IM vs. FP numberrr 2!

[waverunner]

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I know there have been millions of discussion on this before.
But I would still like to get your opinions on this.
I am a 3rd yr med student trying to figure out which residency to apply to.
I pretty much came down to FP vs. IM but I am not sure how I can r/o or rule in one over the other. What are the pros and cons of both?

If anyone had a similar dilemma in the past or are having one now, please drop your 2 cents on this topic...

(My current understanding is that I should go into FP if I want to work in outpatient / clinic setting vs. I should go into IM if I want to be in the hospital for majority of my practice.
Also I see the draw to IM b/c then you'd be able to subspecialize and this leads to more procedure and more money (in general).

As for me personally, FP seems to be what I want to do for the moment since I like outpatient pt care more than inpatient care and I am thinking of pursuing sports medicine fellowships...but I am still not 100% sure)

Any advice / opinions will be appreciated!

Thanks guys!😀

 

[tacrum43]

I know there have been millions of discussion on this before.
But I would still like to get your opinions on this.
I am a 3rd yr med student trying to figure out which residency to apply to.
I pretty much came down to FP vs. IM but I am not sure how I can r/o or rule in one over the other. What are the pros and cons of both?

If anyone had a similar dilemma in the past or are having one now, please drop your 2 cents on this topic...

(My current understanding is that I should go into FP if I want to work in outpatient / clinic setting vs. I should go into IM if I want to be in the hospital for majority of my practice.
Also I see the draw to IM b/c then you'd be able to subspecialize and this leads to more procedure and more money (in general).

As for me personally, FP seems to be what I want to do for the moment since I like outpatient pt care more than inpatient care and I am thinking of pursuing sports medicine fellowships...but I am still not 100% sure)

Any advice / opinions will be appreciated!

Thanks guys!😀

While you'll probably spend more time in the hospital during an IM residency than a FP resident would, many IM practitioners (especially general IM) spend the vast majority of their time doing clinic. There are also several residency programs now that are IM-primary care, with more of a focus of the outpatient setting.

The main difference I see between the two is that FP gets additional training in OB/Gyn, Surgery, and treating pediatric patients too, while IM focuses on more complex medical disease in the adult population. Doing an IM residency also opens up a lot more fellowship opportunities, should want to pursue that later.

Of course, I'm only a 3rd year too, so what do I know. But I am planning to do IM. 🙂

 

[mig26x]

if you want to specialize= IM
if you want to be in the hospital IM > FP
if you want to treat more than adults= FP
salary wise IM>FP if you specialize, if not is still IM but the gap is very narrow.
outpatient medicine FP>IM but the gap is narrow as you can do 100% outpatient medicine as an IM.

One of my best friends is a FP 3rd year resident and just signed a 165,000 base salary deal in FL. He didnt tell me if there were salary bonus or anything like that, but that's pretty good deal for outpatient medicine out of residency.

Im a second year IM and would like to be a hospitalist, received offers 160K-200K w/o bonus which can add 20-30K to salary and this is in FL too.

 

[Brian Griffin]

if you want to specialize= IM
if you want to be in the hospital IM > FP
if you want to treat more than adults= FP
salary wise IM>FP if you specialize, if not is still IM but the gap is very narrow.
outpatient medicine FP>IM but the gap is narrow as you can do 100% outpatient medicine as an IM.

One of my best friends is a FP 3rd year resident and just signed a 165,000 base salary deal in FL. He didnt tell me if there were salary bonus or anything like that, but that's pretty good deal for outpatient medicine out of residency.

Im a second year IM and would like to be a hospitalist, received offers 160K-200K w/o bonus which can add 20-30K to salary and this is in FL too.

I definitely had a huge FP vs. IM debate... I always knew I might want to be a generalist, and at my medical school, FP is our only outpatient experience during third year. I really loved outpatient so I thought I was sure that FP was for me, and was all set to apply... but then I did a bunch of FP electives at the beginning of fourth year, and realized that even though I love primary care, I really did NOT want to do the peds and OB training. I love adult medicine, especially geriatrics, and I like routine office gyn/women's health stuff, but I am just not a peds person. I tried to tell myself I would learn to like peds more, and I still was somewhat attached to the idea of learning a little bit of everything, but by September of fourth year, I was telling myself if I have to do another well-child check or try to examine the ear of another screaming toddler I was going to shoot myself.

Plus... I really want to stay on the east coast, in an urban area, and to be honest, it's just really hard to find good family medicine programs in east coast cities. They're out there, but few and far between. There are just so many more options for IM.

