I have been thinking about FP since i came to med school and just completed my clerkship. I am excited about FP, but i am worried that I won't be knowledgeable enough in enough areas!! I keep thinking that maybe I should focus on one thing so I can become really knowledgable in one area and focus on that. I really enjoy talking to people, love preventive medicine, and like OB, peds, and adults... so FP seems like a no-brainer, right? But I can't help but wonder, why should a child come to me when they could go to a Pediatrician who spent an entire 3 years focusing on peds? what if i miss something that a pediatrician would pick up on, simply because of lack of time and experience? I guess my question to the FP residents and docs out there, do you feel like you know enough to be competent? As a third year medical student, I feel as if i still don't know anything, and I wonder how I could ever practice a specialty like FP that covers such a wide range of diseases! thanks for your help.

I have been thinking about FP since i came to med school and just completed my clerkship. I am excited about FP, but i am worried that I won't be knowledgeable enough in enough areas!! I keep thinking that maybe I should focus on one thing so I can become really knowledgable in one area and focus on that. I really enjoy talking to people, love preventive medicine, and like OB, peds, and adults... so FP seems like a no-brainer, right? But I can't help but wonder, why should a child come to me when they could go to a Pediatrician who spent an entire 3 years focusing on peds? what if i miss something that a pediatrician would pick up on, simply because of lack of time and experience? I guess my question to the FP residents and docs out there, do you feel like you know enough to be competent? As a third year medical student, I feel as if i still don't know anything, and I wonder how I could ever practice a specialty like FP that covers such a wide range of diseases! thanks for your help.


PM me if you'd like my viewpoint. I don't feel like starting a flame war.

The very fact that you're asking these question is what would make you a good FP. Hopefully, if you choose to go into FM, your doubts would be what forces you to study hard, be attentive to your patients, do a more thorough work up, follow your patients closer.

Understand that no one knows everything. Not even specialists know everything about their specialty. But I think we all try our best.

I believe that people should do the thing that they're good at. And if you're not comfortable with uncertainty and breadth, then FM is not for you.

Oh, and to address why someone would come see you, a FP, when a specialist like Pedi or IM or Gyn is available? The answer is, because you're a better doctor.

I've had people tell me they're going to see other docs because I'm not qualified. That's ok. I'm just a FP. Just a FP intern for that. But I've also had patients who have told me that they're bringing their husband and children to come see me. That patients appreciate how I don't give them the referral run-around, when I can easily take care of their problems.

Or look at it this way, how many times in your life have you been disappointed by someone who looks good on paper, but can't step it up in real life? Remember those kids who went to state universities who are now AOA? What about those retards who went to big name schools but are failing med school miserably?

So does a Cardiologist know more about cardiology than an FP? I would hope so. But that doesn't mean that an FP does a lousy job taking care of a patient with cardiac issues. Can't say much for my other FP brethren who failed their boards and scrambled into FP. But for those of us who did well in med school and wanted to become FP's all our lives, we take our training personally and do the best we can.

I have been thinking about FP since i came to med school and just completed my clerkship. I am excited about FP, but i am worried that I won't be knowledgeable enough in enough areas!! I keep thinking that maybe I should focus on one thing so I can become really knowledgable in one area and focus on that. I really enjoy talking to people, love preventive medicine, and like OB, peds, and adults... so FP seems like a no-brainer, right? But I can't help but wonder, why should a child come to me when they could go to a Pediatrician who spent an entire 3 years focusing on peds? what if i miss something that a pediatrician would pick up on, simply because of lack of time and experience? I guess my question to the FP residents and docs out there, do you feel like you know enough to be competent? As a third year medical student, I feel as if i still don't know anything, and I wonder how I could ever practice a specialty like FP that covers such a wide range of diseases! thanks for your help.






From what i have seen, the good docs in Family medicine are really really great doctors and they give the specialty a great name. but of course there will always be people who dont try/work as hard, or never really had it in the first place, that will give fmed a bad name. as with every specialty there are good and bad docs, but you cant judge a whole specialty just by the bad docs you encounter or meet..

