Applying FM & IM PC-track at same institution

[F1rstGen]

I'm a rising 4th year US MD student without major red flags other than low Step 1 score. I was hoping for some insight on whether it would hurt my chances of matching if I applied to FM and the primary care track IM program at the same institution?

My career goals are to serve as a PCP in a rural area (wife and myself are from very small town) but I want to leave open the option to round on patients in the hospital or do some work as a hospitalist at the beginning of my career. I believe IM programs with a primary care track and FM would both prepare me equally well. My 4th year rotations are currently geared toward IM but I would be equally happy in an FM program so my rank list will be focused more on staying local geographically than gunning for a specific program.

Thanks in advance for the help everyone.

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[Mosonik]

Particularly in rural/semi-rural medicine, there is a significant difference in the scope and practice of FM and IM despite both being primary care. There is nothing wrong with having a plan A and plan B but I would recommend you be careful to not equalize them in interviews if it comes up. If it does come up for some reason, your biggest task will be to convince an FM program you do want to see children/pregnant women too since that is a big difference for practice.

 

[IntheClouds4ever]

Particularly in rural/semi-rural medicine, there is a significant difference in the scope and practice of FM and IM despite both being primary care. There is nothing wrong with having a plan A and plan B but I would recommend you be careful to not equalize them in interviews if it comes up. If it does come up for some reason, your biggest task will be to convince an FM program you do want to see children/pregnant women too since that is a big difference for practice.

Could you elaborate on the diffference, besides Peds and pregnant women? After talkin to some FM residents, the scope of practice seems larger for FM if you are going rural/small town. I’m wanting to end up back home where FM docs are in the hospital, ER, and/or clinic and IM seemed to make the versatility more difficult since you wouldn’t have the experience for Peds and preggos.

 

[Mosonik]

Sure. Besides the scope based on age ranges and their respective conditions, I'd say the biggest difference is scope practiced (not necessarily legal scope- as I don't know what general internists can/cannot do). By this, I mean that the variety of procedures and settings in which you can leave residency trained to practice in is wider. General hospital procedures like central lines will be the same for IM/FM but I see FM docs in semi-rural and rural areas doing many more procedures in office and in hospital. The main difference I suspect is because FM programs are willing and often encourage residents to train to the limits of their scope of practice whereas IM has a culture of sub-specialization. Ex of this are various types of scopes like colonoscopy. C-sections are also a big one for rural docs. These options aren't for everyone but should you want to enter a specific area with specific skills like these, you can certainly find an FM program that will support you in this way.