I am shocked by all the pro-surgery responses and disappointed by the lack of pro-FM responses on this Family Medicine forum! C'mon guys!?!?!? Where are the pro-FM people??
I'd like to first say that not every specialty is for every person. I am a Family Medicine resident right now, and I cannot imagine myself (nor would I want to be) doing anything else. On the other hand, I'd hate to be doing a residency in anesthesiology or radiology because that's just not fitting for my personality. However, I have several good friends in those aforementioned fields who'd hate to be doing what I'm doing. Neither person is wrong, nor is any field of medicine worse than (or less than) another.... It's just that different people look for different things in a career.
Although my comments below may (unintentionally) offend many surgery-minded people, that is NOT my intent as I am simply making generalizations about the 2 fields of medicine. I have encountered many wonderful surgeons in my life, both as a MD and as a patient. And I know that there are bad primary care docs just as there are bad surgeons. So, please realize this before sending me any nasty PMs. Also realize before you surgery-minded people PM me something nasty that I am sure that you've bashed primary care docs quite a bit. While I do not feel that surgery is less important than FM, I certainly don't think that FM is any less important than surgery.
Lilybriscoe, let me address a few of your questions....
1) Why so many people tell you not to do FM: the reason that everyone tells you not to go into FM is that in the major university medical centers, the general philosophy is VERY specialist-driven. Although regionally the view-points may vary somewhat, this is generally not true outside of medical schools and their affiliated university medical centers. The other reason that people (especially surgery residents) tell you not to go into family medicine is that many surgeons (although not all of them) look down on any MD who's not a surgeon.
There is a misconception that because family medicine is not as competitive as other specialties the only people who go into FM are those that can't/don't match into anything else. In my opinion however, this could not be farther from the truth. Many of the people I know that go into family medicine are highly competitive applicants who could have matched in a number of highly competitive specialties. I am saddened by all of the med students who originally have a strong desire to go into FM but by the end of their four years of medical school hear so much negative press about the specialty that they chose something else.
Family Medicine is a wonderful field of medicine for those who enjoy close patient interactions and the primary-care diseases -- you can adapt your practice to focus on so many different areas (Women's Health, sports medicine, geriatrics, pediatrics, procedures, working solely in samller ERs, etc...) and the relationships that you'll be able to develop with many of your patients are incredibly enriching. I would argue that FM docs have (in general) better bedside manner and much stronger relationships with their patients than surgeons. The potential for a positive, lasting long-term impact on the lives of your patients (especially when you consider the whole biopsychosocial model) is, I believe, much higher in FM. I know, FM docs can't do an emergency life-saving surgery, but how often does that surgeon follow up (or even want to follow-up) with that patient once the cutting (and post-op stuff) is over?? Family Medicine docs have more opportunity to make a lasting impact on patient because FM docs tend to follow their patients more regularly in continuity over several years whereas patient follow-up with surgeons is typically as needed and ends once the disease is cut out.
2. On personality differences: I think that you are correct in that FM and surg are polar opposites... and I think that the people who chose each specialty tend to have quite different personalities. Again, generally speaking, people that go into FM tend to value patient follow-up and building relationship with patients moreso than surgery. Also, people that go into FM tend to be more laid back and relaxed than people that go into surgery. I'd also argue that people who go into family medicine place more focus on their life outside of the hospital (and the need for personal time with family) than many of the people who go into surgery. While these personality differences are not true for every surgeon or FM doc, these are the general trends.
3. The issue of missions: You can certainly do international mission work in either field, and contrary to some opinions expressed, I think that the patients/diseases you treat as a primary care doc are just as important as the kinds of patients/diseases treated by surgeons. As surgeons tend to look down on every other field of medicine, I am sure I'll get some disagreement, but treating diabetes and heart disease is as important as repairing cleft palates. I also think, although I may be incorrect, that it's easier to arrange medical missions trips in primary care because you don't need a hospital or OR to treat much of what primary care docs treat, and you can typically treat more patients per hour.
I hope that this helps clear up some of the issues concerning your specialty choice, and I apologize to those I may have offended. Just follow your gut feeling and your heart. Don't be afraid to go into family medicine, no matter what anyone else tells you -- after all, they are not the one who has to do this for the next however many years!! If you decide that surgery is your thing though, I do wish you all the best.
Please let me know if I can help shed any more light on your situation!
Best wishes!
Jason
