frcp vs ccfp em

[cold]

I'm starting a ccfp em program in ontario next july. There's been a lot of debate on the boards about these two routes. These are my comments.

 

pros:

 

1) 3 years instead of 5

 

2) family medicine licence (enhances your scope of practice outside the ER)

 

3) 40 k for PGY4, PGY5. vs 200K for PGY4, PGY5

 

4) same hourly rate as an FRCP

 

5) Contrary to popular belief, you can get a job in an academic centre (although it does depend on regional supply and demand)

 

6) if you plan your electives properly and choose the right family medicine program your three years total in ccfp em can be extremely similar in content to the FRCP's. For example I've done 7 months of critical care/ER/anaesthesia in PGY2 family medicine. Almost as much as PGY2 FRCP's.

 

7) in the future the royal college and ccfp will probably unify both programs into a 3 or 4 year ER program, so that there is only one training path for ER. The existing CCFP EM's will be grandfathered in. So if you stick aroung long enough, you likely will have the same letters after your name as everyong else doing ER by virtue of assimilation.

 

 

 

 

Cons:

1) You will not be as good as your FRCP counterparts upon respective graduation. No question. 2 more years of extra training (some residents even do combined Critical care fellowship) really help to fill holes and deficits in your knowledge base.

 

2) as a ccfp em, you will be looked down upon by your FRCP colleagues, whether they admit it or not. It's human nature to despise someone who trained less than you but is able to work at the same job making the same money.

 

3) you will not have intubated or stabilized enough sick children. Pediatric training in CCFP em is too short.

 

4) You will not have enough trauma exposure.

 

5) fellowship opportunities will be closed to you. Crtical care, toxicology etc

 

6) your ER qualification is universally NOT recognized in other countries. CCFP EM is not an acceptable training path to allow you to write the US ABEM exam or the Australian ER boards.

 

 

This may seem harsh but it's the reality. I certainly am not trying to make myself or other ccfp em people look like dorks. However, The further into training I get the more I realize I don't know. CCFP em is probably enough to get you by, and it's a hell of a lot better than just the ER knowledge you got from your family medicine training. However, I've seen some crazy stuff role through those doors in the ER and the FRCP's are more confident handling the most critically ill. Remember you dont' get paid for the weak and dizzy's and chest pain workups. You get paid to confidently do an awake intubation on the 300 pound septic patient with concommitent addisonian crises. Those patients I often find seperate the 2+1 people from the 5 year people. Yes it's a generalization, and there are probably some bright 2+1's who can handle anything, but that is the exception.

 

 

cold hearted

[hopeful123]

Thank you very much for your perspective of the pros and cons of this specialty. I was wondering if you could just give your own personal view on whether you would change anything about the choice you have made for your specialty.

 

Thanks!

[cold]

Sure,

 

It is all personal in the end. So one has to look at their own situation, what they see themselves doing, what really makes them happy.

 

I think if I could go back I would have attempted to get into the FRCP ER program as I think, despite the extra years and the lack of pay, you're better off in the end in terms of prep.

 

I would have also considered Anaesthesia as there is a lot of crossover with ER. The pay is better and you can deal with patients sort of at a distance. Anaesthesiologists are masters of resusciatation, the airway and pharmacology. It's a very powerful specialty despite the veneer of it being solely for people who like to read the paper and do crosswords.

 

Cold

[Majestic82]

 

7) in the future the royal college and ccfp will probably unify both programs into a 3 or 4 year ER program, so that there is only one training path for ER. The existing CCFP EM's will be grandfathered in. So if you stick aroung long enough, you likely will have the same letters after your name as everyong else doing ER by virtue of assimilation.

 

cold hearted

 

Hey Cold,

 

Just out of curiousity, did you actually hear that the two programs (CCFP-EM and FRCPC-EM) will be unified in the future, or is this just your personal opinion on things?

 

Thanks,

Majestic

[Boulux]

Hey Cold,

 

Just out of curiousity, did you actually hear that the two programs (CCFP-EM and FRCPC-EM) will be unified in the future, or is this just your personal opinion on things?

 

Thanks,

Majestic

 

I would love to know as well.

[Guest FockI'mOld!]

Looks as if Cold gave us the "cold" shoulder

[Isosceles]

did you actually hear that the two programs (CCFP-EM and FRCPC-EM) will be unified in the future?

 

I don't know that there is anything official, but I have heard this as well (from an R3 CCFP-EM who talked to us).

[BlackJack]

My concern is that the transition, should it occur, would be too rapid.

 

Also, I was under the impression that the existing CCFP(EM) spots would be rounded up, refined, and released as more FRCPC(EM) spots in the R1 match.

 

For example, if a graduate goes into FM with the intention of pursuing CCFP(EM) in the future but the "grandfathering" occurs while he is in FM residency, then he will be unable to go into CCFP(EM)because it would not longer exist. That would suck majorly.

 

Thus, if this is going to occur, there should be at least a 2 year warning period such that graduating students can make their decision of what to match to in the R1 match.

[Isosceles]

if a graduate goes into FM with the intention of pursuing CCFP(EM) in the future but the "grandfathering" occurs while he is in FM residency, then he will be unable to go into CCFP(EM)because it would not longer exist. That would suck majorly.

 

Yes, but with family docs needed as badly as they are....

.... I have heard said, and rightly so, "Don't match to FM unless you would be happy practicing as a family doc."

 

The EM certification may have just that (additional certification), but it is still an R3 year, extra specialized training on top of Family Medicine, just like R3 training in obs, geriatrics, gen surg, etc.

Family Med is great in that it offers the opportunity to pursue a vast array of interests and to tailor your practice accordingly - but you are still a FP.

(And should be proud of it )

 

That said, I in no way disagree with BlackJack that a 'heads-up' for those affected by the potential change in programs would be in good taste.

[White-Tiger]

Yes, but with family docs needed as badly as they are....

.... I have heard said, and rightly so, "Don't match to FM unless you would be happy practicing as a family doc."

 

I have to disagree with that statement.

There's a LOT of family doctors out there that have never, and never will, practice family medicine in a traditional way. Many tailor their practice to a specific field, be it emergency, obs, etc...

[Isosceles]

ummmm... yeah, as per my post, I totally agree:

 

Family Med is great in that it offers the opportunity to pursue a vast array of interests and to tailor your practice accordingly

 

[White-Tiger]

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