UT Family Medicine Residency

[DoctorMom78]

Can anyone give me their opinion and the pros and cons of the FM residency at University of Tennessee, Knoxville? I already contacted the program and got the information that they send out, but I wanted to know what someone in the program thinks of it. Also, what do you think about the fellowships that they offer? We are moving to Tennessee and I have fallen in love with the area. I would really like to stay and do my residency there and practice rural FM somewhere in the area. Thanks so much!

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[Tn Family MD]

I am an intern here at UT-Knoxville, though I suppose you already knew that from our previous interactions. I think it is a great program, obviously. The fellowships are first rate. The ER fellowship always fills it's two positions. It's one of the few EM felllowship programs that are associated with a level I trauma center and also has no EM residency, so all the cool stuff falls in your lap procedure wise, etc. We also are a certified stroke center, so there is a fair bit of tPA use here and they get to do that as well. Tons of other procedures as well such as intubations, LP's, etc. The OB fellowship is great as well, but it is only open to UT-Knoxville residency grads, so it typically goes unfilled as their are only 8 grads per year and not many FM folks are interested in c-section training these days. It's still a great experience. Also, the Sports Med fellowship is just getting back on it's feet. The attending who runs it has done a fantastic job getting it back on track and in my opinion it shows a lot of promise. We are getting two new fellows in July for Sports Med. And the attending that is over it is very knowledgeable and friendly. He just a month or two ago bought us a new XBOX 360 for our resident lounge. The geriatrics program is about to get back up and running after a major overhaul. We just last year got signed up with one of the nicest nursing homes in the area to provide all their medical staffing and we are about to bring in a new Geriatric fellowship program director that is boarded in oncology as well as geriatrics. So, that program is definitely looking up as well. The homeland securities fellowship is the only one of it's kind in the country as far as I know. It's kinda cool too if you are into that kind of stuff. The behavioral med fellowship is very unique as well and from what I hear it's great as well. The guy that runs it is smart as can be, and triple boarded in Psychiatry, Child and adolescent psych, and FM.

I think overall we have an incredible program with an awesome faculty. We have a guy who is an MD and Pharm.D, another attending is a DO and Pharm.D., We have a behavioral psychologist on staff, several attendings have written texts, some are procedure gurus (we now have two in our university hospital that do colonoscopies as well as more community preceptors doing them so you can get trained in c-scopes here which is important if you are the only doc capable of providing that service in your rural community). Basically, we have a dynamic faculty, great location, outstanding experience, etc. I know I will be ready to be a fantastic doc ready to serve my community when I am done here.

 

[DoctorMom78]

WOW! Thanks! It sounds really great!

I was interested in the OB fellowship, but I am concerned how that would affect my malpractice rates. I don't really have much of an interest in C-sections anyway, but I would love to deliver babies. The geriatrics fellowship is intriquing, but I have 10+ years of working in my father's neurology practice. So, I have been a bit inundated with geriatric issues. (His focus is largely on Alzheimer's and dementia.) The EM fellowship sounds really good too. I am not really that interested in EM, but it sounds like it would be good training for my rural FM practice. I know that there is a rural FM fellowship in Johnson City, but I would like to do everything in one place. It is too far of a commute from where we will be living and I have children so I don't want to move.

It really sounds like the perfect program for me. I hope that I get the opportunity to attend in the future.

 

[sophiejane]

I was interested in the OB fellowship, but I am concerned how that would affect my malpractice rates. I don't really have much of an interest in C-sections anyway, but I would love to deliver babies.

In order to deliver babies and not do c-sections, you have to have another doctor who will do sections on call, and within minutes away in the event of an emergent section. This likely will not always be possible, especially in a rural practice.

Sometimes what starts as a normal delivery can go south very quickly and they have to go right into the OR--I'm only a 4th year medical student, and I've seen it several times. Talk about having problems with malpractice--try explaining to the mom whose baby just died because you weren't qualified to do a section and there was no one around who could...

Not for me, thank you. I plan to do OB, but not until I'm as comfortable with sections as I am with vaginal deliveries. I don't believe it's responsible to do OB any other way, but that's just my opinion.

The malpractice is higher, but as one doc told me, if you want to do it, you'll make it work. It's do-able.

