Future FP resident wants to switch to EM

[Misterioso]

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Most 3rd year med students without a lick of real world experience, and without a girlfriend or a tube of KY are obnoxious to no end. 😀

True

Just calling out your misstatement that EM2's can handle anything that walks in the door.

 

[Misterioso]

Mystery, please go trolling somewhere else. You are being a forum exhibitionist. Quinn, please close this thread before this guy climaxes all over our beloved EM soil 😛 Serious though....this thead has no more purpose.....and I am not about to give mystery one more second of pleasure.

Actually it is you who is "trolling". I'm rationally discussing the issues in this thread while you're resorting to immature insults.

 

[8744]

Actually it is you who is "trolling". I'm rationally discussing the issues in this thread while you're resorting to immature insults.

I think you have an idea which makes sense in a way but then you carry it to ridiculous lengths. Your idea is that much of the work of any physician are "bread and butter" cases which become eventually become routine.

This is true after a fashion and you can certainly dress a PA in a white coat and send him out into the world where he can pass himself off as a physician, fooling most of the people some of the time. (like they do at my FP program because, and let's be honest, FP does not exactly handle a lot of high acuity cases.)

You can also sit a Family Physician behind the nurses station in the MICU and he can certainly handle a good deal of the routine management of most patients.

But then something goes wrong or a patient comes in who refuses to get sick in a nice, slow-paced linear fashion and the lack of critical care training of an FP (or a PA) will be obvious.

No offense but FP doesn't train for that kind of thing except in a very limited way and once you go into practice you hardly ever do anything other than routine clinic work.

I'm all for physician extenders, by the way. I just think that many of them don't know their limitations. The "we can do anything doctors do" attitude comes from not knowing enought ot know what they don't know.

Many of the EM programs where I interviewed admitted upwards of 20 percent of their patients, a good portion of those to the ICU. Automatically I know that the patients are generaly of a higher acuity than the ones I see in FP because in the last year I have sent, out of about 120 patient encounters, only one patient to the hospital and I sent him to the ED first.

 

[EctopicFetus]

Actually it is you who is "trolling". I'm rationally discussing the issues in this thread while you're resorting to immature insults.

Please DO NOT FEED the Troll

 

[EctopicFetus]

BY the way Mystery man is helping us get closer to the goal.

 

[BKN]

BY the way Mystery man is helping us get closer to the goal.

particulary since c-man bites the hook twice each time. 3 for 1. 😀

 

[EctopicFetus]

particulary since c-man bites the hook twice each time. 3 for 1. 😀

YES!! BKN do you still get excited about match or have you been doing it so long that it is just more about seeing who you get. Clearly this is a more anxious time for the students than the PDs. But I was wondering what your take on the matter is.

 

[BKN]

YES!! BKN do you still get excited about match or have you been doing it so long that it is just more about seeing who you get. Clearly this is a more anxious time for the students than the PDs. But I was wondering what your take on the matter is.

Of course I'm still interested. I've just spent 5.5 months doing almost nothing else during my admin time. I reviewed a bunch of apps (hundreds), I've interviewed 80+, I spent many hours putting together a formula to rank them on all the things we look for, and then I fought for my favorites with the rest of the residency committee. Oh yeah, and I tried ( mostly unsuccessfully) to calm down a bunch of hyper SDNers.

I'm tired. I put more time into this interview season then any previous one. I'll be fascinated to see who we get.

I'd like to take a nap, but the RRC site visit announcement came just as the season ended. That'll keep me busy almost till next interview season. 😡

 

[deuist]

As an aside, what is RRC?

 

[Koko]

As an aside, what is RRC?

RRC=Residency Review Committee

 

[Misterioso]

I think you have an idea which makes sense in a way but then you carry it to ridiculous lengths. Your idea is that much of the work of any physician are "bread and butter" cases which become eventually become routine.

This is true after a fashion and you can certainly dress a PA in a white coat and send him out into the world where he can pass himself off as a physician, fooling most of the people some of the time. (like they do at my FP program because, and let's be honest, FP does not exactly handle a lot of high acuity cases.)

You can also sit a Family Physician behind the nurses station in the MICU and he can certainly handle a good deal of the routine management of most patients.

