Combined residency: general surgery and emergency medicine

[Tanya_med.stud]

Is it possible to do a combined residency of general surgery and emergency medicine?

If yes, how long would it take?

Is any of the surgery residency programs more focused on trauma, critical care and acute care surgery?

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[Dral]

I think what you're looking for is Gen Surg residency ---> Trauma Surg fellowship

 

[colbgw02]

Wouldn't you rather do a combined path/psych residency?

Any good surgery program will have plenty of acute care surgery (whatever that is) and critical care. Just make sure you go to a level I trauma center if inclined to trauma. If more inclined, then do a trauma fellowship.

 

[Winged Scapula]

Is it possible to do a combined residency of general surgery and emergency medicine?

If yes, how long would it take?

Is any of the surgery residency programs more focused on trauma, critical care and acute care surgery?

All general surgery programs are "focused" on acute care surgery and you'll get plenty of CC and trauma during residency; if you want more there are Trauma/CC fellowships.

You do not need to do a "combined" residency as GS and EM are 2 different specialties with 2 different jobs. Pick one or the other.

 

[Winged Scapula]

Since the OP purports to be a medical student, moving to the Allo forum.

 

[Tanya_med.stud]

Thanx for all your replies. Sorry I'm new on this site, what's the "allo forum"?

 

[Sublimazing]

I'll help out

Allo = MD....as opposed to Osteo which is DO

As you progress you will see that emergency medicine and general surgery are very very different. They certainly interact and work alongside one another...but their skill sets/training is very different.

This information will become very clear to you as you become a med student.

 

[Kahreek]

I think what you looking for is gen surg -> and volunteering to take call on all trauma. Everyone will love you.

 

[Tanya_med.stud]

Hey, thanx for the resplies. I think I was unclear, Ill try to explain better.

I'm a last year med student from Sweden and I want to do my residency in the US. I'm interested in both emergency medicine and trauma surgery.

So I wonder if it's possible to do a residency somewhere to work with: trauma and resusitation, emergency medicine, trauma surgery and acute care surgery?

 

[alpinism]

Do you like the initial stabilization and resuscitation of trauma patients including doing procedures in the trauma bay? ----> EM

Do you like the long term medical and sometimes surgical management of trauma patients including working in the SICU? ---> General Surgery

Any EM residency at a busy L1 trauma center will have tons of trauma exposure.

You can't do both. The closest thing would be to do a EM residency followed by a CC/trauma fellowship.

 

[Tanya_med.stud]

Im interested in initial resusitation of the trauma patient, but also in following the patient to the OR and doing trauma surgery. Im also interested in acute care surgery such as appendectomies, cholecystecomies etc. Im also interested in emergency medicine such as sepsis, stroke, epilepsy.

Is it possible to combine emergency medicine, general surgery with a fellow in trauma surgery?

 

[Winged Scapula]

Im interested in initial resusitation of the trauma patient, but also in following the patient to the OR and doing trauma surgery. Im also interested in acute care surgery such as appendectomies, cholecystecomies etc. Im also interested in emergency medicine such as sepsis, stroke, epilepsy.

Is it possible to combine emergency medicine, general surgery with a fellow in trauma surgery?

There are no combined Emergency Medicine and General Surgery residencies. You would have to do them back to back which is a minimum of 9 years of training plus the additional fellowship time.

 

[Tanya_med.stud]

Ok, thank u for the reply. To bad they arent possible to combine, I think trauma surg, acute surg and EM overlap in some areas.

 

[Winged Scapula]

Ok, thank u for the reply. To bad they arent possible to combine, I think trauma surg, acute surg and EM overlap in some areas.

I think you misunderstand the practice in the United States.

Most trauma surgeons here practice acute care General Surgery as well.
As trauma surgery becomes increasingly non-operative, the amount of critical care and acute-care general surgery required of many practitioners has increased.

And while there are some facets of emergency medicine and trauma surgery that overlap, the evaluation and management of stroke and seizure is not one of them.

It appears that you are focusing on a very narrow aspect of emergency medicine and trauma surgery. The vast majority of emergency medicine is not management of trauma nor is there long-term management and treatment of sepsis, stroke, and seizure. I think you need to winnow down your interest a little bit more.

 

[Tanya_med.stud]

Ok, so what would you say that the vast majority of emergency medicine do? (In Sweden we dont have residency in emergency medicine or fellow in trauma surgery).

 

[Smurfette]

EM providers in the US have to see everyone who shows up to the ER, from cold and flu symptoms, lacerations, back pain and headaches to heart attacks, strokes and initial evaluation of trauma patients (although the latter can vary by center). They assess the patient and determine if they will require admission to the hospital or if they have a problem that the EM provider can "treat and street" them (i.e. send them home). In other words, they evaluate a patient, and if they determine the patient is having a stroke (or whatever else), they call the appropriate specialist in the hospital to admit and continue treatment of the patient; they do not follow a patient during the remainder of their hospital stay. The vast majority of patients who show up to the ER do not have an immediately life threatening problem, and many of the problems could be managed in an outpatient setting.

