Shooting for family practice

[Yoda DO]

I just started school and have had my first block exam. I am shooting for rural FM, how well do I need to do to get a rural FM residency? Do I need to be in the middle of pack?

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[Mr Kenobi]

Strong with you the neuroticism is.

 

[Doctor Bob]

Rural FM is somewhere between integrated plastics and pediatric In-Vitro Fertilization fellowship in terms of competitiveness.





Seriously. Really? Really? Just graduate and don't commit a felony.

 

[Oo Cipher oO]

It is a fine a worthy goal to be a rural FM physician. It will not necessarily be hard to get such a position as not many physicians apply seeking those types of jobs.

However your more immediate goal is a family medicine residency. These residencies vary in training and exposure to complex cases. Some FM residencies are happy to take anyone with a diploma and a heartbeat. But you should want the best training for your residency. Doing well in school and board exams will set you up in a better position to choose from strong programs in the future. It's too early in the game to set your sights on the lowest benchmark.

 

[DocWinter]

I would suggest studying and working hard for the next 2 years with the mindset of getting into EM or surgery or something mid tier. Then, when you graduate, you can have your pick of the very best rural medicine available, so long as you do what other posters have said by not committing a felony or completely failing out.

I commend your altruistic nature; however, you're expecting a competition when you'll likely be handed a spot happily

 

[YankeeCandle1141]

The absolute dumbest thing you could do is "shoot for rural FM".

Wait til third year when you realize what doctors do, then make a decision.

If you shoot for rural FM, you will close every other door

 

[Yoda DO]

I'll rephrase. I'm doing Rural FM because I have a full ride scholarship to do so and I'm a country doc kind of person. Also, let's assume that I am a nontrad that has been around the block a time or two. Now, can anyone tell me the kind of grades, board scores, etc. that I will need to get into a good rural family medicine residency?

 

[DocWinter]

I'd shoot for a 70% average in your coursework and you'll also want to hit a 192 on the boards. That should do it for ya, honestly.

 

[Yoda DO]

Wow, so basically don't fail out and I'll be ok. @DocWinter How do the other primary care specialties compare?

 

[DocWinter]

I'm not a master of the subject, but you can confirm my understanding of difficulties of primary care residencies by looking at the latest numbers from AMA.

Basically, as far as competition:
Rural FP<FP<peds=psych<IM<obgyn<EM<gen. surgery.

They all could be a spot higher or lower, especially IM depending on quality and location. Rural is typically a undesired location for most candidates, therefore more are available. If it suits you, you shouldn't question your pursuits, but still strive to be at least an average student, for your future pts sake

 

[YankeeCandle1141]

I'll rephrase. I'm doing Rural FM because I have a full ride scholarship to do so and I'm a country doc kind of person. Also, let's assume that I am a nontrad that has been around the block a time or two. Now, can anyone tell me the kind of grades, board scores, etc. that I will need to get into a good rural family medicine residency?

As current medical students, we have been around this exact block more than a time or two.


Don't be one of the thousands of medical students who finds out during third year that they hate the specialty that they pigeonholed themselves into.

 

[Yoda DO]

As current medical students, we have been around this exact block more than a time or two.
Don't be one of the thousands of medical students who finds out during third year that they hate the specialty that they pigeonholed themselves into.

I didn't really intend for this thread to be about my pursuit of FM. I'm already contractually obligated to enter into primary care. It's too late, couldn't take it back if I wanted to. I can choose between the 5 primary care specialties though. So I'd say I'm already half pigeonholed.

 

[YankeeCandle1141]

I didn't really intend for this thread to be about my pursuit of FM. I'm already contractually obligated to enter into primary care. It's too late, couldn't take it back if I wanted to. I can choose between the 5 primary care specialties though. So I'd say I'm already half pigeonholed.

Well then shoot for top level IM that way you have options for fellowships. There is nothing wrong with family medicine if thats what you wand to do.
What I am saying is- there is a lot wrong with prematurely closing doors because people told you to just get by.

 

[Moose A Moose]

I just started school and have had my first block exam. I am shooting for rural FM, how well do I need to do to get a rural FM residency? Do I need to be in the middle of pack?

