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No it's not3. The paperwork is outrageous.
No it's not3. The paperwork is outrageous.
I do love when people outside the field speak with authority on what its like within that field.Dumping ground.
Having to be a generalist.
Low reimbursement.
Irresponsible patients.
Multiple, chronic problems of which maybe 2 can be addressed this visit.
Dumping ground.
5 minute visits with major overhead.
and the list goes on...
It's not Patch Adams where you get to know people and heal them in a warm, fuzzy way. It's yet another person with bad blood pressure, blood sugars, uncontrolled lipids, a host of chronic ailments, health adverse behaviors, etc.
FM is a low prestige field, that's absolutely true. We don't cure someone's cancer, get them through a severe illness in the ICU, cure their appendicitis, and so on. Getting someone's blood pressure, diabetes, or thyroid under control isn't sexy. Same with preventative care. All are very worthwhile but not exciting.
Best possible way I could have said it. Oh and you are only taught how to serve certain things; if not you need to referJust personal opinion - FM feels like being a waitress in a really busy fast food place where ppl order exact same thing over and over, and the main goal is to turn over tables as quickly as possible with a smile .
good family physicians are god sent and if you are one- you will build up patient pool quickly . But it can literally suck life out of you if your personally doesn’t match the “serving style”.
Hot take ~ but I feel like it has less to do with the field and more to do with med students being med students. Money really isn't an issue, even for those w/o scholarships, in any specialty except maybe academic peds. People who get into med school and even more so people who get into top 5 med schools typically have a innate drive that prevents them from setting sights on something not viewed as prestigious.
You mention your stats in this very post, you okay with your peers assuming you bombed your steps? If you in fact are, there's still plenty of med students who aren't.
I disagree regarding the practice style. It’s not too different from other specialties in that you ”serve” bread-and-butter cases often and treat them all the same, then a zebra or unicorn walk into clinic once a week/month. The challenge (and real question) is “how broad of a scope in what walks in are you comfortable with?” FM offers more variety in practice than oculoplastics or radiology, you decide to what degree. That’s what makes it challenging and fun for a driven doc…Just personal opinion - FM feels like being a waitress in a really busy fast food place where ppl order exact same thing over and over, and the main goal is to turn over tables as quickly as possible with a smile .
good family physicians are god sent and if you are one- you will build up patient pool quickly . But it can literally suck life out of you if your personally doesn’t match the “serving style”.
you prematched into FM as a pre-med student? is your flair outdated?I've been prematched into Family Medicine. Only have to do three years of medical school too. At the end of the day, I wanted to be a Dr. Didn't care how. I get to fulfil my dream and everyone knows it. That's what matters to me. Oh, and working banking hours. I've been working in a Call Center doing tons of paperwork, general stuff, and seeing 30+ members for about 6 minutes on average for six years only making 40K. I've got a nice car, about to be new nice house, and I've been travelling my ass off with student loan debt I'm never going to pay off anyways. So I see these next 30ish years being a piece of cake making at minimum 150K. I'm used to it. 😂😂😂
This will happen. My interest starting becoming geared toward primary care after coming in with interest in surgery (I have a construction background, so it was natural haha), and people jumped to the conclusion that "haha yeah Step will do that to you" despite actually scoring in the ~99th percentile.You mention your stats in this very post, you okay with your peers assuming you bombed your steps? If you in fact are, there's still plenty of med students who aren't.
There are 3-year MD programs where you pre-match before matriculation and upon completion you match into their residency program. I assume they're starting this Fall, and in 3 years will move on to their FM program.you prematched into FM as a pre-med student? is your flair outdated?
FM Resident here:
1. It is a difficult specialty if you actually give a damn. Instead of knowing a lot about nothing, you will know nothing about a lot. Not everyone's brain and ego are set up for that.
2. You'll have specialists $%@& on you every day and then tell you they couldn't do your job.
3. If you go to a community program, you will have to get used to every attending having imposter syndrome for the rest of your resident life. It's a very toxic environment.
4. Once you're out of residency and settled into your rural practice, you'll be happy as a clam.
Would you mind expanding a bit more on the amount of paperwork you do in a typical week? I am really interested in rural FM, and this thread is only making me more excited.No it's not
Sorry to derail the convo for a bit - can you expand more on why money may be an issue in academic peds?Hot take ~ but I feel like it has less to do with the field and more to do with med students being med students. Money really isn't an issue, even for those w/o scholarships, in any specialty except maybe academic peds. People who get into med school and even more so people who get into top 5 med schools typically have a innate drive that prevents them from setting sights on something not viewed as prestigious.
You mention your stats in this very post, you okay with your peers assuming you bombed your steps? If you in fact are, there's still plenty of med students who aren't.
