Atlas Shrugged

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I'm halfway through my core rotations at USUHS (have yet to do OB/GYN and surgery) and ended up liking family medicine a lot more than I thought I would. I'm not a huge fan of inpatient, but I think it will be a necessary evil to keep skills sharp throughout my career should I choose FM. I've asked a few attendings what their billets/options are like and usually get weird looks. They told me an email is sent out for your specialty and assignments that are available that year, then some sort of black magic happens and people end up assigned a billet.

I know in the army you will mostly do what you are told and go where your orders take you. But is there any way of knowing what the breakdown or ratio of clinic/inpatient/other duties will be? I don't think I would be happy with 50/50 inpatient and clinic and it would alter my decision in choosing to become a family physician.

I realize that this is a very broad question and the answer will be "it depends", but I am curious to hear about your experiences.
 

DrMetal

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I've asked a few attendings what their billets/options are like and usually get weird looks. .
That's because you're asking the wrong question. You Should be asking more about the specialty as a practice in medicine, not billet assignments.


But is there any way of knowing what the breakdown or ratio of clinic/inpatient/other duties will be? I don't think I would be happy with 50/50 inpatient and clinic and it would alter my decision in choosing to become a family physician.
Well look, if you're a family physician you might someday be associated with a small community Hospital, for which you might be expected to cross cover(especially true in the military). If you really have that much of an aversion against inpatient medicine, then don't do it.
 
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Atlas Shrugged

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I guess I should step back and re-word the question. I am pretty interested in family medicine as a specialty, mostly clinic and procedures. I accept that there will be quite a bit of inpatient. I do not know if I am interested in family medicine in the army. The army dictates what I am going to be doing, and I already know that a battalion/brigade surgeon tour is a probability. If that's coupled with predominantly inpatient work then I am a lot less interested in this specialty.
 

WernickeDO

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I guess I should step back and re-word the question. I am pretty interested in family medicine as a specialty, mostly clinic and procedures. I accept that there will be quite a bit of inpatient. I do not know if I am interested in family medicine in the army. The army dictates what I am going to be doing, and I already know that a battalion/brigade surgeon tour is a probability. If that's coupled with predominantly inpatient work then I am a lot less interested in this specialty.
If you do FM in the military then I don't think you will find yourself doing much inpatient work. On the outside, you can align yourself with a group that does outpatient only. Accept that during residency you will do inpatient rotations...I don't know of any clinical specialties that don't. Yes the Army dictates what you do but that's par for the course.
 

jabreal00

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You won't be doing much if any inpatient for FM billets. There are some MTFs where you may do a week here or there to help cover the hospitalist or inpatient service. However, most billets in the Army for inpatient is close t0 100% outpatient.
 

DrMetal

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I guess I should step back and re-word the question. I am pretty interested in family medicine as a specialty, mostly clinic and procedures. I accept that there will be quite a bit of inpatient. I do not know if I am interested in family medicine in the army. The army dictates what I am going to be doing, and I already know that a battalion/brigade surgeon tour is a probability. If that's coupled with predominantly inpatient work then I am a lot less interested in this specialty.
I'll give you my quick perspective on FM, that I had when I was in your shoes as a student, and still have today: FM is too broad. It's Peds/Obgyn/Adult/Geriatric medicine, with inpatient/outpatient and procedures......It's too much in my opinion. You become a jack of all trades, master of none...it can be dangerous b/c you can miss something. There's a reason why we like to compartmentalize the universe of medicine, with specialty being its own planet. The guy who takes care of a complicated displaced distal radius fracture is not the same guy tooks care a bad CHFer.

I think most FPs know this, so they end up concentrating in one thing or the other, at least in the civilian world.

In the military, as you've already recognized, you can't always chose to concentrate. A FP can be made to all of these things. And so you're somewhat obligated to keep you 'foot in the door' with respect to all of these specialties.
 

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I guess I should step back and re-word the question. I am pretty interested in family medicine as a specialty, mostly clinic and procedures. I accept that there will be quite a bit of inpatient. I do not know if I am interested in family medicine in the army. The army dictates what I am going to be doing, and I already know that a battalion/brigade surgeon tour is a probability. If that's coupled with predominantly inpatient work then I am a lot less interested in this specialty.
No worries. Most of the jobs in FP are all strictly outpatient. There can be some billets with full scope opportunities. In most cases in the Navy they tend to be overseas locations with the smattering of MTF INCONUS. You should ask the question to your Army FP attendees where the full scope opportunities are and avoid them if you want to stay away from the wards.
 
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Atlas Shrugged

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Thank you for all of the replies. I understand the need to keep a "foot in the door" for all aspects of medicine especially if I do FM. That's something that is appealing to me at this stage in the game. As I said earlier, I think some amount of inpatient care is necessary to keep skills sharp, but I can't imagine doing it a majority of the year. The alternative to being a generalist in the military also seems scary; I can't imagine being a subspecialist working on a patient not in the population I treat with a condition I also don't normally treat.

This is an interesting point in training. Walking through one door as all of the others close.

We will see how the next year shapes things.