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FP residency programs.

Discussion in 'Family Medicine' started by jocg27, Jul 25, 2006.

  1. jocg27

    jocg27 Senior Member

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    Starting m2 year here...I have a question about learning about family residency programs.

    There are very many, and unlike most other specialties, they are generally not at the huge academic medical centers we tend to be more familiar with, and in fact, I've heard, in family practice it may be best to avoid the big academic medical centers for the sake of your training anyway.

    For those who are going through the process now or those who already have, how do you even begin to get a sense of the philosophies and atmospheres of different programs, and how you'll fit? I know when it comes down to it away rotations and all are important, but how do you even start to get your list down to a manageable size?

    Most specifically, I'm interested in Chicago and immediate burbs, so any insight about that is great, but even just generally from around the country, what was the process of deciding where to apply and how to rank like for you?
     
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  3. sophiejane

    sophiejane Exhausted
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    I made a spreadsheet, listed things important to me (unopposed, procedure exposure, OB, how much time for electives, academic center affiliation--can be a good thing to be affiliated but not in the middle of one--also location was huge for me). Spent a lot of time online. You just gotta go to the websites and learn as much as you can.

    This forum has been a great resource too. Don't know much about Chicago, but I'm sure you'll find someone here who does.

    Best of luck.
     
  4. lowbudget

    lowbudget Senior Member

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    In terms of doing research on programs: start with the AAFP residency list. You can tell whether a program is opposed/unopposed based on whether or not it shares its facilities with other residencies. For you, I would start with Illinois and surf through the different program websites. Programs tend to harp on their strengths in the text whether its training for low-resource environments (rural/underserve/international) or academics/research where they expect you to have an "interest" for research. Most curricula are similar, but appreciate any notable differences between programs. For example, some programs will do 4-5 months of Internal Medicine Wards, while others will do 2-3 months of Internal Medicine but will also have Cardiology or Pulmonary etc as a requirement. That variety may reflect what faculty resources are available to you as a resident, but at the same time, if the required rotations are so specialized, you may begin to question whether or not the rotations are even pertinent to FM. How do FM programs differ in their curriculum? How does your FM program compare to other Pedi program when it comes to Pedi education? Or Inpatient Medicine? Or Med-Peds? How many inpatient rotations compared to outpatient? How many electives do I get? Also, take into account what the "faculty interests" are, because that's where you'll find the nuances between programs. For example, don't be surprise that OB will be emphasized in programs where a huge chunk of the faculty express Women's Health as an interest. If availabe, look at the Residents' profile also, not in terms of what school they went to, but in terms of what interests they have. Ideally, you want to find a place where the Faculty-Resident-Applicants have interests that are aligned. Few programs will post their procedure numbers. These numbers are good to keep in your head as you compare program to program AND compare specialties. That is, if an FM program brags about how many C-Section or Colpos they do, how does that compare to other FM programs? How does it compare to other OB programs? Don't forget Scutwork, which is hit or miss, and highly subjective but insightful.

    You can get a sense of where a program's priorities are by reading things on the net.

    THEN, when you rotate through your 3rd and 4th year rotations, pick rotations in different settings. Do Medicine clerkship at an academic medical center, but turn around and do, say, Surgery clerkship at a community hospital. Or OB at academic and Pedi in community. And pay attention to the faculty, to the residents, to the environment, to the lectures/rounds, to the procedures performed, and to how faculty/residents interact with each other within their specialty and outside their specialty. Pay attention to how the residents "learn". Is it a sink-or-swim or is it more structured with very defined responsibilities?

    Soon, you'll begin to form your opinion about what kind of environment suits you better and what fits your style. Just remember that you are asked to generalize and make decisions based on very limited impressions and information.

    Hope that helps.
     
  5. raptor5

    raptor5 Fooled by Randomness

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    To me it seems that several programs in the midwest and Texas that were once purely academic are moving toword a combined academic and community training environment to provide the best of both worlds. Anyone have any thoughts.
     
  6. sophiejane

    sophiejane Exhausted
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    Which programs specifically?

    I know that when I talk to other people in TX about FM residencies, hardly anyone has places like Southwestern, Baylor, UTMB (Austin or Galveston), Scott and White, and UTHSCSA at the top of their list, unless it is for geographical reasons. These are the traditional academic residencies, and I think before long, they will be a thing of the past. Some of them appear to be almost exclusively FMGs, which indicates they are having problems recruiting and filling their spots.

    UTHouston has a great program at Memorial, but it's unopposed...

    There is talk of starting an IM program at JPS in Ft. Worth, which will hurt their strong FM program, in my opinion.

    Nobody wants to have their residentcy serve as the dumping ground for the cases that nobody else wants. It's not right for the residents and it's not right for their future patients. I think this is a big part of FM's image problem at present. That, and having people rotate in practices that are referral mills.
     
  7. flighterdoc

    flighterdoc Rocket Scientist

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    Why would anyone want to do an FP residency at an academic center?

    It seems to me that the degree of opposition would be massive, and all the 'good' cases would get turfed out.

    If I were to apply to FP programs I think that I'd go for community, unopposed - where I can get exposure to a LOT of pathology rather than have every newly diagnosed diabetic (for example) taken by endocrinology.
     
  8. NDMD

    NDMD PapaDoc

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    If you have time next week, head to Kansas City for the National Conference of Family Medicine Residents and Medical Students . You'll be able to visit with almost every FM residency in the country.

    http://www.aafp.org/online/en/home/cme/aafpcourses/conferences/conference.html
     

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