Opposed Residency followed by rural Locum Tenens/NHSC sites

[Chachapoyas]

Hey guys,

I was just accepted to medical school and am exploring career options in FM. I know you may say it's too early to think about residencies/specialties, but I think it's good to be prepared and informed, plus family medicine is the field that attracts me the most as of now. The question I have is about opposed FM residencies and practicing locum tenens or in an undeserved areas as part of the NHSC scholarship. Will it be a huge disadvantage for me if I decide to do my FM residency in an academic medical school/medical center setting (unopposed) and then spent a couple of years after doing locum tenens or work at an NHSC-approved site? I imagine it would be a nightmare if I am in the middle of Wyoming or something and am required to perform procedures that I haven't done during my residency. It would also be irresponsible. Is this a valid concern that I have? Should I even be worried about this? Or should I look for rural, opposed FM residency programs?

Thanks for all your time in advance!

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[cabinbuilder]

Too early to be worried. It's up to you to learn all the procedures you need in residency - no one is going to force you to learn them, you will need to plan according when you get to that stage. Also, you have to request privileges when you work at a sight and NO ONE can force you to do what you don't know how to do. Its doesn't happen that way. You cannot do locums on an NHSC scholarship as they will place you where the need is.

See my how to locums guide in this forum for other pointers.

 

[Chachapoyas]

Thanks for your reply, cabinbuilder. I am just trying to think ahead, since there is a combined 6-year MD/FM program at my medical school.

So you don't think an opposed residency would be a major problem?

Also, as an MD, I would like to be able to learn OMM, since I imagine a lot of primary care patients will come in with different pains related to musculoskeletal origins. Is there any way for allopathic physicians to learn OMM during residency? Do we have to go specifically to an osteopathic residency to learn it? Again, may be too far in advance, but I think it's important stuff to keep in mind.

 

[cabinbuilder]

All residencies are different and I went to an unopposed one. Can't really comment as it comes down to how many residents are going to be vying for any given procedure?

Seriously doubt you will learn OMM in residency as an MD. There are courses you can take (I have a friend who did this) but it takes time and effort to practice and learn the techniques so you don't hurt a patient. Then you would have to get permission to be able to use it and bill at your job. I wouldn't think it worth it for you. Easier to refer to one of us who learned it in school and does it all the time.

 

[simpler2]

I'll echo cabinbuilder's sentiment that unopposed vs opposed is never a clear better/worse decision. I've seen unopposed programs where one would get little training to deal with anything but adults with chronic medical conditions and opposed programs that would give one adequate exposure to 99% of problems presenting in a rural community.
Being a DO practicing at a FQHC with a NHSC scholarship, I can say that I find little use for my OMM skills on a regular basis. I do, however, perform trigger point injections multiple times daily. I think the best prep for dealing with chronic pain complaints is to take your ortho / sports med rotations seriously. Also, find a primary care attending you think does an awesome job addressing pain complaints and seek a mentoree relationship with this individual. Pain is tricky to address well...there is no way around it.