Urgent Care for IM Boarded

[oncomine]

I am graduating IM residency. trying to find UC gig but am coming across the need to have experience with toddlers/children

Has anyone found away "around" this - ie places willing to train them with younger patients or (less likely) jobs that don't require this expereience

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[Tri2Fly]

Try looking at academic medical centers that have urgent care, specifically those with training programs. They usually separate out the peds and adult medicine urgent care centers, especially if the medical center has a children's hospital .

 

[Gastrapathy]

What's your plan when you encounter a pediatric patient?

 

[IMreshopeful]

You could try a VA.

 

[deleted547339]

Kids are resilient. It's hard to break them. The other thank that's really nice about seeing kids is they all have PCPs and can usually get in to see them the next days. There's only a few things that you absolutely have to recognize. You need to recognize sick, know about peds ortho, you need to know that neonatal fevers get shipped immediately. Beyond that, almost all of the kids you'll see in an urgent care (or ED for that matter) are healthy, fully-vaccinated children with URIs, strep, AOM or some other virus. You're note expected to take care of sick kids in the same way an ED is.

 

[oncomine]

What's your plan when you encounter a pediatric patient?

to send them to the pediatrician that I will be working with

agreed, kids are resilient, but from my minimal experience I have seen a few that crashed very quickly, not just neonates, a few toddlers as well;

 

[dozitgetchahi]

Seeing kids with IM-only training is an excellent way to get sued for all you're worth. Doesn't matter if anyone 'trains you' on kids - anything goes wrong and the lawyers will be 'training you' in the courtroom.

Just don't.

 

[Instatewaiter]

Seeing kids with IM-only training is an excellent way to get sued for all you're worth. Doesn't matter if anyone 'trains you' on kids - anything goes wrong and the lawyers will be 'training you' in the courtroom.

Just don't.

Strongly agreed. Also, no company would be stupid enough to insure you to see kids when you have no training in peds.

 

[gutonc]

What's your plan when you encounter a pediatric patient?

to send them to the pediatrician that I will be working with

What do you mean by this? Are you assuming that when you're covering a UC shift somewhere there will also be a pediatrician doing the same that will just pick up those kids?

Or do you have a pediatrician buddy that will see any of these kids for you at the drop of a hat, any time of day or night? What's his retainer? Because if it were me, I'd charge you a couple hundred bucks a shift just to answer my phone if you called. Plus another $100 minimum to actually come see the kid. Plus $150/hr on top of that for actual time spent.

Or do you mean that you'll just panic and ship anybody under 18 to the local ED?

If the first one is the plan...well, it's sub-optimal but could be worse. The other 2 are just ridiculous.

 

[Siggy]

What do you mean by this? Are you assuming that when you're covering a UC shift somewhere there will also be a pediatrician doing the same that will just pick up those kids?

Or do you have a pediatrician buddy that will see any of these kids for you at the drop of a hat, any time of day or night? What's his retainer? Because if it were me, I'd charge you a couple hundred bucks a shift just to answer my phone if you called. Plus another $100 minimum to actually come see the kid. Plus $150/hr on top of that for actual time spent.

Or do you mean that you'll just panic and ship anybody under 18 to the local ED?

If the first one is the plan...well, it's sub-optimal but could be worse. The other 2 are just ridiculous.

It's also going to depend on what's wrong with the kid. When I was about 11 I had a bug stuck in my ear that we couldn't flush out at home (and damn thing was beating on my ear drum. My parents thought I was having a psychotic break when it woke up during dinner). You don't have to be a pediatrician to look in an ear with an otoscope, grab a syringe, and irrigate PRN until bug flows out.

 

[deleted547339]

It's also going to depend on what's wrong with the kid. When I was about 11 I had a bug stuck in my ear that we couldn't flush out at home (and damn thing was beating on my ear drum. My parents thought I was having a psychotic break when it woke up during dinner). You don't have to be a pediatrician to look in an ear with an otoscope, grab a syringe, and irrigate PRN until bug flows out.

Yes, but there are still a lot of subtleties you learn about minor emergencies in EM. For example, a bug in the ear is organic material and flushing it with saline can 1) piss the bug off and 2) make it swell up. Using mineral oil works much better.

 

[oncomine]

What do you mean by this? Are you assuming that when you're covering a UC shift somewhere there will also be a pediatrician doing the same that will just pick up those kids?

Or do you have a pediatrician buddy that will see any of these kids for you at the drop of a hat, any time of day or night? What's his retainer? Because if it were me, I'd charge you a couple hundred bucks a shift just to answer my phone if you called. Plus another $100 minimum to actually come see the kid. Plus $150/hr on top of that for actual time spent.

Or do you mean that you'll just panic and ship anybody under 18 to the local ED?

If the first one is the plan...well, it's sub-optimal but could be worse. The other 2 are just ridiculous.

yes ridiculous, options one less so. I'll choose that.

 

[bingbongbink]

Sloan Kettering has an Urgent care / ED fully staffed by IM physicians.

 

[MDROBIN001]

I am graduating IM residency. trying to find UC gig but am coming across the need to have experience with toddlers/children

Has anyone found away "around" this - ie places willing to train them with younger patients or (less likely) jobs that don't require this expereience

A friend of mine have completed his 4 years residency in Nuclear Medicine and was having difficulty finding a job. 2 years ago he started working at an Urgent care with a very good hourly rate. His only pediatrics experience at that time was during med school years. I remember him saying that there are some 66 hours Urgent Care DVD's that he purchased on line that helped him tremendously, so it is doable..

 

[Brahnold Bloodaxe]

A friend of mine have completed his 4 years residency in Nuclear Medicine and was having difficulty finding a job. 2 years ago he started working at an Urgent care with a very good hourly rate. His only pediatrics experience at that time was during med school years. I remember him saying that there are some 66 hours Urgent Care DVD's that he purchased on line that helped him tremendously, so it is doable..

And here we are making fun of NP online training...

 

[James ij]

There are CMEs etc etc you can go to get these kind of experiences. Like Brahnold said, there are NP and PA quickly picking up stuff.

 

[Brahnold Bloodaxe]

There are CMEs etc etc you can go to get these kind of experiences. Like Brahnold said, there are NP and PA quickly picking up stuff.

You completely misinterpreted the real meaning of my post.

 

[jdh71]

A friend of mine have completed his 4 years residency in Nuclear Medicine and was having difficulty finding a job. 2 years ago he started working at an Urgent care with a very good hourly rate. His only pediatrics experience at that time was during med school years. I remember him saying that there are some 66 hours Urgent Care DVD's that he purchased on line that helped him tremendously, so it is doable..

Possible. Yes. It's possible. But it's pretty miserable work for anyone trained to do something different. I mean if you do Nuke Med and can't find a job. Yeah. Man. Hammer out that urgent care.

I wouldn't suggest urgent care to any IM trained people.