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FM residency- academic vs regional sites


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From my understanding academic sites are more off-service, inpatient based and therefore more intense, vs. many regional sites have integrated/longitudinal set up where you're spending more time in different FM/related practice settings (and thus fewer random inpatient rotations). The argument for going the academic route seems to be you'll see more, learn more and be better prepared for practice, especially non-clinic work. However a part of me doesn't buy it, because wouldn't I be better off setting up more time in areas that family docs actually practice in, like FM hospitalist, EM, FM-OB etc.? I'm early on in clerkship, and have a growing dislike for the academic hospital environment, especially after seeing some of the more...exploitative aspects of the training system. However if it means I'll come out a more competent doc, then I'll do it.

Looking for different perspectives. Thanks.

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25 minutes ago, Egg_McMuffin said:

From my understanding academic sites are more off-service, inpatient based and therefore more intense, vs. many regional sites have integrated/longitudinal set up where you're spending more time in different FM/related practice settings (and thus fewer random inpatient rotations). The argument for going the academic route seems to be you'll see more, learn more and be better prepared for practice, especially non-clinic work. However a part of me doesn't buy it, because wouldn't I be better off setting up more time in areas that family docs actually practice in, like FM hospitalist, EM, FM-OB etc.? I'm early on in clerkship, and have a growing dislike for the academic hospital environment, especially after seeing some of the more...exploitative aspects of the training system. However if it means I'll come out a more competent doc, then I'll do it.

Looking for different perspectives. Thanks.

I prefer the regional environment myself for exactly the reasons you describe. Although several ‘urban’ programs in the academic centres do have longitudinal elements, or have a lot of electives, which seem to be able to allow people to make up for some of those deficiencies if they want. Some urban/academic programs are also moving away from as much service for FM residents, but some are very service heavy as you say, and you are still more likely to end up at the back of the line behind a bunch of specialty residents for procedures, etc. You CAN see more volume in urban centres, but it can come with less relevant experience. One risk with regional and rural sites is that they are lower volume, but there are plenty of mid sized sites that actually have decent volume while also having fewer 5 year residents. more one on one teaching, and a more learning focus. I did most of my clerkship in community hospitals, very little in academic centres, so happy to dm more about it - it definitely influenced my fm rank list.

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Also regional there is more one vs one interaction with the staff. Most of the time, you get to tailor your learning towards what you envision your future practice to be. In academic centre, because it is very busy, you end up doing a lot of scut work. I don't mean that you don't learn anything, but different people learn differently so it really depends on how you learn. I have rotated in both sites so it just depends your learning style. Keep in mind though academic does not necessarily co-relate to more "cases" because you will sometimes end up doing the same type of cases as the unique cases sometimes go to the specialty residents.

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