rural residencies?

[mkmgal]

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Last week I finished my first year of med school (AZCOM), and I'm starting to think more about my future career. I'm interested in practicing family medicine in a smaller town, but not in the middle of nowhere. At this point, I don't know if I want to do OB/GYN. With that in mind, what would be the advantage of doing a rural type residency? What specific training would I recieve in a smaller town vs. an urban/suburban residency that would allow me to better practice in a smaller town?

 

[deleted6669]

check out the website for spokane family medicine, rural track available at www.aafp.org under residency search. they have a great rural track program as does klamath family med and tacoma family med and the info there should answer all your questions. using their search function you can look for all rural programs also.

 

[secretwave101]

The advantage to rural is that you can do more stuff. An FP will never compete in a city where there are Ped's, OB's, Internists and Surgeons in abundance.

My impression is that FP is great if you're in the hills, but alot of rhinitis if you're in the city.

 

[PACtoDOC]

I would have to disagree with the previous post. FP's anywhere can see a wide variety of problems, but I would agree that an FP in a rural setting may HAVE TO see lots of rather difficult cases. But don't kid yourself, people have real medical problems in the city as well, and just because there are more specialists doesn't mean that patients are able to go to them first. I was in a large FP group practice for 4 years before med school, and we saw everything all the time. It just meant that we were able to get them to a specialist sooner because there were more of them, but even in the city, specialists though abundant, cannot always see the patient when you need them to. It is very common for the specialist and the FP to agree that the FP will admit the patient to the hospital, and the specialist will simply consult. It was commonplace to all our own cyst removals, biopsies (because patients don't want to wait 2 months to go see derm for a suspicious lesion), toenail resections and removals, colpos and flex sigs for those trained, and even occassional minor plastics (like fixing earlobes from ripped earrings). We were within 300 yards of literally 200 physicians, and our hospital. Yes, rhinitis was commonly seen, but no more than it is in the rural areas. Rural areas don't have the market on pollen 🙂

 

[DRNickiTay]

I am a fourth year at AZCOM. I did an awesome rotation in St. Cloud Minnesota at a Mayo FP program. It is an unopposed FP program and this helps for you to get exposure to tons of OB high risk included and do many deliveries (no OB residents to compete with for cases) as well as participation in other specialties. They are DO friendly and Dr. Blonski the program director is so nice. The residents were very happy and had a lot of input on improving the program. There was a lot of pathology and unique cases. In my four weeks I saw Pott's disease, HIV cases, female circumscion and OB care with this (they have a significant Somolian population) and much more. St cloud is a cute town ans cost of living is very reasonable. The lectures were great (the best I have seen anywhere). They allow third years to rotate and will help with housing. I highly recommend you place in an unopposed FP rotation (withour other residency programs) this was you maximize your participation in cases and get to really manage difficult pathology that you will encounter as a rural docotor. All of the residencts where going to practice in small rural towns.

Here is the link and Liso Olson the coordinator is very nice.
http://www.ama-assn.org/vapp/freida/pgm/0,2654,1202621586,00.html

Here is also the link from scutwork. One review is mine:
http://www.scutwork.com/cgi-bin/links/page.cgi?g=Detailed/2466.html&d=1

PM me if you need more info

 

[secretwave101]

Female circumcision!!!???

You mean St. Cloud, UGANDA??

I hope you mean you saw women who HAVE BEEN circumcised and now need OB care. That kind of thing doesn't happen in developed hospitals...right?

 

[BellKicker]

I think it was the OB care connected with female circumscision. I have seen Somali women come in to get their stitches removed. These women have their vaginas sewn together until they get married. Pretty gruesome and when you think of all that putrid filth that has collected up there during the years (they only leave a very small opening) it's enough to make you gag.

I'm also very interested in rural FP. I've been looking at programs and it certainly strikes me that these rural programs seem more competitive than than regular FP programs. The one in St. Cloud, which would have been a top choice for me because of location wants foreigners to spend one full year at a US hospital (for free, I suppose) before you can even apply. I take that to mean they'd rather die than hire a - gosh - IMG. I haven't seen such a rigid requirement anywhere else and I've looked at many programs.

For me, the smaller the town, the better. I'm from a country that looks like one big suburb. I'm ready for some small town living.

 

[mkmgal]

You guys are so helpful! I really like the idea of getting away from the bigger city and practicing in a smaller town. I definitely don't want to raise a family in a place that has pollution advisory days due to smog. However, I've been battling with whether or not I want to do OB/GYN. I would love to deliver a couple babies a month, yet I've heard you have to deliver quite a few a month in order to just cover your malpractice and other overhead. And, I don't want medicine to rule my life! Is it possible to practice in a smaller town without having OB/GYN privileges? Thanks for all the help!

 

[BellKicker]

Yes! I know for a fact that it's quite possible. I'm not sure about OB/GYN myself.

 

[secretwave101]

In theory, you should be able to do as much or as little OB as you want (and as your patients want). But unfortunately, the factor that most determines how much you do is insruance overhead - so I'm told.