- Joined
- Feb 28, 2006
- Messages
- 67
- Reaction score
- 0
Just curious what thing(s) made you decide to do family med instead of internal med?
zambo said:Just curious what thing(s) made you decide to do family med instead of internal med?
zambo said:How similar would you say are the types of adult cases seen by a FP in the outpatient setting compared to the cases seen by a general IM doctor also in the outpatient setting?
dr.smurf said:diversity and more office procedures!
zambo said:Since the types of adult cases are similar in FM and IM, is it mainly the OB/GYN part of FM that allows for more procedures compared to IM or something else?
dr.smurf said:diversity and more office procedures!
Tn Family MD said:I'm always surprised by how many people narrow their choice down to general surgery and FM.
On a side note, our residency does an amazing job getting us experience in office procedures. I am absolutely ecstatic with my residency choice so far.
Kimmer said:I am a 3rd year rotating in Uro and I "assisted" (uh, cut sutures) on a vasectomy on Tues and my resident said I should do them in the future b/c they are good money makers. I am all about promoting good family planning... & paying off my loans! Is it a common procedure for FPs?
Also I totally hated IM inpatient but then ended up LOVING FM inpatient on my AI....so different! I'm pretty sure I want to practice outpatient but inpatient may not end up being as bad as I originally thought after my IM rotation.
I'm bumping this thread (rather than start a new one) because I'm in the same boat at the moment.
It's the end of 3rd year, and I've spent the past few years feeling certain I wanted to pursue Heme-Onc. I scored well enough on step1 to give me a good shot at IM residencies that would make HemeOnc a realistic option. I've worked on getting LOR's, I've done electives in HemeOnc etc.
But my last IM rotation was at a hospital with an IM residency, I'm a DO student so we don't always get exposure to residents. Anyway, that rotation was pure torture. Partially because the program seems sorta malignant, but partly because I just don't think I care for inpatient medicine all that much.
I've loved my FM and outpatient IM rotations; but have a preference for FM in that regard because the patient population is a little less geriatric, and generally has a little less chronic disease (in my experience so far anyway).
I also loved my OB rotation, and would probably consider that if not for the lifestyle. I didn't mind pediatrics either.
I'm just wondering what I should do. I loved Heme Onc, and I liked the didactic portions of my 1st and 2nd years that death with hematology and oncology. But I hated IM so bad that I worry whether it will be hard to stay motivated well enough to remain competitive for HemeOnc fellowships.
In the meantime, I'm on FM right now, and I'm liking it a lot. I think I can see myself being very nearly as (if not exactly as) happy in Family Med as I would be in Oncology.
Apart from the obvious salary differences, does anyone have any insight into why someone interested in both might pick FM over HemeOnc?
With residency apps coming due I'm in a bit of a panic with respect to my plan going forward.
Thanks in advance!
For me, what I liked about Heme-Onc was a little bit of everything; the patient population was generally very pleasant and for the most part I wasn't seeing a lot of axis II stuff going on there. Similarly to OB, the patients are generally very motivated to do the treatments, and there is something about getting a life threatening diagnosis that in my opinion seems to make people re-prioritize their lives a bit. I didn't have patients getting worked up because we were running behind during clinic, people generally were quite pleasant, and I really felt like they looked up to and respected the input of the oncologist. And believe me, it's not that I need the respect; just that I thought that was one aspect of the patient population that made them enjoyable to work with.
I should also add that I am very attracted to the shortened length of training in FM vs HemeOnc, and it's training that I'm not worried about hating like I think I might for the IM portion of HemeOnc. Also, school hasn't been cheap, and I have to admit that my ability to pay off my loans is probably what makes FM tough for me to fully embrace; but I've seen reports on here where FP's are doing well financially so maybe it would be OK?
I just keep finding myself getting excited anytime a cancer patient comes through one of my other rotations, especially in IM and FM where a suspected malignancy is on the differential. I get excited not because I want the patient to have cancer, but more because I just think I find cancer and the ways it presents fascinating.
