IM/EM vs FP/EM

[bhs_runner]

I am thinking of doing a combined residency in either IM/EM or FP/EM. What are the pros and cons of one versus the other? Does IM or FP go better with EM?

thanks

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[EctopicFetus]

Well the one immediate downside is that the FP/EM programs are all new.. so there is the downside associated with that!

 

[SoCuteMD]

I am thinking of doing a combined residency in either IM/EM or FP/EM. What are the pros and cons of one versus the other? Does IM or FP go better with EM?

thanks

Cons - IM or FP...take your pick.

 

[bhs_runner]

Cons - IM or FP...take your pick.

I like the idea of seeing the same pts. and being able to follow their conditions over a long period of time. I am thinking about doing a dual residency so I can have a change of pace and dont have to work in one place all of the time.


I know that if you do FP then you can work in the ER but how about if you do EM...can you have an outpatient type of practice.


thanks

 

[FoughtFyr]

I like the idea of seeing the same pts. and being able to follow their conditions over a long period of time. I am thinking about doing a dual residency so I can have a change of pace and dont have to work in one place all of the time.

Well, that feeling might change once you have the same patients over time. Endless HTN rechecks are incredibly boring.

I know that if you do FP then you can work in the ER but how about if you do EM...can you have an outpatient type of practice.

No, there really is no "outpatient continuity" type practice for EM. But, do not believe that you can reliably work in EM as an FP. As more and more BC/BE EPs are finishing training, fewer and fewer FPs will be working in EM. Couple that with requirements of malpractice insurance and even fewer FPs will be left in EM.

- H

 

[SoCuteMD]

I like the idea of seeing the same pts. and being able to follow their conditions over a long period of time. I am thinking about doing a dual residency so I can have a change of pace and dont have to work in one place all of the time.


I know that if you do FP then you can work in the ER but how about if you do EM...can you have an outpatient type of practice.


thanks

Sorry, I guess I should clarify what I meant. MOST EPs wouldn't be caught dead in clinic. Seriously - I knew as an MS1 after about 4 hours that outpatient pediatrics would have been the death of my career in medicine! EM and IM/FM are VERY different fields. There are lots of threads regarding the dual residencies, and the general consensus seems to be that most people end up practicing one or the other, rarely both.

 

[AmoryBlaine]

Sorry, I guess I should clarify what I meant. MOST EPs wouldn't be caught dead in clinic. Seriously - I knew as an MS1 after about 4 hours that outpatient pediatrics would have been the death of my career in medicine! EM and IM/FM are VERY different fields. There are lots of threads regarding the dual residencies, and the general consensus seems to be that most people end up practicing one or the other, rarely both.

The classic story that I have heard multiple times is the M1/M2 who says "I'm going to do EM/IM, so I will work in the ED on Tuesdays and Thursdays and then have f/u clinic for my own patients on Mondays and Wednesdays."

Fantasyland. I for one have a very difficult time understanding the benefits of a combined residency program. So you would come out ready to manage penetrating chest trauma and essential hypertension? Great....

 

[LanceArmstrong]

check out this thread from the archives:

http://forums.studentdoctor.net/archive/index.php/t-59241.html
http://forums.studentdoctor.net/archive/index.php/t-83080.html

 

[bhs_runner]

The classic story that I have heard multiple times is the M1/M2 who says "I'm going to do EM/IM, so I will work in the ED on Tuesdays and Thursdays and then have f/u clinic for my own patients on Mondays and Wednesdays."

Fantasyland. I for one have a very difficult time understanding the benefits of a combined residency program. So you would come out ready to manage penetrating chest trauma and essential hypertension? Great....

During my FP rotation the Doctor that I worked with (who went to residency for FP only) worked in the ER about 4-5 times/month (it was a seriously small ER room). That is where I started thinking about a combined residency because I would like to do something like that.

 

[matt_mt19]

The question was whats the difference? I think the biggest difference is that the fellowship opportunities for FP are significantly limited compared to that of IM. Frankly I'm interested in Critical Care, which IM will open that door for certification, at least until the day that people realize EM to CC fellowship is natural and allow board certification.

 

[deleted6669]

The question was whats the difference? I think the biggest difference is that the fellowship opportunities for FP are significantly limited compared to that of IM. Frankly I'm interested in Critical Care, which IM will open that door for certification, at least until the day that people realize EM to CC fellowship is natural and allow board certification.

henry ford hospital in detroit has a 6 yr tripple EM/IM/CC residency if you are really a glutton for punishment and have an interest in both EM and Critical care.

 

[deleted109597]

During my FP rotation the Doctor that I worked with (who went to residency for FP only) worked in the ER about 4-5 times/month (it was a seriously small ER room). That is where I started thinking about a combined residency because I would like to do something like that.

Then do FP. Until ABEM has enough BC/BE people to staff all of the little ones, you can work there just fine.

What is an emergency room room?

 

[SoCuteMD]

The question was whats the difference? I think the biggest difference is that the fellowship opportunities for FP are significantly limited compared to that of IM. Frankly I'm interested in Critical Care, which IM will open that door for certification, at least until the day that people realize EM to CC fellowship is natural and allow board certification.

For some reason I thought CC fellowships were now open to EM grads?

