FM Residencies with heavy OB exposure

[Elevencents]

First, do they exist? Or are all curriculums standardized to the point that one will not be much stronger than another in regards to OB? Looking at several curriculums they appear pretty standardized.

I am interested in doing an OB Fellowship and am wondering if there are certain programs I should be looking at. Or keep it simple and go after programs with good training or FM residencies with OB fellowships in house. I'm not sure how competitive the fellowship programs are if anyone knows?

If there are any practicing, or future practicing, FM Docs with an OB emphasis I would love to hear from you.

Thanks in advance for any assistance!

---

Members don't see this ad.

 

[ezhik]

I found this website helpful in looking for FM residencies with strong OB training (I'm an M4): https://advancedfamilymedicine.wordpress.com/ (appears last updated in 2015).

 

[JamaicanHerb]

I don't make this post to be inflammatory but I have a genuine concern with FM doctors who want to do OB tracks (especially to perform c-sections and laceration repairs).

Why did you go into FM? I've met many of you on my interview trail this season and they all want to do c-sections and lac repairs. If you wanted to do that and you won't go to a program that doesnt have those opportunities then why not just go into OBGYN? I see these guys and gals on the trail and all they can talk about is c-sections and if they get to first assist and how they want to go do rural medicine so they can have the privileges to perform them without competition. If that is the case, apply to OBGYN, especially the guys which seems to be the majority of the ones I've met, because OBGYN residencies want guys because of their uneven demographics. The guys seem to have no interest whatsoever with the rest of family medicine or outpatient clinic work.

 

[Elevencents]

Edited to make this much more simple: I enjoy aspects of FM and OB and since the opportunity exists to pursue said aspects of both that is what I would ultimately like to do. Not sure why that is such a bad thing.

 

[vendtex]

The concern is that not infrequently FPs who do c sections think they are qualified to be doing high risk OB.


Sent from my iPhone using Tapatalk

 

[teacherman84]

Jps in fort worth tx is one that is very ob heavy, high volume and exposure. residents will graduate with numbers to go do primary c sections without doing an ob fellowship.

https://www.jpshealthnet.org/academics_research/residency_programs/family_medicine/procedures

 

[Elevencents]

The concern is that not infrequently FPs who do c sections think they are qualified to be doing high risk OB.


Sent from my iPhone using Tapatalk

That's fair. I can see that being an issue.

 

[SansaStarkMD]

A fellowship trained family practice doc that has as much L&D experience as an OBGYN (if not more) is not qualified to do L&D because of turf wars. Let's just get it out in the open. I'm sure there are plenty of OBGYNs without maternal fetal medicine fellowships doing "high risk OB."

 

[vendtex]

You might want to familiarize yourself with the training differences then.


Sent from my iPhone using Tapatalk

 

[BigSib]

The minimum ACGME threshold for vaginal deliveries for OBGYN residency programs is 200. I don't know what their average is but I assume it's probably much higher than that. I'm a 3rd year FM resident and I'm at 168 deliveries and 61 lac repairs in Dec of last year. I'm not even planning to do OB; it's just part of the program requirements, but certainly we could get higher numbers if we desired. We do a good number of 'high risk' cases and have a good relationship with the community OBs. A single resident manages the L&D floor independently (manages induction/BP, does AROM, updates docs, etc.) while the OBs/FMs are in their clinics; usually there are 5-8 laboring patients per day. Of course they can always rush in if tones are bad or some other critical situation. We deliver most of their babies under supervision unless it is a special case or the OB isn't as familiar with us. At the end of this I definitely feel comfortable doing low risk cases.

There's a resident in our program in 3rd year getting the CS credentialing. She already has about 45-ish CS where she's been the primary surgeon; she's got another year and I think her goal is at least 150. The minimum number for OBGYN residencies is 145.

People opt for the FM tracks because there is significant need/desire to have that skill around the country. Most of the FM jobs I'm looking for in relatively rural areas don't require it but are very happy if a provider is willing to do OB. Overall, if you're planning to do OB I would ensure you're going to get enough experience to feel competent.

 

[Elevencents]

BigSib, what program are you at? PM if you want to keep private. Thanks.