Would you mind expanding a bit more on the amount of paperwork you do in a typical week? I am really interested in rural FM, and this thread is only making me more excited.
Hey there, I'm an MS4 in the PNW applying to full spectrum FM. Good on you reaching out and asking this question. Let's start by recognizing the bias and breadth of opinion you're going to see here. We have people west coast, east coast, deep south, far north, maybe even international chiming in. There is a ton of regional difference. East coast FM is not west coast FM, is NOT global health FM. So let me put in my two cents.Hi everyone!
I'm an incoming M1 at a T5 school, and am very interested in FM (rural in particular). I've shadowed a lot of FM's (and other specialties), and had really great experiences growing up with my FM docs. Would be really interested in sports medicine but would be happy doing FM in general too.
The thing is, it seems like literally no other peers seem to think FM is a good idea, especially at top schools. Is there something I'm hugely missing out/being naive about on why FM is generally considered "bottom of the barrel" in terms of specialty consideration? Why are so many bright students staying away from this field?
My scores were good in undergrad (>3.9, >520), so it's not like I'm worried about my test-taking abilities or anything for more competitive specialties. Med school loans are not a problem since I was fortunate to receive full tuition.
Thanks!
Thank you for your input! It seems like the idea of FM docs "drowning" in paperwork or other administrative responsibilities can be overblown. The way you have set up your practice makes it sound like paperwork is not an issue at all.Im in rural FM. I practice in such a way as to make my paperwork burden essentially consist of skimming notes from specialists (DM retinopathy screens, Neuro or Cards office notes etc) for about 10-15mins a day. If a patient needs me to fill out papers, I have them make an appt and we fill them out together, then I can bill for the issue that created the paperwork.
not how it works. What actually happens is that people who have been gunning their entire lives go into prestigious difficult things, have to work harder than
Just out of curiosity, why Pathology and Physiatry?Peds
Geriatrics
Hospitalist (IM without fellowship)
Pathology
Physiatry
Peds (again)
They're just not super popular. Like half or less of spots get filled by US MDs. I think for pathology the market isnt too great, dunno why PM&R isnt competitive though.Just out of curiosity, why Pathology and Physiatry?
Every specialty is like that. We see the same presentations over and over. Also, productivity is important in every field of Medicine. I think FM is a great choice for the OP, and it's good to see someone excited about it. I also think the lifestyle of an FP is relatively gentle.Just personal opinion - FM feels like being a waitress in a really busy fast food place where ppl order exact same thing over and over, and the main goal is to turn over tables as quickly as possible with a smile .
good family physicians are god sent and if you are one- you will build up patient pool quickly . But it can literally suck life out of you if your personally doesn’t match the “serving style”.
Very little: basically I sign things and that's about it. Prior auths? Nurses do them. FMLA? Nurses do them. I'll review them to make sure nothing is amiss, but that takes almost no time. Honestly my biggest pet peeves are the home health nursing orders that require a signature on every GD page of the 18 page order set.Would you mind expanding a bit more on the amount of paperwork you do in a typical week? I am really interested in rural FM, and this thread is only making me more excited.
If literally all you care about is total income, then yes FM is much lower on the list.The catch is you make no money? Your peers going into specialties will make boat loads of money, live in nicer neighborhoods, drive nicer cars, live a better life (at least that’s what they hope/think)
peds and FM and the lowest paid specialties. That’s the catch
This is why I don't understand these threads. Nothing in here is a secret and 100% of it is a pros/cons value judgement. Picking a specialty is all about tradeoffs. No one can make this decision for another person.If literally all you care about is total income, then yes FM is much lower on the list.
But, as stated previously, money isn't everything. If you work 60+ hours/week to make twice what I do in 36 hours, is it worth it? Not to me. Is it worth it to be on call nights, weekends, and holidays at various times? Again, not to me. Is it worth it to have more years in training to make more money? You get the idea.
SDN has this weird fascination with income over all other factors. I finished residency before my 30th birthday. I haven't worked a night, weekend, or holiday since then. My job is low stress with plenty of time off. In exchange, I take a decent income hit compared to other specialties. For many people, this is a fine trade.
Lol why would you care about the opinion of someone who makes unfounded assumptions about people's scores? Two of our now-PGY1 AOA people are in family med - I would assume they didn't bomb Step. One of my classmates is a borderline savant and they have wanted family med from the start. I did decently well on Step and I'm considering FM myselfHot take ~ but I feel like it has less to do with the field and more to do with med students being med students. Money really isn't an issue, even for those w/o scholarships, in any specialty except maybe academic peds. People who get into med school and even more so people who get into top 5 med schools typically have a innate drive that prevents them from setting sights on something not viewed as prestigious.
You mention your stats in this very post, you okay with your peers assuming you bombed your steps? If you in fact are, there's still plenty of med students who aren't.