...Oh, and to address why someone would come see you, a FP, when a specialist like Pedi or IM or Gyn is available? The answer is, because you're a better doctor...



Oh Man. Tell me you don't really believe that.

I guess my question to the FP residents and docs out there, do you feel like you know enough to be competent? As a third year medical student, I feel as if i still don't know anything, and I wonder how I could ever practice a specialty like FP that covers such a wide range of diseases!

Yes, of course we know enough to be competent, but as in all fields, you never stop learning. You'll know a lot more in another five years, too, whatever field you go into. ;)

The leap in knowledge between years 3-4 is enormous even thuogh people consider 4th year a cakewalk...Towards the end of school is when your differentials should really start to come together and you become a very good at thinking about general medical conditions and management (hopefully b4 step 2!?) It's with that confidence that you can springboard into FP and will be just fine.

Regarding concerns about reputation and patients wanting to see specialists: the US is headed for HUGE problems in primary care. The population is getting older, chronic disease is becoming more prevalent. Experts also predict a HUGE doctor shortage, most significantly in primary care. The patients may not have a choice and trust me, you'll have no problems filling a roster 5-10 years from now....

For me, it's about management. FPs are the watchdogs--you can go to specialist after specialist, but none of them know everything about you (and the rest of your family, if you are lucky enough to have one family doc for all of you). Specialists are bound to miss something, some vital connection, because they don't have your whole story (and we know how hard it is to get a truly throrough and reliable patient history on one visit!).

I don't think any FP is arrogant or confident enough to suggest that they ARE your OBGYN, cardiologist, urologist, etc....but they can handle the most common complaints in all of these departments and they can make a sound referral when one is truly called for. They are your advocate, your homebase.

You don't need an OBGYN for well woman exams, and you don't need a vascular surgeon or cardiologist to manage your hypertension, or an endocrinologist for your diabetes. True, you can go to an NP or a PA for all of that too. The value (and an irreplaceable one for that matter) of the family physician is that they provide all of this and they can also spot serious or subtle but potentially dangerous problems before a mid-level could and give you the appropriate referral. They know the differential of that serum calcium that is creeping up, and they know when and when not to become concerned about it.

As an FP you need to be vigilant and an excellent diagnostician, and you need to be very organized and good at managing every aspect of patient care (psych, medical, social, etc.).

You don't need to cure everyone--you just need to recognize when you can handle it and when you can't. And there is a huge variation there as well--it depends on where you trained, the volume of patients and variety of pathology you learned in residency, and your current volume and expereience. Do you read? Do you go get extra training in procedures? Do you go to conferences?

I think we are seeing a lot more people choose Family who are not choosing it by default. The profession is attracting very bright people, and there are exciting things on the horizon.

Very nice post, sophiejane. :clap:

My interest in family medicine came about from my own fp. She is so much more than just a physician, and she will sit down with you for two hours if you need that attention even if she has a room full of patients she still has to see. She is her patients' biggest advocate, and she's almost always right with a dx.

I think one of the biggest selling points for me is that you get to treat the whole family. You know what's going on with each member (if they all are your patients) and this offers valuable information about their conditions that other specialists don't have. You can prevent a lot of things from becoming disasterous problems through preventative medicine, and patients truly become like family because they come to you with anything and everything.

My family doc is my hero. Just going in to see her makes me feel better, because of who she is and how she treats her patients. Even if I don't get a dx or rx, I still feel better because she just exudes positivity even though I know she has problems in her own personal life (don't we all?). She never lets it get in her way, and I hope to be just like her "when I grow up." :laugh:

I like the wide range of ages you get to treat, the huge variety of things you have to know (I get bored easily, so continuing education is great!) and I especailly like how you can live in a rural area. I am from a small town (1000 residents) and everyone knows everyone. It's a unique environment, and is very rewarding. I never want to work in a big academic hospital, community medicine is definitely for me.

