internal medicine vs. family practice

[crazy250]

what's the difference between these two? from my research, it seems like family practice deals with everyone, but internist just deals with adults. am i right?

what's the advantage/disadvantage of being each one?

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[sophiejane]

Because internists have an older patient population (normally 16 or so is the youngest), they tend to manage more complex internal pathology such as diabetes and hypertension. They also tend to have more patients who are hospitalized. You can opt to only do ambulatory care as an IM specialist, however. In fact, I believe the only residency programs for IM that are exclusively ambulatory-track are AOA residencies. On the other end of the spectrum is the hospitalist, who is an internist who only sees hospitalized patients.

FPs see the entire spectrum of patients, birth to death. They tend to have more ambulatory cases and see fewer patients in the hospital (unless they are rural practictioners) and their focus is often on prevention and health maintenance rather than disease management.

Of course there are many variations, but this is a general outline of the differences.

You have to weigh the advantages yourself. I would suggest going to the IM and FP residency boards on SDN and ask those folks as they are on the front lines.

 

[Shinken]

Also, don't forget that FP residencies also teach basic surgery and obstetrics. IM residencies don't. Most people that complete an FP residency will never do surgery or OB because there are either qualified surgeons and ob-gyn's in their clinic/hospital or because the malpractice insurance skyrockets for an FP that performs surgery or OB. Some people that want to treat the whole family instead of just adults but without surgery or OB opt to train in combined medicine/pediatrics residency programs (4 years total).

The way I've heard doctors refer to both specialties is: FP's know a lot of diseases but not very deeply, Internists know less diseases but more deeply. IM is also more academic than FP, and that's why an internist can specialize in many areas (cardiology, nephrology, etc.) whereas an FP cannot specialize in those.

Go to the Residencies section of SDN and to the "Internal Medicine and IM subspecialties" forum. They have an excellent sticky that explains internal medicine in great detail.

Also, now that I remember, you can get a pdf file comparing the three types of residencies (FP, IM and Med/Peds). The paper was originally published in the American Journal of Medicine. You can download the file at www.medpeds.org

 

[utwisers]

Internists see a wide variety of pts depending on your practice focus. Family Practice is much the same with the exception of not being able to specialize with a Fellowship in Cardiology, Pulmonology etc. If you have no plans on doing a Fellowship and don't want to live in a hospital, Family Practice is probably the way to go. If you enjoy working in a hospital atmosphere and think you might want to do a Fellowship then IM might be the way to go.