Why are combined FM/EM residencies not more common?

[Vivid_Quail]

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Currently, there are only 3 FM/EM programs (5 years) in the country. Why are these programs not more common?

To a naive med student, dual board certification in FM and EM seems to create the ultimate rural doctor, and something like this pathway is what other large countries with remote areas do, see Australia and Canada. With FM/EM, you can legally and practically find work as a hospitalist with an open ICU, in any ED, and start your own outpatient clinic (not just urgent care). The main reason I think this is not very common is that currently FM can work inpatient, outpatient, and in the ED, so why add an extra 2 years of residency?

Maybe I am underestimating FM training but I can't imagine being comfortable handling critically ill patients (trauma or medical) directly out of FM residency. Also, with the EM job market getting worse and worse, I can see FM-trained doctors getting pushed out of the ED in the next 10-20 years. On the other hand, if you only do EM to get that trauma and CC training, you don't have the option to "slow down" and do outpatient or have a more regular sleep schedule with a 7 on 7 off hospitalist gig. Also, FM brings much more OB and peds experience to the table than EM.

Also posted in FM forum to get their opinion.

 

[turkeyjerky]

Well, most of us who chose to become Emergency Physicians loathe the practice of outpatient medicine. So there's just not that much interest there. Most of the rest of your post is fairly accurate though.

 

[Vivid_Quail]

Well, most of us who chose to become Emergency Physicians loathe the practice of outpatient medicine. So there's just not that much interest there. Most of the rest of your post is fairly accurate though.

That makes sense. I guess my interest in FM/EM residency is a combination of wanting to do critical care and paranoia, namely 1) midlevels, 2) EM job market, and 3) circadian rhythm induced burnout. FM/EM allows for adequate training in emergency critical care and an escape hatch for each part of my paranoia lol...

1) no realistic mid-level threat in Canada and they desperately need FM; American EM residency is not recognized there, needs to be 5 years, not 3. FM residency is recognized with no extra exams due to a unique bilateral agreement

2) short and medium term, EM residency allows work in any ED, even ones that require ABEM training and have pushed out all FM-trained docs. If you can't find a job EM in a location, you almost certainly can find hospitalist or outpatient work

3) work more EM while young and not burned to a crisp, save a ton (more $/hr in EM), switch to part-time hospitalist/outpatient once financially independent. After about 40-45 years old, EM docs seem to really start to struggle with the rotating sleep schedule, I don't think I will be any different.

Oh, also being able to snipe the most lucrative hospitalist AND ED locums shifts fits the lifestyle I really want: short crunches of a lot of work in exchange for a lot of time off to travel and have hobbies.

So in short, EM/FM adds two years of residency but feels "safer" long term. Two years of lost attending salary is nothing to sneeze at, but being unemployed or very underpaid because you only have the ED as an option is also a bad situation.

 

[CCM-MD]

If midlevels are your worry all 3 FM, EM and CCM have probably the same degree of issues.

 

[Vivid_Quail]

If midlevels are your worry all 3 FM, EM and CCM have probably the same degree of issues.

Did you read my post? American FM can go to Canada easily, American EM can't practice in Canada at all, and CCM is theortically possible depending on the original residency and the mood of the RCPSC. No midlevel threat in Canada...there are 1.8 mid-levels per 10,000 versus 14.2 mid-levels per 10,000 in the US. Not to mention that the number of midlevel graduates is skyrocketing in the US.

 

[CCM-MD]

Did you read my post? American FM can go to Canada easily, American EM can't practice in Canada at all, and CCM is theortically possible depending on the original residency and the mood of the RCPSC. No midlevel threat in Canada...there are 1.8 mid-levels per 10,000 versus 14.2 mid-levels per 10,000 in the US. Not to mention that the number of midlevel graduates is skyrocketing in the US.

Do you want to work in Canada or the US? Pick one and stick with it. Same thing with FM or EM, pick one and stick with it. Most who do dual residencies like that end up working one or the other and it’s wasted years. Time value of money is a big deal. I have my FRCPC in IM after American training and trust me it’s a giant pain. There maybe no midlevel threat in Canada but it’s hard enough for many specialists to get a job in major metros.

 

[Vivid_Quail]

Do you want to work in Canada or the US? Pick one and stick with it. Same thing with FM or EM, pick one and stick with it. Most who do dual residencies like that end up working one or the other and it’s wasted years. Time value of money is a big deal. I have my FRCPC in IM after American training and trust me it’s a giant pain. There maybe no midlevel threat in Canada but it’s hard enough for many specialists to get a job in major metros.

