Peds in FM

[Charlie0318]

Advertisement - Members don't see this ad

So I am a third year and on my Peds rotation, and must admit I am loving it. I have been thinking FM up until now in school as the diversity and continuity of care appeals greatly to me but I don't do my FM rotations until later in the year. This month of Peds is making me strongly consider it as an option though. This month is also the first month of practicing primarily an outpatient style though, so I am not sure if that is part of why I am enjoying the month so much.

My question: How much peds can/do you do in FM and how much similarity is there between a peds practice and FM practice?

Thank you in advance for your feedback and responses 🙂

 

[andon]

It depends on location, primarily, as to how much peds you do as an FM doc. As an outpatient, it is identicial. As inpatient, you would just ask like a hospitalist no matter what, unless you were a peds subspecialist. If you are in a place with no tertiary peds hospital the really sick kids will be shipped regardless.

Thus, as in all of medicine, it depends.

 

[rachmoninov3]

Pediatrics shares a lot of the same preventive/adovacy that Family Medicine does. Seeing as you are half way through your MSIII year, I'd wait and see if you like OB and IM . If you can live without those two things do Peds. If you can live without OB, do an IM/Peds residency.
In my humble opinion, there is nothing cooler than doing a women's prenatal care, her delivery, and seeing the kid in the outpatient setting. Totally makes my day! I had one yesterday where both parents came to the visit. Dad has his hair spiked in a mohawk. 6 month old son's hair was styled in the same way (not buzzed on the sides just gelled up to spike in the center, just like dad's).

 

[Charlie0318]

Thank you both for the responses!! 🙂

I have done inpatient IM and OB already, and liked both well enough. I could never ONLY do OB, but I enjoyed my time doing it and could see myself enjoying some. IM was interesting, but inpatient was very frustrating, I hated having to take a band-aid approach and using medications as a quick fix to get people out the door instead of sitting down and addressing the real root cause of their problems. A lot of interesting pathology and good learning, but I would shoot myself if I did that for the rest of my life.

I guess what got me was Peds is the first rotation I have done where I could see myself doing it for the rest of my life exclusively. The other stuff has been interesting so far, and enjoyable in small doses, but I couldn't picture myself doing it long term. That is why I was wondering if FM is similar style of practice environment and setting because that bodes well 🙂

 

[ztaw15]

I think part of the problem is that clerkship rotations often bear no resemblance to what the practice of any specialty is actually like as a career. For me, my medicine rotation was probably the biggest culprit, though psych and neuro were pretty big offenders as well.

Think about it. When I did my third year medicine months, I came in, rounded on my patients, met with my interns, met with my residents, and then rounded with the attending as a big group. Then we had a lecture, then we did a lot of jerking around, checking up on things that didn't need to be checked on and just generally wasting time. Or reading if we were lucky, or better yet getting an admission.

Now, I get that this is a teaching service, and I like the way it was run for learning purposes, so I have no problem with that at all. But no private practice internist has a day like this - if indeed the private practice internist still exists, a fact of which I am skeptical.

Some rotations, and residencies, more closely approximate their specialtie's real world practice. Surgery comes to mind, and for me my FM rotation certainly did. Peds was likely as big of an offender as IM, and OB is pretty far off too.

As for psychiatry, well I have literally no idea what a private practice psychiatrist does. I can give you a very good idea of what a psychiatrist at a large state run facility for involuntarily committed people does, but how many psychiatrists does that describe?

Okay, that was a big rant, and it was only vaguely related to your question, but I think the point is an important one.

 

[ztaw15]

Oh, and to more directly address your point, I worked with a practice for eight weeks, and I would say the FM guys there saw 1/4 of their patients were peds, probably 1/4 OB, and the remainder adult medicine/geriatrics. I guess you can mix it any way you want.

I would suggest peds if you wanted to see only kids, no OB. Or if you were possibly interested in a peds subspecialty.

I was/am like you in that way. I liked OB/Gyn, but not all the time. Same for Peds and adult Med. Heck, same for surgery/Psych/Neuro?whatever. I liked them all, but I wasn't obsessed with them enough to want to do only that forever and ever amen.

Obviously there are sacrifices that go along with choosing breadth, but I ended up deciding they were things I was willing to sacrifice - because you just can't do it all, even though some FM guys seem like they do.

 

[jl lin]

Pediatrics shares a lot of the same preventive/adovacy that Family Medicine does. Seeing as you are half way through your MSIII year, I'd wait and see if you like OB and IM . If you can live without those two things do Peds. If you can live without OB, do an IM/Peds residency.
In my humble opinion, there is nothing cooler than doing a women's prenatal care, her delivery, and seeing the kid in the outpatient setting. Totally makes my day! I had one yesterday where both parents came to the visit. Dad has his hair spiked in a mohawk. 6 month old son's hair was styled in the same way (not buzzed on the sides just gelled up to spike in the center, just like dad's).

Nice! Just wondering how prevalent, in general, what you lastly described, occurs in FM. I get that it all depends; but to me I think part of the beauty of family medicine is to see the whole span and people at different phases. Also, as a nurse, I spend a big part in peds. But to a large degree, in peds you are still dealing with adults, b/c you have to relate to the parents, and you have to be open to and understanding of family-centered care. FCC just makes good sense to me, and working in pediatric critical and other areas of peds as a RN, I think it is what causes me to be interested in FM.

In more recent decades, general practice seems to have fallen out of favor as everything is all about specialization. But I remember some docs from my youth that were truly dedicated to FM/GP and really knew an awful lot and were just completely given over to it. Growing up, we didn't have a pediatrician. Our family doc was beyond excellent in every way. When he died, it seemed like the end of an era. Although I have had and have worked with some great docs since them, it just hasn't been the same--especially in FP. I don't mean to overly idealize it. I understand that much has changed in medicine, in general. But when you shared (above), it reminded me of how it really was and can be.

Thanks. 🙂