 

[deleted6669]

For some reason I thought CC fellowships were now open to EM grads?

some allow em grads do the fellowship but you can only take the european board exam in cc at this point unless you are EM/IM

 

[Sweet Tea]

Then do FP. Until ABEM has enough BC/BE people to staff all of the little ones, you can work there just fine.

What is an emergency room room?

What he said.

 

[deleted109597]

some allow em grads do the fellowship but you can only take the european board exam in cc at this point unless you are EM/IM

Correct. Although somebody I know who is doing one said that it will reciprocate here. I didn't bother questioning that person, as this was during a residency interview.

 

[ERMudPhud]

What he said.

I've worked in one before in a seriously small rural ER. It is a single small room by the hospital entrance with one or two beds and thats the whole ER. If want to work in a hospital like that it is a pretty safe bet that no EM boarded physician will take your job so go ahead and do FP. I actually "covered" the ER from home a mile away at that hospital.

 

[bhs_runner]

I've worked in one before in a seriously small rural ER. It is a single small room by the hospital entrance with one or two beds and thats the whole ER. If want to work in a hospital like that it is a pretty safe bet that no EM boarded physician will take your job so go ahead and do FP. I actually "covered" the ER from home a mile away at that hospital.

How about IM instead of FP?

 

[deleted109597]

How about IM instead of FP?

Some internists work in small EDs as well, but their residency has even fewer of the procedures you do in an ED.

Joint residency isn't terribly worth it IMO.

 

[SoCuteMD]

Some internists work in small EDs as well, but their residency has even fewer of the procedures you do in an ED.

Joint residency isn't terribly worth it IMO.

Plus if you just have IM (and no EM) you aren't REALLY supposed to be treating kids. Assuming you are a one-man show in the ED that makes you even less useful.

 

[SoCuteMD]

Hey docB - we really need your input on this thread.

"You can't be a stem cell forever."

 

[kungfufishing]

how about EM/EM?

 

[AmoryBlaine]

how about EM/EM?

Too competitive.

 

[deleted77919]

how about EM/EM?

Yeah it's competitive, but it'll really help you land the Fry Fellowship at In-N-Out . . . All depends on how serious you are about getting that fellowship.

 

[Miami_med]

I'm considering doing a combined residency in neurology/surgery/internal medicine/pediatrics. If I choose to add EM to my roster and spend the full 15 years in residency, do you think that I can avoid doing an urgent care fellowship in order to work in Bob's Emergency Clinic?

 

[kungfufishing]

kind of depends on if you are wanting to sell new or used emergencies; are you sure you'll be satisfied on the lot? Do you think you might want to be a manager or handle financing someday?

As far as the original question from the OP goes, the new EM/FP residencies might offer a more realistic career path than EM/IM. For those people who want to be a rural FP who spends time covering the local ED it would provide more appropriate training than FP alone.

 

[BMW19]

what about after 10years of EM? Perhaps you could work in a clinic if you had the IM or FP

BMW-

kind of depends on if you are wanting to sell new or used emergencies; are you sure you'll be satisfied on the lot? Do you think you might want to be a manager or handle financing someday?

As far as the original question from the OP goes, the new EM/FP residencies might offer a more realistic career path. For those people who want to be a rural FP who spends time covering the local ED it would provide more appropriate training than FP alone.

 

[SoCuteMD]

what about after 10years of EM? Perhaps you could work in a clinic if you had the IM or FP

BMW-

You *could* as you would be board-certified. However, after 10 years of pure EM you would be very poorly-qualified to start treating essential HTN and managing type II DM. Although residency gives a great knowledge base, this knowledge base has to be retained and refined once you graduate. Medicine changes rapidly and providers in any field have an obligation to stay abreast of changes.

 

[deleted109597]

I'm considering doing a combined residency in neurology/surgery/internal medicine/pediatrics.

Sorry, there is only one spot in that residency, and since I got a 375 on Step II, you ain't getting it.
Then I'm doing a neuropedsfamilywomen'spsych and yoga fellowship. You know. For ****s and giggles.

 

[AmoryBlaine]

Sorry, there is only one spot in that residency, and since I got a 375 on Step II, you ain't getting it.
Then I'm doing a neuropedsfamilywomen'spsych and yoga fellowship. You know. For ****s and giggles.

Weak sauce. You still won't be able to practice "wilderness medicine."

 

[Emergen-C]

The question was whats the difference? I think the biggest difference is that the fellowship opportunities for FP are significantly limited compared to that of IM. Frankly I'm interested in Critical Care, which IM will open that door for certification, at least until the day that people realize EM to CC fellowship is natural and allow board certification.

the shock/trauma CC fellowship at univ of maryland is for EM-residency trained docs.

also, did you know that Canada has EM fellowships for graduates of FP residencies? Pretty cool idea...

 

[Miami_med]

Sorry, there is only one spot in that residency, and since I got a 375 on Step II, you ain't getting it.
Then I'm doing a neuropedsfamilywomen'spsych and yoga fellowship. You know. For ****s and giggles.

I hate to tell ya, but Bob's Emergency Clinic frowns on yoga. Besides, I'm behind you, so I'll just take the one open spot another year. Do you think I could match that yoga fellowship if I take six years off to do research at the NIH?