Navy family practice scope during and after residency

[carn311]

I keep seeing it mentioned in the forums, but never addressed directly, that Navy FP residencies are heavily procedural. Could someone flesh that idea out for me a bit. Are the type and frequency of procedures available analogous to a high quality unopposed civilian program?


Could someone also please describe their stateside and deployed scope of practice. Are FPs utilized as full spectrum docs (ie OB, inpatient care) or does the navy mandate you to the clinic only?

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[NavyFP]

I keep seeing it mentioned in the forums, but never addressed directly, that Navy FP residencies are heavily procedural. Could someone flesh that idea out for me a bit. Are the type and frequency of procedures available analogous to a high quality unopposed civilian program?


Could someone also please describe their stateside and deployed scope of practice. Are FPs utilized as full spectrum docs (ie OB, inpatient care) or does the navy mandate you to the clinic only?

Yes, Navy FP programs are heavily procedural. We train in skin lumps and bumps, vasectomies, colposcopy (to include cryo and some do LEEPS), NPLs, lots of OB, and Flexible Sigmoidoscopies. You should be competent to perform first trimester ultrasounds. Optional procedures include C-sections, colonoscopy, upper endoscopy, and D+Cs.

What you practice after residency depends on the duty station and what level of the above are done. There are plenty of spots where you will do full spectrum FP to include inpatient and OB. There are also plenty of spots where you won't.

If you are agressive about maintaining your skills, you can. Sometimes that means doing it on your own time, but I feel it is important to do so. I have mangaged to keep up my OB skills despite multiple non-hospital assignments.
But it has been painful at times.

 

[Gastrapathy]

Yes, Navy FP programs are heavily procedural. We train in skin lumps and bumps, vasectomies, colposcopy (to include cryo and some do LEEPS), NPLs, lots of OB, and Flexible Sigmoidoscopies. You should be competent to perform first trimester ultrasounds. Optional procedures include C-sections, colonoscopy, upper endoscopy, and D+Cs.

What you practice after residency depends on the duty station and what level of the above are done. There are plenty of spots where you will do full spectrum FP to include inpatient and OB. There are also plenty of spots where you won't.

If you are agressive about maintaining your skills, you can. Sometimes that means doing it on your own time, but I feel it is important to do so. I have mangaged to keep up my OB skills despite multiple non-hospital assignments.
But it has been painful at times.

Are there really any Navy FP's credentialed in colonoscopy and upper endoscopy? I have to admit I have a problem with people doing these procedures unless they have sufficient training to recognize abnormal (can you tell the difference between PHG and GAVE, etc?) and do enough to have a measurable adenoma detection/complication rate.

I wouldn't want to be the FP who has to deal with Doug Rex on the stand explaining the standard of care for adenoma detection, withdrawal time, etc.

 

[NavyFP]

Are there really any Navy FP's credentialed in colonoscopy and upper endoscopy? I have to admit I have a problem with people doing these procedures unless they have sufficient training to recognize abnormal (can you tell the difference between PHG and GAVE, etc?) and do enough to have a measurable adenoma detection/complication rate.

I wouldn't want to be the FP who has to deal with Doug Rex on the stand explaining the standard of care for adenoma detection, withdrawal time, etc.

I have heard of a couple. Don't know any personally. I would agree, you would need to do a bunch to be truly competant. Never tried myself outside of a couple during my GI rotation. Its like anything else. If you are very aggressive at getting and maintaining the qualification it is possible. The problem comes when you are not in a spot where you can keep it up. Skill rot is for these things is often inevitable.