My entire post is about rural generalist medicine and you are telling me how it is difficult to find specialist jobs in major metro areas. Come on, that is a stretch even for a professional contrarian. Also, there is much more money to be made in the US in the short term, but in the medium term, Canada could definitely become worth it, that is the point. I don't have to pick one country for the next 30+ years of my career.

FRCPC after American IM is not the same as getting recognition by the CFPC after American FM. AAFP and CFPC has a special arrangement to streamline recognition of each other's training, and as you know, family medicine in Canada is not under the Royal College (RCPSC).

 

[CCM-MD]

My entire post is about rural generalist medicine and you are telling me how it is difficult to find specialist jobs in major metro areas. Come on, that is a stretch even for a professional contrarian. Also, there is much more money to be made in the US in the short term, but in the medium term, Canada could definitely become worth it, that is the point. I don't have to pick one country for the next 30+ years of my career.

FRCPC after American IM is not the same as getting recognition by the CFPC after American FM. AAFP and CFPC has a special arrangement to streamline recognition of each other's training, and as you know, family medicine in Canada is not under the Royal College (RCPSC).

Seems like you have made up your mind. Good luck.

 

[aafisahar]

IM/EM ticks all your boxes plus gives you a validated pathway to any IM fellowship. The trade off is no kids/preggers in clinic, which is actually amazing.

 

[Vivid_Quail]

IM/EM ticks all your boxes plus gives you a validated pathway to any IM fellowship. The trade off is no kids/preggers in clinic, which is actually amazing.

Unfortunately part of my reason for wanting to do FM is kids and OB because...I like kids and OB. But, also for rural medicine. Not everyone who lives in a rural community is a non-pregnant adult as much as that would be an IM attending's dream.

 

[turkeyjerky]

Unfortunately part of my reason for wanting to do FM is kids and OB because...I like kids and OB. But, also for rural medicine. Not everyone who lives in a rural community is a non-pregnant adult as much as that would be an IM attending's dream.

So what's your point--you're the 1/1000 med students for whom an EM/FM program is a good fit? Sounds like you should go for it.

 

[Mushdoc]

If you want to do EM/FM and be a rural family doctor who also works in the ER and you want to do do 5 year training because you want to be the best doctor you can be go ahead and do it. But I would not do it just because you are worried about the job market.

Its really hard to work in a family clinic that gives you enough time off to also work in the ER. Its really hard to work in the ER and find a family clinic that only wants you sporadically. It will be hard to not do one and come back and do it 20 years later.

You may be able to find a really, really rural ER that does 24 hour shifts where the local family docs take turns covering it and the inpatient wards. In this place being dual boarded will not make you more hireable than just being family boarded. They will be happy to have an MD, and if they are going to hire an NP over an MD they are going to hire an NP over an MD regardless of what you're boarded in.

I would say you should do FM residency and if you want to work in the ER in the rural area that can't otherwise hire an EM boarded doc, do whatever training you can to get as good as you can. Pick a rural FM residency.

Realize there is a difference between capability and hireability. Rural areas are not that competitive and wont be.

 

[Vivid_Quail]

If you want to do EM/FM and be a rural family doctor who also works in the ER and you want to do do 5 year training because you want to be the best doctor you can be go ahead and do it. But I would not do it just because you are worried about the job market.

Its really hard to work in a family clinic that gives you enough time off to also work in the ER. Its really hard to work in the ER and find a family clinic that only wants you sporadically. It will be hard to not do one and come back and do it 20 years later.

You may be able to find a really, really rural ER that does 24 hour shifts where the local family docs take turns covering it and the inpatient wards. In this place being dual boarded will not make you more hireable than just being family boarded. They will be happy to have an MD, and if they are going to hire an NP over an MD they are going to hire an NP over an MD regardless of what you're boarded in.

I would say you should do FM residency and if you want to work in the ER in the rural area that can't otherwise hire an EM boarded doc, do whatever training you can to get as good as you can. Pick a rural FM residency.

Realize there is a difference between capability and hireability. Rural areas are not that competitive and wont be.

Thanks for the reply. That all sounds very logical. Do you think rural ED’s are so undesirable that if the ED market keeps getting flooded with more and more graduates every year, that new ABEM BC/BE grads would rather be unemployed or part-time/PRN than work full-time in a rural area? Seems unlikely but maybe people are more stubborn than I think.

