Posted by: sayamika, the killer bunny | 2008 February 17

Frustration (or, Why I didn’t interview for CaRMS)

Rural family medicine residency is a lot of things:

Ad hoc
Inconsistent
Inadequately researched
Low-volume
Full of wonderfully-intentioned people who are woefully ineffectual

Or, to put it another way:

A wonderful opportunity for self-directed learning
A flexible and varied learning experience
A great way to develop independent thinking and confidence

Am I being unfair? Almost certainly. But walk a mile in my (amniotic fluid- and blood-stained) shoes and see how fair you feel like being.

I chose a rural family medicine residency because I hoped it would be a way to learn to deal with complex and serious medical issues without necessarily the backup one would have elsewhere. I had hoped it would afford me a higher level of training due to not needing to participate in the pissing contests so common in teaching hospitals where the family medicine resident is shunted aside in favour of the specialty resident. I had hoped physicians would see that I intended to work in a setting that required me to have and use advanced skills.

Rural family medicine residents don’t have to compete with specialty residents, but they do have to contend with possessive rural family docs who intellectually understand that they need the learning experience, but in practise are not willing to step aside. They have to deal with specialists who are accustomed to working solo, in a bubble, and who may not have had any experience with residents since…. they were one themselves.

I beg for teaching and somethimes I get it.
I read everything I can get my grimy little paws on particularly when I have internet access.
I plead with the nursing staff to call me first like they do in teaching hospitals.
I am pushy even though it does not come naturally.
I hang out on the ward with the nurses even when I am not on call.

And I am still going to need to repeat this rotation if I want to feel happy about my skills in Ob/Gyn. So I can’t say I’d recommend a rural programme right now… keep me away from next year’s applicants if you want any of them to rank the programme…

Update: So, I was hanging out in the hospital since 9:30 this morning. About 1pm, I find out that there are two consults in emerg from overnight…. and what’s more, both are pissed off and have left. I found out about them because the consultant in question rocked up to check on my labouring patient and casually mentioned them.

I asked him why emerg doesn’t call me (like they do in teaching hospitals) and have me assess the patient and report in (like they do in teaching hospitals). I mention that I would be happy to get the experience (like they do in teaching hospitals). He says, what experience? You only have to get the ultrasound report and decide what to do, and he can do that in an instant, so why waste the time? I can’t even argue with that, it so misses the point (but I tried anyway).

That on top of finding out that a patient I have been following for days went for emergency section overnight and nobody called me. What do I have to do?

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Responses

  1. Sorry it sucks.. Wish you were here, with me, at the JGH… I see Ioanna once in a while too.

    Miss you, Hugs!


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