I'm extremely torn between FM and IM. Help please!

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DrDreams

Attending Physician
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Hello everyone I hope you are doing well. I am a fourth-year medical student who has interviewed for both family medicine and Internal medicine. I have come to a point of crossroads where I need to decide between the two. I'm not particularly sure if I enjoy the hospital more or the clinic more. Some background about me is that I am a non-traditional student, married, have children and dealt with a major disease in my lifetime for which I am now cured (some call it remission.) I do have several sequelae as a result of my strife including but not limited to diabetes. So this is definitely a consideration in my future. First and foremost I need a specialty where I will not be doing the same thing over and over again and will not be bored. I need something that is intellectually stimulating and gets me excited but I'm not sure I want to make life death decisions. I would like to have the flexibility to go on vacation and spend time with my family if they have an event such as a school event etcetera.

I am not particularly a fan of pediatrics, because I had a horrible pediatrics rotation. So I'm really not sure what pediatrics is like, but it makes me nervous to handle little people. I also get sick easily so children are pretty darn sick and snotty. I don't mind OBGYN short term but going forward I know I don't want to do any OBGYN.

I know that I want to do complex cases and take into account several comorbidities. I do like talking to people but at the same time I would like to have the opportunity to not talk to people if I don't want to. I find internal medicine to be challenging and cerebral. It constantly makes me think and keeps me on my toes but it definitely wears me out and I feel exhausted. At the end of the day I find that I have no energy and all I want to do is sleep and it's difficult for me to spend time with my family. I understand that intern year for both specialties is roughly the same in terms of rigor. But I cannot decide which one I want to do in the long term.

I found it staying in a clinic made me bored and gave me too much time on my hands especially when patients didn't show up. I found most stuff to be run of the mill cough sniffles etc.


Training wise i am concerned about being able to handle an emergency or critical situation if it was to arise. I like to know everything about everything but I feel overwhelmed knowing little about everything. I have done 6 sub internships in Internal medicine back to back and I am exhausted.

I know that I shouldn't feel this way but I keep having this feeling that being a family medicine physician will make me inadequate. I don't particularly have any intention of specializing as I am older. I do know I may want to choose between hospitalist and outpatient. One thing is that the program's I have looked at family medicine is at the location I want to be in. Internal medicine is not the best of locations. I also would match earlier into family medicine due to pre match vs Internal I'd have to go through the match.

Any advice or guidance would be much appreciated.
 
1. If you don't want to see kids or do OB then don't do family medicine.

2. Don't let residency location sway you too much. Residency will be 3 years, then you have a ton of options available.

3. In many non-academic places, there are still many IM people splitting their time between hospitalist and clinic, which may keep you interested.

4. you can't know everything about everything
 
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Starting to lean towards FM. I don't technically have to see kids afterwards. I don't mind OBGYN too much. And yes the six Sub I made me apply to FM halfway through lol
 
If you want to subspecialize then IM. FM you can still do hospital and clinic (ditto for IM). I find hospital to be draining, clinic less so. There's a reason why they usually do 7 on, 7 off. Have you considered faculty post-residency? If you want to prioritize family/work life balance, FM fits that better. The hospitalists I have seen tend to be more focused on the job and longer hours (typically 12 hours inpatient vs 8 hours in FM clinic).

For the record, I like both hospital and clinic medicine, but I would be bored doing 24-7 clinic, and I would be completely drained by pure hospitalist work, so I will be doing a mix post-residency. Also, we double book in clinic to avoid the problem of no shows + $$.
 
I have no intentions of specializing. But I do want a mix of clinical and hospital. Also having a family life is pretty important to me. You're right though about the 7 days on 7 days off. I also realized in my 7 days off, the kids will be in school so it's not like I get more time with them. So yeah so far, family medicine is my top choice 🙂

Thank you everyone for the guidance. Much appreciated.
 
I’m family Med. I work 4 full clinic days and one short day in the nursing home. I have two kids and a great work life balance. I do some of the same things over and over again in clinic but have enough crazy things that go on to keep me interested. If you don’t want to see kids after you graduate you won’t have to but they are a nice break in the schedule for me.
 
I’m family Med. I work 4 full clinic days and one short day in the nursing home. I have two kids and a great work life balance. I do some of the same things over and over again in clinic but have enough crazy things that go on to keep me interested. If you don’t want to see kids after you graduate you won’t have to but they are a nice break in the schedule for me.

OMG...

Salary????????????

🙂
 
Hello everyone I hope you are doing well. I am a fourth-year medical student who has interviewed for both family medicine and Internal medicine. I have come to a point of crossroads where I need to decide between the two. I'm not particularly sure if I enjoy the hospital more or the clinic more. Some background about me is that I am a non-traditional student, married, have children and dealt with a major disease in my lifetime for which I am now cured (some call it remission.) I do have several sequelae as a result of my strife including but not limited to diabetes. So this is definitely a consideration in my future. First and foremost I need a specialty where I will not be doing the same thing over and over again and will not be bored. I need something that is intellectually stimulating and gets me excited but I'm not sure I want to make life death decisions. I would like to have the flexibility to go on vacation and spend time with my family if they have an event such as a school event etcetera.

I am not particularly a fan of pediatrics, because I had a horrible pediatrics rotation. So I'm really not sure what pediatrics is like, but it makes me nervous to handle little people. I also get sick easily so children are pretty darn sick and snotty. I don't mind OBGYN short term but going forward I know I don't want to do any OBGYN.

I know that I want to do complex cases and take into account several comorbidities. I do like talking to people but at the same time I would like to have the opportunity to not talk to people if I don't want to. I find internal medicine to be challenging and cerebral. It constantly makes me think and keeps me on my toes but it definitely wears me out and I feel exhausted. At the end of the day I find that I have no energy and all I want to do is sleep and it's difficult for me to spend time with my family. I understand that intern year for both specialties is roughly the same in terms of rigor. But I cannot decide which one I want to do in the long term.

I found it staying in a clinic made me bored and gave me too much time on my hands especially when patients didn't show up. I found most stuff to be run of the mill cough sniffles etc.


Training wise i am concerned about being able to handle an emergency or critical situation if it was to arise. I like to know everything about everything but I feel overwhelmed knowing little about everything. I have done 6 sub internships in Internal medicine back to back and I am exhausted.

I know that I shouldn't feel this way but I keep having this feeling that being a family medicine physician will make me inadequate. I don't particularly have any intention of specializing as I am older. I do know I may want to choose between hospitalist and outpatient. One thing is that the program's I have looked at family medicine is at the location I want to be in. Internal medicine is not the best of locations. I also would match earlier into family medicine due to pre match vs Internal I'd have to go through the match.

Any advice or guidance would be much appreciated.
Training:

FM has a heavier Ob/Clinic element to it.
IM spends more time in the hospital.

Practice:

IM can work in a clinic, be a hospitalist, or specialize
FM can see kids and pregnant women / deliver babies (though many don't do OB anymore).
 
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