IM vs FP

[DR1]

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What is the difference between an internal medicine-primary care and family practice residency? What are the benefits/drawbacks of each field? Which is more competitive to match into in California?

 

[DR]

I don't know which is more competitive in Cali, but I can tell you the difference between the two. IM is adult medicine. It focuses on managing adult disease, and can lead to a generalist career in primary care, or a fellowship in one of the IM specialties. Family medicine is a medical mixed bag. It offers trainees exposure to internal medicine, ob/gyn, some surgery, pediatrics...a little bit of everything. Although most of those specialties are not put to use very often unless you are in a rural area, some family docs manage to use some of it in the office. For others, family medicine is just internal medicine, but with some pediatrics (most family med residents will tell you that they didin't do internal medicine because they don't want to only see "old people"). Fellowship wise, internal medicine offers a ton of opportunities; very limited with family medicine.

 

[im2003]

That last message basically details the difference between traditional IM and family medicine. Primary Care IM is very similar to traditional IM except that more time is spent in the ambulatory setting (which you may liken to family medicine programs). However, primary care IM is still going to teach you to manage the gamut of complex adult coniditions (something fp's forego a little of in order to pick up basic skills in peds and ob/gyn). It comes down to what you want to do. If you want to do rural medicie, fp for sure. If you want to see adults only than IM for sure. The primary care IM programs still allow you to go on to fellowships, however, I've been told (truth unknown?) that typically these grads only pursue more office-based subspecialties because they have developed these skills more. That is to say, rheumatology and endocrinology are popular.