through all 66 pages of topics, maybe just the first 5 or 10 pages, but I'm looking for this particular type of program, and so far I've heard of these programs X, Y, Z, can you recommend any others?" because otherwise it does come off sounding a little lazy, not like you actually "tried [your] best"]

You can get some sense of what the inpatient training is like from a program's website, but beyond the number of months on inpatient medicine or ICU (+/- inpatient peds, inpatient surgery) there is also the question of how intense the rotation is, what is your patient load / size of your team, what is your mix of inpatient/outpatient responsibilities, are you doing accessory/extraneous work vs the real work that makes the hospital run, how much responsibility do you have at what level of training when you're on call, how many people do inpatient work after graduating, etc. Many of those things are hard to judge from a website. Hard to gauge overall, but particularly just by looking at the number of months on this or that rotation.

We do a lot of inpatient. So does Contra Costa. Other places in California that do: Santa Rosa, Natividad/Salinas, maybe Northridge, maybe Merced, maybe others I don't know about.

Did you go to the AAFP conference in Kansas City this past month? Tons of programs there, and a great way to get details about all kinds of places before submitting applications.
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Absolutely. Point taken on the limitations of just looking at curriculum which is why folks like VenturaResident you really help understand the rest.
 
Great, Yes there is a garbage ton of posts on FM, in patient. I was specifically looking into california, and hearing about specifics of the programs. I posted again because... Why re-invent the wheel, if someone's been through the research to look these things up. I'll take more time to look through more threads, but haven't found anything that is what I was looking for. Thanks for all the help from people that had productive contributions.
 
Can any current california FM residents comment on how many of their colleagues are taking in patient jobs, and geographically where they are being offered positions? This is the most elusive info I'm having tracking down. A lot of it seems he says/she says.
 
Current California FM resident. 14 residents per class. I can't list everyone off the top of my head, but among this past June's graduates, 4 of them have been doing hospitalist&ER work at our hospital (1 of whom will soon be going to Bangladesh to do a mix of inpt/outpt). Two are doing OB fellowships. 1 is doing exclusively inpatient work in a smallish town in Oregon. 1 is doing a faculty development/hospitalist fellowship in the greater LA area (not sure if in city limits). I directly took a faculty position in LA doing inpatient/outpatient/OB. 1 went to Honduras and is going a mix of inpatient/outpatient. 1 went to New Zealand and I think is just doing outpatient, but I'm not 100% sure. 1 went to Nepal, doing a mix of inpatient/outpatient. Two went immediately to Alaska (Barrow and Juneau) and took temporary jobs doing a mix of inpt/outpt. 1 went to Montana and is doing I think outpatient with OB (including C sections) - I believe not doing hospitalist work, but I"m not sure. Off the top of my head, I can think of just two who are definitely doing exclusively outpatient work in out local clinic system.
 
Hey cyahwheniseeyah, if you're wanting to pursue family medicine residency with heavy inpatient training in Cali, I would strongly recommend Methodist Sacramento. I interviewed there and was very surprised to see how much inpatient they do - 7 out of 8 residents from the graduating class were accepting hospitalist positions in the Northern California area. All of their medicine wards were mixed ICU/medicine, and the program is unopposed. They were very well trained in all procedures as well (intubations, central lines, etc.). PM me if you want some more details. Best of luck!
 
Wow that is exactly what I wanted to hear. I will definitely be applying to Methodist sacremento. I'll send you a message soon enough. Thanks Ventura as well. This type of information is liquid gold.

I'm actually okay with less OB... to be quite frank. Thanks for the information. DO you guys see a culture of discrimination from larger hospitals servicing more urban/metropolitan type cities, when being recruited or applying for hospitalist positions? I'm wondering if getting a Hospitalist fellowship would help at all if that were the case
 
Well that's good that you're okay with doing less OB, because at Methodist Sacramento they don't do much, from what I was told during my interview.

And yeah, I mean in general hospitals (particularly in big cities/urban areas) will prefer to hire internal medicine trained docs for their hospitalist positions, no question about that. The exception is when you have a family medicine residency program that has a good reputation within the city, that hospitals are familiar with, and have hired residents from in the past. Also, in general, smaller hospitals in less urban settings would be more willing to hire family med trained docs as hospitalists.

A hospitalist fellowship would help primarily in terms of certification and recruitment for jobs, but you may likely already have the necessary skill set to be a hospitalist straight out of residency, depending on where you trained. But, like you said, the extra certification would help in terms of marketability.

Just out of curiosity, if you're so set on doing hospitalist work, and are not particularly interested in OB, why not just do internal medicine residency? You get great experience in all inpatient rotations, with some good clinic months thrown in.
 
From what I ve heard from recent grads from my wifes program.. ( I will be applying this cycle to FM).. its getting to be a good amount more difficult to get hospitalist jobs in CA for FM docs..

Most hospitalist jobs require either an IM residency or FM doc with atleast 2 to 3 years of hospitalist work experience... it seems like once you get the 2 to 3 years of hospitalist experience you re close to equivalent to IM when it comes to hospitalist jobs outlook.. but obviously those first few years you ll likely have to work in a rural hospital or maybe even go out of state..

With that said my sister is a 3rd year FM resident and she got a job working in a busy ER in the midwest.. I doubt she could have found a equivalent job in California.. Just thought I would throw that in for anyone thinking of doing FM and working in an ER..
 
OP: if you're really convinced you want to do primarily inpatient, and you really only want to treat adults, just do IM. It will make your life so much easier.
 
