What do you guys think of this...

[DocWagner]

I am an attending at a 250 bed hospital, 60k visit ED in a small University town. There are FP, IM, TY and Path residencies at the hospital.
Part of the FP residency recruitment to incoming and potential residents is "we offer many opportunities and ample training to prepare you to work in many hospital ERs". It is a "selling point" to residents.
I am the current educational director for residents in the ED. The FP residents do only one rotation in 3 years in the ED, furthermore, they have no required EM lectures during their noon conferences.

What are your thoughts on this recruitment method?

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[deleted87716]

The FP residents do only one rotation in 3 years in the ED, furthermore, they have no required EM lectures during their noon conferences.

This is from the RRC requirements for FM residency:

Emergency Care

There must be a structured educational experience to train the resident to deliver emergency care that includes didactic teaching, skills training, and clinical experience in caring for patients of all ages with acute illnesses and injuries in an emergency care setting. Residents should receive structured skills training in all standard current life support skills (e.g. ACLS and PALS), and should learn procedures for both trauma and medical emergencies in patients of all ages.

This clinical experience should encompass 200 hours of emergency medicine training.

The setting used for this training must offer the full spectrum of emergency services, and on-site faculty supervision must be available at all times. Suitable facilities and adequate support personnel must be present for resident training. The patients seen by family medicine residents should be representative of the patient population served by the emergency care facility overall.

200 hours works out to 25 8-hour shifts, which could theoretically be accomplished in a single month's rotation in the ED.

Whether or not this is sufficient to enable residents to work unsupervised in an ED setting is certainly debatable.

 

[EctopicFetus]

I think if the jobs are still out there for these guys thats one thing. My understanding is that they are hard to find for Fp guys.. and with the expansion of EM programs I think the jobs will be even fewer.

 

[leviathan]

I am an attending at a 250 bed hospital, 60k visit ED in a small University town. There are FP, IM, TY and Path residencies at the hospital.
Part of the FP residency recruitment to incoming and potential residents is "we offer many opportunities and ample training to prepare you to work in many hospital ERs". It is a "selling point" to residents.
I am the current educational director for residents in the ED. The FP residents do only one rotation in 3 years in the ED, furthermore, they have no required EM lectures during their noon conferences.

What are your thoughts on this recruitment method?

For interest's sake, there is an additional one year "fellowship" you can do in Emergency Medicine after completing a Family Medicine residency in Canada. The additional year allows you to be certified to work in emergency departments, and is usually a program designed for physicians out in more rural areas. Urban hospitals usually only hire physicians who have completed the 5 year EM residency that we offer. Don't know if this helps or not, but feel free to take a look.
http://www.familymed.ubc.ca/residency/r3programs/ccfpemerg.htm

 

[DocWagner]

Well, yes, but you do not become board certified nor board eligible...which is the primary issue. You can do a fellowship in anything, but if it doesn't lead to board certification, then you are spinning your wheels.

To answer a previous question ACLS training is included in the "Emergency Medicine" training. Therefore, the time in the ED is theoretically cut down. Personally, I think this pretty dishonest way to run your ship, especially when this is being told to new recruits. I have, unfortunately, very little to do with the FP program, therefore, my opinion is not heard.

 

[Noyac]

Well, yes, but you do not become board certified nor board eligible...which is the primary issue. You can do a fellowship in anything, but if it doesn't lead to board certification, then you are spinning your wheels.

To answer a previous question ACLS training is included in the "Emergency Medicine" training. Therefore, the time in the ED is theoretically cut down. Personally, I think this pretty dishonest way to run your ship, especially when this is being told to new recruits. I have, unfortunately, very little to do with the FP program, therefore, my opinion is not heard.

I agree, it is a really crappy way of recruiting. It is obviously an attempt to recruit better residents, unless the program is not filling in the match.

 

[docB]

I'm going to take the liberty of putting words in DocWagner's mouth (he can correct me if I'm wrong ). I hear what his question as "Is it valid for an FP program to advertise itself as training future FPs to work in EDs?"

I personally would say no. It's wrong for them to imply that they are training residents to work in EDs when they will not be ABEM eligible, they will be shut out of most ED jobs and they'll only have had a month of ED experience.

It's no more appropriate for FPs to work in EDs than it would be for me to hang up a shingle and start treating people's diabetes and so on chronically. God, what a mess that would be.

That's what I say but I'm sure the only entities that really count for this are the the FP board and the FP RRC. If they are OK with it, and they probably are, it will continue.

 

[RuralMedicine]

I am an attending at a 250 bed hospital, 60k visit ED in a small University town. There are FP, IM, TY and Path residencies at the hospital.
Part of the FP residency recruitment to incoming and potential residents is "we offer many opportunities and ample training to prepare you to work in many hospital ERs". It is a "selling point" to residents.
I am the current educational director for residents in the ED. The FP residents do only one rotation in 3 years in the ED, furthermore, they have no required EM lectures during their noon conferences.

What are your thoughts on this recruitment method?

Personally I'm not sure how this experience qualifies them to do anything in the ED beyond their residency rotation. I did Med-Peds at an institution where where we did an average of one adult and one pediatric ED month each year. We were ACLS/NRP/PALS certified but those were completed outside of our formal clinical training. I have no disillusion that I could/should be allowed to work in an ED. Well I didn't until I spent a year with admitting privileges where our ED is staffed almost exclusively by non EM trained providers who probably have less experience in EM than I do. (I think it's a bad sign when the Medicine attending on call comes in from home to run ED codes. Attempting to admit a patient with an epidural to medicine on the floor when we do not have neurosurgery support is also very poor form. I'm not sure that "how was I supposed to know? After all the diagnosis was made on Head CT and I didn't order a scan" is an acceptable excuse for this either.) However, I think the solution to the problem involves our hospital hiring EM trained providers not in me suddenly having a myopic view that I could do that too.