Only in medicine would $250k-$300k a year be "no money."The catch is you make no money? Your peers going into specialties will make boat loads of money, live in nicer neighborhoods, drive nicer cars, live a better life (at least that’s what they hope/think)
peds and FM and the lowest paid specialties. That’s the catch
I think this might be changing. Rads is one of the top 5 specialties for income, but our local uni only matched 1 student in rads out of a class of over 100 students. I think the rads lifestyle is getting less appealing and FM more appealing. Fortunately, we are all different and find different aspects of each specialty more appealing. It's ALL just work in the end.If literally all you care about is total income, then yes FM is much lower on the list.
But, as stated previously, money isn't everything. If you work 60+ hours/week to make twice what I do in 36 hours, is it worth it? Not to me. Is it worth it to be on call nights, weekends, and holidays at various times? Again, not to me. Is it worth it to have more years in training to make more money? You get the idea.
SDN has this weird fascination with income over all other factors. I finished residency before my 30th birthday. I haven't worked a night, weekend, or holiday since then. My job is low stress with plenty of time off. In exchange, I take a decent income hit compared to other specialties. For many people, this is a fine trade.
Absolutely, and my goal is not to convince anyone to choose FM. But, I don't want someone who likes FM and chooses not to pursue it based on the usual assumptions about the field.I think this might be changing. Rads is one of the top 5 specialties for income, but our local uni only matched 1 student in rads out of a class of over 100 students. I think the rads lifestyle is getting less appealing and FM more appealing. Fortunately, we are all different and find different aspects of each specialty more appealing. It's ALL just work in the end.
Only in medicine would $250k-$300k a year be "no money."
MedTwitter, tooReally only on SDN.
MedTwitter
Could you expand a bit on this point? I'm curious.3. If you go to a community program, you will have to get used to every attending having imposter syndrome for the rest of your resident life. It's a very toxic environment.
LikewiseCould you expand a bit on this point? I'm curious.
If you are M1 then it is way way too early to even figure out what you like/dislike. Until you start doing rotations and getting into the essence of what all the specialties do I think you are jumping the gun. FM actually has a lot of different aspects to it that you can fine tune what you line into your practice.Hi everyone!
I'm an incoming M1 at a T5 school, and am very interested in FM (rural in particular). I've shadowed a lot of FM's (and other specialties), and had really great experiences growing up with my FM docs. Would be really interested in sports medicine but would be happy doing FM in general too.
The thing is, it seems like literally no other peers seem to think FM is a good idea, especially at top schools. Is there something I'm hugely missing out/being naive about on why FM is generally considered "bottom of the barrel" in terms of specialty consideration? Why are so many bright students staying away from this field?
My scores were good in undergrad (>3.9, >520), so it's not like I'm worried about my test-taking abilities or anything for more competitive specialties. Med school loans are not a problem since I was fortunate to receive full tuition.
Thanks!
Considering the loans you’re paying back, it’s closer to 100k of gross income (until you pay it off) and that could’ve been achieved in other fields not requiring sacrificing so many years and going through all the med school and residency bs. FM and peds are underpaid, really.Only in medicine could a $200k+ job for 40 hours a week guaranteed for life not be "prestigious" lol
Bro are you gonna be paying 100k/yr towards your loans??Considering the loans you’re paying back, it’s closer to 100k of gross income (until you pay it off) and that could’ve been achieved in other fields not requiring sacrificing so many years and going through all the med school and residency bs. FM and peds are underpaid, really.
If you want to pay them off fast, yeah.Bro are you gonna be paying 100k/yr towards your loans??
One of them said well doctors only go into that since they couldn’t get into anything else.
Dang I was gonna refinance into 4% ish and put all my extra cash into the S&PIf you want to pay them off fast, yeah.
Dang I was gonna refinance into 4% ish and put all my extra cash into the S&P
I guess you cant put a price on the satisfaction of being debt free ASAP though
Dang I was gonna refinance into 4% ish and put all my extra cash into the S&P
I guess you cant put a price on the satisfaction of being debt free ASAP though
I was gonna refinance anyway for the perk where you pay $100/mo in residency. A dollar now is worth a lot more to me than a dollar as an attending. And as long as the S&P is performing above 4% avg over the loan repay period, you're making money.How many years are you anticipating having the loan for? You're probably familiar with White Coat Investor but the general advice is to get rid of loans as quickly as possible and ideally within 5 years unless someone is going for PLSF.
Are you waiting for the 0% interest to end in October before privately refinancing?I was gonna refinance anyway for the perk where you pay $100/mo in residency. A dollar now is worth a lot more to me than a dollar as an attending. And as long as the S&P is performing above 4% avg over the loan repay period, you're making money.