Primary care: Internal vs family?

[lost777]

If the goal is primary care, is internal medicine or family medicine the better way to go?

Are there any differences in PCP job opportunities between the two? How about pay?

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[12glaucoma34]

If the goal is primary care, is internal medicine or family medicine the better way to go?

Are there any differences in PCP job opportunities between the two? How about pay?

If I knew that subspecializing wasn't ever going to be an interest, I would go 100% family medicine.

 

[Hkhan]

If I knew that subspecializing wasn't ever going to be an interest, I would go 100% family medicine.

Yeah - less competitive than IM (lower step scores, 0 research fairly common [for those who match]).


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[Drrrrrr. Celty]

Depends on whether or not you're interested in providing gynecological or pediatric services. If no, then IM.

 

[hallowmann]

If the goal is primary care, is internal medicine or family medicine the better way to go?

Are there any differences in PCP job opportunities between the two? How about pay?

If you're OK with women and kids, FM is by far the better way to go for primary care. Job prospects are better too, because UCs and a lot of hospital systems prefer FM docs because they can see kids too. Pay is pretty similar for general IM and FM.

This is only assuming you have no intention of sub-specialization.

Yeah - less competitive than IM (lower step scores, 0 research fairly common [for those who match]).
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Not sure how that's related to the post you replied to, but that is generally true. That said, IM has a pretty broad range of non-competitive programs. Its not a stretch to call many FM programs more competitive than certain IM programs. As far as research, again it varies. There are a lot of research heavy FM programs out there, and lots of FM docs participate in clinical research - usually related to delivery of care, prevention, education, etc.

 

[SLC]

Family Med is a great gig, in my opinion of course. I toyed with the idea of doing IM, thought maybe Onc afterward. No regrets at all anymore.

I like Gyn generally, don't mind seeing kids, plus I think FM docs are better at primary care delivery, it's our area of expertise. Internists are smart, but they seem to get minimal ambulatory primary care exposure in residency training. They usually refer for things FM docs are comfortable (and competent) with, not uncommon (in my experience) for them to have their female patients seeing ObGyn for pap-smears, derm for biopsies, etc.

 

[Mehd School]

Depends on whether or not you're interested in providing gynecological or pediatric services. If no, then IM.

We handled (minor) women's health on my outpatient IM rotation. No kids though. Honestly the average age of patient on that service was probably 75.

 

[rafa 22]

Family medicine all the way! i don't know how it is in the US but in south america doing internal medicine is practically doing geriatrics

 

[acapnial]

Family medicine all the way! i don't know how it is in the US but in south america doing internal medicine is practically doing geriatrics

It's not like that in the us

 

[AlbinoHawk DO]

Depends on whether or not you're interested in providing gynecological or pediatric services. If no, then IM.

This. If I went for primary care, I would at least avoid gyn/ped stuff.

 

[SLC]

It's not like that in the us

Except that it is.

 

[cbrons]

If the goal is primary care, is internal medicine or family medicine the better way to go?

Are there any differences in PCP job opportunities between the two? How about pay?

For adult medicine, internal medicine is the best.

 

[Mehd School]

Except that it is.

It truly is. Like I said in my above post the average age of patient I saw in my IM clinic month was in the mid 70's. One day I saw 3 separate patients that were all over 100 years old. That entire month I saw two patients under 30.

 

[acapnial]

Except that it is.

Nah, in my outpatient clinic I'm yet to have a patient over 70. I know they're on their way but the point is it's hardly geriatrics just because you don't see a lot of patients under 30, or kids.

 

[Mehd School]

Nah, in my outpatient clinic I'm yet to have a patient over 70. I know they're on their way but the point is it's hardly geriatrics just because you don't see a lot of patients under 30, or kids.

Your experiences are atypical.

 

[Drrrrrr. Celty]

Honestly most primary outpatient medicine is geriatrics.

 

[SLC]

Honestly most primary outpatient medicine is geriatrics.

My average patient age (panel n=920) is approx 48years

 

[Drrrrrr. Celty]

My average patient age (panel n=920) is approx 48years

To a babe in their 20s, 30 and up is already one foot in the grave brah.

 

[hallowmann]

For adult inpatient medicine, internal medicine is the best.

Ftfy.

Honestly if you know you're doing outpatient only and won't specialize and you're OK with gyn and peds, FM is the way to go. You'll get much more training in the outpatient setting and more prevention as well.

Either way (IM or FM), you can learn the medicine you need, just like at most FM programs you could easily learn what you need to be a hospitalist. That said, if you know you want primary care, why not go to a program that will train you well for it.

Alternatively, if you don't like Gyn/peds you could do the whole IM PC track. It should get you more outpatient and prevention exposure.

 

[acapnial]

Your experiences are atypical.

All those folks with diabetes, heart failure, copd, ckd, etc that happen to be less than 70, or 60, or whatever all have to see someone, and the average internist sees plenty of them in clinic. Old people get sicker and need more meds so they're a big part of the patients you give care to, but unless the internist really likes old people and selects for them, it's a far cry from actual geriatrics.