Family Medicine = Rural Medicine?

[SmurfMD]

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I have been a long time reader of SDN, and in the past have only posted to sell miscellaneous items. This post, however, is different. After investigating all residency options thoroughly I have concluded I am a good fit for either FM or EM. My main fear of FM is being told I will limit myself to practicing in a rural setting because most patients prefer to see IM or Peds in large cities. How much truth is there to this statement? Having lived in large cities, I do not see myself living anywhere with a population below 500,000. Any input from people practicing in an urban setting or at the very least suburban setting would be greatly appreciated.

 

[cabinbuilder]

Your fear is pointless. Family medicine is a HOT COMMODITY these days wherever you choose to practice. Rural just pays more. There are so few the patients have difficulty finding a provider who is taking on new patients. Don't even worry about it. Just know that in general the less rural you are, the lower the base salary.

 

[MeowMix]

There is plenty of work for FM in large urban settings, but don't expect to be doing urban ER, or full-spectrum work unless you are residency faculty. You can do urgent care, outpt clinic, hospitalist, etc. The vast majority of jobs in our area this year are clinic only or hospitalist, and we are increasingly getting pushed into narrow roles.

I wish I could agree that FM is a hot commodity and people are lining up to hire me.

 

[SmurfMD]

I can see how FM physicians are being forced to choose b/t practice settings, however take into consideration that other specialties don't have choices. EM physicians work in ERs. Anethesios work in ORs. Other specialties are starting to become narrow as well such as general IM - hospitalist vs. outpatient. When I look up FM positions I tend to see openings in suburban or rural areas. I would like to work in an urban area, therefore my intention is to investigate if urban FM is plausible and hopefully not a fading trend. I have noticed what cabinbuilder mentioned, FM is highly desired in rural areas, and the pay is pretty decent. I like primary care, but cringe at the thought of IM. FM is definitely much more attractive to me b/c of the variety of patients and procedures.

 

[smq123]

I'm doing my residency at a suburban program that is about 7-10 miles away from a very large urban area (population ~ 1.5 million). Our office is always busy, and have new patients coming in all the time. The attending clinic is often booked solid for weeks in advance.

Most patients do not know the difference between IM and FM - they will go to whichever office is more convenient, with nicer staff and better parking. Many will bring their children, once they find out that you see kids in your office.

I am a PGY-3, and only looked at jobs in medium-large cities. There were definitely plenty of jobs out there. Which job search websites were you looking at?

 

[SmurfMD]

I was looking mainly at Kaiser in different states, the AAFP website and some random sites that came up during a Google search. Perhaps most of the advertised openings are HMOs and hard to fill positions due to high turnover?

 

[SmurfMD]

As a student it is probably harder to have a real grasp of the job market for FM physicians. I guess what I am looking for is reassurance that the demand for FM will remain constant, hopefully with increasing reimbursements, regardless of where one chooses to practice.

 

[smq123]

I was looking mainly at Kaiser in different states, the AAFP website and some random sites that came up during a Google search. Perhaps most of the advertised openings are HMOs and hard to fill positions due to high turnover?

Part of the problem is is that there are really a ton of places where jobs are listed. Most people seem to look at PracticeMatch, but there are other ways to find jobs (word of mouth, etc.)

Plus, as a resident, you will get a ton of job recruitment emails, calls, and pages.

As a student it is probably harder to have a real grasp of the job market for FM physicians. I guess what I am looking for is reassurance that the demand for FM will remain constant, hopefully with increasing reimbursements, regardless of where one chooses to practice.

I don't know if anyone can give you that reassurance, because no one knows what is going to happen. I can tell you that the job outlook for this year's graduating class seems to be pretty good with a lot of geographic flexibility and very reasonable starting salaries.

 

[cabinbuilder]

I was looking mainly at Kaiser in different states, the AAFP website and some random sites that came up during a Google search. Perhaps most of the advertised openings are HMOs and hard to fill positions due to high turnover?

Wow, you really are limiting yourself as to what is out there. Here are some of the placement agencies that I have looked at/used off the top of my head. There are many many more

Delta Placement
Merritthawkins
CompHealth
LocumTenens.com has temp/perm
Arthur Marshall
MartinFletcher
OnyxMD
Goldfish
Rocky Mountain Med Source

You can also apply directing through a hospital website, look at the ads in the back of medical journals, email the state medical society


Pick a few companies, look at what they have to offer in the region of the country. Inquire about a few positions and have the recruiters find you the job that you want. It is NO COST to you and they arrange everything.

You have a long way to go get. Residency should have lectures for you as to job hunting and different practice options.

 

[SmurfMD]

Again, you guys are the experts, which is why I decided to get some feedback as to how the job market for FM looks like at this point and time, particularly in the urban setting. Those sites are very helpful cabinbuilder, thanks!

 

[microscp2]

I am a second year resident, when is the best time to start looking or repply to the recruiters?

 

[ztaw15]

I did my FM rotation in a large city where super sub-specialization is the norm, and I was at a practice that was full-spectrum, and fairly profitable for the three partners. My attending did inpatient rounds in the am, clinic all day, Deliveries/sections when needed, new admissions and evening rounds after clinic, and procedures one day a week. Totally private practice, too... Not residency affiliated, but they routinely took medical students.

Of course, this was an exhausting pace. I definitely worked seven days a week, and hit 80 hrs every time - and I didn't have to take all of those calls at night.

 

[cabinbuilder]

I am a second year resident, when is the best time to start looking or repply to the recruiters?

Mid third year. It takes a while for licensing, etc. Going on interviews around the country is exhausting so try to narrow it down early. Your phone will ring off the hook. I actually had my husband field all the calls because it looks bad on rotations to be on the phone all the time. It worked out well for us that way.

 

[Prncssbuttercup]

I can't wait to be in this position... 🙂