But then something goes wrong or a patient comes in who refuses to get sick in a nice, slow-paced linear fashion and the lack of critical care training of an FP (or a PA) will be obvious.

No offense but FP doesn't train for that kind of thing except in a very limited way and once you go into practice you hardly ever do anything other than routine clinic work.

I'm all for physician extenders, by the way. I just think that many of them don't know their limitations. The "we can do anything doctors do" attitude comes from not knowing enought ot know what they don't know.

Many of the EM programs where I interviewed admitted upwards of 20 percent of their patients, a good portion of those to the ICU. Automatically I know that the patients are generaly of a higher acuity than the ones I see in FP because in the last year I have sent, out of about 120 patient encounters, only one patient to the hospital and I sent him to the ED first.

No offense, but you're a FM dropout who wants to do EM but couldn't match the first time around. Which makes what you say to be taken with a grain of salt.

 

[EctopicFetus]

Of course I'm still interested. I've just spent 5.5 months doing almost nothing else during my admin time. I reviewed a bunch of apps (hundreds), I've interviewed 80+, I spent many hours putting together a formula to rank them on all the things we look for, and then I fought for my favorites with the rest of the residency committee. Oh yeah, and I tried ( mostly unsuccessfully) to calm down a bunch of hyper SDNers.

I'm tired. I put more time into this interview season then any previous one. I'll be fascinated to see who we get.

I'd like to take a nap, but the RRC site visit announcement came just as the season ended. That'll keep me busy almost till next interview season. 😡

No rest for the weary I guess.

 

[EctopicFetus]

Im off to Paris.. Hope everyone doesnt miss me too much while I am gone..

 

[deuist]

Have a good vacation, EF. I'm sure you're looking forward to seeing life outside of a hospital for a few days.

 

[DrQuinn]

Keep it clean.

Continue.
Q

 

[ERMudPhud]

Just checking his recent quotes..

I think you missed his two best quotes. The one asking if he could be a general surgeon without ever having to touch or see someones butt was classic.

I also liked the thread asking if he could be a surgeon who only operates and delegates all pre-OP and post-OP care to someone else.

Those two threads indicate to me that even for a med student, and I'm not sure he's an MS3 yet, he is very naive about the scope of practice or training involved in ours or really any other specialty.

Hopefully, as his training progresses he will be embarrassed by his early "toolishness" Or maybe he'll be one of those people who is always a tool.

 

[8744]

No offense, but you're a FM dropout who wants to do EM but couldn't match the first time around. Which makes what you say to be taken with a grain of salt.

Dude, Family Medicine blows. Simple as that. If it didn't blow I'd stay in it. The fact is that doing EM as an FP is a career path which is rapidly disappearing.

Regardless of my qualificatons, I think I know a little bit more about FP than you probably do.

 

[EctopicFetus]

Some padding..

 

[EctopicFetus]

Have a good vacation, EF. I'm sure you're looking forward to seeing life outside of a hospital for a few days.

Thanks for the well wishes.. This yr hasnt been bad at ALL. This is more like a getaway with the B&C prior to match, st pattys, house hunting, graduation and me getting away to hang with some friends.. No stress except for waiting on the match. All that being said I know it is 100% out of my hands now so Ill just wait and see.

 

[EctopicFetus]

I think you missed his two best quotes. The one asking if he could be a general surgeon without ever having to touch or see someones butt was classic.

I also liked the thread asking if he could be a surgeon who only operates and delegates all pre-OP and post-OP care to someone else.

Those two threads indicate to me that even for a med student, and I'm not sure he's an MS3 yet, he is very naive about the scope of practice or training involved in ours or really any other specialty.

Hopefully, as his training progresses he will be embarrassed by his early "toolishness" Or maybe he'll be one of those people who is always a tool.

Yeah I must have missed those. I dont know about the residents or other M3 and M4s on here but I never thought I knew as much as this guy does as a m3. I mean he knows everything there is to know about every specialty and clearly no specialty is as great as G Surg. 🙄

 

[EctopicFetus]

Panda dont even let the guy get to you..

 

[TysonCook]

duplicate

 

[TysonCook]

He's an M2 if I'm not mistaken from his other threads in the USMLE forum.

Not too sure that it is wise to post multiple inflammatory remarks when one hasn't even started wards. Just my $.02. 🙂

 

[8744]

Panda dont even let the guy get to you..

