Family 2+1 into EM, options if don't match

[prosoccer99]

As EM has become more competitive, more and more people are considering going into FM for the sole purpose of going into EM, via the +1 match. My question is that if someone doesn't match during this process, are they stuck practicing family medicine? I heard that you can eventually challenge the exam, but I believe you must work a minimum of 4 years to do so. Also, I heard rumblings of internships in Toronto or something, but am not sure how they work? So, for the applicant who does not really have an interest in family medicine, but wants to work in a more rural emergency room, is it possible to basically be forced to be a family doctor for at least a few years, before working EM full time?

 

What are the options for someone who is not interested in FM, does not want to do a 5yr EM residency, and does not match in the FM+1 program?

[A-Stark]

Generally speaking many rural docs do emerg shifts with varying amounts of office FM practice. But I don’t know why you’d go into an FM residency if you had no interest in FM, even with a primary emerg interest. 

[JohnGrisham]

9 hours ago, prosoccer99 said:

As EM has become more competitive, more and more people are considering going into FM for the sole purpose of going into EM, via the +1 match. My question is that if someone doesn't match during this process, are they stuck practicing family medicine? I heard that you can eventually challenge the exam, but I believe you must work a minimum of 4 years to do so. Also, I heard rumblings of internships in Toronto or something, but am not sure how they work? So, for the applicant who does not really have an interest in family medicine, but wants to work in a more rural emergency room, is it possible to basically be forced to be a family doctor for at least a few years, before working EM full time?

 

What are the options for someone who is not interested in FM, does not want to do a 5yr EM residency, and does not match in the FM+1 program?

Yes, you definitely can be "Forced to be a family doctor for at least a few years before working EM full time".   But really, no one is "Forcing" you. You mad this conscious decision. 

You can also just  choose to ONLY do ER shifts at a rural hospital. You'll take a hit financially, but if you have no interest in full-scope FM that is a plausible option.  My perception of EM has mostly been that 1/3 to 1/2 of the patient visits are just those that should have gone to a FM but didnt have access to one. So...not sure how you'll feel about that?

I hope there aren't too many people going through FM with the sole hope of +1 EM or just doing EM, as theres going to be some disappointed individuals..

[yup]

16 minutes ago, JohnGrisham said:

Yes, you definitely can be "Forced to be a family doctor for at least a few years before working EM full time".   But really, no one is "Forcing" you. You mad this conscious decision. 

You can also just  choose to ONLY do ER shifts at a rural hospital. You'll take a hit financially, but if you have no interest in full-scope FM that is a plausible option.  My perception of EM has mostly been that 1/3 to 1/2 of the patient visits are just those that should have gone to a FM but didnt have access to one. So...not sure how you'll feel about that?

I hope there aren't too many people going through FM with the sole hope of +1 EM or just doing EM, as theres going to be some disappointed individuals..

Do you mind elaborating how you take a hit financially by choosing to only do ER shifts at a rural site?  Thanks!

[JohnGrisham]

44 minutes ago, yup said:

Do you mind elaborating how you take a hit financially by choosing to only do ER shifts at a rural site?  Thanks!

You might not be able to necessarily get full-time hours at first?  Depends on where you go obviously, you may be able to get full-time rural ER work right off the bat if you find the right community.

[rmorelan]

40 minutes ago, JohnGrisham said:

You might not be able to necessarily get full-time hours at first?  Depends on where you go obviously, you may be able to get full-time rural ER work right off the bat if you find the right community.

yeah I mean there is no directly per hour penalty - but if you restrict yourself in any field of medicine in any fashion there will be a potential risk of underemployment. 

The people I know that are going to challenge the exam have ended up covering the ER at multiple sites and having strange schedules and travel. That is just the price they are will to pay to get back to emerg in the long run.