Family Practice and General Surgery

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Hi. I'm very interested in working full-time in Africa. I love the idea of family practice and the well-roundedness it offers. However, I am wondering if it would be necessary/wise/feasible to do two residencies: family practice and general surgery. I am just wondering whether the surgical skills gained during the family practice residency (even one with a rural track) would be sufficient for a lone doctor working in Africa.


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Oct 5, 2007
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There are programs with international medicine fellowships that emphasize surgical training and clinical training as it pertains to countries such as Africa. I would think those would be a more efficient way to your goal.


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Oct 8, 2007
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Hi. I'm very interested in working full-time in Africa. I love the idea of family practice and the well-roundedness it offers. However, I am wondering if it would be necessary/wise/feasible to do two residencies: family practice and general surgery. I am just wondering whether the surgical skills gained during the family practice residency (even one with a rural track) would be sufficient for a lone doctor working in Africa.

I am planning a similiar career and deal with your dilemma on a frequent basis. There is a really useful site called run by Dr. Li. There are many ways to gain surgical training, including a residency path.

After speaking with several other physicians who work in resource poor areas, such as remote africa, etc. I have found a common piece of advice. I have been told to complete my FP residency, spend as much time on the OR as I can with standard cases such as appy, choles, etc and get some surgical OB training in c-section and a good foundation in repair of vag lacerations. Then, get to the area you want to work and keep learning. There are doctors there to train newly graduated residents in the procedures that are required in the area. This is what helps residents set up, these "teaching rotations".

As I was told by a remote medicine doctor in africa, training in a double residency in ER or Surgery in the USA, after a FP program will only make you better trained to work in America. Often times, the remote medical doctor not only performs the surgery but also juggles the anaesthesia and lighting and pathology after the case. Train by doing.

A few really, really good books on this subject are:

The Primary Surgery Series Vol. 1 and 2 (Vol. 1 is general surgery and OB, Vol 2 is trauma)
Primary Anaesthesia

There are some links to them from my website, at the bottom of this post, under the section on remote medicine links/library. These books are written by surgeons for general practice doctors to perform procedures in resource poor areas. They are the best investment I have made all year.

Good luck, Erik


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Aug 4, 2003
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Could you imagine how fierce this would be?... I wonder if this position was ever filled:

Family Practitioner/Surgeon (Full Time/ Accompanied)


Directly reports to the Chief Medical Officer with additional administrative accountability to the Hospital Administrator. Provides healthcare services to patients presenting to the hospital (in- and outpatient) for family practice services. Also serves as backup to staff general surgeon in providing basic general surgery/trauma services for ages pediatric to geriatric.


Provides services to inpatients and outpatients including diagnostic evaluation, patient treatment, recovery, and health maintenance program based on current accepted practices encompassed by Family Practice medicine.
Is available to assist staff general surgeon in providing outpatient and inpatient surgical care. Is capable of providing basic general surgery services in the absence of the general surgeon. Such services shall include emergency abdominal surgical procedures that cannot be transferred to other facilities in a timely manner, wound care, and basic surgical management of acute trauma.
Provides additional primary care services including physical examinations, writing a treatment plan, and keeping progress notes covering diagnostic evaluation for care of outpatients and inpatients.
Provides emergency medical services including on-call coverage on a rotating basis with other physicians and responds in timely and courteous manner.
Operates under the general guidelines of treatment policies and procedures to include intervention protocols and after care plans.
Submits, in a timely manner, information as appropriate to update the plan of care for the patient, coordinate other services, maintenance of complete patient chart and billing of services provided.
Works cooperatively with peers and supportive staff to contribute to overall productivity and quality of the care of the team.
Maintains all necessary licensure to qualify for active medical staff privileges and abides by Kwajalein Hospital bylaws, policies, and procedures as well as USAKA rules and regulations.
Assists CMO and Administrator through recommendations for budgetary planning and development of policies and procedures as relates to area s of expertise.
Prepares and presents information to co-workers after attending special programs and workshops as appropriate.
Assumes other responsibilities and duties as assigned by CMO.


Current experience in primary care as well as basic abdominal and general surgical procedures are required. Experience and expertise in endoscopy and cesareans are desirable.
Integrates patient management - examination, evaluation, diagnosis, prognosis and intervention – in a manner designed to optimize outcomes.
Documentation and oral communication are concise, pertinent and meets the professions and departments documentation standards; documentation is timely, legible, and meets standards of completeness and clinical relevance.
Problem solving skills.
Excellent interpersonal skills in dealing both with co-workers and patients.
Computer literacy


Facilitates patient and family education, communication, and problem resolution.
Serves as a resource person
Demonstrates an awareness of departmental practices that reflect Joint Commission International (JCI) and Quality Improvement Standards while performing all work at a level to meet these standards.
Promotes a safe and efficient work environment.
Serves as a leader and/or member, as requested, on task forces, work groups, or committees.


Identifies and promptly addresses unsafe practices and other safety issues in the clinic.
Participates in all safety, infection control and other mandatory training.
Respects and supports patient rights.
Promotes and practices customer and peer relations.



Minimum 5 years recent experience in family practice that includes some basic general surgery. Proficiency in GI endoscopy and experience in performing cesareans and other gynecologic procedures is desirable.
Preferable/desirable to have experience in any of the following: emergency care medicine, hyperbaric medicine, aviation medicine (FAA Aviation Medical Examine), and occupational medicine.
Must be comfortable performing low-volume surgery in an isolated setting.


MD or DO degree
Board certification as family practitioner
Current U.S. physician license.
Proof of eligibility for employment in the US
ATLS and ACLS certification
Continuing Medical Education that documents current and ongoing training in Family Practice and/or General Surgery through participation in workshops, seminars, etc.


Must be flexible and willing to assume many responsibilities beyond the usual scope of a family practitioner in providing basic surgery services in the event that staff general surgeon is absent.
Committed to high-quality medicine

Applicant selected will be subject to a government security investigation/criminal background check and must meet eligibility requirements for access to classified information as required for the position offered.

You and authorized dependents, if any, traveling to Kwajalein are required to have a valid passport in your possession prior to departure. You and your dependents must maintain a current passport during your stay on the island.

HR- 031901

*If you are interested in this posting, please click on this link to send resume. You MUST put the job title in the subject line or your email will be deleted. KRS Recruiter

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