primary care

[earthgirl101]

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I have started looking through the curriculum for various OB/GYN residency programs. I have noticed that some programs, esp. community proigrams, have residents spending the majority of their time on OB or GYN, while others have more off-service rotations (ER, SICU, FM). Does anyone know if this is specific to community versus university programs? I would think that community programs would actually be more likely to train you for primary care, as they may turn out community ob/gyns who do some primary care. Anyone know a program specifically dedicated to primary care ob/gyns?

 

[pruritis_ani]

I think you will find a shift from primary care teaching in ob/gyn residency. Word on the street is that the RRC is no longer requiring logging of primary care cases. Ob/Gyn's in general are getting away from the primary care aspect of our field. I rarely take care of hypertension, diabetes, etc on a non-pregnant patient. My gyn "primary care" consists on annual exams and screening, and only rarely involves day to day managment of medical problems.

A few years back there was a big shift toward primary care, and most are finding that it is not reasonable to expect one to be a trained obstetrician/gynecologist and internist as well.

As far as off service rotations, I think community programs have less because they are generally smaller, and need the residents on service, not off doing surgery or ER. Our off service committments have decreased each year so far....and, nobody is really complaining. As far as I am concerned, the best way to learn ob/gyn is to practice it.

 

[Global Disrobal]

A couple of notes

1. Pruritis_Ani is correct. Primary care stats are no longer required as a STAT entry. The decision was announced at this past APGO meeting. In addition, they removed several other categories including TV ultrasound, cervical conization/LEEP (if my memory serves well).

2. As for the original post, all programs have required off-service rotations (SICU, ER) so there is no difference between community and university programs with respect to this. There is also a requirement for 18 months of OB and 18 months of GYN in the 48 month residency curriculum. The remaining months are generally dedicated to elective/research, primary care, and other ancillary rotations (i.e. geriatrics) depending on available resources. If you search this forum you'll see threads with respect to programs which have a string primary care emphasis. In general, university programs have more residents, teaching faculty, and hence can afford to have more "off service" rotations, versus the smaller/community programs where due to the 80hr work week impact and call-schedule limitations residents are relegated to more "core" rotations (generally L&D).

Best of luck!

 

[whoops00]

I have started looking through the curriculum for various OB/GYN residency programs. I have noticed that some programs, esp. community proigrams, have residents spending the majority of their time on OB or GYN, while others have more off-service rotations (ER, SICU, FM). Does anyone know if this is specific to community versus university programs? I would think that community programs would actually be more likely to train you for primary care, as they may turn out community ob/gyns who do some primary care. Anyone know a program specifically dedicated to primary care ob/gyns?

I'm at a community program that makes a big effort to do primary care in their curriculum. alternatively, i interviewed at a lot of university programs that had no off-service or primary care in their curriculum. it really just depends on the perspective of the program.

and yes, there is a move away from primary care now that they are not required to log it or have it for credentialing. i say, as you're looking at programs, ask at the interviews how much primary care they get in their curriculum. you'll hear, "oh, we get it on all our rotations." which means that they don't have any primary care specific focus. or you'll hear, "oh, we do two months of inpatient medicine, one month ED, and we have a primary care clinic in our outpatient month." and that's more of a sign of a program that likes to emphasize primary care.

good luck.