 

[n3xa]

I found this website helpful in looking for FM residencies with strong OB training (I'm an M4): https://advancedfamilymedicine.wordpress.com/ (appears last updated in 2015).

Ah no wonder I could never find the OB fellowship at West Suburban Medical Center in Oak Park, IL... it's on a completely different website derp.

West Suburban is another heavy OB FM program to look into that didn't seem to crop up on first scan of the site listed above.

 

[LUCPM]

For NSVD, midwives, nurses, or anyone can deliver. When things get complicated, I sometimes wonder if 3 years are sufficient to train someone to handle such complications or high risk OBs.

Sent from my SM-G935R4 using Tapatalk

 

[VA Hopeful Dr]

For NSVD, midwives, nurses, or anyone can deliver. When things get complicated, I sometimes wonder if 3 years are sufficient to train someone to handle such complications or high risk OBs.

Sent from my SM-G935R4 using Tapatalk

When people say "high risk", its usually known antepartum stuff that just requires specialized monitoring. If there are complications at/near delivery, the answer is always "get the baby out". Given how for the potential disasters, that often requires a speedy c/s, as long as the doc is good at that its rarely a problem.

 

[VA Hopeful Dr]

A fellowship trained family practice doc that has as much L&D experience as an OBGYN (if not more) is not qualified to do L&D because of turf wars. Let's just get it out in the open. I'm sure there are plenty of OBGYNs without maternal fetal medicine fellowships doing "high risk OB."

Just as there are plenty of FM docs doing specialized things they weren't originally trained for specifically for. Residency isn't the end all/be all, but a good foundation is important.

Most OBs are pretty quick to pull that "refer to MFM" trigger. The only exception in my area that I know of is an older guy who was the unofficial MFM before we had real MFMs. He has special interest in that and so got all the tough cases for a long time and basically trained himself up enough to do it.

 

[Freezeout]

Almost all of the University of TN programs are OB intensive. ETSU-Bristol is also very OB heavy. Alabama Tuscaloosa is and St. Joseph in Mishawaka, IN is.

 

[NRAI2001]

I don't make this post to be inflammatory but I have a genuine concern with FM doctors who want to do OB tracks (especially to perform c-sections and laceration repairs).

Why did you go into FM? I've met many of you on my interview trail this season and they all want to do c-sections and lac repairs. If you wanted to do that and you won't go to a program that doesnt have those opportunities then why not just go into OBGYN? I see these guys and gals on the trail and all they can talk about is c-sections and if they get to first assist and how they want to go do rural medicine so they can have the privileges to perform them without competition. If that is the case, apply to OBGYN, especially the guys which seems to be the majority of the ones I've met, because OBGYN residencies want guys because of their uneven demographics. The guys seem to have no interest whatsoever with the rest of family medicine or outpatient clinic work.

My thoughts exactly... most FM programs are moving further and further away from L and D.

We have a few of "those" types in our residency. They hate being on medicine, peds, clinic and and pretty much only enjoy their time on L and D. They are only interested in going to some small rural community and pretty much doing OB full time.

The 2-3 in our residency like this realized this in their first year also... why not just go into OBGYN or transfer now.

Sadly I think one of the residents just cant handle adult med or peds... so she "hates IM and peds".

One of the third years in my program is looking to join a practice of 3-4 OBGYN docs where she basically would see a lot of their clinic pts and they supposedly say they will teach her and eventually allow her to do more OBGYN. IMO seems like a situation where she is going to get used.. She realizes it also and has her reservations.

 

[Elevencents]

Appreciate the candor and advice everyone. I'm hearing malpractice is a big reason to stay away as well and to just do an OB residency if that's what you want to do.

I'm just not sure if I really want to do Gyn surgery.

 

[abcdior]

Indiana university
U illinois Rockford

Heavy heavy OB exp.

as much as you can want/handle

 

[TableMD]

I think its reasonable to do rural OB + family if you have taken the time to see the people that are doing it and like their setup. I just think that if you are too lazy to do your own investigation to sit down with the people who actually do it, you probably shouldn't be managing, or thinking you can manage acute OB patients anyways.

The internet for this sort of thing is worthless. GO to the community, see the docs who do it, ask about their life and go to where you can get the training. That is alot easier then dealing with the 2AM page from L&D...