"Primary Care Track" v/s Categorical Internal Medicine

After graduating from Internal Medicine, some of my seniors took up jobs in office-based primary care i.e. Generalists while some others chose to become Hospitalists (dedicated to inpatient care). Generalists see patients in their office, and if the patient is sick enough they admit the patient - now depending on the health system they work in, they may or may not follow the patient once admitted. If they do not, the hospitalists take over care while admitted.

So, as you can likely already sense from the above statement, the primary care track will involve training more towards making one a generalist - more clinic (outpatient, office-based work ) and less of inpatient rotations.

- Both are 3 year residencies
- As you would expect, the Primary care track has more outpatient exposure, i.e. more elective clinic rotations
- Primary care has more exposure to outpatient Dermatology, Women's Health, ENT, Preventive care and Geriatrics (categorical IM residents do not have to deal with Dermatology, ob-Gyn)
- Doing a Primary care track residency DOES NOT MEAN that you cannot do sub-specialty fellowships, you still can and you are very much eligible! But if your mind is set on fellowship, then doing a categorical program will make more sense.
- Less subspecialty rotation months than Categorical

IMO (or In My Opnion), if you are an IMG seeking to maximize interview chances, select both primary care and categorical options when you apply to programs that have both - you can always reason that you are not yet sure what practice type suits you.

Not enough explanation for your satiety ? Lets check out some explanations from the WWW:

1.A sample tabulated difference in residency schedules for the two tracks is mentioned on this Wake Forest University residency website

2. As mentioned here

"Training in the Generalist/Primary Care Track differs primarily during elective time. PGY-1 Generalist/Primary Care Track residents have a structured elective curriculum designed to introduce them to a population level perspective of health. "

3. Or even this explanation should make it clear:

The Categorical training track emphasizes training in general internal medicine with a focus on specialty and hospital-based practice.

While,

The Primary Care track is designed for individuals seeking a career in general internal medicine in either academia or private practice. This track offers a comprehensive training experience that will prepare you to be as comfortable on a home visit as in the ICU.
Source:

Also read:

- Hospitalist salaries in USA

Search words to this article:

- What is the difference between primary care track and categorical internal medicine

- can i apply for fellowships after primary care track internal medicine residency?

Importance of "ACGME Accreditation" of Residencies & Fellowships

I have heard someone make the weirdest pronunciation of the term - "ACGME" LOL - For those who do not know, ACGME is an acronym and stands for : "Accreditation Council for Graduate Medical Education"

I have already mentioned before that the term "Graduate Medical Education" implies Residencies and Fellowships.

The ACGME is basically a private, non-profit organization that certifies the quality of residency /fellowship programs and has become a trusted word on quality for various Medical specialty boards to grant their board certification status to residents from such ACGME-approved programs.

Q. So Why is Accreditation of a Residency / Fellowship Program by ACGME important ?

1. Being trained at an ACGME accredited program is pre-requisite for getting Board Certified in that specialty - and that is true for most specialties. So if your program loses its accreditation status, you stand to be incomplete on the basic requirement for board certification.

2. Most states need a residency / fellowship done from an accredited program for issuing a state physician license

3. Later on, in the job market, you will find most job positions needing a Board Eligible and / Or Board Certified Physician in a given specialty

4. If a program loses its accreditation status, that adversely affects funding from Medicare for its residents, which puts it at a big risk of closure.

That's why, its important to know the accreditation status of a residency / fellowship program while considering admissions. Besides the accreditation status, knowing the accreditation cycle length is also important - here's why:

ACGME conducts site visits and then grants a period of Accreditation - ranging from 1 year to 5 years , after which they come back for a visit (called the accreditation cycle). Its easy to guess that the more the years of accreditation granted - the more confidence ACGME has in the programs ability to fulfill quality residency teaching. Thus, on your residency & fellowship interviews, it's not enough to merely ask "Is your Program accredited by the ACGME?" - you can appear smarter and also ask - "What is the length of the accreditation cycle granted to your program ?"

You can easily find all accreditation information about a program on the public databases at the ACGME website.

Hmmm....Recently, the Obs-Gynecology Residency program at Texas Tech University Health Sciences Center of Odessa was placed on probation - meaning ACGME has warned them will be closely monitoring their quality improvements in resident coaching. Failing to improve could result in loss of accreditation. Read the story here.
On the other hand, the Family Medicine residency program at Rapid City Regional Hospital, South Dakota won a full five years of accreditation in 2008, implying it lands on the good side of ACGME - Read Here.