Hmm interesting points. Thanks for everyone's input. Although, this is my biggest delima. I feel inpatient IM is absolutely fun. But I know that being realistic the life span of hospitalists is yet to be completely determined and across the board is pretty short. That leads me to think one day I will probably transition to a specialty or out patient practice. IF that were the case, I'd much rather be trained FM, because the utility of FM out patient is unparalled at times, given their versatility of inch deep mild wide mind sets. A consideration is to do IM, burn out as a hospitalist sign up for FM residency somewhere and retrain? Am I crazy?
 
Retrain? Yeah, that does sound crazy (not to mention that will also entail a huge financial hit)! Make a choice and let it ride. If you really want to keep the hospitalist option (more) open relatively speaking, go IM. Try for a primary care program if that tickles your fancy.
 
Currently I am applying IM. After all your suggestions, it seems the practical route to take. Thanks again.
 
cyahwheniseeyah said:
Hmm interesting points. Thanks for everyone's input. Although, this is my biggest delima. I feel inpatient IM is absolutely fun. But I know that being realistic the life span of hospitalists is yet to be completely determined and across the board is pretty short. That leads me to think one day I will probably transition to a specialty or out patient practice. IF that were the case, I'd much rather be trained FM, because the utility of FM out patient is unparalled at times, given their versatility of inch deep mild wide mind sets. A consideration is to do IM, burn out as a hospitalist sign up for FM residency somewhere and retrain? Am I crazy?
Click to expand...

I'm sort of on the same page as you, OP, though I'm not looking particularly at California. I am very interested in hospital medicine, but I'm also interested in FM. I want the versatility. I want to be able to moonlight in small ED's and urgent care offices and see all ages, even if my main full-time job is adult hospital medicine. It's partly philosophical. I want to be an expert in general medicine, and I think FM might be a great way to pursue that. Of course, being in MS2, I probably don't know what I want, and it's all just conjecture.

For what it's worth, I did find this recent study on job prospects for FM-trained hospitalists. I find the results encouraging.
http://www.shmabstracts.com/abstract.asp?MeetingID=800&id=110322
 
I will argue however, to your post, look at geographical regions more specifically. I had to do a varied job search for positions in particular cities of interest to live in/nearby. I think the data you presented is skewed to some degree. I.E. North East could mean in the middle of no where New York versus New York, the hospital sizes/beds does not indicate which city it is located. I hate to say it, but unless you're okay living mid west/rural, there is some discrimination against FM trained Hospitalist. And if so, if you do FM to go hospitalist, eventually your out patient skills will atrophy. I think it was a hard pill to swallow but the way medicine is being practiced now, there really is no jack of all trades especially in coastal more desirable liveability locations.
 
Glad to hear you made a well thought at decision! If in the end, you decide to switch to family medicine (aka get burned out by crazy ward months and decide you would never want to do hospitalist medicine 😉), know that you always have the option of switching to family med. I know a couple of people who have done that.
 
@NurWollen focus on each rotation as a new opportunity to experience a new job. #1 helps you do well on rotations #2 will really tease out who you are and what you like. #3 if you still don't know dual apply. #4 still don't know? oh just chose one.
 
VenturaResident said:
Current California FM resident. 14 residents per class. I can't list everyone off the top of my head, but among this past June's graduates, 4 of them have been doing hospitalist&ER work at our hospital (1 of whom will soon be going to Bangladesh to do a mix of inpt/outpt). Two are doing OB fellowships. 1 is doing exclusively inpatient work in a smallish town in Oregon. 1 is doing a faculty development/hospitalist fellowship in the greater LA area (not sure if in city limits). I directly took a faculty position in LA doing inpatient/outpatient/OB. 1 went to Honduras and is going a mix of inpatient/outpatient. 1 went to New Zealand and I think is just doing outpatient, but I'm not 100% sure. 1 went to Nepal, doing a mix of inpatient/outpatient. Two went immediately to Alaska (Barrow and Juneau) and took temporary jobs doing a mix of inpt/outpt. 1 went to Montana and is doing I think outpatient with OB (including C sections) - I believe not doing hospitalist work, but I"m not sure. Off the top of my head, I can think of just two who are definitely doing exclusively outpatient work in out local clinic system.
Click to expand...

Also, I should mention that an additional two of the other folks in this year's class who have been doing some shifts around in our system will be leaving soon to work internationally: one in Liberia and one in Haiti. Mix of inpatient/outpatient.
 
VenturaResident said:
Also, I should mention that an additional two of the other folks in this year's class who have been doing some shifts around in our system will be leaving soon to work internationally: one in Liberia and one in Haiti. Mix of inpatient/outpatient.
Click to expand...

That's a very interesting graduating class. That's very heavy internationally focused group. Interesting... Ventura correct?
 
Yep. Lots of folks interested in global health come here. And yes, Ventura. That's why my screen name is VenturaResident.
More power to you whatever field you wind up applying in; but I think it's important to be clear that Family Medicine folks are pretty much the most versatile and can go directly from residency into all kinds of different practice settings.
 
I didn't read all of the above threads so sorry if anything is repeated. I did my residency at White Memorial Medical Center which is significantly more inpatient heavy than many FM residencies (in the first year alone there are 4 months of high-volume inpatient wards plus 1 month of ICU), and I wouldn't trade the experience I got for anything. I also hear a lot of good things about Contra Costa and of course Ventura in regards to broad training. Hope this helps...
 
Thanks everybody, I've decided to attend a couple interviews in both fields. Hopefully I wont run into the same people. That would be bad.
 
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