 

[betamale]

Thanks for the reply. That all sounds very logical. Do you think rural ED’s are so undesirable that if the ED market keeps getting flooded with more and more graduates every year, that new ABEM BC/BE grads would rather be unemployed or part-time/PRN than work full-time in a rural area? Seems unlikely but maybe people are more stubborn than I think.

It's hard to do rural especially if you have family and impossible if your family really hates rural locals. I work with several ppl who tired to commute to rural for pay then head back to city after shift...it doesn't work out. They all end up taking turns at their city freestanding making $100/hr

 

[Groove]

I think the EM/FM residencies are intriguing and attractive in the sense that they "future proof" you to some degree. That being said, it's really difficult to be great at multiple things. FM is much more than just a weekend study course of outpatient medicine. My NP gf who was trained in FM but has been doing EM for the majority of her career, switched over to a family practice and damn...it took her close to a year to really get the fundamentals down and be able to smoothly and efficiently navigate the maze of FM work. She cried for months talking about how overwhelmed she was with the information and feeling like she wasn't any good at FM. The same goes for EM. You don't want to be the guy that does a couple of EM shifts a month for 3-4 years and then suddenly wants to do it full time. Your skills will atrophy and your ability to efficiently manage and disposition the variety of emergencies that might present themselves to you will definitely be suboptimal. You might be doing your patients a disservice as well as your colleagues. Now, there are always exceptions. We have an FM doc in the area that works in the ER and also does outpatient medicine and I'm not quite sure what his schedule looks like but he seems to juggle them pretty well while appearing pretty competent. Anything is possible I suppose. Personally, I like the idea in flexibility of having FM boards for the inevitable day where I just got sick of EM. I think it's probably easier to transition to FM after a career in EM than it is vice versa. I have no clue about the Canadian credentialing issues with our boards. I think you need to figure out first whether you want to be a Canadian or an American, eh?

 

[nexus73]

Does the intern year for EM count for FM...so you could do EM and practice for years then (somehow bite the bullet on temporary paycut) and go back and do 2 years FM residency to get that outpatient training. If a family doctor subsequently goes through psychiatry residency they typically only have to do 3 years (instead of 4) as their intern year counts.

 

[Vivid_Quail]

I think the EM/FM residencies are intriguing and attractive in the sense that they "future proof" you to some degree. That being said, it's really difficult to be great at multiple things. FM is much more than just a weekend study course of outpatient medicine. My NP gf who was trained in FM but has been doing EM for the majority of her career, switched over to a family practice and damn...it took her close to a year to really get the fundamentals down and be able to smoothly and efficiently navigate the maze of FM work. She cried for months talking about how overwhelmed she was with the information and feeling like she wasn't any good at FM. The same goes for EM. You don't want to be the guy that does a couple of EM shifts a month for 3-4 years and then suddenly wants to do it full time. Your skills will atrophy and your ability to efficiently manage and disposition the variety of emergencies that might present themselves to you will definitely be suboptimal. You might be doing your patients a disservice as well as your colleagues. Now, there are always exceptions. We have an FM doc in the area that works in the ER and also does outpatient medicine and I'm not quite sure what his schedule looks like but he seems to juggle them pretty well while appearing pretty competent. Anything is possible I suppose. Personally, I like the idea in flexibility of having FM boards for the inevitable day where I just got sick of EM. I think it's probably easier to transition to FM after a career in EM than it is vice versa. I have no clue about the Canadian credentialing issues with our boards. I think you need to figure out first whether you want to be a Canadian or an American, eh?

That is a good perspective. However, don't the bolded points kind of reinforce my desire to do a full residency in both FM and EM and not just wing both while doing a residency in only one. I don't want a crash course in FM or a year to get up to speed as an NP, I want a full residency 😉

I agree skill atrophy would be a concern. My idea would be to work full time, 40-50hrs/week, half FM, half EM. Plenty of people work just 20-30hrs/week in only EM or FM. Are they bad doctors? And it isn't like EM and FM have 0 overlap. We all know many many ED visits could/should be seen in FM clinic, not the ED.

 

[Vivid_Quail]

Does the intern year for EM count for FM...so you could do EM and practice for years then (somehow bite the bullet on temporary paycut) and go back and do 2 years FM residency to get that outpatient training. If a family doctor subsequently goes through psychiatry residency they typically only have to do 3 years (instead of 4) as their intern year counts.

