rachmoninov3

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I was wondering if someone could comment on how important it is to be primary c/s certified for jobs in rural family med?

I've heard everything on the interview trail from (1) you'll definately be c/s certified with our residency to (2)community docs train you on the job after residency to (3) the only way is fellowship.
---how true are the last two statements?

thanks for your wisdom
 

EdibleEgg

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The majority of FP's, even rural FP's, are not doing any OB, much less C sections. That doesn't mean you can't, or shouldn't, it just requires the right set of circumstances. If you really want to do OB, doing sections is a big plus. I'm sure there are programs where you can get enough primaries. However, it better be a passion. You should be prepared to do a fellowship and be very flexible about your final practice location.
 
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rachmoninov3

rachmoninov3

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Thanks for the reply. It's not exactly a passion, and I'm not dead set on doing a fellowship---I just wanted to make sure if I'm somewhere rural that it wasn't something that would make or break me as the local doc.
 

thethom

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Agreed, you will not get enough exposure to C/S during residency, but during OB fellowship you will get PLENTY! Probably more than you want during the 1 year fellowship. OBGyn residency is 4 years, you are doing lots of MFM, gyn onc, etc during the 4 years; during a 1 year OB fellowship you will be doing ALL obstetrics, all year, and will have just about as much C/S experience as an OBGYN trained physician, AND will be trained to see male patients lol...just food for thought.
 

2000 Man

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Agreed, you will not get enough exposure to C/S during residency, but during OB fellowship you will get PLENTY! Probably more than you want during the 1 year fellowship. OBGyn residency is 4 years, you are doing lots of MFM, gyn onc, etc during the 4 years; during a 1 year OB fellowship you will be doing ALL obstetrics, all year, and will have just about as much C/S experience as an OBGYN trained physician, AND will be trained to see male patients lol...just food for thought.
With all this OB training after a FM fellowship, do the powers-that-be still try to make it tough for you to get privileges? Or are you now on par with the Ob-gyns in terms of obstetrics?
 

thethom

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Hospitals will req you to have done a certain number of C/S before you can get privileges, some may also req some to be precepted before you can do them independently. Its all dependent on the hospital. You will have to have C/S covered in your malpractice insurance but another MD doing more procedures in the hospital is just another money-maker for them.

Our last OB fellow graduated and is doing FM/OB with C/S, BTLs, and maybe even hysterectomies (not totally sure about that) independently at a nearby army base.
 

cabinbuilder

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I was wondering if someone could comment on how important it is to be primary c/s certified for jobs in rural family med?

I've heard everything on the interview trail from (1) you'll definately be c/s certified with our residency to (2)community docs train you on the job after residency to (3) the only way is fellowship.
---how true are the last two statements?

thanks for your wisdom
When I worked in Montana there was a husband/wife FP team who did their own deliveries and C-sections. They learned in residency by using all their electives to do extra surgery in OB to get their numbers so it is possible.

I have been on the rural track for the last two years. I don't do prenatal care or any OB. Lucky if I do a PAP. It has never been an issue for me getting hired. I do say straight out if I do OB or not. Most small towns send out their pregnancy patients since there aren't enough numbers to warrent the malpractice coverage.

Generally there isn't a community doc to train you and there just isn't enough time in the rural setting because there are soo many needy patients to be seen. I wanted to get certified to do scopes in practice since I learned in residency and just couldn't find the time to take a half day a week to be proctored.

Most rural places are happy to get what they get.