Family medicine with OB and surgical skills, residencies....

[MCAT guy]

Hello,

I was looking at some of the residencies that are considered rural and saw on the university of Washington site for Spokane that they focus on, "ob and surgical skills" alongside family medicine to train well rounded physicians.

Wwmai website for family medicine Spokane.

I was wondering how many other residencies have a similar focus and if anyone has any recommendations for similar programs. Like a list of excellent rural FM surgical skill programs.

Thanks

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[VenusinFurs]

Depends what you mean by surgical.

 

[Moosepig]

I am really interested to know this as well.

I am only a lowly pre-med, but my aspiration is to serve in a third world country (this MSF) so a program like this would be fantastic for me.

 

[VA Hopeful Dr]

Hello,

I was looking at some of the residencies that are considered rural and saw on the university of Washington site for Spokane that they focus on, "ob and surgical skills" alongside family medicine to train well rounded physicians.

Wwmai website for family medicine Spokane.

I was wondering how many other residencies have a similar focus and if anyone has any recommendations for similar programs. Like a list of excellent rural FM surgical skill programs.

Thanks

That usually mean they can train you to do c-sections. Many rural programs offer this.

 

[MCAT guy]

That usually mean they can train you to do c-sections. Many rural programs offer this.

So basically every rural program can teach minor surgical skills?

Are full scope FM skills only useful in small cities? Does having tons of nearby specialist limit FM full scope greatly?

Can anyone name 5 great full scope residency programs so I can research their websites? Is unopposed basically full scope?

 

[drhexane]

Baraboo rural track in Wisconsin!

 

[Bacchus]

Interviewed at the Williamsport, PA program last week. They have a graduating resident who has 50+ C/S under his belt. The OB he's working with I believe doesn't have any plans on retirement and will be around for a while. He just had to ask for the opportunity. The program also requires you meet the ACGME delivery number by the end of your 1st year although you get more deliveries as time goes on.

 

[VA Hopeful Dr]

So basically every rural program can teach minor surgical skills?

Are full scope FM skills only useful in small cities? Does having tons of nearby specialist limit FM full scope greatly?

Can anyone name 5 great full scope residency programs so I can research their websites? Is unopposed basically full scope?

No, they all teach minor surgical skills. I consider a c-section a fairly major surgery.

 

[notinkansas]

What, exactly, do you mean by "surgical skills" As a former surgery resident now seriously considering going into FP- I contend that, if you want to truly develop "surgical skills" you need to complete a surgical residency. C sections are certainly major surgery, but learning to perform c sections does not, in my mind, constitute "surgical skills"

 

[deleted87716]

^ Looks like you missed the "minor" part.

No, they all teach minor surgical skills. I consider a c-section a fairly major surgery.

 

[VenusinFurs]

Do you mean C sections + appys + choles?

 

[scube]

Indiana university has a good program for skills.

 

[cabinbuilder]

Hello,

I was looking at some of the residencies that are considered rural and saw on the university of Washington site for Spokane that they focus on, "ob and surgical skills" alongside family medicine to train well rounded physicians.

Wwmai website for family medicine Spokane.

I was wondering how many other residencies have a similar focus and if anyone has any recommendations for similar programs. Like a list of excellent rural FM surgical skill programs.

Thanks

There is a rural medicine fellowship for FP in Provo, UT that is OB heavy.

 

[andon]

I disagree that you need a full residency to become competent for quite a lot of surgery. Of the full scope programs, only really at the unopposed places will you have a chance to do a lot of Csections, scopes, and other procedures. Even then, however, it is rare that everyone has the attitude that a FM resident can do everything. I do not know where you are looking, but a general rule is to stay away from the east coast because of the culture of -ologists there.

Programs:

Cali: Ventura, Contra Costa
WA: Tacoma, Spokane
TX: College station, Fort Worth (JPS), and Waco

Texas has a ton of unopposed FM programs that let you do a lot, but most people from the west coast want to stay there and aren't willing to change states for training.

College Station, for instance, graduates residents with over 200 primary Csections because of their advanced OB track. They also have opportunities to do international surgical electives where they perform Csections, hysterectomies, ex laps, debridement for nec fasc, etc...

You can get what you want in three years, but many people are choosing to do a fellowship (accredited or unacc) afterwards because more employers are requiring it and fewer residencies get you the numbers you need to feel competent.

