freddydpt

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I spoke to a Dean today and she said there were 14 programs with this emphasis. Has anyone heard about it?
Thanks!
 

raptor5

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Maybe she is referring to some of the pilot P4 programs There is still a small OB requirement but these programs are in some part exempt from the RRC requirements. This will actually start next year. There is no list for these programs yet but they must inform applicants of their P4 status.
 
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Faebinder

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Sport Medicine is not as popular as it used to be and the money part of it is the orthopedics. The requirement of Sport Medicine rotations in FM programs might bring it back a little but dont hold your breath... plenty of competition out there including PMR people and even IM/Ped.
 

divinity09

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no, not really the sports med. i'm suprised the p4 initiative and residency changes aren't generating more discussion. it's incredibly interesting. changing the length of FP residency? starting in the 4th year? integrated MPH's? and they're all different! THAT'S what i was talking about. now why isn't anybody else?
 

Faebinder

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no, not really the sports med. i'm suprised the p4 initiative and residency changes aren't generating more discussion. it's incredibly interesting. changing the length of FP residency? starting in the 4th year? integrated MPH's? and they're all different! THAT'S what i was talking about. now why isn't anybody else?

I dont think any of the changes you mentioned will be wide spread over the country... ya never know though... maybe the P4.
 

drwatson

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I couldn't find any specific curriculum changes. It looks like each program submitted a proposal specific to it's own interest/research/population that it serves.

A 4 year residency that was more outpatient oriented does sound pretty interesting though.
 

divinity09

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i think there are some some radical changes, some incredibly interesting. at the same time, is it necessarily better to take out so much hospital training and focus heavily on outpatient? i like taking care of my inpatients, but i DON'T want to do med-peds (no closed ortho, no behavioral medicine, limited women's health, 0 OB, OH, and it's a year longer). i know it's becoming less and less common, but i do plan to admit my own patients.

fortunately, and like we said, these are just a few experimental sites making these changes and we can find what we need that suits our personal goals among them (since they're all so different), and of course the existing traditional programs. but what if these ideas take off? what if residency training becomes heavily outpatient through all 3 years? what if most FP residencies become 4 year programs (a common theme amongst the P4 sites)? IF you take out the ob (which i know "nobody is using", yet i see help-wanted ads for FP's w/ OB in the journals constantly and know many FP's who manage their own low-risk OB [even in FL!]), what is the difference between med-peds and FP? both 4 years, but one can further specialize, and one can work in hospitals or clinics. seems somewhat limiting to the FP, especially w/ the 'threat' of mid-level practicioners in the outpatient setting.
 

Faebinder

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i think there are some some radical changes, some incredibly interesting. at the same time, is it necessarily better to take out so much hospital training and focus heavily on outpatient? i like taking care of my inpatients, but i DON'T want to do med-peds (no closed ortho, no behavioral medicine, limited women's health, 0 OB, OH, and it's a year longer). i know it's becoming less and less common, but i do plan to admit my own patients.

fortunately, and like we said, these are just a few experimental sites making these changes and we can find what we need that suits our personal goals among them (since they're all so different), and of course the existing traditional programs. but what if these ideas take off? what if residency training becomes heavily outpatient through all 3 years? what if most FP residencies become 4 year programs (a common theme amongst the P4 sites)? IF you take out the ob (which i know "nobody is using", yet i see help-wanted ads for FP's w/ OB in the journals constantly and know many FP's who manage their own low-risk OB [even in FL!]), what is the difference between med-peds and FP? both 4 years, but one can further specialize, and one can work in hospitals or clinics. seems somewhat limiting to the FP, especially w/ the 'threat' of mid-level practicioners in the outpatient setting.


Outpatient is becoming more complicated with more procedures added and patients coming in with geriatric/Chemotherapy/postops/immune-rheum problems that require a different approach than the chemotherapy/postops/immune-rheum that are inpatient. The label "Internal Medicine" vs "Family Medicine" is blurring into "Outpatients Medicine" vs "Hospitalist". I think the move is very positive. There needs to be a focus on what you need to do in your outpatient practice to make the practice successful. Outpatient setting needs more strength in diagnosis, long-term treatment and outpatient procedures. The inpatient setting focuses more on short term treatments/procedures and stabilization of the patients. If you want to keep an inpatient strength as well as outpatient, you can always do a fellowship in whatever you want to stay strong in... such as OB fellowship or Hospitalist fellowship. Of course I think at that point you are trying to keep too many hats on at the same time, even for an FM doc, but it's doable... though for how long before you get tired.

I hope to see more focus on outpatient dermatology, sports medicine and rheumotology in P4.
 
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