Oklahoma residency requirement?

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Pisiform

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I just had a recent interview for an IM program in OK and I was told its a state requirement for IM residency to do a month of Pediatrics and a month of OBgyn?

Can anyone confirm this?

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that said, often if you do a month in the ED there will be peds and ob/gyn patients, unless there's a peds ED

those patients might be shunted away from you in light of the fact you are IM, however, that's not always the case

so don't totally brain dump all that is peds/ob/gyn, as satisfying as it might be now that you're headed IM
at least review peds and ob/gyn emergency medicine before starting the rotation unless told otherwise

same thing could come up depending on how they structure your neuro rotation,
IM docs often think neuro = 90% old stroke people, but there's a lot of youngsters with HA and sz. That overlaps with adults so that's good. But there's all sorts of weird peds neuro things. So it depends, I've heard differing reports of when IM residents are put in spots where they don't completely avoid kids and preggos and when they aren't.

There's a reason why that unlimited license you try to get by passing your intern year and USMLE 3, why USMLE 3 includes basic peds/ob/gyn knowledge. On a very technical level, to be an MD with an unlimited license means by definition that you have a certain knowledge base that does include those undesirable populations. Remember that your first year and try to carry that much with you going forward in your residency. You never know when schedules change or available elective months might call on you to know a lil of that stuff. (I know an IM resident who went to do medicine in Uganda.... pretty sure that clinic is gonna have her see all comers). I know @jdh71 tells a story when the medicine service were primary on a preggo in the ICU....

TLDR
I doubt you get a whole month of either peds or ob/gyn to do IM even in OK
however, it's possible in an IM residency to have various situations that put you more or less in proximity to them
keep sharp
 
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If you do a subspecialty fellowship after residency you may also end up seeing peds/adolescents if there isn't a pedi endo/rheum/ID/etc anywhere nearby. Many adult rheumatologists see kids with arthritis at times because pedi rheums are in such short supply and so limited geographically to major metro areas...
 
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that said, often if you do a month in the ED there will be peds and ob/gyn patients, unless there's a peds ED

those patients might be shunted away from you in light of the fact you are IM, however, that's not always the case

so don't totally brain dump all that is peds/ob/gyn, as satisfying as it might be now that you're headed IM
at least review peds and ob/gyn emergency medicine before starting the rotation unless told otherwise

same thing could come up depending on how they structure your neuro rotation,
IM docs often think neuro = 90% old stroke people, but there's a lot of youngsters with HA and sz. That overlaps with adults so that's good. But there's all sorts of weird peds neuro things. So it depends, I've heard differing reports of when IM residents are put in spots where they don't completely avoid kids and preggos and when they aren't.

There's a reason why that unlimited license you try to get by passing your intern year and USMLE 3, why USMLE 3 includes basic peds/ob/gyn knowledge. On a very technical level, to be an MD with an unlimited license means by definition that you have a certain knowledge base that does include those undesirable populations. Remember that your first year and try to carry that much with you going forward in your residency. You never know when schedules change or available elective months might call on you to know a lil of that stuff. (I know an IM resident who went to do medicine in Uganda.... pretty sure that clinic is gonna have her see all comers). I know @jdh71 tells a story when the medicine service were primary on a preggo in the ICU....

TLDR
I doubt you get a whole month of either peds or ob/gyn to do IM even in OK
however, it's possible in an IM residency to have various situations that put you more or less in proximity to them
keep sharp

the question was if having to do a peds and ob/gyn a requirement for an IM residency

the answer is per the ACGME
http://www.acgme.org/portals/0/pfassets/programrequirements/140_internal_medicine_2016.pdf
is that, of rotations outside of IM, the core requirements are 1 month of EM, Geriatrics, and Neurology (they don't define how long an assignment in the last 2).

I take it you are on an elective?

question to OP though...could this be a requirement of the Osteopathic residency and their TRI?
 
the question was if having to do a peds and ob/gyn a requirement for an IM residency

the answer is per the ACGME
http://www.acgme.org/portals/0/pfassets/programrequirements/140_internal_medicine_2016.pdf
is that, of rotations outside of IM, the core requirements are 1 month of EM, Geriatrics, and Neurology (they don't define how long an assignment in the last 2).

I take it you are on an elective?

question to OP though...could this be a requirement of the Osteopathic residency and their TRI?

rokshana, as you usual you miss my point, seemingly on purpose

first of all, the OP asked about the STATE of OK and their IM residency requirements. Therefore, I assumed they were talking about what a specific IM program there might require with regards to ob/gyn and peds. As an aside, I actually did interview at both programs in OK.