God bless you. Be sure to use OMM daily and have at least two Norman Rockwell paintings in your waiting room.

 

[Seth Joo]

I just started school and have had my first block exam. I am shooting for rural FM, how well do I need to do to get a rural FM residency? Do I need to be in the middle of pack?

You will become a rural Family doctor as long as you survive medical school, anyone can get Family Practice. By the way the hardest residency to get is the three year OMM. I found out that is the hardest one to get because there are only a handful of places each year.

 

[Yoda DO]

Thank you everyone for the encouraging words and outpouring of support for my pursuit of FM. I'm going to go cry myself to sleep now.

 

[kenjixshadow]

Thank you everyone for the encouraging words and outpouring of support for my pursuit of FM. I'm going to go cry myself to sleep now.

You can do an ACGME FM to avoid OMM and work as a locum and still rack up those $$$. I would avoid rural FM though. Or if you change your mind and don't want to do primary care anymore, be sure to match into an academic IM so you can get a fellowship later on.

 

[NurWollen]

You can do an ACGME FM to avoid OMM and work as a locum and still rack up those $$$. I would avoid rural FM though. Or if you change your mind and don't want to do primary care anymore, be sure to match into an academic IM so you can get a fellowship later on.

Why would you avoid rural FM?

 

[Oo Cipher oO]

Thank you everyone for the encouraging words and outpouring of support for my pursuit of FM. I'm going to go cry myself to sleep now.

You asked for advice not support. We are just strangers on the Internet. We have no real idea of your history or motivations for going into FM.

I think it's great you have a small town doctor personality. I do as well. But as a 4th year I am working hard to get the best residency at the busiest urban center to get the best and widest educational exposure. This preparation will help me better handle my own solo practice in whatever setting I choose.

The answer to your question is relatively simple. You just need to pass medical school. But there is danger in setting your goals to just pass so early. First you don't know yet how much effort is required for just passing. If you are less motivated to fully apply yourself then your classmates you run the risk of academic troubles.

 

[hallowmann]

Just study. Learn the material as best you can. Do as well on boards as you can. Make the decision on what you want to do in 3rd year. I actually like FM, but its still too early for me to decide as a new 3rd year, so you deciding how hard you need to work to get any residency seems like a bad idea to me.

As long as you pass your classes and boards, you should get some residency, and that usually means FM, because there's thousands of programs and many AMGs aren't interested in it. That said, don't set your bar there, just let that idea comfort you on those 13 hour Step 1 study days.

 

[wjs010]

Isn't EM considered primary care too in some locations?

 

[TheBoneDoctah]

I love how you guys are ripping this guy/gal to shreds for wanting to become a family doc. Not everyone wants to live in the ER or in an operating room. Also, I am pretty sure most of you told your schools that "you wanted to become a family doc and use OMM to treat your patients better...."

I think what everyone is trying to say is...if you want to be a family doctor, graduate medical school, pass your boards, and become a family doc.

 

[racerwad]

Isn't EM considered primary care too in some locations?

Nope.

 

[67552931811]

Isn't EM considered primary care too in some locations?

At one of my interviews, when I applied, the school spun it as so. Which, I mean, was cool for all the EM-crazed folks.

Still. It's not PC, though the ED functions as a walk-in clinic 99% of the time (don't obliterate me EM peeps).

 

[kenjixshadow]

I love how you guys are ripping this guy/gal to shreds for wanting to become a family doc. Not everyone wants to live in the ER or in an operating room. Also, I am pretty sure most of you told your schools that "you wanted to become a family doc and use OMM to treat your patients better...."

I think what everyone is trying to say is...if you want to be a family doctor, graduate medical school, pass your boards, and become a family doc.

I didn't. I straight up told my school that I have no desire in primary care whatsoever (but flirted it in an agreeable way). I didn't have to lie. They knew that I'd be one of the kids who is aiming a competitive specialty, so why not? The more "wow" matches a school gets, the more they will be attractive to future applicants.

 

[NurWollen]

I don't think people are criticizing the OP for wanting FM. They just are giving the (very good) advice to work hard. Keeping options open is never a bad thing.

