Deciding between FM & IM Question

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[MedicineZ0Z]

Varies heavily by residency. Outpatient heavy FM residencies are everywhere but usually are ones with lower quality of training. Inpatient heavy ones (which will be just average ish compared to IM residencies) provide better training overall.

Do you want to see kids? Do any sort of obgyn? If yes to either, do FM.
Do you want to do outpatient procedures? If yes, do FM. IM residencies rarely give you training in outpatient procedures.

Overall, FM is better geared than IM towards making you better at outpatient practice. The most outpatient heavy IM residencies will be the same in terms of prepping you but will very likely lack in procedural training if you're interested in that.

 

[Splenda88]

On average, you will be better with inpatient medicine if you do IM. The same is true for outpatient if you do FM.

If you want to do hospital medicine, IM will open more doors.

 

[MedicineZ0Z]

I sort of misunderstood your post and thought you wanted to do outpatient only later for sure. Anyway, to add - if you want to do both; it just depends on the other factors as well. It's not realistic to do inpt/outpt and also ob, so you can scratch that off.
But if you want to see kids and do outpatient procedures while also doing hospital medicine - FM is your pick. If you think adult only and maybe hospitalist with no clinic, IM is the easy pick.

Best to find a very strong FM residency. You'll come out very well prepared to be an excellent hospitalist and be very strong in clinic as well.

 

[Lurts]

Yeah, not sure why you think that inpatient/outpatient and OB would be a no-go. Sure, in a huge metro it’s probably a pretty tough ask to be able to do all of that, but mid-sized town and smaller I think it’s absolutely a possibility. I get ~5 job offers a day and probably half of these include all three in all parts of the country.

To the original point though, amount of outpatient experience in FM residency will vary dramatically depending on the focus of the program, but at its least would probably match the best of IM residencies in terms of time spent outpatient. If you intend to spend a large portion of your career doing outpatient primary care, I’ve never understood why someone would do IM over FM.

 

[MedicineZ0Z]

Depends where you're at and where you train. I know lots of FM folks in my area doing exactly that, including recent grads.

ETA: Though I certainly agree that there are few programs that will prepare you for this, and few job opportunities that would facilitate this. But it is possible if you know that's what you want to do and specifically look for those opportunities.

Yeah, not sure why you think that inpatient/outpatient and OB would be a no-go. Sure, in a huge metro it’s probably a pretty tough ask to be able to do all of that, but mid-sized town and smaller I think it’s absolutely a possibility. I get ~5 job offers a day and probably half of these include all three in all parts of the country.

To the original point though, amount of outpatient experience in FM residency will vary dramatically depending on the focus of the program, but at its least would probably match the best of IM residencies in terms of time spent outpatient. If you intend to spend a large portion of your career doing outpatient primary care, I’ve never understood why someone would do IM over FM.

I meant doing major inpatient coverage which ultimately takes up a lot of time and doesn't allow for doing Ob. But yeah I did rotate with a doc who did all of the above + high volume community ER and was incredibly competent at every little thing he did.

 

[SXMMD]

I have no ambitions on doing a competitive IM fellowship (cards, GI etc.). I would perhaps do something that is 1 year in length if I find that I am truly passionate about it but being a nontrad I'm ready to move on with my life. One place I talked to stated that their IM primary care track is roughly 40% outpatient based. That begs the question, what percent of a FM residency is outpatient?

Just my 2 cents, others may differ:

REALLY want to do outpatient and care for kids and preggos in addition to adults? FM

Kind of want to do the above but not sure 100%? Im/peds or fm, tailor your practice after residency

Only adults and no fellowship? Depends inpt, outpt, or both

Inpt only: IM>fm

Outpt only: FM or IM with primary care track

Adult both inpt and outpt: IM with primary care track>FM imo but FM is definitely capable. IM without primary care track ymmv

Adults only and fellowship, or unsure fellowship? Depends on the type of fellowship you're thinking about IM or FM

 

[MedicineZ0Z]

Just my 2 cents, others may differ:

REALLY want to do outpatient and care for kids and preggos in addition to adults? FM

Kind of want to do the above but not sure 100%? Im/peds or fm, tailor your practice after residency

Only adults and no fellowship? Depends inpt, outpt, or both

Inpt only: IM>fm

Outpt only: FM or IM with primary care track

Adult both inpt and outpt: IM with primary care track>FM imo but FM is definitely capable. IM without primary care track ymmv

Adults only and fellowship, or unsure fellowship? Depends on the type of fellowship you're thinking about IM or FM

IM/Peds is a big step and in some cases may be overkill for the type of practice you walk into afterwards.

 

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