Rheumatology fellowship after family medicine residency.

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ricky31

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I want to know that why can't we do rheumatology fellowship after family medicine as it is completely outpatient and does not require much of inpatient work as i love family medicine, but rheumatology is making me interested as we see a lot of rheumatology patients in our practice and patient has to wait for many months.

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I want to know that why can't we do rheumatology fellowship after family medicine as it is completely outpatient and does not require much of inpatient work as i love family medicine, but rheumatology is making me interested as we see a lot of rheumatology patients in our practice and patient has to wait for many months.

Primarily because rheumatology is a subspecialty of internal medicine, and the fellowship programs won't accept graduates from other residency programs (not just FM).
 
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Primarily because rheumatology is a subspecialty of internal medicine, and the fellowship programs won't accept graduates from other residency programs (not just FM).
Well I understand that and my question is that why can't it be opened for family medicine though it is for internal med same is with geriatrics which is for both internal med and family medicine, some fields can become common for both.
 
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Well I understand that and my question is that why can't it be opened for family medicine though it is for internal med same is with geriatrics which is for both internal med and family medicine, some fields can become common for both.
Historical happenstance more than anything. But it's unlikely to change anytime soon without a large concerted push that just doesn't exist.

Ex: Medical/anesthesia critical care fellowships are open to EM grads these days, but that was because there was a strong contingent of EM practitioners interested in critical care that laid the groundwork there.

That isn't the case for FM applying to rheum, endocrine, or any of the other primarily outpatient IM subspecialties.
 
A lot of things about US medical education don't make sense. That is the short answer.

I think rheumatology, ID, Endocrinology, Allergy & Immunology should be open for fellowship to FM just like IM
 
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I want to know that why can't we do rheumatology fellowship after family medicine as it is completely outpatient and does not require much of inpatient work as i love family medicine, but rheumatology is making me interested as we see a lot of rheumatology patients in our practice and patient has to wait for many months.
Why don't you just do 1-2 months electives in residency in rheumatology? That's what one of my colleagues did and then went to work with a rhuematologist's office to keep her skills up and take care of those types of patients too. She basically got on the job training as well when there were questions but she was pretty much set after 2 rotations.
 
I want to know that why can't we do rheumatology fellowship after family medicine as it is completely outpatient and does not require much of inpatient work as i love family medicine, but rheumatology is making me interested as we see a lot of rheumatology patients in our practice and patient has to wait for many months.
It is just the way it is set up.

Sleep medicine is avail to FP's, as is sports Med or even pain Med.

Med school rotations is where you map out how you are going to level up your career
 
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There are many rheum/endo/ID...etc spots open since they are the lesser of the popular IM fellowships... some are open to taking FM grads.. I didn't believe until I heard it myself from a few Fellowship coordinators when I contacted them.
 
There are many rheum/endo/ID...etc spots open since they are the lesser of the popular IM fellowships... some are open to taking FM grads.. I didn't believe until I heard it myself from a few Fellowship coordinators when I contacted them.
[citation needed]

There's 20% more IM applicants for Endocrine than there are spots for the last 3-4 years with typically ~20 spots total unfilled in the match (and ~70 applicants who didn't match who would love those spots). Last year, Rheum had a full 50% more applicants than spots with <10 spots unfilled in the match.

I mean yes, ID has less applicants than spots (as does nephrology for example), but I've never heard of an ID fellowship accepting someone not IM trained, given that they wouldn't be eligible to take the boards. I suppose it's not impossible for that field, but otherwise I call bull**** on your assertion about scores of open rheum/endo spots that are willing to accept FM trained people.
 
[citation needed]

There's 20% more IM applicants for Endocrine than there are spots for the last 3-4 years with typically ~20 spots total unfilled in the match (and ~70 applicants who didn't match who would love those spots). Last year, Rheum had a full 50% more applicants than spots with <10 spots unfilled in the match.

I mean yes, ID has less applicants than spots (as does nephrology for example), but I've never heard of an ID fellowship accepting someone not IM trained, given that they wouldn't be eligible to take the boards. I suppose it's not impossible for that field, but otherwise I call bull**** on your assertion about scores of open rheum/endo spots that are willing to accept FM trained people.

The other question is whether or not these are accredited fellowships. I have heard of some DO programs that have their own fellowships....the ones that I had heard of required that the trainee pay a fee and not receive a salary. (Yeah, I know.)
 
The other question is whether or not these are accredited fellowships. I have heard of some DO programs that have their own fellowships....the ones that I had heard of required that the trainee pay a fee and not receive a salary. (Yeah, I know.)
Those have to be going away with the ACGME merger, right?
 
I personally think it's a turf issue to a degree. I think it would be reasonable for an inpatient heavy FM resident to be trained in Rheum, however will likely always be an IM only specialty.

I dont think the AAFP would do anything to make it open to us, because seeing rheum only patient's goes against the goal of providing access to primary care. I think people put up with the difficulty of 3 years of IM residency wards with the goal of doing fellowships or hospitalist work. I doubt they would be happy about the fellowships being expanded to nonIM boarded folks. Even if they did technically open it up, I think a decent of amount of rheum program directors would be skeptical of nonIM applicants.

I think the idea of doing two residencies is terrible, but if I really wanted to do rheum, I would go back and do IM or peds, depending upon your patient preference, but that would likely be atleast 600K in opportunity cost...
 
It is because of the evolution of medicine in this country. Post WWII, the specialty model of care took off. As the specialist trained longer and their demand and pay increased, the GPs pay and prestige was comparatively decreasing. So Family Medicine evolved as a specialty that gives docs who want to be GPs a proper residency training. You see, the longer training was intended to preserve the GP model and allow new doctors who are going to be GPs gain knowledge in new medical expertise. But their practice model was to stay more or less the same.

In other words, the purpose of FM residency is to make better GPs, not to prepare doctors to become a specialist. That's why the list of specialties available to FM will always be limited compared to other specialties. That said, we should be thankful for the choices available. Currently there are 6 ABFM recognized specialties/CAQs.
1. Sleep
2. Sports
3. Pain
4. Hospice and Palliative
5. Geriatrics
6. Adolescent Medicine.

I did HPM fellowship and am happy with my FM/HPM hybrid practice.
 
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