FM vs IM?

[Medschoolready95]

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I'm an incoming MS1 and so forgive me (and correct me!) if any of these assumptions are not true.. Why does it seem like family medicine is less "prestigious" than internal medicine? Isn't the work very similar for an outpatient internist and a family medicine doc?

 

[ricksimmonsrafowens]

I'm an incoming MS1 and so forgive me (and correct me!) if any of these assumptions are not true.. Why does it seem like family medicine is less "prestigious" than internal medicine? Isn't the work very similar for an outpatient internist and a family medicine doc?

reasons for bias are historical. IM was an organized and board certified specialty way before FM. Some academic institutions don't have family medicine residencies (Johns Hopkins, Vanderbilt). IM also tends to focus more on research and large specialty-changing trials. Prestige and academia dominates in IM training, whereas best FM training is usually found in the community.

 

[Chelsea FC]

Prestigious to who? Medical students or the public in general? Because the public has little to no idea of the difference between the 2. And I think medical students view them around the same in prestige. At the end of the day who cares ???

 

[Medschoolready95]

Historical reasons. IM was an organized and board certified specialty way before FM. Some academic institutions don't have family medicine residencies (Johns Hopkins, Vanderbilt). IM also tends to focus more on research and large specialty-changing trials. Prestige and academia dominates in IM training, whereas best FM training is usually found in the community.

Interesting! I did not know that. Thanks for clarifying!

 

[Medschoolready95]

Prestigious to who? Medical students or the public in general? Because the public has little to no idea of the difference between the 2. And I think medical students view them around the same in prestige. At the end of the day who cares ???

I primarily was referring to prestige among other medical professionals. Prestige is not and should not be important at all. I was just wondering because it did not make sense to me, given how similar they seem

 

[Frogger27]

IM is the basis for all the prestigious sub specialties (cardio, GI, etc).. while FM does not offer these types of fellowships

Although different training, an IM and FM doc would function simarlarily in an outpatient primary care setting

 

[jdh71]

I do think in general the out patient internist handles the elderly and more complicated with multiple chronic illness better than FM. Outliers not withstanding. We all know very good FM docs. This statement is NOT me crapping on FM. This is my experience and subsequent bias based on the patients I get into my ICU and get seen by me as consults in the pulmonary clinic.

 

[NYCdude]

Yes, in the very specific scenario of outpatient general medicine, the FM and IM docs work in the same capacity.

But most IM graduates work as hospitalists or subspecialists.

 

[Chibucks15]

I worked with this doc who had his own outpatient practice (IM) but followed his patients when they were in the local smallish hospitals. Best of both worlds but I feel like that’s a dying breed

 

[Sleepingdoc]

Yes they are both similar in outpatient setting... but IM is more inpatient trained. IM seems more prestigious because they are more of a hospitalist and are seen more frequently managing critical illness than an outpatient setting... Like one of the other poster above said- who cares if one is more prestigious? Eventually you will end up doing what you like, I have known people with very high board scores who chose IM and FM.

 

[Angus Avagadro]

Prestigious only to the members of the Ivory Tower Club who cant wait to tell you the trained at an Ivory Tower. I think the bias comes from some family med programs not filling during the match and being forced to take marginal candidates to fill their slots
It's sad because I know some really fine, high stats family docs who are there by choice.

 

[DoctwoB]

Prestigious only to the members of the Ivory Tower Club who cant wait to tell you the trained at an Ivory Tower. I think the bias comes from some family med programs not filling during the match and being forced to take marginal candidates to fill their slots
It's sad because I know some really fine, high stats family docs who are there by choice.

Note that’s true of many IM programs as well. The top programs are very competitive, but there are a lot of community programs that don’t fill or fill with IMGs.

 

[Planes2Doc]

IM is focused a lot on inpatient medicine plus sub-specialties. FM is technically supposed to be the only "true" primary care specialty with a focus on outpatient medicine. You can definitely do outpatient primary care with internal medicine, or you can be a hospitalist as a family medicine physician. When it comes to that cross-over, you can see some head butting. IM physicians will say they are better equipped to handle more complicated patients, while FM physicians will say they can do the same thing. Then you get a collective circle-jerk with bashing one another. At the end, it's best to work your hardest to do what's best for your patient, and not your ego.

tl;dr: Do IM if you want to practice hospital medicine or go into sub-specialties. Do FM if you want to practice primary care in the outpatient setting.

 

[Angus Avagadro]

IM is focused a lot on inpatient medicine plus sub-specialties. FM is technically supposed to be the only "true" primary care specialty with a focus on outpatient medicine. You can definitely do outpatient primary care with internal medicine, or you can be a hospitalist as a family medicine physician. When it comes to that cross-over, you can see some head butting. IM physicians will say they are better equipped to handle more complicated patients, while FM physicians will say they can do the same thing. Then you get a collective circle-jerk with bashing one another. At the end, it's best to work your hardest to do what's best for your patient, and not your ego.

tl;dr: Do IM if you want to practice hospital medicine or go into sub-specialties. Do FM if you want to practice primary care in the outpatient setting.

I'd like to add there are IM and FP Hospitalists, so you can do inpatient care as a FP. Also, rural areas may not have hospitalists so the patients physician does the inpatient care.
Some FP residents are the only residents in the whole hospital, so they get lots on inpatient experience. IM is no guarantee to doing inpatient care. Several years ago, my internist was told to hand off all inpatient care to the Hospitalist
Btw, my internist takes care of all the Hot Shot Docs and administrators at the local university system. Lastly, about 10% of current hospitalists are Family Med trained.