I think in the next 20 years FM will have a much bigger place in american health care because of the cost effectiveness of the family physician, which means that you will find a place in urban settings (where there are already many FP's) if you so choose.

 

[VenusinFurs]

I disagree that you need a full residency to become competent for quite a lot of surgery. Of the full scope programs, only really at the unopposed places will you have a chance to do a lot of Csections, scopes, and other procedures. Even then, however, it is rare that everyone has the attitude that a FM resident can do everything. I do not know where you are looking, but a general rule is to stay away from the east coast because of the culture of -ologists there.

Programs:

Cali: Ventura, Contra Costa
WA: Tacoma, Spokane
TX: College station, Fort Worth (JPS), and Waco

Texas has a ton of unopposed FM programs that let you do a lot, but most people from the west coast want to stay there and aren't willing to change states for training.

College Station, for instance, graduates residents with over 200 primary Csections because of their advanced OB track. They also have opportunities to do international surgical electives where they perform Csections, hysterectomies, ex laps, debridement for nec fasc, etc...

You can get what you want in three years, but many people are choosing to do a fellowship (accredited or unacc) afterwards because more employers are requiring it and fewer residencies get you the numbers you need to feel competent.

I think in the next 20 years FM will have a much bigger place in american health care because of the cost effectiveness of the family physician, which means that you will find a place in urban settings (where there are already many FP's) if you so choose.

Not necessarily true.

 

[andon]

would love to hear about programs that offer c-sections, scopes, NICU, ICU, etc on the east* coast where you do not have to deal with a "family medicine is for dummies" environment

 

[kdur]

would love to hear about programs that offer c-sections, scopes, NICU, ICU, etc on the east* coast where you do not have to deal with a "family medicine is for dummies" environment

Here you go:

OB Fellowship Address
853 N Church St Ste 510
Spartanburg, SC 29303-3077

http://www.spartfam.org

Lincoln OB/GYN Residency Program Address
234 E 149Th St
Bronx, NY 10451-5504


Cone Health OB Junior Faculty Address
1200 N Elm St
Greensboro, NC 27401-1004
http://www.conehealth.com

Obstetrics/Maternal Child Health Fellowship Address
111 Brewster St
MEMORIAL HOSPITAL OF RHODE ISLAND FAMILY CARE CENT
Pawtucket, RI 02860-4474

http://www.brownfamilymedicine.org


Lawrence Family Medicine Obstetrical Fellowship Address
34 Haverhill St 3RD FLOOR
Lawrence, MA 01841-2884

University of Rochester Maternal Child Health Fellowship Program Address
777 S Clinton Ave
DEPT OF FAMILY MEDICINE
Rochester, NY 14620-1448

http://www.urmc.rochester.edu/fammed/teaching/fellowship/obgyn.cfm


MAHEC Family Medicine OB Fellowship Address
118 Wt Weaver Blvd
Asheville, NC 28804-3415

http://www.mahec.net/

 

[VA Hopeful Dr]

Here you go:

OB Fellowship Address
853 N Church St Ste 510
Spartanburg, SC 29303-3077

http://www.spartfam.org

Lincoln OB/GYN Residency Program Address
234 E 149Th St
Bronx, NY 10451-5504


Cone Health OB Junior Faculty Address
1200 N Elm St
Greensboro, NC 27401-1004
http://www.conehealth.com

Obstetrics/Maternal Child Health Fellowship Address
111 Brewster St
MEMORIAL HOSPITAL OF RHODE ISLAND FAMILY CARE CENT
Pawtucket, RI 02860-4474

http://www.brownfamilymedicine.org


Lawrence Family Medicine Obstetrical Fellowship Address
34 Haverhill St 3RD FLOOR
Lawrence, MA 01841-2884

University of Rochester Maternal Child Health Fellowship Program Address
777 S Clinton Ave
DEPT OF FAMILY MEDICINE
Rochester, NY 14620-1448

http://www.urmc.rochester.edu/fammed/teaching/fellowship/obgyn.cfm


MAHEC Family Medicine OB Fellowship Address
118 Wt Weaver Blvd
Asheville, NC 28804-3415

http://www.mahec.net/

Seneca Lakes in SC also does c/s

 

