Ideal FM program for an EM +1

[Moonlight2]

Hi everyone. My apologies if this has been discussed before, but I'm really interested to know which Family Medicine programs would be ideal for someone who aims to apply for a plus one in emergency eventually, especially in Ontario. I've heard that the ideal family program for this purpose would be very flexible, with plenty of elective time to let you do as much emerge as you possibly can (or even more!) during the first year.

Thanks.

[MDwannabe02]

I don’t know if there are any ideal programs specifically for this purpose, but I can speak in generalities and from experience (also Ontario). 
 

Rural programs will likely give you the best experience in acute care. You can pick up more ER shifts during FM blocks, which is tough to do in urban programs if you’re in FM. 
 

That being said, you still have to play the CaRMS game. This comes down to a lot of schmoozing. Your best bet is at your home school, so try to present yourself as well as possible to the staff, PD, APD, etc there. Elective time is helpful too, but you won’t get a ton pre-CaRMS likely, so that’s a bit of a gamble. 
 

I did rural FM with all my off-service at the urban centre at my home school I wanted to (and ultimately did) match too. For what it’s worth though, I think it’s a relatively less competitive site (everywhere is competitive though). I did electives in one other in-province school and one OOP school. I applied to every single English speaking PGY3 FM/EM program in Canada and only received an interview at my home school. Thankfully, it was all I needed. Take from this what you will

[zxcccxz]

I can wholeheartedly endorse doing any rural program. Simply put, the biggest advantage is that when you're on your family medicine blocks (anywhere from 10-12months of your 2 year residency), you aren't limited to doing clinic - you can do emerg shifts, GP-A, surgical assist, etc.

There's also a certain degree of flexibility that comes from being the only learner or one of the only learners at a site. Your rotations aren't going to be service-based because preceptors usually don't have residents/med students working with them, so not only will call probably be lighter than big academic sites, but for example, you can say you want to go do psych emerge on a given day because they don't rely on you to do the rounding or see the clinic patients.

Rural training also has a bigger focus on acute care, so by design the program is already going to have more block time in areas such as ER/anaesthesia. A lot of urban programs are also shifting towards making ICU a selective or completely removing it from their mandatory rotations, which is not the case for rural. On average, because a lot of training is longitudinal, there is more elective time set aside in rural programs too, which you can spend doing visiting electives.

As a rural resident you're going to be funded for a number of acute care courses that your urban colleagues will not. In urban FM programs you'll get the standard BLS, ACLS, ATLS, and maybe PALS. Certain programs may also have additional courses (e.g., NRP, ACORN). But you're not gonna get CASTED or POCUS independent partitioner certification (normally $5000 out of pocket!!) like in some rural programs, which is super helpful for emerge.

Anecdotally, rural residents have better match rates into CCFP-EM.

There's also a lot of perks to rural programs (e.g., you get $20,000 student loan forgiveness in your first two years of residency from the Canadian government). 

I'm only familiar with rural programs in Western Canada, but among them, these ones have a reputation for being strong for EM (not an exhaustive list): UBC-Prince George, UBC-Nanaimo, UofC-Lethbridge, UofC-Medicine Hat, UofA-Red Deer, UofA-Grand Prairie, USask-North Battleford, UManitoba-Brandon, UManitoba-Steinbach.

Happy to chat more if you have questions.

[frenchpress]

8 hours ago, zxcccxz said:

I can wholeheartedly endorse doing any rural program. Simply put, the biggest advantage is that when you're on your family medicine blocks (anywhere from 10-12months of your 2 year residency), you aren't limited to doing clinic - you can do emerg shifts, GP-A, surgical assist, etc.

There's also a certain degree of flexibility that comes from being the only learner or one of the only learners at a site. Your rotations aren't going to be service-based because preceptors usually don't have residents/med students working with them, so not only will call probably be lighter than big academic sites, but for example, you can say you want to go do psych emerge on a given day because they don't rely on you to do the rounding or see the clinic patients.

Rural training also has a bigger focus on acute care, so by design the program is already going to have more block time in areas such as ER/anaesthesia. A lot of urban programs are also shifting towards making ICU a selective or completely removing it from their mandatory rotations, which is not the case for rural. On average, because a lot of training is longitudinal, there is more elective time set aside in rural programs too, which you can spend doing visiting electives.

As a rural resident you're going to be funded for a number of acute care courses that your urban colleagues will not. In urban FM programs you'll get the standard BLS, ACLS, ATLS, and maybe PALS. Certain programs may also have additional courses (e.g., NRP, ACORN). But you're not gonna get CASTED or POCUS independent partitioner certification (normally $5000 out of pocket!!) like in some rural programs, which is super helpful for emerge.

Anecdotally, rural residents have better match rates into CCFP-EM.

There's also a lot of perks to rural programs (e.g., you get $20,000 student loan forgiveness in your first two years of residency from the Canadian government). 

I'm only familiar with rural programs in Western Canada, but among them, these ones have a reputation for being strong for EM (not an exhaustive list): UBC-Prince George, UBC-Nanaimo, UofC-Lethbridge, UofC-Medicine Hat, UofA-Red Deer, UofA-Grand Prairie, USask-North Battleford, UManitoba-Brandon, UManitoba-Steinbach.

Happy to chat more if you have questions.

I don’t disagree with any of this, except that Nanaimo is definitely not a rural program. And in terms of acuity, they don’t even do overnight call. Residents get some great training there, but I would not consider it equivalent to a rural program. But in Nanaimo and many of the other urban and mid-sized UBC programs you can potentially do more months of rural rotations. 

In terms of UBC programs, chilliwack has been historically also been quite popular for emerg gunners due to the longitudinal emerg and hospitalist shifts 

[zxcccxz]

7 hours ago, frenchpress said:

I don’t disagree with any of this, except that Nanaimo is definitely not a rural program. And in terms of acuity, they don’t even do overnight call. Residents get some great training there, but I would not consider it equivalent to a rural program. But in Nanaimo and many of the other urban and mid-sized UBC programs you can potentially do more months of rural rotations. 

In terms of UBC programs, chilliwack has been historically also been quite popular for emerg gunners due to the longitudinal emerg and hospitalist shifts 

Oh looks like you’re absolutely right - thanks for chipping in. Should’ve added that other than the UofC programs, I don’t actually have personal experience with any of the others & it’s just based on what I’ve heard (to be taken with a grain of salt)

[Atlas1372]

Anyone has any information about the Ontario programs?