I don't understand why this is the least competitive specialty. Docs seem happy and not overly stressed, most patients like and respect them, decent lifestyle, great job market, at least 200 k/year, you can "specialize" in an area (some docs do more OB stuff, some do more procedural work, some do more peds ect). If you get stuck and don't know what to do, most of the time you can punt to a specialist. It seems like a great gig. What's the catch?
Enjoying my FM rotation. What's the catch?
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Probably better off posting in medical student forum
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deleted407021
Yeah, maybe have a mod move to MD or DO forums.
I think there are a ton of FM residency spots, as well.
I think there are a ton of FM residency spots, as well.
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"at least 200k?.." I'd like to know where you live lol. FM Physicians where I am sit at about 130.
My personal opinions:
1) My professors keep pushing me to FM because of all the great "procedures" you do. Then they go on to describe lancing, pimple draining, wart removal and whatnot. I consider this stuff I would do to myself at home. (Though I do know some FMs that do colonoscopies, US, deliveries, IUD placement, even vasectomies)
2) Graduating with nearly 200k in debt + interest and then making 130K/year doesn't sound awesome. Obviously this depends on school, and area. But for me, the math doesn't add up for where I am.
3) I get bored. I love the idea that FM has such a wide variety of things you can see and its great to be able to do some procedures, but in practice, 80%+ of the stuff I usually see walk through the door is diabetes, HTN, CV disease, Rx refill.
4) I don't like to punt.
Though to be fair, I think FM in general gets a bad name that it doesn't deserve. I think FM docs have to be great diagnosticians as you never know what will walk through your front door. I think the patient relationships are really quite solid. Some docs get to take care of all members of a family, which I guess can be fun. Nearly all of them have and pursue many interests outside of medicine and as you said, quite happy. But I'm pretty sure its not for me. However, you should NOT feel bad about enjoying FM or feel like its not a viable career choice because of money or prestige or whatever other stupid reason people don't like it. Just my 2 cents.
Thanks for your thoughts. I live in midwest suburbia. Nice place to raise a family. City size of around 100 k. My FM preceptor told me that the floor was at 180 k for an FP right now, but should be at least 200 k in 5 years. Are you in a very desirable location? 130 k is very low. As far as seeing diabetes, HTN, CV disease ect, don't specialists also see the same things over and over 80% of the time, too? A cardiologist will see lots of HF, a-fib, vascular disease; a surgeon will perform the same procedures over and over, an anesthesiologist does lots of anesthesia things, an eye doc sees lots of similar eye things. It just seems like no matter what doc you are, you will have your more mundane bread a butter conditions.
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Yes, the $$$ can vary greatly depending on where you live. @hsmooth has a very lengthy tread on being a FM. He makes in the $245 range with 8 weeks vacation...says he would make in the $300K range of he only took 4 weeks vacation. His weekly schedule is ridiculously good.
@Poit , if you haven't checked out this thread yet, you should.
I'm a Family Medicine attending in my 2nd year of practice. Ask me anything
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Midwest suburbia sounds nice. Wouldn't mind being there myself some day haha. And I could see them making more than where I am. I'm northeast suburbia metropolitan area of about 500k. I honestly haven't asked a ton about salaries but I did make a comment once that allude to FM doc having around 180 and he laughed at me and said I'm way off. Then 4 other docs in the room gave me similar ranges. So n=5, but seems legit for where I am. And as @Toutie pointed it, this is widely variable. (though I would hope they would be going up with healthcare reform. But who knows what'll happen with that)
Anyway, yes, specialists will see the same thing too you're 100% right. I guess it comes down to what you're okay doing. They tell you to pick your speciality not based on the coolest thing you see, but the bread and butter right? This is obviously personal opinion but I just hate hearing/managing/thinking about diabetes. But on the other hand, I could do screening colonoscopies all day. Are colonoscopies a glorious procedure? absolutely not. But I'd rather be sticking scopes in buttholes than writing more prescriptions for metformin. If you don't mind the bread and butter of FM, then it sounds like a good fit, and there's no hidden catch. I've actually heard people describe it as a hidden gem. I think it takes the right personality, but it really works for those who like it.
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Job market for primary care is one of the best, and I think salaries are actually around $200k for private practice on average, as primary care is one of the few fields with rising income recently.