I'd be lying if I said that this match isn't going to be a nail biter for me.

 

[Misterioso]

The fact is that doing EM as an FP is a career path which is rapidly disappearing.

That's irrelevent to the discussion. The fact remains a FP (or IM or general surgeon) can and do cover the ER and do the duties of an EP.

 

[8744]

That's irrelevent to the discussion. The fact remains a FP (or IM or general surgeon) can and do cover the ER and do all the duties of an EP.

If you look at most of the advertisements for physicians to cover EDs, after board certified Emergency Physicians they will usually settle for board certified IM with emergency experience or general surgeons. Places willing to take FP are few and far between and getting scarcer.

IM physicans are a lot better trained for acutely ill patients than FPs.

There's a lot of overlap in many specialities but this doesn't mean that the specialties are equivalent. Naturally if I am in an auto accident and the first guy on the scene is a Family Physician I'm not going to complain. On the other hand if a trauma surgeon pulls up in the next car that would be better.

As to EM being primary care, this is also true to a certain extent. On the other hand the new trend is to have a "Fast Track" or other urgent-care-like section of the ED staffed by PAs, NPs, or even moonlighting Family Physicians freeing the Emergency Physicians to concentrate on the higher acuity cases.

Many of the programs where I interviewed mentioned this as a selling point of the program explicitely promising that they would take great pains to allow their residents to focus on the higher acuity cases.

 

[ewells]

...As to EM being primary care, this is also true to a certain extent. On the other hand the new trend is to have a "Fast Track" or other urgent-care-like section of the ED staffed by PAs, NPs, or even moonlighting Family Physicians freeing the Emergency Physicians to concentrate on the higher acuity cases.

Many of the programs where I interviewed mentioned this as a selling point of the program explicitely promising that they would take great pains to allow their residents to focus on the higher acuity cases.

I know that this was not your main point, but it relates to something that came up at one of my interviews when I asked the canned question "What are your weak points?" An assistant PD told me that some of his graduates thought that they had not gotten enough training in low acuity medicine, due to their fast track, and that they were having their residents spend a few shifts there as a result, so if they went to work after residency at a hospital without an urgent care area, they would have seen enough sore throats etc. to be comfortable. It was a strange image for me; a doc who is comfortable treating life threatening CP, but who would pass on the pt with an ankle sprain.

 

[FoughtFyr]

I am not a huge fan of FP's doing OB, ED, or half the stuff they do but until we live in a country the size of Ireland we are stuck with them doing it. They serve their purpose, and have been doing a decent job at it for over a century. Most of the people alive on this earth today and in this country were delivered by non-OB's. I realize this is changing but it hasn't yet. So when east LA meets West Phili, all this will be moot. But until this, the heartland will still need to be served by the best it can get. I know its not ideal, but its the system we are in today. And thusly, the OP still has a small chance of proving some EM care to people somewhere in this country. I know the window is closing, as it should. I think Rockford scared the primary care out of you for sure.....sounds a lot like my school! 🙂

Check out the thread on the FP forum about FPs doing comestic surgery. That is why I bristle at the EM "fellows" or the pseudo-OBs. FPs believe (like misterio about GSurgeons) that they can do anything!

- H

 

[corpsmanUP]

I know that this was not your main point, but it relates to something that came up at one of my interviews when I asked the canned question "What are your weak points?" An assistant PD told me that some of his graduates thought that they had not gotten enough training in low acuity medicine, due to their fast track, and that they were having their residents spend a few shifts there as a result, so if they went to work after residency at a hospital without an urgent care area, they would have seen enough sore throats etc. to be comfortable. It was a strange image for me; a doc who is comfortable treating life threatening CP, but who would pass on the pt with an ankle sprain.

Fast track stuff can be learned moonlighting or in medical school. If you can't treat a URI, an ankle sprain, simple pneumonia, an easy lac, LBP, etc....then you really were not paying very close attention in 3rd and 4th year. I know I have had my fill of boring outpatient FM/urgent care stuff for a lifetime. I realize I will still always have to do some of it but I can tell you that my future jobs will be selected based on NOT having to do a lot of this stuff. That stuff is for PA's and NP's, not even docs at all. I based several of my top rankings on the fact that fast track stuff would be either non-existent or minimized there. I think anything more than 1 shift a month in fast track is basically making you slave labor as an EM resident. If I wanted to do fast track I would have stayed a PA.

