Are there many opportunities to do this? would the residency start over at PGY 1 or would it be possible to enter as a PGY2?
Thanks in advance for the info!
Thanks in advance for the info!
switch from FM to EM?
- Thread starter drmdrmd
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You won't be boarded in EM. You would need to do another residency for that. The older FM guys got grandfathered into EM board certification.
That being said there are still plenty of ERs that have FM boarded docs (and even IM boarded, but how can an IM doc do ER without peds training...anywayys) working full time. This has been discussed in previous threads and the EM guys will tell you that its impossible to find full time ER jobs as a FM doc but there are plenty. I can send you links to large trauma centers with FM boarded full time ED docs if ya need. (My residency program is at a trauma center with several FM trained ED boarded docs).
..of course you would have to do all the night shifts and other crap that you have to do in the ED..sooo... ;-P!
Best of luck!
That being said there are still plenty of ERs that have FM boarded docs (and even IM boarded, but how can an IM doc do ER without peds training...anywayys) working full time. This has been discussed in previous threads and the EM guys will tell you that its impossible to find full time ER jobs as a FM doc but there are plenty. I can send you links to large trauma centers with FM boarded full time ED docs if ya need. (My residency program is at a trauma center with several FM trained ED boarded docs).
..of course you would have to do all the night shifts and other crap that you have to do in the ED..sooo... ;-P!
Best of luck!
You probably would have tp start from PGY - 1 level unless u r joining in a 4 yr program, where they might waive the first yr for u.
But why do u wanna change ?? A well trained FM doc is not only as valuable as a well trained EM doc, but can probably atleast earn a similar income if not more. In addition, as the previous poster said, u can always work in the ED with just ur FM training too.
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The maximum amount of credit you may receive is 6 months. So you would start as a PGY 1, but have more months of electives/vacation during your final year.
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That six months of credit only comes with completing a residency in another field. Leaving your FM residency gives you nothing.
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Not so. I did a prelim IM year before my PGY1-3 EM program, and I got one month off. ABEM says you have to have a minimum number of months of residency, so programs can cut time off and still be in compliance.
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I won't argue value (too subjective), but there is a significant difference in income between EM and FM. Especially if you take into account the number of hours each is working.
Outpatient FM, 8-5, M-F, no nights, no weekends, seeing 25pts a day (not hard to do but not everyone desires to see this many), billing mostly 99213s and 99214s, mid-$200s. Most in the private setting work M-Th or Friday half-day so somewhat less. Avg FM vs avg EM, not too far off from each other on the CMS.gov survey: https://www.cms.gov/AcuteInpatientPPS/Downloads/AMGA_08_template_to_09.pdf
Graduates of my program have been seeing $160-180 starting. I have an offer already for $200k to start (M-Th, half day Fr). Sports med will be a little more.
Very common misconception that FM makes very little.
Graduates of my program have been seeing $160-180 starting. I have an offer already for $200k to start (M-Th, half day Fr). Sports med will be a little more.
Very common misconception that FM makes very little.
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$267k vs. $197k is a 35% increase in salary, which I would describe as significant. That being said, I hope you guys get paid because we need smart primary docs.
You need a business mind to make money, not a particular specialty, I personally know atleast half a dozen FM docs (granted that they are pretty experienced, and not just fresh outta residency) who are making close to a 1/2 a million a year, and no, they are not working any more than any other ED doc. It also depends a lot on where u choose to practice, of course u wund't be earning a lot in NYC or any other major big city, but isn't that true for EM, or for that matter any other specialty, just a matter of demand and supply. Gotta know where the real demand is, so if the question is just about the amount of money, there a lot of places with a lot to offer, just gotta look for them.
And as far as the value is concerned, u gotta admit, 95% of the stuff we see can, and should be seen in a clinic, and hence a well trained confident FM doc would be a great resource to the society.
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Who is this we you speak of, regarding the 95%? Will not argue that a well-trained FP is valuable to society. Completely disagree with your assertion (mostly from your prior post) that an FP is interchangeable with a residency trained EP when it comes to working in the emergency department. While there are EDs with acuity so low as to qualify more as urgent care centers attached to a hospital, they are far from the norm. Admission rates hover somewhere in the low teens as an rough national average, with some significant outliers at the higher end (our shop admits ~35% of our patients, which includes our minor care and peds population).
I never said that a FP is interchangeable with an EP.
"We" means the majority of the EM community. I myself am an ED resident training at a level 1 trauma center with an annual census of >100,000. Admitting a patient from ED doesn't mean that they couldn't have been seen in the clinic. How many of the patients that you see are truly "emergent" ? Most patients come to ED coz they have no access to primary care (either they never had a PCP, or couldn't see one on time). I bet a lot of your 35% get admitted because there is a significant social reason to their problems in addition to the medical issues. All those infinite chest painers, most of who could simply follow up with a PCP/cardiologist in real life get admitted, just to get some sort of risk stratification (i.e. a stress test in most cases). Most of your other cases (mild to moderate acute CHF, diabetics, nonspecific abdominal pains, sicklers, minor alcohol withdrawal, pneumonias, pyelos, hypertensives etc etc etc) can be easily managed in the clinic if only the PCP would care to send some labs and simple ekgs and xrays, start treatment, and then follow up on the patient in a day or two. Of course this also means that the patient should be reliable enough, which unfortunately, majority of inner city population is not.
If you talk to docs from other countries with advanced medical care, you rarely hear about patients turning up with ridiculous complaints like chronic back pains or vaginal discharges in an ED. This is unique only to big inner city ERs in America. People consider ED as the be all and end all to medical care in today's world.
Anyways, I have written enough, no offense to you. This is just my personal opinion.
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You must have some amazing docs where your at....I'm pretty sure the thread above talked about seeing 25 pts per hour in the FP clinic office. I'm hardpressed to see any ED doc that can consistently (safely) see anywhere close to even 5 patients per hour! As much as some people think we only see minor care stuff in an ED, there is no way these patients could get worked up in an FP office. Are you saying that less than 5% of your patients get CT scans? I'm yet to see FP with a CT scanner in their office! Same with labs? Do less than 5% of your patients get labs in your ED (yeah FP can do labs, most send out, very little urgently).
