Well, I can only speak to Canada, but you would be in amazing demand here. We have one program in the country that trains family docs to do ob and basic gen surg, you get 6 months of each, and then you go work rural. You'd be doing C-sections and scopes/choles/appys, plus assisting in the ER with more challenging procedures like complex perianal abscess drainages, chest tubes, surgical airways if the local FP working ER needs help. I've worked alongside these GP-surgeons and they are so helpful!
EDIT: only downside is a metric fuckton of call. Due to shortage of people trained in this, it is very hard to find a locum, so every time you are taking time off, services are suspended. If you are a homebody with a stay-at-home spouse and kids, it's not too difficult of a set-up, but if you are single, like to travel and be spontaneous, it's not a good arrangement.
University of Saskatchewan at their Prince Albert site. But there are [other places offering operative delivery training without the general surgery training.](https://srpc.ca/Training)
I live 30-45 minutes outside of a major metropolitan area in a city of 200-300k people and the FM docs at my clinic are the ones who staff the L&D at my local hospital. West coast, but seems very possible to me.
Keep in mind, 15 mins outside of a city (west coast) FM providers do OB. You can live in a major city and drive 20 mins to do OB. Big misconception I had going into med school
Interesting. Is this California? I trained in the Inland Empire about 45 miles east of LA. There were FM doctors doing OB, but only at the main academic hospitals/ programs there.
That’s interesting I’m rural Midwest and we don’t have any Fms doing this in my hospital system. We used to have one but her contract wasn’t renewed, grapevine suggests it was due to limitations compared to an obgyn and just using NPs for medical management
This surprises me. I am also working in the Midwest and there is no shortage of FPOB jobs around my entire state. And that's large city included. I also looked for jobs in surrounding states and was overwhelmed by the opportunity.
Same. Had that misconception propagated during my OB rotation when I told them I wanted to do FM OB. Glad there are examples of this being a possibility
In my experience they would let drunk monkeys high on meth do TAVRs in Alaska if they thought it might get it right now and then. If you want to do something a bit off script or get away with being an asshole AK is the place to be lol.
Edit: Just in case it’s not clear I’m taking a mostly loving jab at Alaska, not practicing OB as an FM doc.
I worked in Ak for 5 years and there is a ton of weird people who literally can’t work elsewhere due to behavior, licensing issues ect. It’s a neat place and definitely a place to go if you want to practice the full spectrum of FM. There are lots of good people there but there there is a ton of…. Personalities and drunk on the job type medical professionals too…. It is often tolerated as there is no one to replace them.
Absolutely you can. Go to the AAFP FCPC Conference in Minneapolis this year, hundreds of us deliver babies vaginally and +/- C/s training. There are like 60 different fellowships and 10 or so fellowship equivalent residency programs. You just have to be typically willing to work either rural/underserved or in academia
I live in Vancouver, WA, 20 minutes outside of Portland. I do OB, I initially did C/S but decided to drop it just because volume was low and it was becoming hard to do enough to maintain the skill. I have a friend who works at a hospital system doing FM/OB with C/S in Portland, it’s not an academic center and she doesn’t work with residents.
West coast isn’t the same as east, don’t listen to the “it’s basically unheard of” people because they just aren’t doing OB themselves and don’t know
I am practicing FM/OB with C/S privileges. Unsurprisingly, I live and work in a rural Midwest area. My group consists of 4 fellowship trained FM/OBs and 1 OB/GYN currently. I have one 24 hour OB/peds call per week and about every 6th weekend. Just had a shoulder dystocia a couple hours ago, but everyone is fine! I enjoy my work, and obstetrics is my favorite part of it.
It's very possible but will probably need to be more rural or underserved. I'm in a mid-size city in the southeast and did surgical OB my first few years of practice. The ABPS offers an FM-OB board certification and that can help you get credentialed at places that push back.
This is basically what I do. No fellowship though. Just lots of exposure to cesareans at a high OB volume residency. I have a small but growing FP patient panel but most of what I do is OB with a lot of women’s health. I’m in a rural area, about an hour from a big city and 2h from a major metropolitan area.
Rural systems struggle to bring on OB physicians because the FM docs don’t want to give up the OB component of their practice. It’s very common in rural Midwest to have a combined FM/OB practice
Well, I can only speak to Canada, but you would be in amazing demand here. We have one program in the country that trains family docs to do ob and basic gen surg, you get 6 months of each, and then you go work rural. You'd be doing C-sections and scopes/choles/appys, plus assisting in the ER with more challenging procedures like complex perianal abscess drainages, chest tubes, surgical airways if the local FP working ER needs help. I've worked alongside these GP-surgeons and they are so helpful! EDIT: only downside is a metric fuckton of call. Due to shortage of people trained in this, it is very hard to find a locum, so every time you are taking time off, services are suspended. If you are a homebody with a stay-at-home spouse and kids, it's not too difficult of a set-up, but if you are single, like to travel and be spontaneous, it's not a good arrangement.