I have no idea, but I have wondered that too. I think part of the ACGME requirement for FM is to have two continuous years of longitudinal outpatient clinic, so I guess you could still get that done in an abbreviated FM residency. EM just spends so much time in the ED during residency (obviously), that I don't think EM has many months that can convert to credit for FM months. Something I should look into.

 

[Mushdoc]

That is a good perspective. However, don't the bolded points kind of reinforce my desire to do a full residency in both FM and EM and not just wing both while doing a residency in only one. I don't want a crash course in FM or a year to get up to speed as an NP, I want a full residency 😉

I agree skill atrophy would be a concern. My idea would be to work full time, 40-50hrs/week, half FM, half EM. Plenty of people work just 20-30hrs/week in only EM or FM. Are they bad doctors? And it isn't like EM and FM have 0 overlap. We all know many many ED visits could/should be seen in FM clinic, not the ED.

I would make sure you speak to some FM docs who work only part time. It doesn't sound easy. Your patients would not be happy with you only being available 2-3 days a week. It would be hard to get clinic space (its either going to be empty half the week and you have to pay for it, or you have to find a specialist or another FM doc who wants the rooms the other half of the week.) Your support staff is not going to only want to work part time either.

 

[DeadCactus]

More don't exist because there is a viable 3 year training path that ends with working in a rural area practicing full-spectrum medicine. The number of people willing to give up $500k+ and 2 years of their lives in the name of gold standard training is small and frankly I questions how much initial training matters 5-10 years into practice. Additionally, people who pursue this training are going to work in rural areas and not gravitate to academic centers where they can spread the gospel and open new training programs. EM/IM is more popular and widespread because it opens up niche positions, a wealth of fellowship options, and gravitates toward academic setting.

 

[Doc Doc Doc Goose]

I love this thread. And maybe I’m crazy but this sort of schedule idea came to me:

Week 1 - outpatient FM clinic
Week 2 - 3-4 shifts ED
Week 3 - off completely
Week 4 - outpatient FM clinic
Week 5 - 3-4 ED shifts
So every “month”, in a staggered way, you have two weeks of FM or EM. It’s like a knock off of the 7 on 7 off deal.

Like that to me, would be AWESOME. Barring you don’t over extend your FM patient roster, I don’t see how two “part-time” gigs could not be acquired that way, especially in a rural setting.

It’s insane, yes, but certainly reads well on paper. Let a dreamer, dream. If they “waste” two years of their lift, so be it. Roll the dice and tell me how it goes.

 

[RustedFox]

I love this thread. And maybe I’m crazy but this sort of schedule idea came to me:

Week 1 - outpatient FM clinic
Week 2 - 3-4 shifts ED
Week 3 - off completely
Week 4 - outpatient FM clinic
Week 5 - 3-4 ED shifts
So every “month”, in a staggered way, you have two weeks of FM or EM. It’s like a knock off of the 7 on 7 off deal.

Like that to me, would be AWESOME. Barring you don’t over extend your FM patient roster, I don’t see how two “part-time” gigs could not be acquired that way, especially in a rural setting.

It’s insane, yes, but certainly reads well on paper. Let a dreamer, dream. If they “waste” two years of their lift, so be it. Roll the dice and tell me how it goes.

Yeah, I thought this was "do-able" as a student as well.

Me, and everyone else.

There are 452.3 reasons why nobody does this.

 

[Lexdiamondz]

I love this thread. And maybe I’m crazy but this sort of schedule idea came to me:

Week 1 - outpatient FM clinic
Week 2 - 3-4 shifts ED
Week 3 - off completely
Week 4 - outpatient FM clinic
Week 5 - 3-4 ED shifts
So every “month”, in a staggered way, you have two weeks of FM or EM. It’s like a knock off of the 7 on 7 off deal.

Like that to me, would be AWESOME. Barring you don’t over extend your FM patient roster, I don’t see how two “part-time” gigs could not be acquired that way, especially in a rural setting.

It’s insane, yes, but certainly reads well on paper. Let a dreamer, dream. If they “waste” two years of their lift, so be it. Roll the dice and tell me how it goes.

7 on 7 off works for hospital based settings where you don't have longitudinal relationships with patients and there's an oncoming hospitalist or night float to hand off patient care to.

In something clinic based this isn't as viable for reasons mentioned earlier in the thread. More fundamentally, your patients tend to be "needier" as a PCP, and if you're only available 8-10 days out of the month on average they're going to find another PCP.

