Finished Internal Medicine, now do Peds or FP?

[answerman]

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I was wondering if you guys could give me some input on this
I was struggling between med/peds and family practice as an intern in internal medicine 2 yrs ago! I ended up doing just straight internal medicine because I thought med/peds (2 residencies at once) would be overwhelming and I slightly prefer medicine over peds; I decided against family practice because I wanted to keep my options open. Now I am in my final year of internal medicine residency and realize that I really miss the pediatrics alot (though I do like working with adults). I am also tired too from all the internal medicine call after 3yrs.
In my heart i always wanted to do family practice but when I think about it I realize that I don't like OB and I don't like surgery - the only thing that FP has that I like more than IM is the younger population and especially the pediatrics! In the future I see myself working with both adults and kids but certainly with many more adults than kids. So what would you guys do if u were in my situation, would you do pediatrics or FP?

 

[Homunculus]

I was wondering if you guys could give me some input on this
I was struggling between med/peds and family practice as an intern in internal medicine 2 yrs ago! I ended up doing just straight internal medicine because I thought med/peds (2 residencies at once) would be overwhelming and I slightly prefer medicine over peds; I decided against family practice because I wanted to keep my options open. Now I am in my final year of internal medicine residency and realize that I really miss the pediatrics alot (though I do like working with adults). I am also tired too from all the internal medicine call after 3yrs.
In my heart i always wanted to do family practice but when I think about it I realize that I don't like OB and I don't like surgery - the only thing that FP has that I like more than IM is the younger population and especially the pediatrics! In the future I see myself working with both adults and kids but certainly with many more adults than kids. So what would you guys do if u were in my situation, would you do pediatrics or FP?

unfortunately the call isn't much better during a peds residency 🙂 you should definitely take a hard look at what a peds resident will deal with-- NICU/PICU, complex medical kids (ie the ex 24 weekers, lol). if you like straight up outpatient (and straight up inpatient) peds i would do FP. reason being FP is very very flexible, and if you don't want to do OB or surgical procedures, you don't have to. on the flipside, if you really like adults (which boggles my mind-- how do you put up with them?? ) you will be painting youself into a corner doing a second residency in peds simply due to not being exposed to adults for 3 years. at least with FP you have a mix.

looking back, i think the flexibility of FP makes it much better than people realize. if mid-career you decide you want to switch from family based medicine to women's health, sports med, boutique med, kids, adults, etc you can simply do it.

--your friendly neighborhood PICU-ing caveman

 

[answerman]

Thanks for the input - anyone else with ideas for me?

 

[KidDr]

I was wondering if you guys could give me some input on this
I was struggling between med/peds and family practice as an intern in internal medicine 2 yrs ago! I ended up doing just straight internal medicine because I thought med/peds (2 residencies at once) would be overwhelming and I slightly prefer medicine over peds; I decided against family practice because I wanted to keep my options open. Now I am in my final year of internal medicine residency and realize that I really miss the pediatrics alot (though I do like working with adults). I am also tired too from all the internal medicine call after 3yrs.
In my heart i always wanted to do family practice but when I think about it I realize that I don't like OB and I don't like surgery - the only thing that FP has that I like more than IM is the younger population and especially the pediatrics! In the future I see myself working with both adults and kids but certainly with many more adults than kids. So what would you guys do if u were in my situation, would you do pediatrics or FP?

While I agree with what Homunculus said, just realize that you won't see tons of kids during an FP residency. I have a lot of friends doing FP residencies and they've all commented on this fact. It's not that they're not happy in FP, because for the most part they are, it's just that the majority of their time is spent seeing adult patients (both inpatient and outpatient). Most programs have one or two inpatient peds months over the course of 3 years. In their outpatient clinics they seem to see about 20% peds patients (I'm sure it varies from program to program, but this is probably about average).

While it sounds like this is what you're after, because you see yourself working with "many more adults that kids" in the future, you'll get much more in-depth training in peds by doing a peds residency. But many peds residencies are just as painful (in terms of amount of call) as some IM residencies, and I'm sure the thought of doing 3 more years of call doesn't appeal to you at all...and, I bet you could find a FP residency that would cut some time off the residency (I'd hope at least 6 months) because you've already done so much adult medicine.

I guess the bottom line is that a FP residency isn't going to give you tons of intense training in peds, and it's going to require you to get training in some areas you don't care for (surgery, OB), but it will get you to where (I think) you want to be--in a place where you at least have the option of seeing kids instead of being stuck seeing adults all day long. Good luck with this, it can't be an easy spot to be in contemplating doing a second residency.

 

[KidDr]

One more thing I forgot--you might want to think about posting this in the FP forum too to get their input.

 

[spyyder]

fellowship maybe?

 

[answerman]

Thanks! But which fellowship after doing internal medicine - other than allergy & immunology (which is nearly impossible to get into) and adolescent medicine (which still would not allow me to see <12 y.o.) could allow me to see both kids and adults?

 

[answerman]

Appreciate your replies so far! Any more suggestions would be greatly appreciated!