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Urgent Care Fellowship

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8 years 3 months ago #81283 by Zeze'sMum
Hi Ladies,
I am a PGY2 FM resident and a mom to a 16mths old. Having a baby changed everything for me including how much time I was willing to work when I finished residency.

After much research, I came across the options of Urgent Care and the lifestyle, flexibility and "Lack of burnout" is much appealing. My questions to you are

1-Anyone here work at urgent care or know someone who does? I just want more inside "behind the scenes info" on the lifestyle.

2- I am strongly considering an urgent care fellowship. Though a lot of people say I don't need it because I am FM; i think an extra yr on brushing up on procedures and acute care wont do me any harm (plus it will allow me to pop out baby #2...shh...don't tell..lol) There are only 3 places in the country but I don't know how competitive it is.

Generally any information I can get on urgent care will be much appreciated. Thanks!

I can do all things through Christ; that includes being a mom, doctor and wife!

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8 years 3 months ago #81303 by sahmd
Wow, I had not heard that there were urgent care fellowships. Maybe others can correct me if I'm wrong, but pretty much anyone can do urgent care. You don't even need to do residency first. You just need a license. It seems to me that you will be qualified to do the job after completing a FM residency. You may as well start doing the job and enjoying the benefits of the lifestyle right away.

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8 years 3 months ago #81323 by babylove
I agree don't even do the fellowship! Fm res will give you plenty of preparation!

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8 years 3 months ago #81325 by AnnaM
LOL. One of the three places you are considering is at my alma mater.

I agree that a fellowship would not be necessary if you are in family medicine.

I worked in urgent care for a year right out of residency. Having been trained in a program with good continuity, I found urgent care very frustrating. I sent people off to the hospital or referred them back to their family doc (or tried to help find them a family doc) and never heard how things went after that. I was also frustrated by the number of people with chronic issues who did not have a PCP and waited til things hit the fan before dropping in to urgent care.

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8 years 2 months ago #81375 by mumster
Hello, Zeze'sMum

I am a Diplomate of the ABFM, practiced traditional FM for many years, then, Urgent Care for twice as long. I am also a clinical instructor in one of the Urgent Care Fellowships. I have a family. I find the responses you’ve received so far to be careless and naïve.

I don’t need Urgent Care Fellowship to do urgent care since I’m an FM
Correct. And you can also do Sports Medicine, Geriatrics, Addiction Medicine, Women’s Health, be a Hospitalist, etc without undergoing a fellowship. Doing does not equate to competence. For me, competence in urgent care equates to a 3-year experience or a 1-year fellowship.

FM Residency will give you plenty of preparation
At this point in your training, can you honestly say you are comfortable in interpreting an x-ray, differentiating unstable vs. stable fractures, performing an infraorbital block to suture a lip laceration? How many occ med patients have you seen so far – and what’s a FROI? Do you know how to bill and code in urgent care? You don’t want to be the reason why your practice is going under! Would you have correctly diagnosed these real cases out of a crowd of all-stable-looking patients? 1) cc. Sinus infection – final dx: metastatic brain ca 2) cc. Groin pull after activity – final dx: ectopic pregnancy 3) atypical chest pain in a 20-something with chronic pain syndrome – final dx: NSTEMI. Can anyone pretty much do urgent care?
Before the advent of urgent care associations, many physicians like myself learned from trial and error. In other words – I didn’t “enjoy the benefits right away”. There were many sleepless nights in the 1st 3 years.

Urgent Care is frustrating; there is no continuity.
Yes, there is no continuity, that’s why it’s called urgent care. It is not everyone’s cup of tea. For others, it is their mug of champagne. Urgent Care docs take pleasure in providing instant gratification - and I don’t mean rx the demanded abx or pain pills. In addition, the urgent care is a portal for those who are in a medical limbo. We help get these patients plugged in. We are, after all, primary care docs at heart. The challenge is establishing that relationship and trust in 5 minutes – enough to convince the patient why they need to see a PCP for follow-up. The worst thing you can do is to give the impression that you’re the PCP. So, is this your tea or champagne?

Lifestyle, flexibility, lack of burnout
In any career path, you will burnout if you hate your job. Lifestyle is a perk, not the premise. Flexibility depends on your definition of the word. You know you are in an urgent care practice if: you work 12-14 hour shifts, weekends and holidays (i.e., open when the PCP’s office is closed). What's great about it is a 40-hr workweek can mean 3-4 days off per week and no beeper call. But don’t expect to be at the bus stop to meet your kindergartner when it’s your workday.

Urgent Care Fellowship will allow me to pop out baby #2
Requirement to graduate: 50-60 hours per week x 52 wks. Vacation: 3 weeks. Residency may allow you to extend your training but we can’t be as flexible. One main reason is lack of funding. It doesn’t mean you can’t have a baby while in training. But it will be tough since you still have to fulfill those required hours within said timeframe.

Competitive – yes. So far, 4 positions per year. We don’t fill the position just because we need to. The applicant’s goals must be in concert with the program’s educational mission.

Hope these are helpful.

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8 years 2 months ago #81383 by Zeze'sMum
Wow!
I want to thank you ladies for ALL the responses I got. Obviously I have a LOT to think about but Ultimately I have VERY excited about the future and the number of choices I have.

I can do all things through Christ; that includes being a mom, doctor and wife!

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