Aside from that, when you practice two specialties in two different departments with two different bosses, you're going to have to meet two entirely different sets of expectations. Why hire a part-time guy who wants to work alternating 1-2 weeks a month when I could hire a full time one who will do that, and take sick call, and who doesn't have a second boss who is competing with me for my employee's time?

 

[GatorCHOMPions]

I love this thread. And maybe I’m crazy but this sort of schedule idea came to me:

Week 1 - outpatient FM clinic
Week 2 - 3-4 shifts ED
Week 3 - off completely
Week 4 - outpatient FM clinic
Week 5 - 3-4 ED shifts
So every “month”, in a staggered way, you have two weeks of FM or EM. It’s like a knock off of the 7 on 7 off deal.

Like that to me, would be AWESOME. Barring you don’t over extend your FM patient roster, I don’t see how two “part-time” gigs could not be acquired that way, especially in a rural setting.

It’s insane, yes, but certainly reads well on paper. Let a dreamer, dream. If they “waste” two years of their lift, so be it. Roll the dice and tell me how it goes.

There’s a guy I work with in academics who does 50/50 EM/FM. He makes less than the straight EM people but it seems like a good balance that he enjoys. His 2-2.5 clinic days per week are fixed and the EM shifts fill in around them.

 

[VA Hopeful Dr]

There’s a guy I work with in academics who does 50/50 EM/FM. He makes less than the straight EM people but it seems like a good balance that he enjoys. His 2-2.5 clinic days per week are fixed and the EM shifts fill in around them.

Academics could easily make this work, since in my experience academic family medicine physicians usually don't work more than about two or two and a half days in clinic per week.

Out in the real world, patients are not going to be happy about the limited time you're available. Nor will your partners who have to cover for you the rest of the week.

 

[Doc Doc Doc Goose]

7 on 7 off works for hospital based settings where you don't have longitudinal relationships with patients and there's an oncoming hospitalist or night float to hand off patient care to.

In something clinic based this isn't as viable for reasons mentioned earlier in the thread. More fundamentally, your patients tend to be "needier" as a PCP, and if you're only available 8-10 days out of the month on average they're going to find another PCP.

Aside from that, when you practice two specialties in two different departments with two different bosses, you're going to have to meet two entirely different sets of expectations. Why hire a part-time guy who wants to work alternating 1-2 weeks a month when I could hire a full time one who will do that, and take sick call, and who doesn't have a second boss who is competing with me for my employee's time?

Maybe they don’t need a full time employee but recognize that another FM doc could bring their practice revenue. Is that not true?

And when you say “available?” You mean like for phone calls? Cause it’s not like appointments are made every other week. You go see your PCP; follow up appointment in 4-6 weeks, at the earliest. Alright well now the question is, follow up in 3 weeks, 6 weeks, or 9.

 

[Leonthemedico]

Unfortunately part of my reason for wanting to do FM is kids and OB because...I like kids and OB. But, also for rural medicine. Not everyone who lives in a rural community is a non-pregnant adult as much as that would be an IM attending's dream.

I will answer you here, although you quoted me in the other thread. This thread is more vibrant and more active.
Come to Eurepe, I am in a 5 year Fm program in the most mountanous part of Europe you can imagine. We have lots of snow. The nearest big city is 1 hour away in any direction so you are the one that has to transfer that cardiogenic shock to the hospital while juggling adrenaline, dobutamine, O2, diuretics. We do everything from FM, urgent care, prehospital resuscitations, transfers, peds, obgyns, surgery, anything you can imagine. Sometimes you even get to rescue people with a helicopter in the mountains.
We are so rural that even anethesiologists come to work for us part time. We are so underserved that I have the feeling that our managers would literally take anyone that has a pulse.
When i started residency I imagined FM to be this ideal specialty that is family friendly where you work 40 hour weeks but I quickly upped it to 60-70 hour weeks.
Now on the downside we work for 1/3 of the salary you guys in the states have. Most of my colleagues are burned out, they really wish there were more ED specialists here that would take the EM part and leave us to do only FM.
FM and EM have one thing in common. And it is the undifferentiated difficult patient with some unspecific simptoms.
But all other diseases are night and day. Treating hypertension in the most optimal way that prolongs life expectancy in the heart failure patient is one thing but resuscitating hearth failure is something completely different. It takes a lot of learning, effort, long weeks to learn those things. Learning double the matherial is really difficult. It is impractical in my opinion unless you are in the most rural part of the world and you are paid much much more.

