If fellowship is completed, what are your qualifications?

[Guest Gracjan]

I have a few questions about the completion of one of the several fellowships that a FP can complete (ie. EM, or anasthesia). What sort of qualification would he/she have after that fellowship and how would it affect their work? for example if one completed an anasthesia fellowship, would they be able to work the same as someone who completed the anasthesiology residency?

 

also another question, I dont want to seem like this is all i care about, but my decision is not based on this, but out of curiousity how does the financial aspect change once a fellowship is completed? I know generally FP's charge 27$ per visit (10-15min), and if they completed an anas. fellowship what could they do/charge? And this same question applies to the other fellowships that may be completed by FP's.

 

Thank you.

[Guest aneliz]

Most of the third year family programs like ER, Anaesthesia and Ob are designed for people who need additional skills to practice in communities where there aren't necessarily 'specialists' in these areas available. (ie not in academic centres)

 

I did a rural family medicine elective last summer, and there were several docs there that had done third year training.

 

Two had done Anaesthesia - and together they shared the 'anaesthesia' call schedule. This means that they did the general anaesthesia for any scheduled surgeries as well as any emergency surgeries at the hospital. (The hospital has a general surgeon that they share with two other hospitals) This involved induction of general anaesthetic, intubation and maintenanec of anaesthetic during surgery. However, neither of them would do 'complicated' cases (ie medically unstable people, very small children, difficult airways, spinal anaesthesia, epidurals, etc). These people were all referred to a larger centre where there were specialists in anaesthesia. Both also worked as GP's on the days when they were not doing anaesthesia, and having the extra training reallly didn't impact too much on their day to day office practices. Financially, they had a regular family practice, and were also able to bill the anaesthesia codes when they did anaesthesia.

 

Several others had the third year of ER. They worked 24 hour shifts covering the ER. This gave them a few extra skills and some more practice dealing with ER-related stuff than the average family doc. However, there were also several family docs that also did ER that didn't have the extra training. Again, financially, they were paid for doing the ER work on top of the their regular family practice... but they all still had a regular family practice as well.

 

The third year programs will give you some extra skills and some extra tricks beyond what most people learn and can do at the end of a family practice residency... however, one extra year does not make you equivalent in all ways to someone that did a five year specialty program in that area. You would be able to do some things (like simple general anaesthesia) but not others and you would still have cause to refer some patients to a 'specialist' in that area.

 

As well, it would be unusual for somebody with a three year qualification to be working in a tertiary care setting (with the exception of some ER people). Those with FP + anaesthesia work in the community (not always rural but not in an academic centre).