This continued shrinkage in minimum standards has degraded the value of the ABFM certificate. It no longer automatically conveys hospital privileges or the right to work in the emergency department. Hospital ownership has led to an insane hyperregulation literally forbidding the office diagnostics for care of fractures and high white count cases. Many are automatically sent elsewhere to the ER. Emergency medicine continues to experience high value in the market place and in the match.
Residents in weak FM programs become self-fulfilling prophecies. They usually take the path of least resistance, and find a day job upon graduation. There are some exceptions.
Family medicine faculty in weak programs develop "preferences" which they use to avoid anything requiring night work in the hospital. All deliveries and night work are sent to those OB and ER with no additional involvement by their "family doctor". These rules will further weaken the identity of FM.
The lack of uniform training and subsequent lack of credibility internationally, was one of the reasons we developed the fellowship process for Family Medicine Obstetrics 1992-2010[Fam Med 42:7-12-716]. This eventually led to the Boards in Surgical Family Medicine Obstetrics.
Note that these boards do not include the phrase "American" Board, because some of us see this as a global health issue. Family Medicine Lite (the limited generalist) will be at a disadvantage in underserved and frontier areas. 80% of the planet is impoverished and medically underserved.
Surgical Family Medicine Obstetrics will have its board meetings Feb 24-25, so that is a conflict if the this date remains as the chosen date for the Phoenix meeting. Surgical Family Medicine Obstetrics will be having its revival tent meeting at Marina del Rey June 26-28, 20122. Yall come.
In memory and honor of Steve Jobs, Johnny Cash, and Bob Hope--our meeting theme will be jobs, cash, and hope.
Don't forget--Endocsopic Elvis meeting Nov 4-5 Memphis. Elvis will be giving out the Memphis "mileage" awards for those FP endoscopists who have performed over 5,280 feet of high grade endoscopy.
WMR
If that is true, then it sometimes seems that our organizations are our worst enemies....
And at the AAFP conference the staff manning the ABFM booth advised me that they were aware of no problems or concerns RE the maintenance of certification modules.
Sincerely,
Dan S.
Yes, the draft RRC requirements (which are on hold except for the OB ones) has a two tiered systems (basic OB – 20 deliveries vs competency – 80 deliveries). I have real heartburn with the 80 numbers as many hospitals have granted privileges at 50 deliveries, a large number of our grads with 50-80 deliveries are still out there practicing OB and were quite competent to do OB with numbers shy of 80.
I fear we are losing ground by setting the bar higher and losing programs that will be graduating “OB-competent” family docs. I have raised this number issue with Jim Martin (who is on the RRC) but they negotiated this with the OB RRC without any input from PD’s or the STFM procedures group – a grave error in my opinion.
Michael L. Tuggy, MD
Index--Residencies, Limited generalist, OB or not 2OB?
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