That said, there is a fair amount of anti-FM bias in medicine, and it's not cool. The FM doc I rotated with for my 1st FM rotation was easily as brilliant as any subspecialist I've met. If our health care system and culture put the value on FM doctors that they deserve, untold numbers of patients' lives could be changed for the better. It's a noble specialty, and it's a shame that so many schools and specialists try to deter students from pursuing it.

 

[IslandStyle808]

Isn't EM considered primary care too in some locations?

More like tertiary care in all locations....

 

[W19]

I don't think people are criticizing the OP for wanting FM. They just are giving the (very good) advice to work hard. Keeping options open is never a bad thing.

That said, there is a fair amount of anti-FM bias in medicine, and it's not cool. The FM doc I rotated with for my 1st FM rotation was easily as brilliant as any subspecialist I've met. If our health care system and culture put the value on FM doctors that they deserve, untold numbers of patients' lives could be changed for the better. It's a noble specialty, and it's a shame that so many schools and specialists try to deter students from pursuing it.

I am not sure schools discourage student from going into FM; it's more like financial circumstances and the way primary care docs are treated these days that force these students to look elsewhere... Most med students are crushed by debt, so it's understandable that a lot of them don't want to go into a specialty that get compensated 180k/year an average while dealing with a bunch of paper work. Others specialties are doing well... why not go where the gravy is? Look at EM now! These docs are making 350k+/year working 12-12hrs shift per month... Reading the EM forum, one would believe that 400k is probably the average salary of that specialty. EM has become the new anesthesia now in term of salary... Lol.

http://forums.studentdoctor.net/threads/the-budget-of-the-joneses.1154075/

 

[NurWollen]

I am not sure schools discourage student from going into FM; it's more like financial circumstances and the way primary care docs are treated these days that force these students to look elsewhere... Most med students are crushed by debt, so it's understandable that a lot of them don't want to go into a specialty that get compensated 180k/year an average while dealing with a bunch of paper work. Others specialties are doing well... why not go where the gravy easy? Look at EM now! These docs are making 350k+/year working 12-12hrs shift per month... Reading the EM forum, one would believe that 400k is probably the average salary of that specialty. EM has become the new anesthesia now in term of salary... Lol.

http://forums.studentdoctor.net/threads/the-budget-of-the-joneses.1154075/

Yeah, no wonder EM so insanely popular right now. That's another specialty I'd consider as I like the breadth of knowledge it involves. I just imagine having to work nights and holidays and weekends for 30 more years and picture it being sort of like dying slowly.

 

[W19]

Yeah, no wonder EM so insanely popular right now. That's another specialty I'd consider as I like the breadth of knowledge it involves. I just imagine having to work nights and holidays and weekends for 30 more years and picture it being sort of like dying slowly.

The way compensation is in EM now, one can work for just 15 years and call it a day if you use your money wisely...

 

[67552931811]

I am not sure schools discourage student from going into FM; it's more like financial circumstances and the way primary care docs are treated these days that force these students to look elsewhere... Most med students are crushed by debt, so it's understandable that a lot of them don't want to go into a specialty that get compensated 180k/year an average while dealing with a bunch of paper work. Others specialties are doing well... why not go where the gravy is? Look at EM now! These docs are making 350k+/year working 12-12hrs shift per month... Reading the EM forum, one would believe that 400k is probably the average salary of that specialty. EM has become the new anesthesia now in term of salary... Lol.

http://forums.studentdoctor.net/threads/the-budget-of-the-joneses.1154075/

You also have to consider hours in that FM number. They aren't working 60-70 weeks to make 180. I know FM docs pushing 300... It's all relative.

 

[YankeeCandle1141]

I love how you guys are ripping this guy/gal to shreds for wanting to become a family doc. Not everyone wants to live in the ER or in an operating room. Also, I am pretty sure most of you told your schools that "you wanted to become a family doc and use OMM to treat your patients better...."

I think what everyone is trying to say is...if you want to be a family doctor, graduate medical school, pass your boards, and become a family doc.

Thats really not at all whats happening here. The advice is to not set low goals before you know what you are doing.

Also, you have been in medical school for about 1 week. You will see this too when you get to rotations.

