FP working in the ER?

[DocBrown]

Advertisement - Members don't see this ad

I'm on my FP rotation now, and I never thought I'd like it, but I do. I had always been into EM, which I realize is bascially FP with an acute slant.

Is it possible to finish a FP residency and then work in an ER? I think it'd be nice to work in the ER for a while, but then open up a nice private outpatient practice later.

 

[iatrosB]

I'm on my FP rotation now, and I never thought I'd like it, but I do. I had always been into EM, which I realize is bascially FP with an acute slant.

Is it possible to finish a FP residency and then work in an ER? I think it'd be nice to work in the ER for a while, but then open up a nice private outpatient practice later.

Ask this in the EM forum. Basically, they say that you can do it in some places now (mostly rural) but it will happen less frequently as EM residencies crank out more grads. Check out the EM forum though, it has been discussed quite a bit.

 

[ARealist2]

I'm on my FP rotation now, and I never thought I'd like it, but I do. I had always been into EM, which I realize is bascially FP with an acute slant.
Is it possible to finish a FP residency and then work in an ER? I think it'd be nice to work in the ER for a while, but then open up a nice private outpatient practice later.

I've wondered about this also. At my school at least half of the people I've met that are finishing up their FP residency are planning on working in the E.R. Most of them are working in rural areas around our city; they say that the E.R.'s in the city will not take them, but they can easily work in the rural E.R. I just don't understand what the advantage of this is. I mean there are plenty of other things that they could do, and I can't imagine choosing a 12 hour night shift over an 8 to 5 kind of job.

 

[DrQuinn]

I've wondered about this also. At my school at least half of the people I've met that are finishing up their FP residency are planning on working in the E.R. Most of them are working in rural areas around our city; they say that the E.R.'s in the city will not take them, but they can easily work in the rural E.R. I just don't understand what the advantage of this is. I mean there are plenty of other things that they could do, and I can't imagine choosing a 12 hour night shift over an 8 to 5 kind of job.

There are a lot of advantages to EM than FP... and vice versa. I'm not sure of your level, but by the end of your M3 year, you'll be able to see if you're the "EM type" or the "FP type." There really is a BIG difference between the two!

I agree with iatrosB, post this message in the EM forums...
but remember, basically the entire Emergency Medicine community (ACEP, AAEM, etc) recommend you obtain an EM residency if you want to work in the ED. There is very little acute care taught in FP residencies (many of my friends are in FP residencies), and I now how uncomfortable they feel in an acute setting.

Good luck!

Q

 

[seattledoc]

You can work in a ED but it's true that you pretty much have to go rural to find work. I worked in an ED after my FP residency in a rural town in Washington. The only reason FP's worked there is because there weren't adequate EM docs to staff it. It was a fun change of pace, paid slightly better than working in the FP office, and kept my skills up. At the time (2000-2002), we got paid about $100/hr. I would typically see about 35-40 pts in a 12 hr shift and was usually the only doc in the hospital after 5pm.

peace

 

[dr.smurf]

seattledoc,
how did you feel regarding your ability to handle acute er cases? did you have advanced emergency training (fellowship, electives, etc.)? Do you think ACLS, ATLS, ALSO, PALS, NALS courses give you that extra comfort? Im very interested in persuing er after residency to some degree. my ideal scenario would be doing both traditional fp (out/in pt) with some er thrown in there. is this unrealistic? i know it really depends on where you end up practicing, rural vs. suburbia vs. urban.

thanks a lot!

 

[ARealist2]

thanks a lot![/QUOTE]

The FP residents @ my school just take as many emergency dept. electives they can during their third year .

 

[seattledoc]

seattledoc,
how did you feel regarding your ability to handle acute er cases? did you have advanced emergency training (fellowship, electives, etc.)? Do you think ACLS, ATLS, ALSO, PALS, NALS courses give you that extra comfort? Im very interested in persuing er after residency to some degree. my ideal scenario would be doing both traditional fp (out/in pt) with some er thrown in there. is this unrealistic? i know it really depends on where you end up practicing, rural vs. suburbia vs. urban.

thanks a lot!

I rarely felt like I was pushing the limits of my abilities. It wasn't a trauma heavy ER but we still got the occas GSW or car crash. The surgeons on call were ~5-10min away if I needed them. The staff was well trained and half the time they were one step ahead of me. (I'd ask for labs to be sent and a CXR and they would have already done both and would point to the film that was hanging on the light box...nice) I had taken ACLS, ATLS, and PALS courses as they were required.

I think it's very realistic to have a traditional FP practice and also do some ER work on the side. In many rural parts of the country, if ER coverage is an issue for the hospital, the on-call doc simply works the ER overnight. At the hospital where I worked, some of the FP docs worked 5-6 shifts per month in the ER and probably earned 1/3-1/2 of their income doing so. Their reimbursement for their in-office practice was pretty lousy and the ER work was keeping them afloat.

So is everyone going to have the same comfort zone for this type of work? Of course not. I would say that you should get as much ED training as you can, maybe work in an urgent care and see what you think and then move up to ER work.
peace