In any case, I proceeded to outline to them the situations in which, to my knowledge, one might be in internal medicine training yet in the midst of said program be called on to care for pediatric or obstetric patients. I did so, because it seemed to me, that the OP might be interested to know, to what extent training in IM might include such populations.

Essentially, the short answer is no, you do not have to do any months of peds or ob/gyn per ACGME. However, that still doesn't answer the OP's question as many residency programs have leeway to include requirements that are outside of the ACGME requirements. In fact, I have heard of some of the programs with PC tracks including outpatient clinics and urgent care, where in fact pediatric or obstetric patients would be seen. Typically the residents are being supervised by FM docs in those clinics as it is within the scope of care of those attendings to supervise IM residents in such scenarios.

In fact, in your post you question if it's possible for there to be requirements outside of ACGME. The answer is, yes.

So rather than quote those ACGME requirements, I chose to say that to my knowledge, peds and/or ob/gyn rotations are not part of IM training, however that does not mean that peds or ob/gyn populations are never included.

One of the appeals of IM to many was not having to see those populations. If I had the impression that a program would include those as full rotations, I would feel trepidation. I wanted to reassure OP that was not typically the case, while highlighting that they would still need to retain some knowledge for USMLE 3, just as many IM programs tell their interns. I also explained the other circumstances where to my knowledge an IM resident might see those populations, in case such knowledge was at all useful. Some might be glad to know under what settings they might have to see those populations and what knowledge base would be most useful (eg pediatric emergency medicine, not necessarily the childhood vaccination schedule).

Also rokshana, don't think that it goes unnoticed by me that most of your posts where you quote me or address me you seem awfully interested in what I am doing when I am not on this board. That is frankly none of your business, and I'm actually more curious as to why it seems to matter so much to you. I've never asked what you are doing otherwise, I feel that is rude on an anonymous forum for professionals if such inquiries are coming from a place of anything aside from genuine concern or friendship. I hope you're not trying to gather information about me to try to deduce my identity. That would be a TOS violation, of course.

In any case, I'm wondering what of the information I shared with the OP was either so bothersome to you. Granted, it's been a few years since I have interviewed, and your knowledge might conflict with mine, and that's fine. Programs are changing year by year. Some month by month even. What I said was based on the 25+ interviews I went on and the information I gathered on the trail. As such, it may be incomplete, inaccurate, inaccurately recalled, hearsay, or outdated.

Have a nice day.
 
rokshana, as you usual you miss my point, seemingly on purpose

first of all, the OP asked about the STATE of OK and their IM residency requirements. Therefore, I assumed they were talking about what a specific IM program there might require with regards to ob/gyn and peds. As an aside, I actually did interview at both programs in OK.

In any case, I proceeded to outline to them the situations in which, to my knowledge, one might be in internal medicine training yet in the midst of said program be called on to care for pediatric or obstetric patients. I did so, because it seemed to me, that the OP might be interested to know, to what extent training in IM might include such populations.

Essentially, the short answer is no, you do not have to do any months of peds or ob/gyn per ACGME. However, that still doesn't answer the OP's question as many residency programs have leeway to include requirements that are outside of the ACGME requirements. In fact, I have heard of some of the programs with PC tracks including outpatient clinics and urgent care, where in fact pediatric or obstetric patients would be seen. Typically the residents are being supervised by FM docs in those clinics as it is within the scope of care of those attendings to supervise IM residents in such scenarios.

In fact, in your post you question if it's possible for there to be requirements outside of ACGME. The answer is, yes.

So rather than quote those ACGME requirements, I chose to say that to my knowledge, peds and/or ob/gyn rotations are not part of IM training, however that does not mean that peds or ob/gyn populations are never included.

One of the appeals of IM to many was not having to see those populations. If I had the impression that a program would include those as full rotations, I would feel trepidation. I wanted to reassure OP that was not typically the case, while highlighting that they would still need to retain some knowledge for USMLE 3, just as many IM programs tell their interns. I also explained the other circumstances where to my knowledge an IM resident might see those populations, in case such knowledge was at all useful. Some might be glad to know under what settings they might have to see those populations and what knowledge base would be most useful (eg pediatric emergency medicine, not necessarily the childhood vaccination schedule).

Also rokshana, don't think that it goes unnoticed by me that most of your posts where you quote me or address me you seem awfully interested in what I am doing when I am not on this board. That is frankly none of your business, and I'm actually more curious as to why it seems to matter so much to you. I've never asked what you are doing otherwise, I feel that is rude on an anonymous forum for professionals if such inquiries are coming from a place of anything aside from genuine concern or friendship. I hope you're not trying to gather information about me to try to deduce my identity. That would be a TOS violation, of course.

