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FRCPC or CCFP-EM - the eternal EM discussion

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I recall reading that family docs working in emerg aren't permitted to use the same billing/fee schedule as docs who undertook the 5 year route. Is there any truth to that? I'm assuming that the difference in schedules means the 2+1 year route amounts to lesser pay.

 

Slightly off topic, but related - same question about the 2+1 geriatrics route vs the 5 year program. Do they use different fee schedules?

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With respect to the second question, they absolutely would use different fee schedules. Geriatricians are internists and would have access to GIM fee schedules should they be doing any general medicine.

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I recall reading that family docs working in emerg aren't permitted to use the same billing/fee schedule as docs who undertook the 5 year route. Is there any truth to that? I'm assuming that the difference in schedules means the 2+1 year route amounts to lesser pay.

 

Slightly off topic' date=' but related - same question about the 2+1 geriatrics route vs the 5 year program. Do they use different fee schedules?[/quote']

 

I do believe there are differences between CCFP and FRCPC ED consult billing. However I'm not aware of the intricacies.

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I do believe there are differences between CCFP and FRCPC ED consult billing. However I'm not aware of the intricacies.

 

I was told repetitively that a different billing code between FRCP and CCFP(+/-EM) exists only in Quebec

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AFAIK in Ontario, the only difference in billing codes is that FRs can bill H055 instead of H065 ("consult in ER" ie patient sent in with a note from their regular doc).

 

The difference between the two codes is about 25 bucks.:rolleyes:

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Have there been any more differences that exist between these programs? I'm hearing a lot more students saying that most centres are being very critical about not hiring CCFP-EMs as opposed to the FRCPCs. Is that true? With family in mind (right now), I'd love an extra year to get exposed to acute care in EM for future use in rural areas or potentially developing countries. I know CCFP-EM is not internationally recognized, but it's worth having skills in remote areas if you're the only one around. 

 

Thoughts? 

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I'm still having a bit of trouble clarifying the differences between these two programs. From the blog post comments I am reading "If you just want to work in the ER a CCFP(EM) will suffice, if you want to have a serious career in academia and research then go through the FRCP." - does this hold true? I enjoy emerg but the main thing holding me back is the academic/research aspect of it. Are there any other things that set FRCP apart from CCFP-EM? I'm imagining it would be difficult to work in larger city centers such as Toronto without the FRCP, but this isn't a goal of mine. I understand with the CCFP route, there is still a risk of not getting the EM +1, but even then I seem to be reading that doctors can work in the emerg part time without the +1

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As a family doctor, you don't need the +1 to work in community emerg. The +1 is if you were looking to work in an academic/tertiary care centre. One thing to note is that you said there's a risk of not getting the +1. I'd say it's greater than just a risk. CCFP-EM is more competitive than FRCP in terms of number of applicant to number of spots.

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As a family doctor, you don't need the +1 to work in community emerg. The +1 is if you were looking to work in an academic/tertiary care centre. One thing to note is that you said there's a risk of not getting the +1. I'd say it's greater than just a risk. CCFP-EM is more competitive than FRCP in terms of number of applicant to number of spots.

 

Thanks. Does anyone have an example of which classifies as which? Is population size 100-200k too big to be a community emerg?

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Thanks. Does anyone have an example of which classifies as which? Is population size 100-200k too big to be a community emerg?

 

As examples, North York General, Toronto East General, Etobicoke General, Scarborough General are all "community" emerg departments.

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As a family doctor, you don't need the +1 to work in community emerg. The +1 is if you were looking to work in an academic/tertiary care centre. One thing to note is that you said there's a risk of not getting the +1. I'd say it's greater than just a risk. CCFP-EM is more competitive than FRCP in terms of number of applicant to number of spots.

 

That is not true anymore. Many community ERs are now requiring CCFP-EM / FRCPC training. As the job market becomes saturated in certain areas and some FRCPC choosing not to work in academic/tertiary centres, you will see more and more of them at community sites. Maybe if you want to work in a small town with just one small hospital/ER, sure you can get away with not doing additional training.