 

[Vivid_Quail]

Ignoring the EM part for a second, is it unrealistic to work part-time in FM? Do you actually have to worry about patients not wanting to be seen by you and no one hiring you if you only have clinic 2-3 days a week?

I go to med school in a major city. There are almost no PCPs taking new patients and there are continuous job openings for PCPs. It is hard to believe that patients and employers in rural areas would rather have an FM doctor 0 days a week instead of 2-3. Just doesn't really make sense but maybe I am too naive to understand some other detail at play here.

 

[Doc Doc Doc Goose]

Ignoring the EM part for a second, is it unrealistic to work part-time in FM? Do you actually have to worry about patients not wanting to be seen by you and no one hiring you if you only have clinic 2-3 days a week?

I go to med school in a major city. There are almost no PCPs taking new patients and there are continuous job openings for PCPs. It is hard to believe that patients and employers in rural areas would rather have an FM doctor 0 days a week instead of 2-3. Just doesn't really make sense but maybe I am too naive to understand some other detail at play here.

Amen. Preach. Encore.

 

[deleted6669]

Ignoring the EM part for a second, is it unrealistic to work part-time in FM? Do you actually have to worry about patients not wanting to be seen by you and no one hiring you if you only have clinic 2-3 days a week?

I go to med school in a major city. There are almost no PCPs taking new patients and there are continuous job openings for PCPs. It is hard to believe that patients and employers in rural areas would rather have an FM doctor 0 days a week instead of 2-3. Just doesn't really make sense but maybe I am too naive to understand some other detail at play here.

a few things. I know lots of folks who are EM/FM or EM/IM. All but two of them work full time in EM. One alternates weeks in the ED and as a hospitalist, the other covers the ED at a hospital with an unopposed FM residency and works 2 ED shifts and two clinic shifts a week.
I don't know anyone who has transitioned full time into FM. That being said, the EM/FM and EM/IM docs I know are all more comfortable with a variety of IM/PEDS/OB presentations than a typical EM physician.

 

[Vivid_Quail]

a few things. I know lots of folks who are EM/FM or EM/IM. All but two of them work full time in EM. One alternates weeks in the ED and as a hospitalist, the other covers the ED at a hospital with an unopposed FM residency and works 2 ED shifts and two clinic shifts a week.
I don't know anyone who has transitioned full time into FM. That being said, the EM/FM and EM/IM docs I know are all more comfortable with a variety of IM/PEDS/OB presentations than a typical EM physician.

This is probably the most helpful reply yet...thank you! Pretty telling that almost all of them do ED full-time. The IM/PEDS/OB part makes sense, but probably not worth the extra time spent in residency. It is not like EM residency doesn't have a lot of required peds time (unless I am mistaken about EM grads being comfortable with peds EM). I imagine the most $/hr is in EM right now, over IM and FM, I wonder if more will go into IM or FM as the EM job market continues to deteriorate.

 

[deleted6669]

Funny story- I know a guy with 5 board certifications who still works in the ED:
started FP, liked hospitalist medicine so did a second residency in IM, followed by pulmonology fellowship. Worked in the ED at a time when grandfathering was allowed and took and passed the test. Later went back and did anesthesiology. Hated surgeons. Works in the ED full time.

 

[Vivid_Quail]

Funny story- I know a guy with 5 board certifications who still works in the ED:
started FP, liked hospitalist medicine so did a second residency in IM, followed by pulmonology fellowship. Worked in the ED at a time when grandfathering was allowed and took and passed the test. Later went back and did anesthesiology. Hated surgeons. Works in the ED full time.

Damn, I wonder what is it like getting credentialed as a centenarian.

 

[deleted6669]

He actually got a lot of credit for prior work. FP took him 3 years, IM 2 more. EM was free. I think 2 each for pulmonology and anesthesiology. So pgy-9, but with a big time lapse between pulmonology and anesthesiology. I know a triple, boarded surgeon who probably spent as much time as a resident.

 

[Backpack234]

Wait...is this a thing? I thought there wasn’t enough funding for us to go back to residency. With the current EM market it might be time to reconsider

 

[DeadCactus]

Wait...is this a thing? I thought there wasn’t enough funding for us to go back to residency. With the current EM market it might be time to reconsider

The funding issue is overblown and stems from an ignorance of how residency funding works in the current era.