I would NOT base my decision on the length of training. I feel that people who do this are forgetting that you practice 30+ years - and the additional training only comes up to less than 10% of your future years!
Another option would be Med/Peds - you would only lose the OB aspect, plus still be able to specialize (if you want) or go immediately into an outpt/inpt practice with kids/adults
OB or women's health in general? The majority of locations you'll live in the US won't have FM trained docs doing deliveries. You'll either have to do academics or live in a very rural location.I think the OB aspect is one of the most appealing parts of Family Med for me.
OB or women's health in general? The majority of locations you'll live in the US won't have FM trained docs doing deliveries. You'll either have to do academics or live in a very rural location.
I'm just wondering what I should do. I loved Heme Onc, and I liked the didactic portions of my 1st and 2nd years that death with hematology and oncology. But I hated IM so bad that I worry whether it will be hard to stay motivated well enough to remain competitive for HemeOnc fellowships.
In the meantime, I'm on FM right now, and I'm liking it a lot. I think I can see myself being very nearly as (if not exactly as) happy in Family Med as I would be in Oncology.
Apart from the obvious salary differences, does anyone have any insight into why someone interested in both might pick FM over HemeOnc?
This is probably not true of all heme/onc fellowships or all oncologists. But that was why I don't regret not doing it. Your experience on your rotation may have been very different....
Why is the lid nailed onto a coffin? To prevent the oncologist from running one last round of chemo.I would say this is pretty common. I once read that the biggest optimist is very close to you, its your local oncologist. I suppose you need to be this way to maintain your sanity, just as some people use offensive humor to cope.
In my experience, we would often get end stage cancer patients who were treated by large cancer centers or private oncologists with "curative" treatment up until the last week of their life. I do not think specialists - and oncologists specifically, are to onboard with end of life care.
One of my FM colleagues says "If your doctor is IM-trained, you'll die with perfect labs. If your doctor is FM-trained, you'll die with grace, and dignity, and with someone holding your hand."
...my experiences with heme/onc during residency and med school just completely turned me off the field. They treated patients without a single thought to the big picture. Even during my med school rotations, I never had any idea where the goal posts were, or if there even WERE goal posts. "We're going to continue chemo"....until? Until her intestines fall out? Until her eyeballs pop? Until Armageddon? And even when I dared to ask, no one could tell me.
...This is probably not true of all heme/onc fellowships or all oncologists. But that was why I don't regret not doing it. Your experience on your rotation may have been very different....
I would say this is pretty common. I once read that the biggest optimist is very close to you, its your local oncologist. I suppose you need to be this way to maintain your sanity, just as some people use offensive humor to cope.
In my experience, we would often get end stage cancer patients who were treated by large cancer centers or private oncologists with "curative" treatment up until the last week of their life. I do not think specialists - and oncologists specifically, are to onboard with end of life care.
One of my FM colleagues says "If your doctor is IM-trained, you'll die with perfect labs. If your doctor is FM-trained, you'll die with grace, and dignity, and with someone holding your hand."
This is probably a gross over-generalization, but I think it sums up why I'd rather do FM than heme/onc. I liked that heme/onc didn't focus on any one body system (not JUST the GI tract or JUST the heart or JUST the lungs or JUST the kidneys, etc.), and if I had to pick an IM subspecialty, I'd probably have picked heme/onc or ID.
But my experiences with heme/onc during residency and med school just completely turned me off the field. They treated patients without a single thought to the big picture. Even during my med school rotations, I never had any idea where the goal posts were, or if there even WERE goal posts. "We're going to continue chemo"....until? Until her intestines fall out? Until her eyeballs pop? Until Armageddon? And even when I dared to ask, no one could tell me.
It wasn't any different when I was a resident (at a different hospital, with different oncologists who had trained elsewhere). They were scheduling patients to try new chemo regimens a week before the patient died. It was an attitude and a philosophy that I just didn't like very much.
This is probably not true of all heme/onc fellowships or all oncologists. But that was why I don't regret not doing it. Your experience on your rotation may have been very different....