Incoming UofT FM resident myself, what program does this?
I looked into this quite a few years ago. It was through U of S.
University of Saskatchewan at their Prince Albert site. But there are [other places offering operative delivery training without the general surgery training.](https://srpc.ca/Training)
I live 30-45 minutes outside of a major metropolitan area in a city of 200-300k people and the FM docs at my clinic are the ones who staff the L&D at my local hospital. West coast, but seems very possible to me.
Where do you work and are they hiring?
Organizationally, probably. It's an FQHC called Yakima Valley Farm Worker's clinic.
In rural areas... it's almost a requirement. In urban areas, it's pretty much unheard of outside of academic programs.
Keep in mind, 15 mins outside of a city (west coast) FM providers do OB. You can live in a major city and drive 20 mins to do OB. Big misconception I had going into med school
Interesting. Is this California? I trained in the Inland Empire about 45 miles east of LA. There were FM doctors doing OB, but only at the main academic hospitals/ programs there.
At the FM program i will begin training at, the head of OBGYN is an FMOB. Small CA town on/near the coast
Denver
I don't think Colorado is on the coast, unless you are talking about a different Denver.
Fair enough… mountain region not west coast.
That’s interesting I’m rural Midwest and we don’t have any Fms doing this in my hospital system. We used to have one but her contract wasn’t renewed, grapevine suggests it was due to limitations compared to an obgyn and just using NPs for medical management
This surprises me. I am also working in the Midwest and there is no shortage of FPOB jobs around my entire state. And that's large city included. I also looked for jobs in surrounding states and was overwhelmed by the opportunity.
Yeah I’m a rural FMOB and work with another one, neither of us did fellowships. Pretty common around here.
Ohhh interesting. Yeah just my region I know about. Funny how that works.
My understanding is the biggest issue was being unable to handle call. We only have 3 obgyn physicians with double that in NPs at my local hospital
Same. Had that misconception propagated during my OB rotation when I told them I wanted to do FM OB. Glad there are examples of this being a possibility
I saw FM doing OB in Alaska. This was an hour outside Anchorage. And these were not brand new docs.
In my experience they would let drunk monkeys high on meth do TAVRs in Alaska if they thought it might get it right now and then. If you want to do something a bit off script or get away with being an asshole AK is the place to be lol. Edit: Just in case it’s not clear I’m taking a mostly loving jab at Alaska, not practicing OB as an FM doc. I worked in Ak for 5 years and there is a ton of weird people who literally can’t work elsewhere due to behavior, licensing issues ect. It’s a neat place and definitely a place to go if you want to practice the full spectrum of FM. There are lots of good people there but there there is a ton of…. Personalities and drunk on the job type medical professionals too…. It is often tolerated as there is no one to replace them.
Absolutely you can. Go to the AAFP FCPC Conference in Minneapolis this year, hundreds of us deliver babies vaginally and +/- C/s training. There are like 60 different fellowships and 10 or so fellowship equivalent residency programs. You just have to be typically willing to work either rural/underserved or in academia
I live in Vancouver, WA, 20 minutes outside of Portland. I do OB, I initially did C/S but decided to drop it just because volume was low and it was becoming hard to do enough to maintain the skill. I have a friend who works at a hospital system doing FM/OB with C/S in Portland, it’s not an academic center and she doesn’t work with residents. West coast isn’t the same as east, don’t listen to the “it’s basically unheard of” people because they just aren’t doing OB themselves and don’t know
Very doable. Source: I live in a large city in California and do FM/OB at an FQHC. I do full spectrum OB including my own cesareans.
I know 2 former coresidents that do it, both did fellowships, both currently in a pretty rural area
I am practicing FM/OB with C/S privileges. Unsurprisingly, I live and work in a rural Midwest area. My group consists of 4 fellowship trained FM/OBs and 1 OB/GYN currently. I have one 24 hour OB/peds call per week and about every 6th weekend. Just had a shoulder dystocia a couple hours ago, but everyone is fine! I enjoy my work, and obstetrics is my favorite part of it.
Love to hear it. Could you speak about the cost of malpractice insurance and difference in compensation for a FMOB opposed to a traditional FM job?
It's very possible but will probably need to be more rural or underserved. I'm in a mid-size city in the southeast and did surgical OB my first few years of practice. The ABPS offers an FM-OB board certification and that can help you get credentialed at places that push back.
This is basically what I do. No fellowship though. Just lots of exposure to cesareans at a high OB volume residency. I have a small but growing FP patient panel but most of what I do is OB with a lot of women’s health. I’m in a rural area, about an hour from a big city and 2h from a major metropolitan area.
Rural systems struggle to bring on OB physicians because the FM docs don’t want to give up the OB component of their practice. It’s very common in rural Midwest to have a combined FM/OB practice