 

[sophiejane]

Check out the thread on the FP forum about FPs doing comestic surgery. That is why I bristle at the EM "fellows" or the pseudo-OBs. FPs believe (like misterio about GSurgeons) that they can do anything!

- H

Whoa, there. Let's not confuse microderm abrasion, chemical peels, laser hair removal and Botox with "cosmetic surgery". There is a difference between a surgery and a procedure and the thread to which you refer is talking about procedures.

You do not and should not need board certification in dermatology to oversee microderm abrasion and laser hair removal by trained technicians. Board certification in FM and extra hours of CME should be (and is) sufficient.

Why so much hating on the FPs here? It's amusing to me that there is so much joy taken in making Fps everyone's whipping boy. It's just not worth even arguing or getting into a piSSIng contest with people like that.

Thanks for your support of rural FPs, corpsman. may you all be lucky enough to have one of us nearby if you should ever pass through our godforsaken little towns and need our services. 🙂

 

[Jeff698]

If you can't treat a URI, an ankle sprain, simple pneumonia, an easy lac, LBP, etc....then you really were not paying very close attention in 3rd and 4th year.

That's an interesting observation. I'd say I made it through 3rd and 4th year with very little exposure to typical outpatient type issues. Almost all of my medical school exposure was to in-patient medicine. With HMOs and admission criteria being what they are these days, in-patients are, for the most part, pretty sick folks. Certainly not run of the mill URIs.

I'm not sure if this was just a UTMB thing or not, but we didn't do much out-patient medicine at all.

Take care,
Jeff

 

[corpsmanUP]

Whoa, there. Let's not confuse microderm abrasion, chemical peels, laser hair removal and Botox with "cosmetic surgery". There is a difference between a surgery and a procedure and the thread to which you refer is talking about procedures.

You do not and should not need board certification in dermatology to oversee microderm abrasion and laser hair removal by trained technicians. Board certification in FM and extra hours of CME should be (and is) sufficient.

Why so much hating on the FPs here? It's amusing to me that there is so much joy taken in making Fps everyone's whipping boy. It's just not worth even arguing or getting into a piSSIng contest with people like that.

Thanks for your support of rural FPs, corpsman. may you all be lucky enough to have one of us nearby if you should ever pass through our godforsaken little towns and need our services. 🙂

We in EM have the backline to the helicopters....so we'll just meet them at the nearest LZ anyway. 😉

I didn't read the thread FF quoted but I can tell you that all the things you just listed are within the scope of ANY physician. The thing is, even derm docs have no training in much of what they do in modern cosmetic stuff, and they end up learning from the same CME weekends the FM's learn it from. The reality though is that most of these services will be done without physician oversight in the near future and should be. Why the hec do you need a physician to do laser hair removal?

 

[sophiejane]

I know I have had my fill of boring outpatient FM/urgent care stuff for a lifetime.QUOTE]


If it's that boring then you probably aren't doing it right, i.e., using that sinusitis to check up on whether they were overdue for a colonoscopy (then doing it, thank you very much), depression screening, etc.

It wasn't so long ago that you were a champion of FM and ready to be one yourself, corpsman. If you knew how boring FM was when you were a PA, why did you want to do FP up until your 4th year?

You yourself have posted many a post about PA and NP's using "cookbook" medicine and that you wanted to be a primary care doc because you wanted more than that.

Such a change of heart in such a short time? Or am I misunderstanding your point....?

 

[la gringa]

i'm with jeff - didn't do any of that 4th year at all and barely any in 3rd year save for peds and ob...

 

[BMW19]

Aren't there EM fellowships post FP, I thought there were a few?

BMW-

 

[8744]

I know I have had my fill of boring outpatient FM/urgent care stuff for a lifetime.QUOTE]


If it's that boring then you probably aren't doing it right, i.e., using that sinusitis to check up on whether they were overdue for a colonoscopy (then doing it, thank you very much), depression screening, etc.

That's it exactly. I don't want to have to address all of the health maintenance stuff at every visit. It's boring, a drag, and I'm already tired of the requirement that I essentially nag every patient on every visit about their weight, their smoking, and their drinking.

