Fort Wayne Family Residency

The second week of inpatient family went great. I can't say enough great things about Dr. Connerly and the FP residency program here at Fort Wayne. I'm surprised it's not a lot more competitive than it is. Everyone talks about the Memorial program in South Bend as the big competition, but the only reason they are competitive is that they pay $11,000 a year more than Fort Wayne! And Fort Wayne pays relatively well, it's just that Memorial is the top paying FP program in the country. Oh, and you do sports medicine with the Notre Dame football team :).

Fort Wayne is better, from what I can tell, in terms of didactics, Night Float, hours for moonlighting, opportunities for moonlighting and pathology (tertiary ctr vs. community ctr). The Residents are trying to address the pay difference. And the Program will have a brand new 30,000 sf clinic open next May and a new regional hospital they will be moving into starting next year and completing in 2011. I even got on local TV this week with a few Residents, the Program director, hospital CEO and Mayor to announce the new building project at a press conference.

Speaking of pathology though, I saw the worst case of lymphedema ever here. It was elephantitis like we saw in Path class from photos taken in Third World countries. Oh, it also smelled like necrosis. We eventually got 19 liters of fluid off him so he could walk again! That's about 45 pounds off one leg! It still probably weighed 80 to 100 pounds, but he could get around with a walker when I left the service.

This is an environment where I could feel comfortable learning inpatient medicine. No comparison with the VA hospital.

Last week I was at St. Joe's hospital for OB/Gyn. It has been a great refresher. I delivered a couple babies, did lots of pelvic exams, did a couple circumcisions, got in on one C-section and rounded on lots of new moms and babies. I saw 14 year olds give birth, nuchal cords and even got to suture a very large second degree tear. We even had one nuchal cord rupture, one shoulder dystocia (with a fractured clavicle) and one muconium aspiration. As at Parkview over the past two weeks, the Residents and Attendings have been terrific. The main Attending, Dr. Pebble, is an admitted dinosaur.

Dr. Pebble is a Family physician that does general anesthesia, general surgery, Gyn surgery, OB and has his own family practice! He's like a walking legend. I bet there's less than a dozen docs like him left in the country. Heck, he even does anesthesia for friends doing heart surgery and learned laproscopic surgery on his own! Oh, did I mention he's also very cool and a great teacher?

I started getting gentle pressure to apply to the program if I decide on Family. I also attended a drug rep dinner and a welcome back party for one of the Docs returning from Iraq. It was a chance to meet many of the existing Residents and some of the new ones coming on next year. Everyone was very friendly. I also had a chance to hear more about ER work as a family doc. One of the Family Residents has an offer for $126 an hour plus benefits as a hospital employee in a small community. No call, no pager, 36 hours a week and a reasonable mix of day and night shifts. Not bad!

I'm presently studying for my second try at the surgery shelf exam. I missed passing the last one by two questions. After a conference call with the Dean, I would have passed if I hadn't changed some answers! I didn't criticize him for the poorly written questions, mostly because these results don't play into our Residency applications. It's just pass or fail. Kinda sucks anyway, because I had hoped to be studying Emergency for next week and/or Boards which will help for my last shelf exam - Family Medicine. I now have to take that after the last rotation.

In the next three months, I have two shelf exams, one standardized patient exam, third year finals and two sets of Step 2 Boards! Gotta love medical school, especially as a D.O. I had planned on just taking our required Osteopathic COMLEX Step 2 Board exam, but fourth year friends who just matched said that we need to take the Allopathic version (USMLE Step 2) if we are planning to apply for anything vaguely competitive, such as Emergency. So that's more stress, more time and another $500! This D.O. thing is sure getting expensive and time consuming. I mean I like OMM (manipulative medicine), but twice the Board tests, about twice the money (private vs. a state school) and 200+ extra lecture hours is adding up.

On the plus side, I did get to do some soft tissue techniques and HVLA on a couple of the MD Residents, which they loved. It's a handy skill for family, friends and patients but I'm not sure it's worth the cost at this point.

I forgot to mention the weather. It's been snowing the last few days! Very wet and windy. We finally got some sun this weekend. One of the Docs mentioned Fort Wayne is in a convergence zone of the Great Lake and Canadian weather patterns so it actually has fewer sunny days than Seattle! They made a new record earlier this year with 96 days of cloudy weather - yuck!

One more week in the ER. I'm sure missing the family, especially over the weekends. At the same time I'm concerned one week in the ER just isn't enough time to make a 20-year career decision. By the time I get to EM audition rotations in the Fall, changing directions will be much more difficult. I'm just going to try to make the most of next week, starting Monday at 9am...