community programs and "private patients"

[earthgirl101]

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Someone warned me today about "private patients" at community programs, and thought residents there had less autonomy because each staff wanted to be the primary decision maker on his/her patient. Conversely, the thought was that at university programs residents are essentially in charge of labor and delivery and are supervised by whichever staff is on, not the patient's primary OB. Thoughts? I was leaning toward community programs because I don't think I want to do a fellowship and I thought they may be friendlier/more laid back as well as provide training in the type of community OB/GYN I plan to practice.

 

[pruritis_ani]

My experience has been the opposite. But, it is less dependent on the type of program than the design of the program.

Look for a program with a lot of "clinic" patients. If the patients come from resident clinic, there will be lots of autonomy. If you are covering for privates, they will be less willing to turn over complete care.

The downside of a lot of clinic patients is usually a LOT more time needs to be spent in clinic.

 

[Diane L. Evans]

True private patients at most institutions less autonomy. I think the greatest learning is at a university program where all the patients are clinic patients not only will you be thrown in the trenches you'll rapidly learn from your errors.

just my 2 cents

I do know of good community programs that involve more autonomy

 

[minime]

My program has a mix of clinic and private patients. The clinic is very busy and we have a great deal of autonomy. We also have private patients, some of whom we are involved with. It's good to be involved with private pts. to see how other people do things.