I'm just not that judgemental. I also know enough to disregard BMI occasionally. Yes, I know. BMI corresponds to lifetime risk. On the other hand my program wants us to counsel everybody about their weight based solely on their BMI. The scenario then becomes me telling an attractive young lady who is not an emaciated fashion model and who just came in for a sore throat that she is a disgusting fat-body.

Talk about destroying somebody's self esteem.

I hate to start a flame war but the specialty is being taken over by mid-level providors. No cut on them, I repeat, but they're only moving in because they can and the market realizes this.

 

[WilcoWorld]

Sophiejane - I agree with your point that the skills of a good FP are of a different nature than those of a good microderm abrasionist. Convincing, manipulating, fooling (or whatever you want to call it) your patients into doing what's best for them requires a lot of skill, and that is a skill that most EP's, & Gen Surgeons lack.

And FoughtFyr can fight for himself, but I think you're misunderstanding his point. He is not FP bashing - in fact, he's one of the first to recognize that EP's shouldn't consider themselves a fellowship away from becoming FP's. He is simply stating that, given the incredible complexity & specialization of medicine today, we all must know our limits and respect them.

I am just now starting to understand that the skills specific to a good EMP are not intubation, chest tubes, & IJ's (though he/she must have those in the arsenal as well). The skill specific to EMP's is the ability to manage the intubated patient with an IJ, the trauma patient with a chest tube, the STEMI, all while moving the vag bleeders, sore throats, and ankle sprains through the department efficiently and safely. In a word, multitasking.

 

[FoughtFyr]

Whoa, there. Let's not confuse microderm abrasion, chemical peels, laser hair removal and Botox with "cosmetic surgery". There is a difference between a surgery and a procedure and the thread to which you refer is talking about procedures.

O.k., so what are the "limits". Since the FP seems to be able to a. run a complex practice caring for their own patients "cradle to grave" (to quote the aafp), b. run an ED with a little fellowship training (or without it), c. take some CME and do some minor cosmetic procedures, d. take that sports medicine fellowship and do ortho, why have any other type of physician? I mean with a general surgery fellowship added, everyone else is obsolete 😕...

You do not and should not need board certification in dermatology to oversee microderm abrasion and laser hair removal by trained technicians. Board certification in FM and extra hours of CME should be (and is) sufficient.

Yeah, kinda the same thing as with EM. You would probably get about 90% of it right, but it is that difficult 10% that makes a profession. I flat out disagree with your assertion that "board certification in FM and extra hours of CME should be (and is) sufficent." Legally, holding a medical license (with or without board certification or CME) is sufficent. Where is the proof that BE/BC in FM with CME improves on that (in the case of cosmetic procedures)?

Why so much hating on the FPs here? It's amusing to me that there is so much joy taken in making Fps everyone's whipping boy. It's just not worth even arguing or getting into a piSSIng contest with people like that.

I'm not hating at all. I think FM is an amazing field. I think FPs are great primary care providers. I have no problem referring to them, recommending them, or seeing one myself. I admire FPs as masters of primary care. But that is what they are. They are not cosmetic surgeons, orthopedists, or EPs, regardless of fellowship or CME.

- H

 

[ewells]

Fast track stuff can be learned moonlighting or in medical school. If you can't treat a URI, an ankle sprain, simple pneumonia, an easy lac, LBP, etc....then you really were not paying very close attention in 3rd and 4th year. I know I have had my fill of boring outpatient FM/urgent care stuff for a lifetime. I realize I will still always have to do some of it but I can tell you that my future jobs will be selected based on NOT having to do a lot of this stuff. That stuff is for PA's and NP's, not even docs at all. I based several of my top rankings on the fact that fast track stuff would be either non-existent or minimized there. I think anything more than 1 shift a month in fast track is basically making you slave labor as an EM resident. If I wanted to do fast track I would have stayed a PA.

If you ask me what I want get the best training in it will be the lifesaving interventions every time, so I think that we agree for the most part. But (as I am sure you know) there are plenty of places we could all end up practicing where fast track will be part-time or nonexistent. I just thought that this was interesting feedback from people who had been practicing for awhile.

