primary care programs

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noladoc2b

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hi everyone. i'm applying this year to primary care internal medicine programs. anyone know what kind of USMLE scores are needed to get interviews at the big-name academic urban programs (like in boston, new york, seattle, san francisco)? are there cutoffs like in categorical IM? what are they looking for??thanks!

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Well, I'm afraid that I can't answer your questions with an exact answer, but I can offer you some round-about information that might be useful. The family practice residency director at my school told us that they look very favorably upon extracurricular activities that show a dedication towards primary care and community outreach programs (like participating in health fairs, free health clinics). I imagine that the same would hold true for primary care clinics. Also, I heard that a UCSF primary care IM program wasn't even filled last year, so I definitely think that PC IM programs are much easier to match into then categorical programs when you are talking about the big names. However, remember that if your goal is to be a good primary care internists, your future career may actually be better served by going to a non-university affiliated strong community program that will give you more autonomy in managing complicated medical cases by yourself (less specialists support/control), and let you do more procedures by yourself (like all of the flex sigs won't be taken by GI, all of the stress tests won't be by cards, etc). Academic reputation has far less weight when you are talking about residency for primary care in internal medicine if you are just planning on going out into private practice after residency. If you are not certain that you want to go into primary care, I'd highly recc that you stick with the categorical programs.
 
Which UCSF Primary Care program did not fill last year? Do you have a link with this information?
 
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I actually received my unfilled list from my office of student affairs over e-mail and I am unable to find where they found the list to begin with over the internet. The UCSF program was the Fresno program, this list reports that it matched 0 out of 4 spots. It lists it under categorical, but I believe that it is actually a primary care spot since there is no lists for primary care internal medicine programs on my list (it's a list of all unfilled residency programs from 2003).

Just to give you some other named unfilled prgroms, in 2003:
UCLA medical center: matched 26 out of 32 spots
Georgetown: 28 out of 31 spots
Boston U: 5 out of 6 spots
U Rochester: 18 out of 22 spots
Hospital of U Penn: 6 out of 8 spots (?)
 
What's the difference between primary care and categorical? Will you be shut out from fellowships if you are in a primary care program?
 
You won't be absolutely "shut out" of fellowships, but it is generally the feeling by programs that if you wanted to specialize, then you should have done categorical. But there are those who do fellowships from primary care programs. However, be aware that the tides are shifting toward a non-primary care training situation; there are even programs that are shutting down their primary care track because they don't see the point. First of all, less and less people are going into primary care now. Second, regulations state that 1/3 of our training in categorical IM must be outpatient, so the gap between the 2 has closed somewhat...and that was the biggest difference between the tracks.
I recall one of my interviews at an Ivy League institution, and I asked about their primary care residents...they said that about 90% go on to fellowship...and that they could get those numbers because of the status of the program (big NE ivy league place)...so my next question was: if 90% are doing fellowships, then why do it? Some of them told me that it was easier to get a spot in the primary care track, and they could use the name then. Additionally, they said that many of them realized midway through training that they didn't want primary care anymore after experiencing what direction medicine is heading in. This is a big trend nationally. So, I couldn't see a reason for doing the primary care track. Anyone from a categorical program can do primary care...the other way around is slightly more difficult.
 
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