[superfan56]

idk, i run into a lot of kids on the interview trail that want full scope that is full blown surgeries as well as FM. It's a bit naive to think you can handle all of that imo. besides the ridiculous malpractice you'll have, as a patient, I wouldn't feel someone that is medicine trained is the top of their game in surgery and vice versa. seems a bit ambitious.

i interviewed at a program recently that made a good point. just because we meet the bare minimum in some 40 deliveries according to the acgme, doesn't mean someone knows deliveries as well as OB's. Not to sell family med short, but there has to be some conscious regulation of when to refer out, surgery being probably top of the list. just because we rotate in the ICU for a few months during the course of 3 years doesn't give the know how to run an ICU. Good luck with trying to get a hospital to employ you as an ICU doc or surgeon.

 

[andon]

not fellowships, but the 3 year programs

 

[andon]

It is also not the point to be practicing surgery and ICU and whatever else

 

[AlmostJesus]

idk, i run into a lot of kids on the interview trail that want full scope that is full blown surgeries as well as FM. It's a bit naive to think you can handle all of that imo. besides the ridiculous malpractice you'll have, as a patient, I wouldn't feel someone that is medicine trained is the top of their game in surgery and vice versa. seems a bit ambitious.

i interviewed at a program recently that made a good point. just because we meet the bare minimum in some 40 deliveries according to the acgme, doesn't mean someone knows deliveries as well as OB's. Not to sell family med short, but there has to be some conscious regulation of when to refer out, surgery being probably top of the list. just because we rotate in the ICU for a few months during the course of 3 years doesn't give the know how to run an ICU. Good luck with trying to get a hospital to employ you as an ICU doc or surgeon.

The point of these programs isn't to do medicine at a hospital of any great size. It is to provide services where they would otherwise be unavailable. Places such as Hettinger, ND ( http://www.wrhs.com ) are 60+ miles from the nearest referral center. Thus, they have FP docs that have sought out extra training to be able to provide the extra surgical services that would be out of reach in such a frontier area. The hospitals are generally overjoyed to grant privileges to these doctors to do the more routine surgical skills such as appys, choles, and C-sections. They do not bill themselves as surgeons, they bill themselves as full scope family practice.

 

[civic4982]

The program I'm at now as a PGY3 does all the c sections with faculty. For those that are surgery squeamish then they can stay and run the board. We're an unopposed program and there's not currently an OB track outrightly but our residents can get lots of experience if they desire. I was an OB resident previously and finished my OB intern year so had passed on these opportunities later on when full scope was not something I found out I really desired.

I have always feel that I should get as much exposure as possible so i try to take every opportunity to scrub or do procedures with experienced staff when possible. as an example there was a day on pulmonology service that I had a patient with a eosinophilia pneumonia and in that same week i did a bronchoscopy and a few mornings later ended up doing a bone marrow biopsy with heme onc staff and scrubbing on a vats with CV surgery!

If you end up finding a unopposed place the opportunities to do whatever you want so far as exposure is concerned.

Now if you're talking competency to do the surgical procedures yourself....... Well often that requires more training than 3 years of postgraduate training at 80 hours max per week will offer in my humble opinion.

Good luck!


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[raptor5]

There is a rural medicine fellowship for FP in Provo, UT that is OB heavy.

While they advertise the fellowship, they do not offer it due to lack of funding. Last fellow was a few years ago. It is OB heavy but mediocre on responsibility. Most residents get a good number of deliveries and learn sections.

 

[cabinbuilder]

While they advertise the fellowship, they do not offer it due to lack of funding. Last fellow was a few years ago. It is OB heavy but mediocre on responsibility. Most residents get a good number of deliveries and learn sections.

Wouldn't surprise me. I interviewed there for it about 5 years ago. Didn't take the position because I can't stand OB and wasn't impressed with the lack of other rotations and I got the feeling that if I didn't want to do OB it would be up to me to create rotations for myself.

 

[VenturaResident]

Good luck with trying to get a hospital to employ you as an ICU doc or surgeon.

Here in Ventura, we get excellent ICU training, and do happen to have ICU attendings who are family medicine trained. Doesn't seem like it has much to do with luck - they are super sharp and superb at their job.

Lots of surgical and procedural training here too for people interested in full scope family medicine.