So... I started researching IM programs, and when I discovered IM programs with primary care tracks, I realized that was perfect for me. My school has a lot of specialty services so I wasn't even exposed to IM docs doing general medicine during third year. But once I started doing a little more research, I found that, yes, there ARE many IM docs out there who are generalists and who work primarily in the outpatient setting.

In the end, I matched into an IM program with a primary care track, and I'm very happy!! Plus it's nice to have the *option* to specialize if I should decide to... it's just nice to have the possibility of pursuing a specialty, should I change my mind. And I'm so happy to not have to see kids... I'll like my own kids (if/when I have them someday), but not other people's kids, haha.

My opinion is, I think if you can't bear the idea of giving up doing OB or peds, then FP is for you. Or, if you love the idea of working in a rural area and being the only doc in a 50 mile radius, then FP is for you. I did a rotation in a rural area and most of the FP docs I worked with cited that as the reason they chose FP.. .and they're REALLY doing it all, delivering babies, procedures (EGDs, you name it), etc. Otherwise, I would recommend checking out IM primary care tracks. 🙂

 

[iatrosB]

I agree with most everything Brian stated. I had a large FM vs. IM debate as well. At the end of the day I couldn't stomach any OB training and was willing to give up peds (another well child would make crazy too).

I matched into an IM program with a primary care track and couldn't be happier. Outpatient primary care is wide open for me.

I will disagree about rural areas though, I've been in several where there was IM docs (and they are badly needed there). Yeah, you can't do OB/peds/appy's/chole's...but that model is dying quickly anyway.

 

[waverunner]

Can IM grad puruse sports med? Do IM people usually puruse that?

 

[iatrosB]

Can IM grad puruse sports med?

Yes. It is open to FM/IM/peds...that said, it's usually FM that get in because the fellowship is usually associated with an FM residency...and IM people don't usually apply.

Do IM people usually puruse that?

No, the income is not that different...and honestly, neither is the work at the end of the day. Very few get to be the glorious professional team doctor and most do mainly physicals for high school/community college and do joint injections.

 

[jabreal00]

If you want to do mainly outpatient the question you have to ask yourself is whether you like doing peds, and dealing with preggers? If not do IM. If so do FP. Office based procedures (jt injections, mole removals, abscess drainage) can easily be done by IM or FP, although FP have that intergrated into their residencies vs IMs (more inpatient based).

---------------- Listening to: Bent - Cylons In Love via FoxyTunes

 

[waverunner]

Thanks for all the replies / advices.
I took a look at a few of IM-primary care track curicurrum and it looks awfully similar to some of the FP program.

Would you guys agree if I say IM-primary care track and FP are pretty much the same with exception of fellowship availabilities?

 

[iatrosB]

Would you guys agree if I say IM-primary care track and FP are pretty much the same with exception of fellowship availabilities?

Not even close!

IM...no OB, surgery, peds. In FP programs you will spend at least 6 months doing these...that's a lot of time for a 3 year program.

Plus at the end of an IM/primary care, you still can't see peds/ob.

 

[gutonc]

Would you guys agree if I say IM-primary care track and FP are pretty much the same with exception of fellowship availabilities?

Nope. FM has OB and peds which you will not get in IM training. If you want either of those (besides routine women's health stuff) you need to do FP. If you want to just treat adults, IM-PC is the way to go. And if you do IM-PC and wind up wanting to specialize after all you've still got options.

 

[DrJosephKim]

Remember that you can still be a hospitalist, even if you train in family medicine. Also, if you like the acute care setting (and have any interest in ER), then you may wish to consider family medicine so that you have that option in community settings.

 

[dragonfly99]

drkim is right that if you like the ER and urgent care, fp would be better. Urgent care centers like to hire fp and med/peds more than IM in some cases, because they can see whatever comes in through the door. There are moonlighting opportunities in ER's or urgent care if you are an IM doc too a lot of times, though. I did IM residency and work in an ER at one of the VA hospitals sometimes on weekends...they only see adults so it's OK for an internist.

As far as doing sports med via the internal medicine route, I wouldn't count on that. Some internal med programs used to have sports med fellowships, but those are being done away with (or have already). The ABIM decided to do that, I believe. It was either lack of interest and/or that sports med really doesn't jive with an IM residency background, which basically trains you to take care of mainly old people. Family practice and peds (and I think some ER programs?) have sports med fellowships, but I wouldn't hold your breath about getting into any of these as an IM resident...they very likely would not take you. So I'd be careful about planning on sports med if you choose IM residency...would be better to do peds, or fp, or even ER.