Hey E,
FP faculty jobs are a dime a dozen. Its not real competitive to offer a job whereas you have to see patients and train medical students and residents all for the lowest paying end of the pay scale. You can land a gig at most FP programs with a good strong pulse and a desire to teach. Residency director positions are a bit more coveted but even still you see DO's heading up allopathic residency programs in FM. Its just not competitive. You almost always see the same old faculty jobs listed in the back of JAAFP month after month. We have one sports med faculty that I know here at our school who sees virtually nothing but pain patients that the pain specialists couldn't fix with injections, and who ortho refused to operate because they had no true evidence of a physical defect needing surgery. And most of them are either postal workers or workman's comp gone way bad!!! I know as an Fp that I would refer my patients with injuries to ortho after I failed to treat them effectively with non-invasive or minimally invasive options. There really is no reason in between to send someone to a sport's medicine doctor in my opinion. Granted, a lot of ortho docs are narrow minded and only focus on surgery, making them bad choices for initial consults and service as team physicians. But don't kid yourself, there are plenty of good orthos around who know rehab, prevention, and are full-spectrum sport's medicine docs, and yet they can operate if need be. To me an ortho doc like this is the only real sports medicine physician. Based on the standard of care and on board certification, is there anything more a sports med doctor can do that a well trained FP cannot do? Thats what I would base my desire for doing a fellowship on. Like cardiology...we all know that a basic internist should not be doing caths, so thus a fellowship in cardiology is worthwhile. FP simply has no real viable fellowships because you are not limited from practicing EM, geriatrics, or sports medicine as an FP versus a fellowship trained FP. If FP guys really want to expand, what they need to do is create opportunities to train as an FP in IM subspecialties. It makes sense to me that an FP could easily do well in cardiology, GI, and a few other subs. IM domination over these fields is not going to last forever, and there is already talk of this happening in the near future. That would be pretty cool.
