Other ABFM, Now Want ABEM

[Itssalsatime]

hey all,

My wife has her ABFM, and is currently practicing emergency medicine at a rural stand-alone ED. She has been there for 18 months. A case came in the other day (procedural) and she did not know how to do it.

She feels extremely uncomfortable now, the place that hired her in told her she only need airway management skills (which she took CME’s for).

Now she I wanting to go to an emergency medicine residency for proper training.

My first thought was a fellowship (Knoxville or Jackson TN).
I am curious about a residency though. Would she only need 2 years? Does she have to go through the match process again or can she chose somewhere local and interview?

We have established ourselves in our area now, found a great school for our two kids and everything.

Not sure what to do.

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[Lexdiamondz]

hey all,

My wife has her ABFM, and is currently practicing emergency medicine at a rural stand-alone ED. She has been there for 18 months. A case came in the other day (procedural) and she did not know how to do it.

She feels extremely uncomfortable now, the place that hired her in told her she only need airway management skills (which she took CME’s for).

Now she I wanting to go to an emergency medicine residency for proper training.

My first thought was a fellowship (Knoxville or Jackson TN).
I am curious about a residency though. Would she only need 2 years? Does she have to go through the match process again or can she chose somewhere local and interview?

We have established ourselves in our area now, found a great school for our two kids and everything.

Not sure what to do.

I would reach out to any EM residencies affiliated with the institutions she trained at, or where she went to school for starters. She likely will have to enter the match again, but may be fortunate enough to not have to do a full three year residency depending on how much credit she gets for the rotations she did in FM - if anyone would be likely to give her some leeway in this regard it would be an EM programme affiliated with her original residency or med school. Otherwise she could consider a fellowship which, while it wouldn't give her a pathway to board certification, would give her enough continuous exposure to EM for her to feel more comfortable.

No offence, but as she is right now she's a pretty dangerous ED provider being 1.5 years out of residency with only marginal airway skills (CMEs really don't mean jack ****) and no procedural skills at a standalone ED. That is a recipe for disaster.

 

[Itssalsatime]

I would reach out to any EM residencies affiliated with the institutions she trained at, or where she went to school for starters. She likely will have to enter the match again, but may be fortunate enough to not have to do a full three year residency depending on how much credit she gets for the rotations she did in FM - if anyone would be likely to give her some leeway in this regard it would be an EM programme affiliated with her original residency or med school. Otherwise she could consider a fellowship which, while it wouldn't give her a pathway to board certification, would give her enough continuous exposure to EM for her to feel more comfortable.

No offence, but as she is right now she's a pretty dangerous ED provider being 1.5 years out of residency with only marginal airway skills (CMEs really don't mean jack ****) and no procedural skills at a standalone ED. That is a recipe for disaster.

Yeah, we know that now. It is a level 2 center. I don’t understand why they even hired her knowing all of this. Coming out of residency-we were so naïve and just took the job because it seemed so great at the time.
even the medical directors as both of the facilities are family medicine trained, and they told her she just needs airway management.

Anyways-thanks for the reply

 

[betamale]

Oh man, that's not good. The U of Tennessee fellowships look very solid; seem like they have been around awhile and are referral centers, ie, lots of procedures and are probably the gold standard as far as fellowships go. There are other well established/supported fellowships in large hospitalis like North State in California and Texas Tech in Odessa; U of Alabama Huntsville opened one also. There is another fellowship in Tupelo, MS which l heard is done at a Level I and II hospital(s) so I think she would get a lot of experience there.

The fellowship I went to made us rotate through anesthesia to learn intubation; I looks like most of the fellowship do that as well. After my fellowship, I had about 30 intubations; feel fairly confident so I feel like the EM fellowships will prepare you for intubations. I also got to do a bunch of central lines, cardioversion, critical care management during fellowship.

Listen to the airway podcasts.

The fellowships are generally ran by ABEM guys and they are generally very good at teaching the fellows and letting them(us) do all the procedures and learn them well.

Yeah, we know that now. It is a level 2 center. I don’t understand why they even hired her knowing all of this. Coming out of residency-we were so naïve and just took the job because it seemed so great at the time.
even the medical directors as both of the facilities are family medicine trained, and they told her she just needs airway management.

Anyways-thanks for the reply

hey all,

My wife has her ABFM, and is currently practicing emergency medicine at a rural stand-alone ED. She has been there for 18 months. A case came in the other day (procedural) and she did not know how to do it.

She feels extremely uncomfortable now, the place that hired her in told her she only need airway management skills (which she took CME’s for).

Now she I wanting to go to an emergency medicine residency for proper training.

My first thought was a fellowship (Knoxville or Jackson TN).
I am curious about a residency though. Would she only need 2 years? Does she have to go through the match process again or can she chose somewhere local and interview?

We have established ourselves in our area now, found a great school for our two kids and everything.

Not sure what to do.

 

[Lexdiamondz]

Oh man, that's not good. The U of Tennessee fellowships look very solid; seem like they have been around awhile and are referral centers, ie, lots of procedures and are probably the gold standard as far as fellowships go. There are other well established/supported fellowships in large hospitalis like North State in California and Texas Tech in Odessa; U of Alabama Huntsville opened one also. There is another fellowship in Tupelo, MS which l heard is done at a Level I and II hospital(s) so I think she would get a lot of experience there.

The fellowship I went to made us rotate through anesthesia to learn intubation; I looks like most of the fellowship do that as well. After my fellowship, I had about 30 intubations; feel fairly confident so I feel like the EM fellowships will prepare you for intubations. I also got to do a bunch of central lines, cardioversion, critical care management during fellowship.

Listen to the airway podcasts.

The fellowships are generally ran by ABEM guys and they are generally very good at teaching the fellows and letting them(us) do all the procedures and learn them well.

Were these all ED intubations or OR intubations?

I'd be pretty wary of any programme that only got me 30 tubes in the OR at the end of fellowship. Tubing an optimised PT vs tubing a patient who is unstable with an unclear PMHx and unknown comorbidities are very different things.

 

[Itssalsatime]

Well, this is our plan. Lowering her shifts from 14/month to 11 per month.
Working as a mid-level at a trauma 1 hospital downtown for 3 shifts per month and when procedures come in she can go watch.
She is also able to shadow any of the pediatric EM doctors or ICU doctors on her days off.
We are also signed up for two procedure CME’s.

Doing the best we can considering we are now stuck in this situation due to poor decisions we made financially (buying a house right out of residency instead of waiting)

 

[CCM-MD]

Working as a mid-level at a trauma 1 hospital downtown for 3 shifts per month and when procedures come in she can go watch.