EM with IM/FP Residency Training?

[DoctorFunk]

I will be starting medical school this fall and have recently become interested in practicing emergency medicine (either exclusively or in addition to clinical work). Prior to this recent swing in opinion, I was pretty set on FP in a rural area of the Midwest, and would still like to end up in a rural area in the future. Accordingly, I applied for and will be interviewing for the National Health Service Corps scholarship, which would limit the residency I could train in to IM, FP, Peds, or Psych.

My question is this: how frequently do rural hospital ERs hire docs with IM or FP residency training? Would it be better for me in the long run to think about declining this scholarship (perhaps in favor of the loan repayment program if I decide against EM in the future) and going with an EM residency?

Any help you can offer with either question would be much appreciated...seems kind of odd, but I feel like I'm being forced to a certain extent to make a major decision about specialty options before even entering school!

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[docB]

This question comes up frequently on this board. Search it and check out some of the past discussions. What I would say is that you have to choose between primary care and EM. You can't do both. The opportunities to work in EDs as a non res trained and non boarded doc are disappearing fast. At the very least you would be relegated to a minor role and would likely be phased out when BC people became available. Good luck with either one.

 

[Doczilla]

There are combined EM/IM residency programs which are 5 years. Some (if not all) will allow you to do 2 years there if you have completed your IM residency. You can look these up on FREIDA on the AMA website. There are fellowships available in EM for FP trained docs. Pediatricians can also do a 3 year EM fellowship and become boarded in Peds ER.

DocB is right about ERs hiring fewer docs without board certification in EM. This will only become more difficult for the FP who wants to moonlight in the ER. Rural areas are still pretty desperate for anyone to work the ER, and so your chances are better out there. Liability may be an issue, as insurers are less thrilled about covering an IM or FP doc moonlighting in the ER when they haven't really done more than a month or two of training in that specialty.

He's also right about choosing one or the other. It's pretty tough to have an actual practice AND work the ER regularly. You don't need to be FP trained to do FP in a rural area, and the physician shortage is such that you may be able to volunteer at a rural clinic on off days. If the scholarship is the only reason you are considering FP, then you should reconsider the scholarship. There are other ways to pay for medical school. Talk to the school's financial aid department. Most people balk at the size of the loans they will have to take for med school because you could buy a house with it, but many practices will pay signing bonuses or pay off your med school loans if you work for them for a specified period of time. Many areas short of physicians will do the same.

'zilla

 

[deleted6669]

This question comes up frequently on this board. Search it and check out some of the past discussions. What I would say is that you have to choose between primary care and EM. You can't do both. The opportunities to work in EDs as a non res trained and non boarded doc are disappearing fast. At the very least you would be relegated to a minor role and would likely be phased out when BC people became available. Good luck with either one.

as a DO one can do an em/fp 5 yr dual residency.....

 

[docB]

as a DO one can do an em/fp 5 yr dual residency.....

True. Or he could do two separate residencies. In terms of the original question which was basically "Can I do an FP residency and then plan to work in ERs?" I stand by my answer. I also don't know if the National Health Scholarship will cover a dual FP/EM residency.

 

[iatrosB]

True. Or he could do two separate residencies. In terms of the original question which was basically "Can I do an FP residency and then plan to work in ERs?" I stand by my answer. I also don't know if the National Health Scholarship will cover a dual FP/EM residency.

They specifically say they won't. They won't even let you do med/peds anymore!

 

[hyperbaric]

as a DO one can do an em/fp 5 yr dual residency.....

Where can I find more info on a combined EM/FP DO residency?

 

[deleted6669]

WWW.ACOEP.ORG HAS A LIST OF ALL DO EM RESIDCENCIES. IF YOU LOOK THROUGH THEM YOU WILL SEE SOME HAVE THE COMBINED OPTION. IF I AM REMEMBERING CORRECTLY THERE IS 1 PROGRAM IN NY AT ST BARNABAS(A LEVEL 1 TRAUMA CTR), 2 IN MICHIGAN(1 IS AT PONTIAC OSTEOPATHIC HOSP.), AND 1 IN OHIO, BUT CHECK THE SITE TO BE SURE-E