anxietypeaker said:
hey everyone. I was just on pandas blog about his experience in family medicine internship. And to put it bluntly, im actually kinda concerned about the quality of family medicine training in general compared to Internal medicine training. I've always thought family medicine is so cool as far as being able to see a little bit of everything. Moreover, family medicine seems to be the best PCP speciality (IN MY OPINION). Only the US and Canada have IM or peds also as PCPs. The UK, Korea, australia and others have IM and Peds as specialists. But with the kinda treatment/training that panda talked about and how FM is seen by med students/other docs, its kinda dissappointing.So for my questions:
1) Do most FM residencies have equal resources/etc as IM residencies? I thought ACGME accreditation would make most programs more or less equal.
2)What are some of the more prestigious (better) programs out there (im not asking for a ranking, just a few that have distinguished programs)?
1 year into residency, my advice is when you're looking at FM programs is to look at:
1) Experience - which is (Responsibility^Call Frequency) x (Patient Volume + Procedure Volume)
2) Teaching - which is (Didactic) + (Experience x Supervision) + (Faculty Commitment)
3) Hospital capabilities - which is (Ancillary support + Technology)
4) Quality of Life - which is (Resident Satisfaction x Hospital Capabilities + Faculty Support) / (Experience)
There's no perfect program or training, and prestige plays NO part in the above factors. And you'll realize that some attendings are good at some things but not others. What you want is to optimize those 4 variables, and ask yourself "Am I going to make the most out of my training".
Yeah, will Internal Med have more training than FMed in Internal Med? Sure.
But does OB make you sharper in Pedi? Yes.
Or does Surgery help on your Medicine patients? Yes.
Does learning how to cut and sew on Surgery and Derm help you in FM Clinic? Yes.
What about putting together Ortho, Neuro, those damned Nursing Home Visits with Sports Med, Occupational Med & Therapy, and Physical Therapy/Rehab? Hell yeah.
The beauty of Family Medicine is being able to put it all together. If you're the type of PERSON who gets easily frustrated because you don't know the answer, then Family Medicine is not for you. The toughest part in my past year is making the best of my time with every case and every opportunity. And I think every intern (who cares) runs into this problem. This is a specialty where you have to be strong enough to See One, Do One, and Teach One. You simply don't have the time to See 400, Do 200, and Ask 5 bagillion questions. If you can't handle that, you have a problem. You have a failure to learn. And so you need to find a program that will fit your needs (whatever the hell they are). I mean, I've had drinks with a couple of practicing pediatrician and residents who say that their training at the prestigious Texas Children's Hospital (Baylor) did NOT prepare them for what they wanted to do, which was Primary Care Pedi. Makes no damned sense to me. But I'm guessing that they were in the minority... they picked the wrong program.
I don't think asking questions is pissing anyone off. If there's concern that your training is going to be inferior, QUIT NOW because you will NEVER have the confidence in yourself to do the right thing for your patients. Your colleagues can see it, and your patients can SMELL it.
I personally am happy that Duke shut down. It's good for Family Medicine that ******ed programs disappear and good programs stick around (and hopefully, not the other way). And I'm even happier that Panda's around to present the M&M for the rest of us to learn from it.