 

[corpsmanUP]

I think its just what you are comfortable with and what you bring to the table to begin residency. I just don't like treating URI's, UTI's, minor MS complaints, and lots of the typical fast track stuff. I realize I will have to lots of it in the future, but at least I will not be taking care of these same people at 3 AM on my day off when they get their finger stuck in a bowling ball. FM docs do a lot of fast track in their office but they have to deal with the people later as well. I just got burnt out in my 4th year from working my entire way through med school. I was in my 7th year of being a PA in FM/urgent care at the end of my 2nd year of med school and I was simply sick of dealing with all that stuff all the time. I wanted some higher acuity thrown in there. I literally had more excitement in the few years I was a paramedic than half a career as a PA.

My background gave me the flexibility to not have to do fast track stuff and spend more time learning the real EM. I am completely comfortable seeing 30-40 patients in 5 hours in an urgent care/fast track situation. But even that is a skill that takes a long time to master. The main difference is that through trial and error and some many thousands of patients later, I can tell you that its real hard to screw up a fast track patient with incorrect treatment. There are so many ways to skin a cat that you basically just have to learn to recognize who is really sick and who isn't. The main thing about fast track is to be able to know who got mistriaged by the nurse, and who really should have been in the ED proper.

So for me, most of my top choices were places that used midlevels to see most of the fast track stuff. My top program doesn't have residents working in fast track AT ALL! This was 50% of why I chose this program, among its other great attributes. But like Wilco said, I think if you have never been exposed to this stuff then you do need to spend some time doing fast track.

Jeff, I see what you mean. My school was very primary care oriented where we spent at least 3 months in outpatient family medicine. It was dumb of me to assume every school would educate their students the same. Your comments thus make total sense.

 

[Zeion]

I would go through the match with NRMP and upon matching, contact the program you match to and let them know that you have changed course and now are persuing EM. You would then need to let that PD know that you don't want to sign your contract. At that point you are at the mercy of the PD and no PD in their right mind is going to force a first year to come to their program if that individual doesn't want to be there. Ever been around an unhappy resident? It is like having a bad hangnail that won't heal. Being open and honest will keep you from violating NRMP and having to sit out a year from any sort of match if it should come to that.


Next, come late June/early July you should check the SAEM website daily for PGY-1 vacancies and there will be some, because there are always one or two poor souls who choose to follow their significant other or have "personal reasons" for not showing up for residency orientation and moving on with their medical trainning. So you contact these programs (you can't be picky), as they will be desperate, and your low scores and class rank will be trivial to the PD compared to having an open slot to fill.

In the mean time you obtain EM faculty letters of rec, ATLS, anything else that might help show you are now devoted to EM.

Overall, this is kind of a gamble, but better than wasting a year doing something you don't want to be doing.

Derek,

I am pretty much in the same category. My story is a long one but I'm a born and raised U.S.er but had to do the foreign medical school route. I was considering FP with a subsequent fellowship in Sports Medicine (b/c of my avid athletic and sports involvement) but after finishing my interviews I realized something...."What am I doing?????" I've come to realize that EM has everything that I truly desire from and wish to contribute, to medicine.

My dilemma is what should I do???? I know that I can continue the FP thing and then try to get into an EM 1st year position however, I am re-thinking this option. In my opinion, doing a prelim Surgery internship would probably more advantageous let alone more appealing to EM residencies than an FP residency would. I may be wrong in my rationale.....but.....I also know the weight of a surgical internship as well. On this note....I noticed you recommending that one can tell the PD that one has matched with that you've gone a different direction....wouldn't that lead to some negative consequences or "black-balling" of the person or is a legitimate reason going to have to be come up with in order to do this?

I know for a fact that I'd much prefer doing a surgery internship over an FP internship but I also was told by one of my best friends (whose a 1st year OB/GYN resident) to go after a categorical spot rather than a prelim spot....Thus the many dilemma's I'm facing with a little over a week before "Match Day."

-Zeion

 

[Zeion]

BTW.....to fellow physicians....

The question I posed to Derek is not not solely for him. I welcome everyone's opinion and advice 10000%.

Looking foward to reading to the replies.

