IM vs FM Primary Care Training

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PCPDoc983

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10+ Year Member
Hey all,

I am in a very confused state, as I am an M4 who applied for both FM and IM this year (couldn't make up my mind since I loved aspects of both). Im really unsure how to make my rank list since I am in a dilemma: I love primary care, and realize you can do that with either FM or IM. I have no intention of becoming a hospitalist or a specialist. BUT, I absoultely HATE Ob-Gyn and Surgery (i.e. I never want to deliver another baby if i had to or ever scrub in the OR again), and dont have an absolute passion for peds (I like seeing kids and adolescents, but I could live without it too).

The problem is: IM residencies suck at preparing residents for primary care and outpt procedures (most have only 1 half day of clinic per week all 3 years, and most are HEAVY in ICU and floor medicine). I also applied to some IM-Primary Care tracks but didnt get too many interviews from them since my scores werent great 🙄. Problem with FM is that I will hate my life for the OB and Surgery months (can be upto 6 months of stuff I have zero desire to do).

How should I make my rank list? Should I deal with the fact that my primary care training in IM will suck and rank that higher? Or should I just suck it up and deal with hating OB and Surgery and rank FM higher? Thanks for any advice.
 
From what you've posted, I would concentrate on IM programs with a primary care track.
 
Thank you for your 2 cents guys. I was leaning towards that direction but needed someone else to tell me that.

It's really sad that IM programs are not doing a good job incorporating outpt training into their curriculums. Basic things like womens health, derm procedures, rheum/sports medicine training are compromised for esoteric inpatient problems, something the FM docs do very well. Either way, I hope my IM training will leave me prepared to do what I want to do.
 
I think you just need to shop around.

I am told that not all FM programs are OB heavy. If you could find one that was light on OB, that might be a good option.

Lots of IM programs have Primary Care options. Many have clinic structures other than the 1/week standard. U Cincinnatti has this interesting "Long Block". Unfortunately, low scores may limit your options.

Sorry, re-reading this and it really doesn't seem to help much.
 
Don't approach this as "what do I want to do for the next 3 years?". Approach it as "what do I want to do for the rest of my career?".

Six months of OB and surgery, when considered in the setting of a 3 year residency can seem daunting. When looked at in terms of a 30 year career, it's irrelevant.

Decide what you want to be doing 5, 10 and 20 years from now and choose the residency that will get you there. There are plenty of FPs (usually in urban areas) who do mostly adult medicine, minimal peds and no OB. There are also plenty of internists who do a ton of outpatient procedures.
 
aProgDirector said:
I am told that not all FM programs are OB heavy. If you could find one that was light on OB, that might be a good option.
Click to expand...

Very true. Our program was pretty light on the OB.

gutonc said:
Don't approach this as "what do I want to do for the next 3 years?". Approach it as "what do I want to do for the rest of my career?".
Click to expand...

Also very true. 👍
 
You may want to look for an FM program with a light surgery rotation. I know a handful that do not require FM residents to really do much other than observe in the OR, round on patients, and go to the surgeon's outpatient clinic. There are also programs that are light on OB (you have to just do the minimum required deliveries...40 or so I believe) and those same light OB programs will allow you to just observe c-sections.
 
I would go FM. Most places acknowledge that some residents don't want to do OB, so beyond your required number you can generally defer your deliveries to residents who want the Csections and SVD's. For surgery, most programs I interview at (which are the more intense FM residencies), have very mellow surgery months unless you want to be the person learning how to do surgery for missions/work abroad. Mellow meaning people go home at 5, no call.
 
there are definitely IM programs that have a primary care track. Even some with a women's health care track. Do your homework carefully and research the programs well.

Also, ask at the programs. Even at my program which has 5 ICU months and only 2 truly primary care ambulatory months (besides the 1/2 day of clinic a week), our PD will make arrangements for you to have an extra 1/2 day a week of clinic at a private clinic. And from what I hear, the private clinics are WAY WAY WAY better in so many ways than residency clinic. And the subspecialty rotations can be arranged to be at least half outpatient rather than all inpatient.
 
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