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I'm still having a bit of trouble clarifying the differences between these two programs. From the blog post comments I am reading "If you just want to work in the ER a CCFP(EM) will suffice, if you want to have a serious career in academia and research then go through the FRCP." - does this hold true? I enjoy emerg but the main thing holding me back is the academic/research aspect of it. Are there any other things that set FRCP apart from CCFP-EM? I'm imagining it would be difficult to work in larger city centers such as Toronto without the FRCP, but this isn't a goal of mine. I understand with the CCFP route, there is still a risk of not getting the EM +1, but even then I seem to be reading that doctors can work in the emerg part time without the +1

 

That is not true. There are many people who go through the FRCPC program and choose not to be involved in academia/research. There are even grads who choose to work full-time in community ERs, away from the academic/tertiary centres. There are also many people who go through the CCFP-EM route and become full-time involved in research/academia. 

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You'd probably need FRCPC to practice in the US without extra hassles and restrictions, that would be something to look into further to be sure (hence why I say probably).

 

For sure. Canadian CCFP is not recognized in the USA.

 

If the USA is an option for emerg nerds, writing the US boards and applying stateside would be a good move since their ER residency is only 3 years.

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Is it reasonable/possible to do a CCFP residency during/after FRCPC-EM? I like emerg but don't know if I can handle overnight shifts and the adrenaline rush after 65. I understand that there's a subspecialty year in year 4 of FRCPC-EM, would it be possible to work towards CCFP certification during that year? What about after FRCPC? (I would imagine that the FRCPC-EM program would cover most if not all of the year 1 rotations in various specialties). 

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You'd be insane to do it after. A 5 year residency is a huge haul and the last year is the most stressful and exhausting of your life. I can't imagine anyone going back and doing family after just finishing a 5 year royal college residency.

 

If you think you'd like to step back and do family at some point, you are probably much better off just doing CCFP-EM.

 

Also, hopefully by age 65, you've saved for retirement and you can cut back/retire if you find working ER shifts is too much to handle.

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Is it reasonable/possible to do a CCFP residency during/after FRCPC-EM? I like emerg but don't know if I can handle overnight shifts and the adrenaline rush after 65. I understand that there's a subspecialty year in year 4 of FRCPC-EM, would it be possible to work towards CCFP certification during that year? What about after FRCPC? (I would imagine that the FRCPC-EM program would cover most if not all of the year 1 rotations in various specialties). 

 

Somebody a few years ahead of me wanted to work towards a CCFP during the 4th year of her ER program.  She was shot down by one or both of the CCFP and the RCPSC.  Don't know more details than that.

 

I know a bunch of people who have transferred from some sort of Royal College speciality to family medicine.  All of them have said the CCFP would only credit them six months of their previous residency.  So you'd be looking at an additional 18 months of training after your residency.  You'd probably have to match in the second round to a rural spot in Fort Mosquito, but you could likely do it if you were motivated and interviewed well.

 

But why would you?  Doing it right after your first residency seems like an awful lot of work for little reward.   Maybe wait until you're 5 or 10 years out, then figure out where you're at in life and decide then what you want to do.

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Hi,

 

I am a Canadian who is currently a first year student in the US. I want to apply for family residency in Canada and I was also interested in doing the +1 in EM. Based off conversations with my Canadian friends who are currently in/graduated medical school as well as this forum, it seem that acquiring the +1 is difficult. I was wondering anyone had information as to if US programs also offer a plus 1 similar to that in Canada and if it would be recognized in Canada?

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2 questions,

1) Tried opening up the blog link at the beginning of this thread. Safari tells me the server no longer exists. Anyone know if this page is still floating around somewhere?

 

2) I hear a lot of talk both in the real-world and PM101 forums about larger centres not hiring CCFP-EM docs in their EDs. Anyone know if there are any OFFICIAL resources on this? Or is it something passed on through word-of-mouth or even hospital specific policy?

Thanks in advance for any answers :)

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I am a CCFP-EM working in a tertiary care hospital in BC doing full time emergency medicine. We teach medical students and residents including the occasional 5 year elective resident. I do not do any research but my center is looking to grow in that area and I totally could if I wanted. 

As for who is hiring, I finished my EM year 2 years ago. 2 of my cohort are working in large academic centers not in BC. As far as I know, the only places in Canada that restricts to hiring 5 year EM residents are VGH and maybe st. Mike’s in Toronto. Everywhere else, I have heard of CCFP-EMs being hired in the last few years. It’s all about talking to the right person at the right time. 

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