Surgeons evaluate patients for surgical problems and management of surgical problems. This includes traumas; much trauma is non-operative or is babysitting patients with multiple injuries that include neuro and ortho problems that the trauma surgeon does not manage. A surgical patient who has a stroke is going to have the stroke issues managed by a different doctor (internist or neurologist), as would patients with heart attacks. Patients with strokes, heart attacks and epilepsy who require hospitalization for these issues would NOT be admitted to a surgeon, but to the appropriate medical colleague (hospitalist/cardiologist/neurologist).

 

[alpinism]

Well unfortunately here in the US, there is a difference between what EM is supposed to do and what they actually do.

As a specialty, EM is supposed to provide the initial medical care and stabilization of all serious medical emergencies involving any organ system. For example: strokes, seizures, brain bleeds, meningitis, encephalitis, MI, arrythmias, tamponade, AAA, dissections, PE, status asthmaticus, overdoses, poisoning, sepsis, pancreatitis, appendicitis, cholecystitis, pyelonephritis, SBO, fractures, dislocations, etc...

Then, in addition, EM docs also assist trauma surgery in caring for major traumas. Trauma is only a small part of what an EM doc does.

In reality, around 90% or more of most EM in the US is primary care such as colds, flu, headaches, back pain, abdominal pain, UTIs, rashes, sprains/strains, etc...

 

[Tanya_med.stud]

Ok, thank you for both of your answers. 🙂.

In most hospitals in Swe the specialists (internal med, surgery, ortho, uro) are working in the emergency dept and they have different queues. The patient first meets a nurse who decide which queue the patient should be in.

If the nurse makes a wrong decision and puts the patient in the internal med queue and the patient belongs to the surgical, then the patients needs to wait 10 more hours in the "right" queue. Guess every system has its own problems.

Does EM in the states take pediatrics, ent, ophtalmology, obgyn, psychiatry?

 

[Smurfette]

yes, the EM physician evaluates all ages and problems.

 

[Tanya_med.stud]

So there isnt a special psychiatric and pediatric emergency department?

 

[alpinism]

Some hospitals have a separate pediatric ED staffed by docs who either did a peds residency then an EM fellowship or vice versa (EM residency then a peds fellowship). These are mostly large academic medical centers and children's hospitals.

However, every EM residency has pediatric rotations and EM docs are fully trained to treat children.

With the exception of a few places, most hospitals don't have a separate psychiatric ED and those patients are seen alongside all the other patients.

 

[Tanya_med.stud]

Ok.

Where are the best places to do residency in Emergency med, General Surgery and Fellowship in Trauma Surgery? (is there a ranking list?)

For the fellow, I found this link (do you know any of them?):
http://www.trauma.org/archive/resources/fellowships/fellowships.html

In Sweden they usually say that more metropolitan and larger hospitals have more traumas and more variety of surgeries, but for residency it can some times be better to be at a smaller hospital cause you there will be able to do more first hand. Is it the same in the US?

 

[SouthernSurgeon]

Ok.

Where are the best places to do residency in Emergency med, General Surgery and Fellowship in Trauma Surgery? (is there a ranking list?)

For the fellow, I found this link (do you know any of them?):
http://www.trauma.org/archive/resources/fellowships/fellowships.html

In Sweden they usually say that more metropolitan and larger hospitals have more traumas and more variety of surgeries, but for residency it can some times be better to be at a smaller hospital cause you there will be able to do more first hand. Is it the same in the US?

There are about a million threads on what the "Best" residency programs are in each field, as well as varying definitions of what "best" means (i.e. best in terms of academic prestige, research, hands-on experience, etc).

There are also about a million threads on the challenges of matching into ANY surgery residency program as a non US citizen, much less one of the above "best" programs.

I recommend the search function.

 

[Tanya_med.stud]

Best = a hospital large enough so the residence can learn resuscitation of trauma patients, be able to see a large variable of surgeies and do research, but not too large so it becomes difficult for the residence to do surgeries by him/herself.

What do you mean by "search function", which "search function"?

 

[SouthernSurgeon]

Best = a hospital large enough so the residence can learn resuscitation of trauma patients, be able to see a large variable of surgeies and do research, but not too large so it becomes difficult for the residence to do surgeries by him/herself.

What do you mean by "search function", which "search function"?

In the top right corner of this webpage is a box that says search and has a magnifying glass. If you enter keywords/phrases, it will search old topics on the site and you will find an abundance of information on this topic.

 

[DermViser]

In the top right corner of this webpage is a box that says search and has a magnifying glass. If you enter keywords/phrases, it will search old topics on the site and you will find an abundance of information on this topic.

This should be like a floating box on SDN.