Length of IM Residency

[Med0123]

Intensivists do bronchoscopy at the bedside, but as a corollary, how many gastroenterologists are comfortable intubating a patient who's gotten too much sedation in the endoscopy suite?

 

I think ensuring more technical skills among generalists is key - and internists in the community need to be able to place central lines and presumably deal with their complications.

 

intensivists can perform bedside bronchoscopy because it is a mandatory part of their training

[thebouque]

What's up with intubating? Most GIMs are comfortable with the technique, unless they've spent 99% of their career in a university center where all the calls are covered by residents and the ICU is covered by designated intensivists.

[cheech10]

I know there are some GIM docs that can intubate and bronch and cover the ICU, especially in smaller centres (I'm an internist and intensivist myself at a community hospital in Toronto), but these skills are not that common among all GIM docs. It's rare for GIM-only MDs to do any bronchoscopy (especially on non-intubated patients), same with GI endoscopies. There are exceptions, I'm sure, but they're limited to smaller centres where there is no respirologist or gastroenterologist. Don't assume that the training will be readily available in GIM programs just because they're 5 years instead of 4, and the opportunity to perform these procedures in practice will likely be extremely limited.

[bloh]

Maybe it was an exception then, but at one of the big hospitals of my medical school, there were 2 GIM who scoped (GI). Where I did my rural family med rotation, one of the GIM performed brochoscopies.

 

I certainly think it's an exception and depends on a lot of factors. A newly trained GIM will not be able to squeeze their butt at the gravy table in lieu of GI/resp; there's far too many specialists as it is.