My issue with FM is that a lot of the interesting pathology seems to get referred out to specialists, and you also lock yourself out of being a hospitalist (or are at least not as well trained as IM/peds for those jobs) or being an organ system specialist. The pace of clinic also seems to force referrals for patients with complex illnesses, especially with the increasing ownership of clinics by affiliated hospitals that encourage those referrals and want FM docs to see as high patient volume as possible. The reduced patient acuity and complexity, as well as lower earning potential, probably discourage a lot of applicants. Personally, IM fellowships seem to allow you to do a lot more for only an extra 2-3y of training.
My issue with FM is that a lot of the interesting pathology seems to get referred out to specialists, and you also lock yourself out of being a hospitalist (or are at least not as well trained as IM/peds for those jobs) or being an organ system specialist. The pace of clinic also seems to force referrals for patients with complex illnesses, especially with the increasing ownership of clinics by affiliated hospitals that encourage those referrals and want FM docs to see as high patient volume as possible. The reduced patient acuity and complexity, as well as lower earning potential, probably discourage a lot of applicants. Personally, IM fellowships seem to allow you to do a lot more for only an extra 2-3y of training.
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deleted407021
Thanks for pulling the trigger on what all of us were thinking haha
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Because I don't enjoy the work. That's the only reason. If you like it, and it makes you happy/balances the things you care about in life, then go for it.
A lot of med students hate their gen surg rotations with a passion, but I didn't let that make me quit pursuing gen surg
A lot of med students hate their gen surg rotations with a passion, but I didn't let that make me quit pursuing gen surg
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If you want to titrate bp and diabetes meds for 99% of your day be my guest.
How people do adult medicine at all vexes me
How people do adult medicine at all vexes me
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I ruled out path, rads, etc early on because of the lack of patient interaction. My FM rotation made me realize that there is such a thing as too much patient interaction.
It's entirely personality dependent, though. If you like it, go for it.
It's entirely personality dependent, though. If you like it, go for it.
What specialties offer you (personally) the best balance of patient interaction?
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Actually, if you trust the Medscape physician compensation reports, the midwest (North Central and Great Lakes regions) are regularly the highest paid areas of the country, with the coasts coming in near the bottom. I also believe that trend is true for pretty much every specialty. I'm in the midwest as well and other than my med school professors I don't know any FM docs making less than 200k (but I don't count them because academia typically doesn't pay as well). One of them in my hometown actually laughed at me when I asked why FM supposedly started at 125k and said to add about 50k to that (this was 5-6 years ago as well).
Medscape: Medscape Access
I actually found myself doing this a lot more on my IM rotation than FM. I think a solid 80% of my IM patients were 70+ year olds with either type 2 DM, HTN, or some form of heart disease who were getting their meds adjusted. Almost every acute case I saw was an elderly person with pneumonia or an exacerbation of some chronic condition like COPD. The portion of it that was on the floors was the most boring rotation of the year and epitomized exactly what I don't want to do with my career. My FM rotation did have a decent amount of med adjustments, but it was a lot more acute cases. Sick kids, sports injuries, allergies and infections, some derm, etc.
I think the big downfall of FM compared to IM is the inability to really specialize in FM. However, if we're comparing FM to general IM, I'd pick FM every time.
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I'm just a newly minted MS-4, but in my experience rads/path/anesthesia falls on one end of the spectrum while FM/psych falls on the other. Anything in between wasn't ruled out for me based on patient interaction. Some people may put any form of IM/peds on the high end as well.
The right balance will vary from person to person. If you like heavy patient interaction, then FM may be the right balance and any specialty with less patient interaction won't feel like enough. And of course there are other factors that will contribute to your specialty choice (surgical vs. non=surgical, generalized vs. specialized, etc you know the drill).
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Regarding salaries, this is not true in the majority of FM nowadays. Places are hurting for FM, especially if you're willing to not be in the middle of a city. I'm FM and I haven't met a single FM doc who makes less than $200k. I'd say typical is $200k-$250k, with the potential to be dramatically higher than that. I haven't had a single job offer that was less than $200k (with great sign on bonus, loan repayment, and only 4 days/week). Sure, some places you get paid less, but $130k is not the norm.
OP- there is no "catch". If you like the specialty, go for it! A few of the reasons I chose it: great work-life balance, lots of procedures (colonoscopies, vasectomies, c-sections), ability to do clinic/hospitalist/urgent care/ER. Again, if you like the specialty, go for it. No catch.
