EM and OBGYN combined... is it possible?

[Futureobmed]

I knew a couple doctors who would rotated working in the ER with working up on the floor (mostly IM). But I've yet to see an ER/OF GUN mix. Is it even possible? And if so, how do I get there?

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[Futureobmed]

I knew a couple doctors who would rotated working in the ER with working up on the floor (mostly IM). But I've yet to see an ER/OF GUN mix. Is it even possible? And if so, how do I get there?

*rotate* sorry about that... I'm typing on my phone

 

[Druggernaut]

You could probably find a rural ED that would be willing to hire you after completing an OBGYN residency. However, residencies in emergency medicine exist for a reason. Most of what we see in the ED are adults with medical illness, so the IM guys can mostly get by, but your training as an OBGYN would have very limited overlap with what you'd receive in an EM residency. You'd be doing your patients a big disservice and opening yourself up to a great deal of liability.

 

[Futureobmed]

So

You could probably find a rural ED that would be willing to hire you after completing an OBGYN residency. However, residencies in emergency medicine exist for a reason. Most of what we see in the ED are adults with medical illness, so the IM guys can mostly get by, but your training as an OBGYN would have very limited overlap with what you'd receive in an EM residency. You'd be doing your patients a big disservice and opening yourself up to a great deal of liability.

So on would be better off just left alone?

 

[TraumaLlamaMD]

If you want to see all-comer emergency patients with the occasional pregnant woman, do an ED residency.

If you want to see primarily pregnant patients with acute medical problems, do OB and consider future employment in the ED or triage unit of a women’s hospital.

 

[CherryRedDracul]

Most, if not all, EM programs do at least one 4 week rotation on OB.

Otherwise, I don't see much utility in a combined EM/OBGYN program. First, it's going to a lot more years of residency. Second, it is practically certain that you will eventually choose one field over the other. You won't have the time to practice both fields equally and competently at the same.

 

[Rendar5]

Yes it's possible. Do an ob/gyn residency followed by an EM residency. You'd have to work a ridiculous amount to keep yourself up in both fields. Minimum 8 shifts/month for ED, then you'd have to fit in office hours, surgical hours, and call for the remainder of the time for your ob/gyn practice

 

[rbnsafsadgf]

I knew a couple doctors who would rotated working in the ER with working up on the floor (mostly IM). But I've yet to see an ER/OF GUN mix. Is it even possible? And if so, how do I get there?

Makes little sense. Very little overlap.

If you are interested in both fields, consider doing a family medicine residency that is OB heavy and work in a busy rural ED afterwards. You can work in both environments with three to four years training (family residency with option OB fellowship year).

 

[Finn3]

If you want to see all-comer emergency patients with the occasional pregnant woman, do an ED residency.

If you want to see primarily pregnant patients with acute medical problems, do OB and consider future employment in the ED or triage unit of a women’s hospital.

Would compensation for an acute care OBGYN or Emergency OB be commensurate with ED pay? Many obstetricians do a few months in SICU. Was wondering if a pitch for this would be feasible seeing as how some ED docs aren't as comfortable with the crashing OB patient or OB issues? If hospital risk was decreased would it be an ideal offering?

 

[Finn3]

Yes it's possible. Do an ob/gyn residency followed by an EM residency. You'd have to work a ridiculous amount to keep yourself up in both fields. Minimum 8 shifts/month for ED, then you'd have to fit in office hours, surgical hours, and call for the remainder of the time for your ob/gyn practice

What if you wanted to do the equivalent of a laborist, but in an ED setting. Primarily triaging obstetric emergencies more efficiently? My thought is it could be a benefit if quality is being measured and risk reduced. Any thoughts on this?

 

[TraumaLlamaMD]

Would compensation for an acute care OBGYN or Emergency OB be commensurate with ED pay? Many obstetricians do a few months in SICU. Was wondering if a pitch for this would be feasible seeing as how some ED docs aren't as comfortable with the crashing OB patient or OB issues? If hospital risk was decreased would it be an ideal offering?

No idea - out of my field of choice I’m afraid. I just remember doing my OB/gyn rotation at a women’s hospital with its own ED and triage unit for pregnant patients. I couldn’t tell you whether the docs staffing this ED were primary OB or ER trained.

If you’re asking how much a specifically trained OB/ED doc could fetch in a regular ED, or if this is even a position that exists, I’m not sure the volume is there to support someone who isn’t trained to handle the majority of the patient base.

 

[The Knife & Gun Club]

The price of malpractice insurance for combined ER/OBGyn would be enough to bankrupt a small European country.

 

[ridethecliche]

What if you wanted to do the equivalent of a laborist, but in an ED setting. Primarily triaging obstetric emergencies more efficiently? My thought is it could be a benefit if quality is being measured and risk reduced. Any thoughts on this?

This is why OB folks are on call...They respond when something's up.

If there's a true OB emergency, there's no way in hell someone on staff isn't getting woken up to come and start surgery. Medicine works because folks know their roles and there's a mechanism for involving those that know more than you. Police officers, firefighters, and EMT's have been able to deliver a baby with phone instructions. When things get complicated, you get a specialist involved. The jack of all trades is the master of none.

A good ER doc knows exactly when they need to get others involved so that they have backup when a situation gets out of their hands. You can stabilize a patient for only so long.

 

[Mt Kilimanjaro]

I knew a couple doctors who would rotated working in the ER with working up on the floor (mostly IM). But I've yet to see an ER/OF GUN mix. Is it even possible? And if so, how do I get there?

You do family medicine and work in a rural hospital where you can do both. Or do FM w OB at one place and EM moonlighting elsewhere.

 

[theseeker4]

What if you wanted to do the equivalent of a laborist, but in an ED setting. Primarily triaging obstetric emergencies more efficiently? My thought is it could be a benefit if quality is being measured and risk reduced. Any thoughts on this?

Anywhere with enough OB patients to at all justify an OB in the ER already has an "OB ER" which is the OB triage area on the OB floor. This is already going to be staffed with OB/GYN residents and/or midlevels with attending backup. No reason to keep an OB patient in the ER unless there is no in-house OB and they are severely unstable, which will be such a rare occurrence there is still no reason to have an OB in the ER. The OB in house or on call will come down to the ER if the patient is that unstable anyway.