Question about mini-procedures (derm, joint injections)

[Dakayus]

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I was wondering how FP's learn join injections and such. Does everyone learn them or is it a select few residencies?
For learning EGD's and colonoscopies for FP's do many hospitals allow you to perform them after being certified by them seeing as it encroaches on GI territory?
I primarily want to learn how to do LP's, EDG, colonoscopy, derm surg, and joint injections, but I'm having a bit of trouble finding specifics in residency webpages that says this except JPS and a few others. I'm trying to remain in California if all possible.
Any opinions on procedure heavy California FM residencies?

 

[cabinbuilder]

What you learn in residency is really up to you.

Joint injections: do a month of orthopedic surgery clinic and learn it. (that's what I did)

EGD/Colonoscopy: Do a month of gastroenterology and learn how to do the EGD's and colonoscopies. Once you get out of residency then it will be up to you to be proctored by whoever does them at that facility to certify you to appease the administration. I also shadowed an FP in residency who did colonoscopy/EGD and had it arranged to be there with him on Wednesdays so I could practice.

Derm procedures: I learned most of this in family practice clinic since it's impossible to get a patient into derm especially if they are medicare/medicaid. Our attending did all sorts of procedures so he taught us if we were interested.

So, the residency overview really won't tell you what you will/will not learn. It's up to you to be aggressive in residency, be available and make it known that you want to learn procedures.

 

[EdibleEgg]

I can't imagine finishing a FM residency without ample exposure to LP's, joint injections, minor derm etc. Endoscopy is a different animal. You won't get exposure at every residency, and be careful about vague numbers and chances for experience. Even if you do get the numbers, it will may be difficult to get privileges in some places. It's not impossible, I do a few hundred endoscopic procedures per year at my hospital, but you really have to commit to it and be ready for some lumps.

 

[TexasPhysician]

You should get plenty of experience with joint injections, derm procedures, LP's, and colonoscopies. If you didn't do any of these in medical school, you went to the wrong school. For residency, they should be pretty common.

 

[Dakayus]

Well I've watched plenty of them, got to do minor derm procedures many many times, but I've never had the opportunity to do joint injections as my attendings didn't have patients that needed them and as far as EDG/colonoscopies I've never had a chance to perform them either. I suppose since I didn't do a GI rotation is probably the reason why.

What opportunities do you have after residency to learn more smaller procedures? I.e. if I didn't learn to do sigmoidoscopy can I still learn it somewhere? I'd love to do a few EGDs here and there but could never do the amount that GI docs do. I love having such a broad scope of abilities and such to my disposal. Thanks for everyone's input!

 

[Dakayus]

.

 

[MedicineDoc]

There are also cme courses on derm and in office ortho and joint injections, egd colonoscopies just about anything you want to work on or try to pick up where you pretty much just sit around listening to lectures and practicing all day.

 

[styphon]

Joint injections: We have to do a sports medicine rotation where we get a chance to do these. Also have gotten to do some in my clinic for additional numbers

Derm procedures: I have done these in my ambulatory surgery, inpatient surgery, and inpatient family medicine rotations

EGD/colonoscopies: We have a family doc who does colonoscopies, and if you can work it out with a GI dr for an elective...

 

[nabeya]

I was wondering how FP's learn join injections and such. Does everyone learn them or is it a select few residencies?
For learning EGD's and colonoscopies for FP's do many hospitals allow you to perform them after being certified by them seeing as it encroaches on GI territory?
I primarily want to learn how to do LP's, EDG, colonoscopy, derm surg, and joint injections, but I'm having a bit of trouble finding specifics in residency webpages that says this except JPS and a few others. I'm trying to remain in California if all possible.
Any opinions on procedure heavy California FM residencies?

In my residency, we learned by having monthly procedure conferences. We also rotated in Sports Medicine and Rheumatology where we got more exposure and experience. Lastly, we used Pfenningers textbook "Procedures in Primary Care" as reference guide for procedures that we wanted to look up.

I do shoulder and knee injections all the time, patients love it and they're extremely easy to do. I'm in private practice now but on occasion have done Carpal tunnel, tennis elbow injections and hip injections but not very often.

If you go to a good residency, this is bread and butter type of stuff.