Prelim Surg then FP?

[secretwave101]

I'm interested in practicing international medicine as much as possible, and hoping to find training that will make me the most well-rounded for situations where medical care is scarce.

One of my latest ideas is to do a prelim year of surgery, just to get very solid expereince with it. Then apply to FP residencies that emph. procedures. Also, if I really liked surgery, I could potentially stay on that track.

Would that work? If you do a prelim year, and want to stay in surg., do you have to match all over again and is it another 5 years? Would any program be interested in taking me if I told them I was probably going to go to FP after the year? Is this a dumb idea in general?

---

Members don't see this ad.

 

[Skylizard]

Originally posted by secretwave101
...One of my latest ideas is to do a prelim year of surgery, just to get very solid expereince with it. Then apply to FP residencies that emph. procedures. Also, if I really liked surgery, I could potentially stay on that track.

That might work. However, If you want procedural experience, you should make sure the surgery program thinks you want to be in surgery...NOT FP. If you say you want FP, you will be lucky to finish with some skin procedures. The team will likely treat you like the medicine boy. The chiefs will be thinking about "buffing" the interns that will end up being the surgery PGY2s in a year. From a leadership point of view, cases will likely be handed-out with that in mind.

Originally posted by secretwave101
...Would any program be interested in taking me if I told them I was probably going to go to FP after the year?

Yes, surgery programs will give you prelim spots because prelims are man/lady-power. Will you likely get the same training as a prelim wanting to be a categorical GS resident? Probably not. While everyone should be equal, programs will try to tailor your training with your future plans in mind.

Originally posted by secretwave101
.....If you do a prelim year, and want to stay in surg., do you have to match all over again and is it another 5 years?

If you work hard, some programs will be able to work you into a categorical PGY2 spot, help you find a categorical PGY2 spot at another institute, or help you match into a categorical PGY1 spot.

Originally posted by secretwave101
.....Is this a dumb idea in general?

It isn't a bad idea. You just need to be realistic about you can expect in a prelim-GS spot depending how you present your goals. Also, if you want the max training in surgery as an intern, match as a categorical not a prelim. Your match obligation is really only ONE year. If you like surgery stay and you are already matched. If you don't you can apply to FP...quietly and continue getting the maximum surgical intern training you want.

 

[droliver]

I agree with skylizard. You'd prob. be treated the best & have the best experience if you went for a categorical spot. You can always find a FP spot to switch too

 

[deleted6669]

there are actually fp residencies with a decent amount of surgical exposure. check out the ventura county fp residency program. they do c-sections, appys, etc as primary surgeon and all their residents are required to pass ATLS. just a thought...

 

[SomeFakeName]

If your ultimate goal is to become an international doctor serving in needy areas with few/no other physicians immediately available, I think you should opt for the full 5-year general surgery residency, not a FP residency. A fully-trained general surgeon can handle any problem that a FP can, however the reverse is not true.

 

[secretwave101]

Yeah, I've been wondering about that. FP's are supposed to be the docs who can treat the broadest range of illnesses. But I've wondered if they're mostly just trained to RECOGNIZE the broadest range, but don't really treat much.

I'm still pondering through the question: Which kind of doctor will be the most helpful to an underserved population?

Maybe you're right. Maybe its a surgeon. But it seems like surgeons never get the time off to volunteer in those places with any regularity anyway. At least FP's get some free time.

 

[SomeFakeName]

secretwave, look at it from a patient's view in a remote area. If they experienced trauma or an acute condition, what type of physician do you think would be most desirable to handle the situation? As you said, a FP could diagnose and prescribe the right meds for the condition, but would they be trained to effectively stop major bleeding, reverse shock, or perform most other major emergent procedures? Even if all resources are not there, I truly believe a general surgeon is the best option to at least effectively stabilize the patient until they can be tranferred to a hospital that has the resources to better treat the patient.

 

[SomeFakeName]

...and also some gen surg programs offer a few months of elective time in rural/remote areas. I believe Brown Univ offers an elective rotation in Africa and I'm sure others have exposure to other underserved populations.

 

[secretwave101]

OK, but what about all the chronic stuff that most people deal with? Do surgeons know as much as FP's about treating diabetes and chronic infections like TB? Who deals better with malaria etc? What about malnutrition diseases like Beri Beri etc.? How about complicated pregnancy management (not surg) like gestational diabetes?

I'm not trying to refute you...I'm asking the questions to you and to myself.

Also, I'm familiar with the Brown program via their web site. Sounds very cool.

 

[volvulus]

You have to remember though that your surg internship will not consist of too much OR time. Depending on what program you go to, PGY1's in surg will mainly be managing pts on the floors. The OR is reserved for junior and senior residents.