Getting into Emerg CCFP programs

[Guest hizo1]

I know of a lot of people who are thinking of going this route to work emerg. I have not shown much interest in emerg until now, and I'm worried that it's too late for me to be considered for the 5-year Royal College program. I also think I'd want a general family practice in the future, though I'd focus solely on emerg during my first few years of practice.

 

How difficult is it to obtain a 3rd year CCFP emerg spot? What is the approximate applicant to position ratio, and can one apply in subsequent years if one fails to obtain admission the first year out?

 

Thanks

[Guest coastalslacker]

I planning on going the CCFP route, and am not too worried if I don't get a spot. There are lots of doctors who work in emergency rooms in smaller centres without any extra emerg training. After you've worked a requisite number of hours in the ER you can take the certification test. I've heard it takes a couple of years to get enough hours, but those are years spent drawing a full salary, not a resident's salary. Sorry I can't give you any stats.

 

I'm thinking along the same lines as you hizo, I want to just do emerg at first and then, when I either get bored or need a change go into a family practice or get into something different.

[Guest therealcrackers]

There are a number of spots in programs across the country for CCFP + 1 year programs... several of my classmates are considering these as they move through their family practice residencies. One of the docs on a Windsor rotation with me is in her 3rd year emerg... she said at the time, getting into the program was competitive, but not tremendously so.

[Guest UWOMED2005]

I was gungho 3 year emerg when I started family medicine residency. . . I'll probably still apply but I'm not as sure. . .*

 

Overall, my understanding is that most people in the family medicine programs I applied to got in. . . many didn't get their first choice, but as long as they applied to a number of programs and had good letters of reference etc, they usually got in somewhere.

 

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* Since this will probably be asked. . . why. . . I'm less interested in the 3rd year program now. . . Well, location is becoming more important to me. I'm less interested to go wherever I need to just to do the 3rd year.

 

As well, since location is important to me, I can easily forsee doing the 3 year program and then not having a job opening in emerg in the center I want. But you know what? The same issue can arise with the 5 year emerg program. Or any specialty program. . . Anyways, if I do the 3rd year emerg program, I could forsee myself then not practicing emerg anyways if there's no jobs available in my desired location.

 

As well, a large part of the reason I want to do 2+1 emerg is to combine acute care with traditional family practice. . . well, the Calgary Health region offers tons of opportunities to do that without doing a +1 year.

 

Family medicine really isn't as awful as that miserable PGY-3 surgery resident tries to convince you it is!

 

Finally, now that I am a resident and have my massive med school debt, I realize how a resident's salary just barely covers the bills! It's extremely tempting to be out after 2 years and start making headway on that debt and a mortgage. It's not a great reason not to do extra training, but the truth is that's reality!

 

Just some thoughts of mine you might find useful.

 

And I would think many family residents have similar concerns. . . leading many who were initially interested in PGY-3 Emerg to not pursue that career. . . and explain why getting in isn't as touch as you might think it would be.

[Guest Ian Wong]

Moved into the Primary Care forum out of the Med Students forum...

 

Ian

[Guest marbledust]

I think one of the great things about the third year EM program is that you don't necessarily have to do it right after finishing a family medicine residency. I know of a few family doctors in Calgary who practiced for a few years, in one case for 13 years, then decided to apply to the emergency program. It's an option that is always open--although as UWOMED2005 mentioned, you have to factor in things like location choice and salary...as well as living the life of a resident again after working as a licensed physician.

 

I think many people don't realize how flexible a career in family medicine can be. There are an amazing amount of opportunities out there that aren't common knowledge. You just gotta do a bit of research...

[Guest UWOMED2005]

Yeah. . . actually I'm DEFINITELY considering practicing for a year or two before doing the CCFP-EM program. . .

 

One thing to consider is ensuring the year you graduate is a year the center you want is hiring. . .

[Guest DrSahsi]

I did the CCFP(EM) year straight out of my CCFP, and have worked with lots of physicians with and without the (EM) designation. I think the extra year of training goes a long way to preparing one for a career in the ED. Sure, after a few years you manage to get the experiential grounding to function as a "seasoned" emergency physician no matter what, but I've found the extra year of training helps to accellerate that process. The extra year of training helps, but isn't an absolute necessity to function well in an emergency department environment. Much of that depends on the invididual physician.

 

The fact that you essentially sacrifice a good chunk of a year's salary is also an important point to consider. It wasn't as big a deal for me at the time as it might be for some (I thought getting the experience outweighed the cost). You have to decide for yourself if it's worth it.

You're still going to suffer from the jitters before each shift for the first 6 months to a year of independent practice either way.

 

The way emergency departments in this province (Ontario) are hemorrhaging physicians, I don't see any great hiring problem in the near future. I can't speak for the rest of the country, though. I know major centres in Alberta and BC, for instance, can be hard to penetrate.

 

As for competition, because there are many spots, as well as many ways to get one's CCFP(EM) certification, if it's something you really want, I'm sure you'll find way to get it. If you're not going to do a CCFP(EM) year, make sure you incorporate enough critical care, anaesthesia, etc... into your CCFP training years, so you're not hobbled when you get out there on your own.

 

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