In any case, I'm wondering what of the information I shared with the OP was either so bothersome to you. Granted, it's been a few years since I have interviewed, and your knowledge might conflict with mine, and that's fine. Programs are changing year by year. Some month by month even. What I said was based on the 25+ interviews I went on and the information I gathered on the trail. As such, it may be incomplete, inaccurate, inaccurately recalled, hearsay, or outdated.

Have a nice day.

no i get your point...usually its to say, hey!! i know (or at least i think i know) everything about everything...in one night i think you have responded to more threads than i have in a whole year..(oh and to advertise your MEGA post on something about residency and internship).

no don't really care, though we have been spared the verbal diarrhea that are your posts for quite some time now...fgured you were actually having to do real rotations at your program and now...eh...you have free time and are now spending it here...you must be a fast typist (or have a lot of time on your hands).

your knowledge= generally unsubstantiated opinion...
 
I'm not aware of OK having any special requirements, and a quick glance at say the University of Oklahoma's IM program doesn't seem to support anything of the sort. It would be a very strange requirement if it existed.

As for treating kids and pregnant women in general, well, it depends. Peds populations aren't really included in any IM residency as exclusive rotations and individual hospital policies vary on just how young a pt can be seen by an internist. That said, adolescent medicine is actually available as a subspecialty through IM and being exposed to adolescents is pretty normal. We didn't have a PICU at the hospital where I did my residency, so all critically ill kids had to be transferred. Occasionally, there'd be a critically ill 16 or 17 year old for a reasonably adult issue and we'd admit them to the medical ICU service to expedite care rather than transfer. In addition, our peds service had a strict cap and if they were full the patient would have to be transferred to the local children's hospital. In that situation, our medicine attendings had admitting privileges down to ~15 years old, and I took care of a handful of adolescents during residency on wards. We always consulted the peds service (no cap on consults for them, only admissions) just for CYA purposes, but a 17 year old isn't really any different from an 18 year old. In my moonlighting gig, I have admitting privileges down to 16 myself... though given that the median age of the patients I've seen is probably 75, it hasn't really been an issue yet.

OTOH, pregnant women can get the full spectrum of medical disease, and women we take care of routinely can also turn out to get pregnant. Internists everywhere I'm aware of do have privileges to take care of a medically ill pregnant woman (obviously comanaged with Ob, but who is primary varies) and you should get exposure to these populations in your residency. I've intubated a pregnant woman, had one in such severe shock we put her on ECMO, actually saw an acute post-partum case of Sheehan's syndrome in the ICU, etc. Whether as primary or consult, on medicine or a subspecialty, you'll see your share of them, and it's important to at least be aware of the issues going on.
 
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no i get your point...usually its to say, hey!! i know (or at least i think i know) everything about everything...in one night i think you have responded to more threads than i have in a whole year..(oh and to advertise your MEGA post on something about residency and internship).

no don't really care, though we have been spared the verbal diarrhea that are your posts for quite some time now...fgured you were actually having to do real rotations at your program and now...eh...you have free time and are now spending it here...you must be a fast typist (or have a lot of time on your hands).

your knowledge= generally unsubstantiated opinion...

No to ignore Dr. Funktacular's advice, but I do want to say this in full view of this board.

99% of my posts outside the lounge are *meant* to be helpful. I apologize if you do not find them so, or that you don't like them or the way they are written. I would ask you that if you address me or my posts in the future, if you could be more polite. I don't think I'm generally impolite to you.

If you just can't help yourself, I would ask that you simply use the "ignore" function of SDN rather than continue to be rude.

I have not ignored your posts to date because I prefer to read what you have to offer in a thread before offering my own *thoughts.* As opposed to insults, which is what you choose to do having read mine.

From this point forward, since you do not appear to wish to simply ignore me or refrain from insulting me, either by SDN function or merely by choice, I am ignoring you. I expect that is likely to create more posts where I address points you may have already made, which I agree does not add value to the board.

However, at least I will not have to see your rudeness and can more easily not respond to it. This is why I might encourage you to do the same. Perhaps then you will not feel so annoyed, and I will not feel insulted, and more of the posts can be content that is on point, and less of your insults or my response to said insults. Surely you have noticed that my responses to your insults tend to be far longer than the original post insulted for length, yet you can't seem to let it go. I will admit, clearly I cannot neither. While I may not initiate these exchanges, I will see to it that they end.

Thank you for participation in SDN in your well-intentioned advice to others. Have a nice day & be well.
 
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