Oh Man. Tell me you don't really believe that.

Personally, I don't believe it. But I think my patients do. And frankly, that's all I care about. Especially if they're paying customers who trust me to do a procedure. And don't mind waiting a little bit in the waiting room just to see me. And refuse to see other residents who have open schedules when I'm fully booked and don't mind coming back a week later when I have openings. It's one thing when Faculty say you're doing a good job, but it's another when your patients say your doing a good job. Why would they come see a FM intern when these private insurance patients could easily go down the hall to see IM, Pedi, Gyn attendings? I don't know. I do care about the things that I don't know and try to fill in the gaps. I'm sure other FM residents, attendings, and private practice docs do the same.

BTW, Panda, I'm sorry that Duke FM didn't work out for you. I've heard many things about Duke when I was applying and have read many things on this forum this year. So, best of luck with the EM match this coming week. Hopefully, it'll end your misery.

Very nice post, sophiejane. :clap:

My interest in family medicine came about from my own fp. She is so much more than just a physician, and she will sit down with you for two hours if you need that attention even if she has a room full of patients she still has to see. She is her patients' biggest advocate, and she's almost always right with a dx.

I think one of the biggest selling points for me is that you get to treat the whole family. You know what's going on with each member (if they all are your patients) and this offers valuable information about their conditions that other specialists don't have. You can prevent a lot of things from becoming disasterous problems through preventative medicine, and patients truly become like family because they come to you with anything and everything.

My family doc is my hero. Just going in to see her makes me feel better, because of who she is and how she treats her patients. Even if I don't get a dx or rx, I still feel better because she just exudes positivity even though I know she has problems in her own personal life (don't we all?). She never lets it get in her way, and I hope to be just like her "when I grow up." :laugh:

I like the wide range of ages you get to treat, the huge variety of things you have to know (I get bored easily, so continuing education is great!) and I especailly like how you can live in a rural area. I am from a small town (1000 residents) and everyone knows everyone. It's a unique environment, and is very rewarding. I never want to work in a big academic hospital, community medicine is definitely for me.

so your a mac fan too.. i like the comment about the intel chip in the mac..
i LOV my macs, .
loyal mac user/fan for many years,late 80s early 90s. probably before most of you..

Personally, I don't believe it. But I think my patients do. And frankly, that's all I care about. Especially if they're paying customers who trust me to do a procedure. And don't mind waiting a little bit in the waiting room just to see me. And refuse to see other residents who have open schedules when I'm fully booked and don't mind coming back a week later when I have openings. It's one thing when Faculty say you're doing a good job, but it's another when your patients say your doing a good job. Why would they come see a FM intern when these private insurance patients could easily go down the hall to see IM, Pedi, Gyn attendings? I don't know. I do care about the things that I don't know and try to fill in the gaps. I'm sure other FM residents, attendings, and private practice docs do the same.



Fair enough and well said.

BTW, Panda, I'm sorry that Duke FM didn't work out for you. I've heard many things about Duke when I was applying and have read many things on this forum this year. So, best of luck with the EM match this coming week. Hopefully, it'll end your misery.

When I am free and clear of the program I may post an article on my blog about my time at Duke.

although I am not an FP, many of my colleagues are. I have been in Priv Prc for almost 4 years now. Let me just say FP is a great and needed field of medicine. Many pts would rather have their FP do derm evals, Gyn evals, etx than a specialist.

FP gives you enough training to handle most of the situations you are presented with. If ever things get complicated then you refer to a specialist. that is the way the system works. Don't worry your training in fp will allow to handle 75% of everything you see by yourself. the rest you refer.

although I am not an FP

what are you?

what are you?

i'm batman :laugh:

i'm batman :laugh:

so you are not even a practicing md/do at all...just a masked crusader... :)

so you are not even a practicing md/do at all...just a masked crusader... :)


"just a masked crusader"

yes-- from a certain point of view...