Family vs Internal Med in NE

[makimo]

Hello Everyone !
I am a 4th yr med student who is interested in a residency in "primary care". After doing my 3rd year clerkships I moved from a view that I was definatley going to do FM to wondering if IM Primary Care is more for me. I am interested in Boston residency programs and plan to practice on the North Shore. Now I am not sure whether FM or IM Primary Care is the right choice for me. I am wondering if anyone else struggled with this or a similar uncertainty. Does anyone have any thoughts on IM vs FM in terms of residencies or private practice? Also...has anyone else applied to two or more types of residencies and if so, how did that work out (I am thinking of applying to both FM and IM residencies in the area and making a decision after the interviews). I have spent far too much time stressing about this so any ideas would really help me! Thanks :wink: , Makimo

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[makimo]

one other question....alot of administrators have "warned" me that FP docs dont get as much respect as other specialties. So far that is not what I have seen, but I am not sure if I am simply inexperienced, or if their "warning" is indeed untrue....ANy thoughts????

 

[NuMD97]

IF FP is considered the "stepchild" of the myriad specialties out there, this would be most unfortunate. I have friends doing FP and what they do is in some ways just extraordinary: having to have a broad knowledge base in not just one area of expertise but in five. That alone tells you a lot.

Frankly, from the patient's perspective, many are tired of trying to figure out just what specialty they need to go to for their immediate concerns. FP eliminates the guessing and allows the "orchestra leader" as it were to make those decisions in patient care where it belongs: in the hands of a capable physician.

Tough choice choosing between IM and FP, but it depends on what you want to do, and also where you intend to practice. Good luck.

 

[dankatzzz]

Family medicine is more broad than Internal Medicine Primary Care tract, but is less in depth. The more family medicine people I see and the rotations they do I get the feeling that the residents are always treated as second rate. For example: when they do a rotation in Internal medicine it seems like less is expected from them and obviously they do a lot less IM related rotations. When they do OB they certainly do a lot less than OB/GYN residents here. So, I don't know if it is just my school, but the impression I get is that they are "guest" residents in a lot of the rotations they do. They are only on their own turf in the clinics. I did encounter a lot of "looking down" at FP people. It seems that the more of a metropolis that you may want to practice in the more they will look for the specialist (unless you are talking about inner city), or for the internist. E.g. most women will go to an OB/GYN to deliver their babies and not FP. If you practice on the North shore, in places like Salem, Newberryport, Glouster, Rockport, etc...those areas have a population that is more likely to seek the OB/GYN for deliveries and the internist for other problems - eventhough FP may prepare you better for dealing with a clinic-based practise. BTW, have you taken your third year FP and IM rotations already? I didn't quite understand the difference until I took them. IM is a lot more academic and rigorous. I saw your post about Boston programs. I am also personally interested in any feedback that people have.
Dani

 

[gherelin]

I am just starting my internship in FP, after struggling to decide between IM, Pathology, Neurology, and FP (so you can tell I'm a bit of a nerd by that menu of possibilities!) I chose FP for the culture of FP--for me, that is what is most distinctive about it-it's hard to come up with just a few words to describe it. to me it just seemed very humane, holistic, lots of humor, supportive attitudes, less concern with issues of prestige and authority, broad perspectives on the human organism, health, medicine, life in general. there are lots of very rigorous and academic FPs out there---our program has several including an expert on ACLS and ECG Reading with a number of textbooks to his credit as just one example----just as there are some less rigorous IMs. I guess I won't know until I'm out of residency if I made the right choice, but at least so far (with just a week of orientation behind me!), I feel very good about it. Good luck and feel free to email me with any specific questions.

 

[gherelin]

p.s. perhaps more women would go to FPs to deliver their babies if they understood it as an option. I myself would prefer an FP (and an out of hospital delivery) for an uncomplicated pregnancy.

 

[NuMD97]

Originally posted by dankatzzz:

•••quote:••• The more family medicine people I see and the rotations they do I get the feeling that the residents are always treated as second rate. For example: when they do a rotation in Internal medicine it seems like less is expected from them and obviously they do a lot less IM related rotations. When they do OB they certainly do a lot less than OB/GYN residents here. So, I don't know if it is just my school, but the impression I get is that they are "guest" residents in a lot of the rotations they do. ••••One way around this problem is to seek out an unopposed residency in FP. That is to say, it is the only program at that hospital so there is no competition between the specialties as to patient assignment. Just something to consider.

 

[dankatzzz]

I agree with the previous two posts. It also looks like my post most somewhat negative. I also enjoyed my FP rotation immensly and was considering it for all the reasons mentioned. I do know some physicians who are excellent, well respected, and with many publications who are FP. So, decide with what your heart is telling you to do. FP docs are generally more laid back than IM's, so I could see residency being more humane.