Anesthesia Residency - adding on Emergency Medicine Qualification

[Thio]

Hi everyone,

 

Just got matched to an anesthesia program! I'm terribly excited

 

I'm having to pick my electives now and I've been thinking for a while that I would like to work in the ED and as an Anesthestist in the future. I'm wondering if possible, will I be able to meet the royal college emergency medicine requirements by taking my electives in required rotations?

 

Anyone done this before or know anything 'bout it?

[A-Stark]

Probably not. There is a guy at UofA who has both certifications (but doesn't practice in EM as far as I know), but he did the EM training in the States (IIRC).

[burrb]

Meet royal college requirements by taking only electives? I don't think that's possible. You can always do two residencies....

 

If you're interested in emerg-like stuff, have you considered a fellowship in ICU after anesthesia? I think you do a 4 year core anesthesia residency and apply for ICU and do another 2 years = 6 years total training, qualifying you to do anesthesia and work in the ICU as an intensivist.

[Lactic Folly]

That's like asking whether a Royal College ER resident can become certified in anesthesiology through electives...

 

There's more to Royal College requirements than just rotations - you need an organized academic curriculum, regular feedback and evaluation to ensure you are meeting competency milestones, etc. That being said, if you transferred residencies, or did a re-entry program somehow, you'd likely be able to get credit for the overlapping rotations.

[Thio]

Thanks for the input,

 

I know GPs can do the +1 to then work in emergency departments, can an anesthetist take part in something similar ? I know its not an anesthesia fellowship like regional, O&G, ICU, chronic pain- but if +1 year of training for a GP allows them to work in emerg departments, can something like this be true likewise for anesthesia?

 

Anyone got any leads of people who would know about anything like this ?

[aaronjw]

Thanks for the input,

 

I know GPs can do the +1 to then work in emergency departments, can an anesthetist take part in something similar ? I know its not an anesthesia fellowship like regional, O&G, ICU, chronic pain- but if +1 year of training for a GP allows them to work in emerg departments, can something like this be true likewise for anesthesia?

 

Anyone got any leads of people who would know about anything like this ?

 

Except that +1 for a FP won't likely get them into a urban ER these days.

 

Also imagine (likely wrong) there is a certain amount of overlap between the two skill sets to allow a +1 whereas how much overlap of skill set is there for EM and anesthesia.

[NLengr]

Thanks for the input,

 

I know GPs can do the +1 to then work in emergency departments, can an anesthetist take part in something similar ? I know its not an anesthesia fellowship like regional, O&G, ICU, chronic pain- but if +1 year of training for a GP allows them to work in emerg departments, can something like this be true likewise for anesthesia?

 

Anyone got any leads of people who would know about anything like this ?

 

The plus one is through CCFP and builds on the family med residency. Anesthesia is through the Royal college. The two issues are the different governing body for your residency, and the lack of a family med residency (the CCFP considers EM as part of the practice realm of family medicine).

[NLengr]

Except that +1 for a FP won't likely get them into a urban ER these days.

 

Also imagine (likely wrong) there is a certain amount of overlap between the two skill sets to allow a +1 whereas how much overlap of skill set is there for EM and anesthesia.

 

From every EM (CCFP or Royal College) resident I have talked to that is untrue. From what I understand, the only areas that may be closed are major UofT or UBC academic hospitals. Most academic centre's in the country use a mix of CCFP and RC EM staff. Plus there is the option of community hospitals in any city, which CCFP EM staff work in (including Toronto and Vancouver from my understanding).

 

A classmate of mine from med school is CCFP EM and she just got a staff job at an academic teaching hospital.

 

If an EM resident or staff want to correct me, feel free.

[aaronjw]

From every EM (CCFP or Royal College) resident I have talked to that is untrue. From what I understand, the only areas that may be closed are major UofT or UBC academic hospitals. Most academic centre's in the country use a mix of CCFP and RC EM staff. Plus there is the option of community hospitals in any city, which CCFP EM staff work in (including Toronto and Vancouver from my understanding).

 

A classmate of mine from med school is CCFP EM and she just got a staff job at an academic teaching hospital.

 

If an EM resident or staff want to correct me, feel free.

 

But what's the likelihood of it actually happening these days and in the future. I had a friend who picked EM over the FP+1 option because he wants to remain mostly urban) and was told by an EM that it was unlikely he'd see much opportunity with what's currently being pumped out.

 

If what he was told is not really reflective of the truth then he's not going to be overly happy lol

 

GTA area btw.

[NLengr]

But what's the likelihood of it actually happening these days and in the future. I had a friend who picked EM over the FP+1 option because he wants to remain mostly urban) and was told by an EM that it was unlikely he'd see much opportunity with what's currently being pumped out.

 

If what he was told is not really reflective of the truth then he's not going to be overly happy lol

 

GTA area btw.

 

GTA is different than most of the country, as I stated in my last post.