 

[DoctorMom78]

In order to deliver babies and not do c-sections, you have to have another doctor who will do sections on call, and within minutes away in the event of an emergent section. This likely will not always be possible, especially in a rural practice.

Sometimes what starts as a normal delivery can go south very quickly and they have to go right into the OR--I'm only a 4th year medical student, and I've seen it several times. Talk about having problems with malpractice--try explaining to the mom who's baby just died because you weren't qualified to do a section and there was no one around who could...

Not for me, thank you. I plan to do OB, but not until I'm as comfortable with sections as I am with vaginal deliveries. I don't believe it's responsible to do OB any other way, but that's just my opinion.

The malpractice is higher, but as one doc told me, if you want to do it, you'll make it work. It's do-able.

I know. I either need to do an OB fellowship and be able to handle everything or not do OB at all. I am not sure which is the best way to go. I agree with you. I would not feel comfortable doing OB without being able to do C-sections. I have four children of my own and I know how crazy and unpredictable pregnancy can be at times. I have some time to figure it out.

 

[Tn Family MD]

In the state of Tennessee, the average rate of malpractice for an FM doc who doesn't do OB is between $10,000 and $15,000 per year. For FM docs who do OB including c-sections, the average rate is between $25,000 and $35,000. That is not really as significant a difference as most people believe. Also, there are plenty of hospitals I have been in contact with who will gladly pay your malpractice if you agree to do your deliveries at their hospital. This is because they actually make more money on each delivery than the doctors do. The physician charge for a delivery varies. For TennCare patients, it is about $1,500 for a vaginal delivery and about $2,000 for a c-section. Private insurance pays about $3,000 for a vaginal delivery and about $3,500 for a c-section. Keep in mind that deliveries are bundled services, so that amount includes the deivery and all pre-natal care as well. If you do the math, you don't have to do very many deliveries to return enough money to cover the additional mal-practice coverage. Also, keep in mind that there are higher mal-practice rates than the baseline if you are doing c-scopes and other high risk procedures, but the numbers I gave for OB coverage on an FM doc also allows you to do those high risk procedures as well with no additional mal-practice. Interestingly, mal-practice coverage is less for an FM doc who does OB in this state than for an Ob/Gyn physician. I assume it is because malpractice carriers believe that FM docs who do OB happen to do less OB than someone who strictly practices Ob/Gyn or maybe it is because the Ob/Gyn docs also do gyn surgeries as well. I don't really know the reason for sure, but it is an interesting little factoid.

The bottom line is this, if you truly want to do OB, there is no financial reason not to do it. At least not in this great state of Tennessee.

 

[DoctorMom78]

In the state of Tennessee, the average rate of malpractice for an FM doc who doesn't do OB is between $10,000 and $15,000 per year. For FM docs who do OB including c-sections, the average rate is between $25,000 and $35,000. That is not really as significant a difference as most people believe. Also, there are plenty of hospitals I have been in contact with who will gladly pay your malpractice if you agree to do your deliveries at their hospital. This is because they actually make more money on each delivery than the doctors do. The physician charge for a delivery varies. For TennCare patients, it is about $1,500 for a vaginal delivery and about $2,000 for a c-section. Private insurance pays about $3,000 for a vaginal delivery and about $3,500 for a c-section. Keep in mind that deliveries are bundled services, so that amount includes the deivery and all pre-natal care as well. If you do the math, you don't have to do very many deliveries to return enough money to cover the additional mal-practice coverage. Also, keep in mind that there are higher mal-practice rates than the baseline if you are doing c-scopes and other high risk procedures, but the numbers I gave for OB coverage on an FM doc also allows you to do those high risk procedures as well with no additional mal-practice. Interestingly, mal-practice coverage is less for an FM doc who does OB in this state than for an Ob/Gyn physician. I assume it is because malpractice carriers believe that FM docs who do OB happen to do less OB than someone who strictly practices Ob/Gyn or maybe it is because the Ob/Gyn docs also do gyn surgeries as well. I don't really know the reason for sure, but it is an interesting little factoid.

The bottom line is this, if you truly want to do OB, there is no financial reason not to do it. At least not in this great state of Tennessee.

Very good information! I am definitely going to consider the OB fellowship then.

