CCFP(EM) in the USA?

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White-Tiger

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Hello everyone,
I am currently a first-year medical student at McGill University in Montreal. As it stands now, I am pretty interested in Emergency Medicine.

As some of you may be aware, in Canada there is two streams to enter emergency medicine. Either follow the Royal College specialty program with is a 5 year residency or complete a family physician residency (2 years) with the possibility of a 3rd year giving you special competence in emergency. With the latter stream you end up with CCFP(EM) credentials. In Canada, there is not much of a distinction in terms of employment between the two streams.

I am quite interested in going the CCFP(EM) route as I like the diversity of practice a family physician can have with the added benefit of being a recognized emergency physician. The problem is this route is not quite recognized in the USA and won't lead to ABEM certification. However, because the extra year of emergency in Canada brings the total years spend in residency to 3, this means that a CCFP(EM) physician can sit for the family physician licensing exams in the USA and thus gain his certification.

My question is what is the current situation for family physicians with prominent ER experience? Are they very employable? How do you see this situation changing the in the future (next 10-15 years)?

I ask because, as stated, I would much prefer going the CCFP(EM) route but I don't really feel like cutting any bridges if I ever decide to relocate down south later in life.

Thanks in advance.
-WT-

Edit: I also heard it is possible for a practicing CCFP(EM) physician wishing to relocate to the USA to complete an extra 2 years in EM residency in the states to qualify for the ABEM exam(given he's already done a year in Canada). But I don't know how feasible that is?
 
You're unlikely to find a good EM job with family practice training in another country.

The Residency Review Committee allows US emergency medicine residencies the discretion to grant up to 6 months credit for previous training within a certain time frame of your last training (I think it's 1 year). However, this is allowed, but not always practiced.
 
Nope. You've got to do the whole residency, or at least 30 months of it.
If you sit for the FM boards, you might get a job in the sticks, for the time being. But that will be less likely in 10-15 years.
 
You are coming from a great medical school and could probably make yourself competitive for a US EM residency spot. If you know you want to come here and do EM anyway, why not just come and train here too? Difficult, maybe. But more realistic than the FM route I think.
 
Edit: I also heard it is possible for a practicing CCFP(EM) physician wishing to relocate to the USA to complete an extra 2 years in EM residency in the states to qualify for the ABEM exam(given he's already done a year in Canada). But I don't know how feasible that is?

Not exactly. ABEM will allow credit of up to 6 months if the candidate has had at least two years of LCME accredited training (I don't think Canadian training qualifies) within the previous 60 months from starting EM training.

but there are a lot of requirements:
1. The PD cannot promise this in advance since it requires individual permission.
2. After the match/contract the candidate's previous program provides the gaining PD a copy of the rotations completed.
3. The PD then compares it to his curriculum and applies for a month for month equivalency for the rotations he wishes to credit. No EM months will be credited.
4. ABEM makes the determination.

I am unaware of a policy that would allow a CCFP(EM) qualified candidate to complete two years of EM training in the US and sit for the boards. Contact ABEM for clarification.

All told, I would not expect that Canadian training will help, nor would transferring to a FM program in the US for two years guarantee that you could get into EM training with a shortened program. 🙁

BKN
 
I'm not clear - do you want to practice Family Medicine or Emergency Medicine? Practicing both is possible if you wished to work a shift or two each month as a locum tenens in the ED (but again, becoming difficult to do unless you are a BCEP) while practicing as a full-time family doctor. If you have dreams of practicing both EM and FP equally, I would advise you commit to one specialty or the other and train only in that specialty.

If you still want to do both, I would train in Family Medicine in Canada and rotate heavily in the ED during your residency. Then, I would apply to a US residency in EM. Being board certified in FP (even from Canada) will make you competitive and this pathway will only require 1 year of additional training to your Canadian system.
 
I'm not clear - do you want to practice Family Medicine or Emergency Medicine? Practicing both is possible if you wished to work a shift or two each month as a locum tenens in the ED (but again, becoming difficult to do unless you are a BCEP) while practicing as a full-time family doctor. If you have dreams of practicing both EM and FP equally, I would advise you commit to one specialty or the other and train only in that specialty.

If you still want to do both, I would train in Family Medicine in Canada and rotate heavily in the ED during your residency. Then, I would apply to a US residency in EM. Being board certified in FP (even from Canada) will make you competitive and this pathway will only require 1 year of additional training to your Canadian system.
We have it pretty good up here with the CCFP-EM program. You can work as an EP in all but the largest teaching hospitals. The same doesn't apply for the US, and it will only become more difficult with time.
 
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