-Z

 

[BKN]

Derek,


My dilemma is what should I do???? I know that I can continue the FP thing and then try to get into an EM 1st year position however, I am re-thinking this option. In my opinion, doing a prelim Surgery internship would probably more advantageous let alone more appealing to EM residencies than an FP residency would. I may be wrong in my rationale.....but.....I also know the weight of a surgical internship as well. On this note....I noticed you recommending that one can tell the PD that one has matched with that you've gone a different direction....wouldn't that lead to some negative consequences or "black-balling" of the person or is a legitimate reason going to have to be come up with in order to do this?

I know for a fact that I'd much prefer doing a surgery internship over an FP internship but I also was told by one of my best friends (whose a 1st year OB/GYN resident) to go after a categorical spot rather than a prelim spot....Thus the many dilemma's I'm facing with a little over a week before "Match Day."

-Zeion

It's always a bad sign when somebody starts quoting himself. . .

I imagine you would end up taking a open surgical or IM prelim. To me a FP year 1 is about equivalent is attractiveness

but you wanted to know how an EM PD would look at it.

 

[Zeion]

What would provide the BEST way of getting into an EM residency via back door, if one does not match or scramble into an EM position? Prelim. Surgery or Internal Medicine?

9 days and counting to the Match.....Answers please????!!!!!???!!!

 

[BKN]

What would provide the BEST way of getting into an EM residency via back door, if one does not match or scramble into an EM position? Prelim. Surgery or Internal Medicine?

9 days and counting to the Match.....Answers please????!!!!!???!!!

No way to tell. Depends on the preferences of an individual PD. I know some who would prefer either. Possibly IM would have the advantage.

 

[edinOH]

Nelson Perret MD at LSU
.

May be the best physician I have ever known.

 

[Derek]

You really need to check with the NRMP, but I do believe that if you match into FP this year and the program you match to forgives you of this (what paper work this includes I have no idea), you are free and clear. The problem comes in if they want you to show up and you end up breaking your NRMP contract then you have to sit out a year from the match and you are limited to the SAEM website for residency vacancies to land a spot.


If you are serious about this, e-mail your FP programs now and tell them you have had a change of heart and will not be able to complete your first year of FP and you regret the problems this may cause for their program if you are to match there. At the same time look at what programs haven't filled in EM for the last few years (??King-Drew) and contact the program director and find a way to have your application material in his/her hand before match day so if there is a scramble for that program you are ahead of everyone else.

This is a big time gamble. I wouldn't advise you to do this, it is merely an option. 😕

 

[8744]

You really need to check with the NRMP, but I do believe that if you match into FP this year and the program you match to forgives you of this (what paper work this includes I have no idea), you are free and clear. The problem comes in if they want you to show up and you end up breaking your NRMP contract then you have to sit out a year from the match and you are limited to the SAEM website for residency vacancies to land a spot.


If you are serious about this, e-mail your FP programs now and tell them you have had a change of heart and will not be able to complete your first year of FP and you regret the problems this may cause for their program if you are to match there. At the same time look at what programs haven't filled in EM for the last few years (??King-Drew) and contact the program director and find a way to have your application material in his/her hand before match day so if there is a scramble for that program you are ahead of everyone else.

This is a big time gamble. I wouldn't advise you to do this, it is merely an option. 😕

So just out of curiosity can you withdraw from the match after you submit your rank list? This is not clear to me. If it were possible my advice to the OP would be to do it, scramble into either an open EM spot or a preliminary spot and try next year.

 

[Zeion]

So just out of curiosity can you withdraw from the match after you submit your rank list? This is not clear to me. If it were possible my advice to the OP would be to do it, scramble into either an open EM spot or a preliminary spot and try next year.

Not sure if anyone answered my previous question.....So if one had to go into a residency outside of EM, if EM does not become an option.......What would provide the BEST inside tract to getting into EM subsequently? IM, Prelim. Surgery or FP?

Btw....Thanks to all who've helped with answering my post. It's been greatly appreciated.

 

[colforbinMD]

Not sure if anyone answered my previous question.....So if one had to go into a residency outside of EM, if EM does not become an option.......What would provide the BEST inside tract to getting into EM subsequently? IM, Prelim. Surgery or FP?

Btw....Thanks to all who've helped with answering my post. It's been greatly appreciated.

BKN answered it. It will depend on the preferances of each EM PD that ends up with your application when you apply as a pgy-2. His guess and he is most likely the best positioned to guess at all on this topic was that Possibly IM would have the advantage.