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200k should be the absolute floor for FM. If you're making below that it's because you live in LA, take tons of vacation, or are an academic faculty at a prestigious institution. All of these are situations that doctors choose to put themselves in and are not the norm. Everyone I know is closer to 225-300k and then there are rural ones who literally make 400k. Not to mention if you run your own practice with NPs there really isn't a financial ceiling. The job market is also phenomenal.
That being said, I'd never do FM myself and that's just personal preference, but it really isn't that bad of a gig especially considering you can relax and enjoy all four years of medical school. I have yet to talk to a FM resident or attending who doesn't love what they do.
That being said, I'd never do FM myself and that's just personal preference, but it really isn't that bad of a gig especially considering you can relax and enjoy all four years of medical school. I have yet to talk to a FM resident or attending who doesn't love what they do.
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I could see jobs that would be exclusive to family because FM doctors see kids and need to have a working knowledge of Pediatrics. They can also do deliveries and are probably better than IM doctors at female-specific disorders. IM specializes in the pathophysiology of adults so things like COPD, CHF, GI issues, etc. As an adult male, my PCP is always going to be an IM physician. If you want both, do Med/Peds which will add two years of your training and that will be the true counterpart to the FM physician. If you choose that route, make sure your plan is to be a generalist unless you want a specific niche like ID or congenital cards. GI/Cardiology/Heme-Onc disorders require vastly different training between kids and adults.
What does loan repayment typically look like for an FM doc? How many years is the contract for to have your loans repaid? This is coming from a med student that will have almost 300k in debt
Makes sense, thanks!
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Completely depends on the area/hospital/job. Anywhere from $20k to $200k towards loans. Contracts between 2-5 years.
Side note- I have $380k in loans, so I feel you
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I guess it depends on the city. I'm in the largest city in my state and I haven't heard of any FM getting lower than $180k unless they were part time. And the one I know making 180k also moonlights a significant amount-- the 180 is only from his 1 job, not sure what he makes moonlighting on top of that.
There are going to be people who make crap salaries everywhere. And people who make great salaries even in larger cities. You have to search for the right job and negotiate everything. You wouldn't believe the number of recruiters that contact me every single day about FM jobs. FM is currently in a good position.
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If you're worried about it because of my comment, I think it's easy to see my experience is an outlier. I'm not in a "big city" but also not really a rural area. Also the FMs I asked are all academic, so that'll cut down on it a bit too. Then there's always the chance I misunderstood or something. But from everyone else's posts it seems clear that 1) salary is variable and 2) it can actually be really quite good.
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As someone that went through family I can honestly say it gets a bad rap. taking care of chronic disease is extremely important in America. I've met everyone from kids to heroin addicts and suicidally depressed people to the nicest old folks you could ever meet. I loved just getting to know people and learn about the experiences of others. They are often the first to detect signs of serious disease. If you don't like people and getting to know your patients then yes you will not enjoy FM. But they play an important role in healthcare
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The academic docs most likely make up for this difference somewhat with their pension. If the difference weren't made up to some degree in someway or form, then no one would want to do academic medicine.
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It is a great gig and if I had to do it all over again, I would choose FM without hesitation.
i will disagree with you with the punting, but other than that I agree.
Lots of variety, procedures in office and hospital, and on top of my office work I have done ER shifts, hospitalist shifts, house doc coverage, urgent care shifts.
Most of the advertised salaries are only base salary. A lot of docs are paid wRVUs based and we can make over 2x those amounts if we work volume
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Honestly, I find punting to be a huge positive part. You are NOT supposed to know everything. It's important to know what you can treat and what you need to escalate. I feel good knowing that I have a network of specialties I can call/text to send patients to them so the patient can be taken care of.
You should never feel bad or call it "punting" a patient. There are sadly few doctors that refuse to punt any patient to any specialist and become a cowboy. Of course, they don't last long and get sued up the butthole and/or get patients taken away from them. They don't learn that almost all specialists do some degree of referring out/consulting. Only a fool would think otherwise.
You should never feel bad or call it "punting" a patient. There are sadly few doctors that refuse to punt any patient to any specialist and become a cowboy. Of course, they don't last long and get sued up the butthole and/or get patients taken away from them. They don't learn that almost all specialists do some degree of referring out/consulting. Only a fool would think otherwise.
