Going based on some of the websites
http://www2.medicine.wisc.edu/home/housestaff/hsprimarycare
http://www.stonybrookmedicalcenter.org/medicine/residency/primarycare_track.cfm
http://im.dom.uab.edu/primary.htm
Most are teaching scopes, derm, injections, ortho, womens health etc...
What I mean is that the curriculum is 90% similar in that they are 'virtually' interchangeable. Perhaps a FM doc will be more thoroughly trained in primary care (larger breath), but my confusion is that if most of what is taught through the primary care track is the same, why limit yourself by pursuing a FM residency. Perhaps later on you decide there was one specific areas you found to be more interesting and you can then do a fellowship. Hospitalist position are also primarily given to IM trained docs. Why reduce your options out of the door. Sure there is ped/ob training missing, but the numbers suggest that few are including this population in their practice. I like primary care, but also want to keep my options open. I am just curious why this isn't considered a better route.
Cool thanks. Yea, I think the websites you provided are really interesting. Derm procedures are everywhere and aren't hard to set up. Women's health is easy too, although I'm not sure from the website you showed us if people are doing colposcopies (which we get in FM). And I'm not talking about rotating or what not. I'm talking about the resident's own clinic is set up to do these procedures. Some programs will even do LEEPs and cones. Ortho is hit and miss. Most primary care clinics will have a few, especially chronic stuff. Occasionally you might get an acute, but the place to get lots of ortho injuries would be in urgent care, which a lot of IM docs don't feel comfortable staffing. I don't know the IM faculty at those programs listed, so it's something you might ask, whether the resident's staff an urgent care (or at least have an opportunity to do so). One of the program you listed has a sports med clinic. I believe that same program has a fellowship, so I would ask how the work is divided between residents, fellows, and faculty.
Interesting you mentioned scopes, because I was curious whether IM-PC was teaching its residents to do GI scopes... looks like they're doing flex sigs, which are falling by the wayside. Standard of care, to be frank, is colonoscopy, and I'm curious how willing GI is willing to teach primary care how to do screening colonoscopies. I know on the FM front it's not easy. But, I haven't seen anything that suggests that IM-PC are having easier time getting colonoscopies as well. Interesting...
One also interesting thing that was missing on the websites is exercise stress testing. Again, you would think that they would teach it to IM-PC, but I'm not convinced that their own residents are doing those procedures on their own patients either. Again, interesting.
You should pick whatever best suits your interest, like I said, but I haven't seen anything thus far that convincingly makes IM-PC that much more superior to FM residency when it comes to primary care work. I think the procedure offerings are par, if not worse; unless there's evidence that points to the contrary.
I also think it's interesting that you said that "few" FM docs are including peds and OB. Is this a general impression that you have? Because in 2008, 87% of FM docs surveyed practice pediatrics and 27.7% of FM docs do OB.
http://www.aafp.org/online/en/home/aboutus/specialty/facts/4.html
So that's 9 out of 10 FM docs see kids and 1 out of 3 do obstetrics, which is more than a "few" in my opinion. And the 1/3 for OB was more than I expected. I mean, I would have thought it was 1 in a million. But... that's why we have these statistics... to dispel myths. You can check out the regional breakdown in that same survey. AAFP is really good about updating it frequently.
Lastly, I think it really depends on what you consider "limiting" yourself and FM, out of all the specialties given its breadth, is by definition and by comparison less limiting. If you define "limiting" as a specialty where the board won't allow you to do a subspecialty that will train you to do procedures that will result in you making a crapload of money... then, yes, FM is limiting in that sense.
But for me, if the patient is human and is from planet Earth, I feel like I can have a decent first shot at taking care of them. In that sense, I don't think FM is limiting at all. Quite the contrary.
I think it all depends on how you look at things.
I'm not gonna talk you out of what you want to do. I'm not sure if there is such a thing as a "better option". I think there may be a "better option"... for *you*... but I don't think either FM or IM-PC is superior to one or the other.
I just want you to look at things from a different perspective than what others may be leading you to think.
Good luck.