 

[jktiger5]

Can you please tell me how competitive of a program it is. What are the qualifications to get an interview? I am a 3rd year medical student and am very interested in the program. is a 200 a high enough score?
Thanks.

 

[aterry]

Any new information on this program? I have read a small amount on UT-Chattanooga and couldn't find anything new on UT-Knoxville. If I am slow and simply didn't find the right place, I'd appreciate a link. Thanks!!

 

[ananursing]

I was considering the OB fellowship, but I am worried how that would impact my negligence prices. I don't really have much of a new in C-sections anyway, but I would really like to provide infants. The geriatrics fellowship is intriquing, but I have 10+ decades of operating in my dad's neurology exercise. So, I have been a bit overloaded with geriatric concerns. (His concentrate is mostly on Alzheimer's and dementia.) The EM fellowship appears to be really excellent too. I am not really that considering EM, but it appears to be like it would be excellent exercising for my non-urban FM exercise. I know that there is a non-urban FM fellowship in Jackson Town, but I would like to do everything in one position. It is too far of a travel from where we will be residing and I have kids so I don't want to shift.


Respite Care London

 

[ztaw15]

http://gsm.utmck.edu/family_medicine/main.cfm

Active department. Lots of fellowship offerings. Can't say much more than that. Residents are all enthusiastic, but that's almost always true of any place. Have not rotated there.

 

[MJB]

I rotated there as a 4th year. Was my first choice for a long time as I lived in Knoxville. Ended up being my 2nd choice mostly due to the perceived weakness of OB. I ended up electing to go to a program that is unopposed.

Overall, hindsight being 20/20 I probably wish I had just stayed. Everywhere has it's pluses and minuses. You just have to determine what you are looking for.

I enjoyed my time there and would have no reservations.



One thing I will forever tell anyone that will listen..ROTATE WHERE YOU THINK YOU WANNA GO..I wouldn't go to any program I haven't spent at LEAST a couple days with. You can be sold a lot of BS on interview day.

 

[aterry]

Any recommendations on who to rotate with? I applied for an ambulatory elective there and am in the process of getting that set up. Any thoughts? Is the OB very weak?

 

[MJB]

Any recommendations on who to rotate with? I applied for an ambulatory elective there and am in the process of getting that set up. Any thoughts? Is the OB very weak?

I cannot honestly answer that as I had no experience on their OB service.

I will say that it was something that came up when I asked about their perceived weakest areas during interview.

My recommendation would be to pick out some places you think you may like and try to rotate there, then ask the residents. Residents will be surprisingly candid in most instances.

 

[aterry]

Someone PMed me about my thoughts on where I rotated and I thought hey, someone else might find this useful too! So here are my thoughts on this great program

UT Knoxville:
I rotated here in August and I totally loved it. My time was spent doing 2 weeks on the inpatient service and 2 weeks of outpatient service. The inpatient service was great and fairly typical. Pre-rounding with the residents starting at 6:30 or so, then going to morning report (which is a mix of lecture and actual case report) then rounding most of the morning with the attending on the service. I even got to deliver a baby at the end of one morning! Then there is a lunch time didactic (and they feed you) and then we spent the rest of the afternoon doing admissions and following-up on the morning tasks. We checked out to the night team around 5. I was treated as part of the team, allowed to present my own patients to the attending with my own A&P and was definitely not treated like a "scut monkey" haha. The residents were patient and kind. They taught a lot and offered great advice. The attendings were not intimidating and were very approachable. I found that I really enjoyed my time on that service as a whole. My two weeks on outpatient were great as well! Very nice 8-5 hours. Attending lunch lecture. Also was given the opportunity to do tons of procedures like vasectomies, colposcopies and others. Went to a nursing home, chronic disease management clinic and skills labs. All in all it was very well-rounded and I am thankful for the experience. Knoxville as a city is pretty cool, obviously depending on what you are looking for. The people both at the residency and in the city are very warm and hospitable. Growing up in the south, I found it to be very comfortable. People have been very rude here in South Florida so it was a very nice reprieve!! There is a good amount to do being a college town as well as ample outdoor opportunities. Cost of living seemed fairly reasonable. All-in-all, great experience. Not really too much bad to say about the program.