 

There is still opportunity in the non UofT hospitals in the GTA for the CCFP EM's from my understanding.

[Laika]

GTA is different than most of the country, as I stated in my last post.

 

There is still opportunity in the non UofT hospitals in the GTA for the CCFP EM's from my understanding.

 

There are even opportunities at U of T hospitals in the GTA. I think most (all?) of the staff ER docs at MSH are CCFP EM.

[ploughboy]

There are even opportunities at U of T hospitals in the GTA. I think most (all?) of the staff ER docs at MSH are CCFP EM.

 

Since the Sinai is the 'home' of the CCFP-EM program at U of T, that is likely to continue for the foreseeable future.

[ploughboy]

Hi everyone,

 

Just got matched to an anesthesia program! I'm terribly excited

 

I'm having to pick my electives now and I've been thinking for a while that I would like to work in the ED and as an Anesthestist in the future. I'm wondering if possible, will I be able to meet the royal college emergency medicine requirements by taking my electives in required rotations?

 

Anyone done this before or know anything 'bout it?

 

It's not too late to switch to emerg...

 

No you won't, for the reasons that other people have listed in this thread already. Lots of overlap in the training and practice (airway, acute situations), but lots of differences that won't let you sit both exams.

 

As far as I can tell you have a coupe of options (bona fides: I did the anesthesia and emerg tours when I went through CaRMS the first time, but I haven't thought about this topic for years)

 

- do two full-out Royal College residencies: after your first one do another one. At present it would be very difficult to get into an FRCPC EM residency in the second round of CaRMS right now, but who knows how that will change in 5 years. Or maybe you could agree to take on a ROSA somewhere. Are you really willing to be a resident for 10 years? Anecdotally, the people who I know who took this route are only practicing *one* of their two base specialties anyway. It seems like a big investment on your part for potentially little return.

 

- do a CCFP residency and a plus one after your RC residency: potentially a little bit easier to re-match, since there are more family medicine spots. But it's only relatively easier, and will still be difficult to match unless you do a ROSA. Total commitment: 8 years.

 

- do a CCFP residency after your RC residency and work 400 hours per year x 4 years in a small ED, then challenge the CCFP-EM exam. Total commitment: 7 years as a resident plus 4 as a staffman. You need to be willing to work outside of the centre of the universe to do this.

 

Overall, it's probably not worth it. As somebody else mentioned, if you like acutely sick patients then a critical care fellowship might scratch that itch, though the job prospects aren't great at the moment.

 

Did I mention it's not too late to switch to emerg...

[preppy038]

to add on CCFP-EM,

 

by urban if you mean North York Gen, Markham Gen, Credit valley, most if not all ER docs there are 2+1.

 

Most 5-year guys are really academic-oriented and work in the big tertiary hospitals like St. Mikes, Sunnybrook. There's plenty of hospitals in the community that are within urban settings that are run by 2+1s.

[GrouchoMarx]

to add on CCFP-EM,

 

by urban if you mean North York Gen, Markham Gen, Credit valley, most if not all ER docs there are 2+1.

 

Most 5-year guys are really academic-oriented and work in the big tertiary hospitals like St. Mikes, Sunnybrook. There's plenty of hospitals in the community that are within urban settings that are run by 2+1s.

 

St Mike's has a lot of 2+1s.

[ploughboy]

St Mike's has a lot of 2+1s.

 

St Mike's has four CCFP-EM docs, by my count, and they've all been there for years. The last 10+ hires at Mike's have been FRCPCs.

[BoyInTheBubble]

St Mike's has four CCFP-EM docs, by my count, and they've all been there for years. The last 10+ hires at Mike's have been FRCPCs.

 

I know a 2+1 that's starting this month! (After a bit of time in the community...)

[ploughboy]

I know a 2+1 that's starting this month! (After a bit of time in the community...)

 

With a pathway to academic appointment and membership in the practice plan, or on a one-year contract to cover the shifts that they're short?

[BoyInTheBubble]

Covering shifts I think. (I didn't clarify...)

 

But its fairly reasonable to assume that he is in a better spot to get that full time job then he was previously...

[frozenarbitor]

I was at Sunnybrook ED a couple months ago doing elective. Quite a few 2+1 doctors there include junior staffs.

[ploughboy]

Covering shifts I think. (I didn't clarify...)

 

But its fairly reasonable to assume that he is in a better spot to get that full time job then he was previously...

 

He's absolutely in a better spot by getting his foot in the door, but he's probably the exception and not the rule at St Mike's these days. Good on 'im.

[ploughboy]

I was at Sunnybrook ED a couple months ago doing elective. Quite a few 2+1 doctors there include junior staffs.

 

Definitely lots of young smart 2+1s hired at Sunnybrook in the last couple of years. There's been a bit of churn there in the last few years, for a whole bunch of reasons none of which I'm gonna comment on publicly.