Setting of medical career terminology

[deeproots]

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Hi all! I'm applying to MD schools this cycle, and I'm having a really hard time answering the "describe the setting in which you envision conducting your medical career" questions. Well, I know what I want to do, but I'm having trouble putting it into words. Here's the gist of it:

As an family medicine MD, I would love to divide my time between working in a hospital and a clinic setting in a rural location. I would also enjoy working part-time in a free clinic.

I know I know, that sounds crappy. I've been looking up options for family medicine/primary care providers regarding working in a hospital AND a clinic, but I don't know the terminology used for this. The physician I shadowed during my undergrad spent a few days a week at a rural family medicine clinic, and she spent the rest of her time seeing patients on an inpatient basis in a hospital. Both the clinic and the hospital are run by my university.

I also spoke to a research-focused physician who did part time work in an STD clinic, which I thought was really awesome. I think working in a free clinic, STD clinic, etc. would be incredibly rewarding.

However, I feel like my future goals sound too broad and unfocused, like I don't know what I want to do. I'm trying to hone it in while also using concise terminology that makes sense. I've also been reading a bit about how family medicine physicians are discriminated against when it comes to doing inpatient work in a hospital--I don't know the reasoning behind this and don't want to touch on any controversial topics.

Any insight y'all could offer would be very much appreciated!

 

[allojay]

Hi all! I'm applying to MD schools this cycle, and I'm having a really hard time answering the "describe the setting in which you envision conducting your medical career" questions. Well, I know what I want to do, but I'm having trouble putting it into words. Here's the gist of it:

As an family medicine MD, I would love to divide my time between working in a hospital and a clinic setting in a rural location. I would also enjoy working part-time in a free clinic.

I know I know, that sounds crappy. I've been looking up options for family medicine/primary care providers regarding working in a hospital AND a clinic, but I don't know the terminology used for this. The physician I shadowed during my undergrad spent a few days a week at a rural family medicine clinic, and she spent the rest of her time seeing patients on an inpatient basis in a hospital. Both the clinic and the hospital are run by my university.

I also spoke to a research-focused physician who did part time work in an STD clinic, which I thought was really awesome. I think working in a free clinic, STD clinic, etc. would be incredibly rewarding.

However, I feel like my future goals sound too broad and unfocused, like I don't know what I want to do. I'm trying to hone it in while also using concise terminology that makes sense. I've also been reading a bit about how family medicine physicians are discriminated against when it comes to doing inpatient work in a hospital--I don't know the reasoning behind this and don't want to touch on any controversial topics.

Any insight y'all could offer would be very much appreciated!

My advice/ $0.02 is to keep it simple. Don't worry about using big words and sounding like a medical professional. Schools know that you're not wholly familiar with Medicine but they want you to have some idea of what you see yourself doing. I think your explanation is good enough. No need to make the question anymore complicated than it needs to be. Just answer it, plain and simple. But be sure to always connect your answers with the school's mission. For example, if your school is primarily based on serving underserved communities, then you'd want to include your motivations to serve an underserved community when you graduate.and so on. Good luck!

 

[deeproots]

My advice/ $0.02 is to keep it simple. Don't worry about using big words and sounding like a medical professional. Schools know that you're not wholly familiar with Medicine but they want you to have some idea of what you see yourself doing. I think your explanation is good enough. No need to make the question anymore complicated than it needs to be. Just answer it, plain and simple. But be sure to always connect your answers with the school's mission. For example, if your school is primarily based on serving underserved communities, then you'd want to include your motivations to serve an underserved community when you graduate.and so on. Good luck!

Thank you, allojay! I'm trying to describe my desired setting based on my shadowing opportunities, so I'm able to bypass all those fancy words 🙂 I appreciate your insight!

 

[allantois]

Family doctors are not the only ones who can simultaneously work both inpatient and outpatient (many surgeons do so among many other specialists). You can say that you see yourself working in a rural clinic throughout the week as well as coming to a hospital a few days in a week and also volunteering at free clinics every now and then. Basically what you said is fine.

 

[LizzyM]

Rather than focus on the location where care is provided, think about the kind of relationship you'd like to have with patients. From what I hear you saying, you'd like to develop long-term relationships with patients of all ages caring for them in an ambulatory care setting (office/clinic) and in an inpatient setting (hospital, maybe nursing home??).

A "free clinic" means you either work as a volunteer or you are paid. Either way, you provide services to people who receive care at no cost and that care is provided in an ambulatory setting. So, in essence that is the same as the other although the population served might be different in terms of socioeconomic status.

Treating people in an STD clinic is going to be (one hopes) a one-time thing rather than an on-going relationship. Still, it is important work and if you are willing to meet the need, more power to you.

Much of the care provided in the hospital setting is provided by specialists (surgical specialists of various types, cardiologists, neurologists, etc). There might be a place for someone in family medicine caring for patients with routine issues such as normal vaginal delivery, newborn care, and some of the very common medical conditions that require hospitalization such as community acquired pneumonia, congestive heart failure and kidney infection with sepsis. However, I would have my doubts about someone from family medicine managing a patient in the ICU but maybe that's my ignorance.
The family medicine doc may know something about many different conditions and be able to work up and refer patients for specialty care and provide ongoing medical care across the lifespan including preventive services such as vaccines and screening tests but I think that there is some feeling that they can't do all that and be up to the minute on all the hospital protocols for every organ system and body part.

Some doctors "round" on their patients who are hospitalized out of courtesy but the care is managed by a "hospitalist" whose job it is to care for the patient in the hospital. This saves the community-based doctor from running back & forth to the hospital morning and night to make rounds and write orders and follow up on test results and so forth but helps them stay in touch with their patients. The drawback some see is that the primary care doc may not get paid for these courtesy visits and may not be able to write orders on those patients.

If you shadowed someone affiliated with a medical school, it is likely that they are a salaried physician who is supervising residents in a clinic setting and a hospital setting and that's a bit of a different beast.

 

[deeproots]

Family doctors are not the only ones who can simultaneously work both inpatient and outpatient (many surgeons do so among many other specialists). You can say that you see yourself working in a rural clinic throughout the week as well as coming to a hospital a few days in a week and also volunteering at free clinics every now and then. Basically what you said is fine.

Thanks, allenlchs! This is very helpful 🙂

 

[gyngyn]

Don't use "love" in your essay. This is not Petrarch.

 

[deeproots]

Rather than focus on the location where care is provided, think about the kind of relationship you'd like to have with patients. From what I hear you saying, you'd like to develop long-term relationships with patients of all ages caring for them in an ambulatory care setting (office/clinic) and in an inpatient setting (hospital, maybe nursing home??).

A "free clinic" means you either work as a volunteer or you are paid. Either way, you provide services to people who receive care at no cost and that care is provided in an ambulatory setting. So, in essence that is the same as the other although the population served might be different in terms of socioeconomic status.

Treating people in an STD clinic is going to be (one hopes) a one-time thing rather than an on-going relationship. Still, it is important work and if you are willing to meet the need, more power to you.

Much of the care provided in the hospital setting is provided by specialists (surgical specialists of various types, cardiologists, neurologists, etc). There might be a place for someone in family medicine caring for patients with routine issues such as normal vaginal delivery, newborn care, and some of the very common medical conditions that require hospitalization such as community acquired pneumonia, congestive heart failure and kidney infection with sepsis. However, I would have my doubts about someone from family medicine managing a patient in the ICU but maybe that's my ignorance.
The family medicine doc may know something about many different conditions and be able to work up and refer patients for specialty care and provide ongoing medical care across the lifespan including preventive services such as vaccines and screening tests but I think that there is some feeling that they can't do all that and be up to the minute on all the hospital protocols for every organ system and body part.

Some doctors "round" on their patients who are hospitalized out of courtesy but the care is managed by a "hospitalist" whose job it is to care for the patient in the hospital. This saves the community-based doctor from running back & forth to the hospital morning and night to make rounds and write orders and follow up on test results and so forth but helps them stay in touch with their patients. The drawback some see is that the primary care doc may not get paid for these courtesy visits and may not be able to write orders on those patients.

If you shadowed someone affiliated with a medical school, it is likely that they are a salaried physician who is supervising residents in a clinic setting and a hospital setting and that's a bit of a different beast.

Wow, thanks LizzyM! This gives me quite a bit of insight into the typical work environments of different physicians. I was surprised how little info I could find on this topic online. I very much appreciate the information!!!

 

[drcrispmd]

Some family docs admit their own patients and care for them in the hospital. They will see them before and or after their clinic hours. Some community hospitals have open ICU and family docs can care for their patients in that setting (obviously there are critical care doc if needed). At my residency the ICU was open. Family docs can Aldo do OB and deliver babies and care for mom and the newborn. Family med docs also take care of peds in the hospital and outpatient. You can taylor your practice however you want.

 

[deeproots]

Don't use "love" in your essay. This is not Petrarch.

Haha, thanks gyngyn. I will be sure to avoid that word.

 

[deeproots]

Some family docs admit their own patients and care for them in the hospital. They will see them before and or after their clinic hours. Some community hospitals have open ICU and family docs can care for their patients in that setting (obviously there are critical care doc if needed). At my residency the ICU was open. Family docs can Aldo do OB and deliver babies and care for mom and the newborn. Family med docs also take care of peds in the hospital and outpatient. You can taylor your practice however you want.

Thanks drcrispmd. This is very helpful. Question, if you don't mind: when the family docs admit their own patients and care for them in the hospital, are these courtesy visits or are the family docs compensated for these?

 

[gyngyn]

Thanks drcrispmd. This is very helpful. Question, if you don't mind: when the family docs admit their own patients and care for them in the hospital, are these courtesy visits or are the family docs compensated for these?

You are compensated for services delivered. If your rounds are documented you will be reimbursed consistent with the time spent and acuity of the problems managed.

 

[drcrispmd]

If you admit them you take care of them and bill for them. You write all the notes, order meds, labs, tests, consults, etc. If there are issues during the day the nurses call you and at night the call whoever is on call for your group. Hospitalist have nothing to do with these patients.

Hospitalist admit patients who do not have a doc or their primary doc does not admit patients.

 

[deeproots]

You are compensated for services delivered. If your rounds are documented you will be reimbursed consistent with the time spent and acuity of the problems managed.

Excellent. Thank you so much for your help!

 

[deeproots]

If you admit them you take care of them and bill for them. You write all the notes, order meds, labs, tests, consults, etc. If there are issues during the day the nurses call you and at night the call whoever is on call for your group. Hospitalist have nothing to do with these patients.

Hospitalist admit patients who do not have a doc or their primary doc does not admit patients.

Thank you very much for the help, drcrispmd!