 

[TheBoneDoctah]

Thats really not at all whats happening here. The advice is to not set low goals before you know what you are doing.

Also, you have been in medical school for about 1 week. You will see this too when you get to rotations.

I agree with you about not setting low goals because you don't know what's going to happen...however the OP stated he WANTED to become a family doc and is locked into family med. I don't think asking for a target score is necessarily setting a low goal.

 

[Yoda DO]

I'll be honest, it was nice to hear that I can get into FM with lower than average stats, but I don't plan on slacking off. I am in the middle-ish of my class and hopefully I can stay there. I know it might sound crazy to some of you city dwellers, but I am built for rural medicine.

 

[YankeeCandle1141]

I'll be honest, it was nice to hear that I can get into FM with lower than average stats, but I don't plan on slacking off. I am in the middle-ish of my class and hopefully I can stay there. I know it might sound crazy to some of you city dwellers, but I am built for rural medicine.

And it might sound crazy to you, but you have no idea what rural family medicine is. You dont know what internal medicine is. You dont know what academic medicine is. You do not know what procedural medicine is.

Saying that you know you want rural family medicine is adorable, but just like 99.999%% of pre-meds and m1s who are "dedicated to rural primary care", your idea of family medicine and the reality of family medicine are very very different.

 

[Yoda DO]

@YankeeCandle1141

Did rural primary care do something to personally offend you? Isn't it possible that maybe, JUST maybe, I do know what I'm getting myself into and I'm completely OK with that?

@cabinbuilder Help me out please!

 

[cabinbuilder]

@YankeeCandle1141

Did rural primary care do something to personally offend you? Isn't it possible that maybe, JUST maybe, I do know what I'm getting myself into and I'm completely OK with that?

@cabinbuilder Help me out please!

How can I help you?

 

[YankeeCandle1141]

@YankeeCandle1141

Did rural primary care do something to personally offend you? Isn't it possible that maybe, JUST maybe, I do know what I'm getting myself into and I'm completely OK with that?

@cabinbuilder Help me out please!

 

[Yoda DO]

How can I help you?

I was hoping you could shed some light on rural primary care for those of us that are interested. I would love to hear a few pros and cons(mainly to keep YankeeCandle from blowing a gasket) from someone living it.

 

[cabinbuilder]

I was hoping you could shed some light on rural primary care for those of us that are interested. I would love to hear a few pros and cons(mainly to keep YankeeCandle from blowing a gasket) from someone living it.

Rural medicine. Access to care is limited. People do not have money. You cannot prescribe the latest hot drug, you stay with the standard and the cheapest. People don't have money for gas so you can't send them to the specialist who is 100 miles away because they will never get there. You put a shot of rocephin in the butt of every child who comes through who is filthy and in rags because that is probably THE ONLY medication he will receive for days until payday. Rural people are very tough and only come in as a last resort when something that has been tolerable for the past 2 months is now a huge raging problem that is interfering with the horse ranching, or farming, or fishing. You better be pretty savvy with improvising with what you have, it may not be the latest equipment, etc. You better be good at cutting things open, draining pus, taking out cysts, setting bone, splinting, casting. You need to know when someone needs to be in the hospital and you better be pretty damned convincing when money is tight and going to work is more important that being well. Know that people don't trust the ER in rural places, will come to urgent care death warmed over. You better be good at your belly exams. Be able to read your own CT and xrays because you may not have a radiologist on site and it may take many hours to get a report. Better be up on your derm because the nearest one is 8 hours drive away. Be able to do your own biopsies. No rheumatology or nephrology either usually.

 

[YankeeCandle1141]

I was hoping you could shed some light on rural primary care for those of us that are interested. I would love to hear a few pros and cons(mainly to keep YankeeCandle from blowing a gasket) from someone living it.

Ok...i am gonna just attempt to explain this one last time then I am done here.


The fact that you need to ask for pros and cons of rural family medicine is EXACTLY what I am talking about. I am trying to help you here, but you are being a child about it. You have literally zero experience in any medical field. When I say to set your goals higher, it has nothing to do with my gasket. In fact, it has nothing to do with me at all. At this point, I kind of want you to blindly "shoot for rural fm" and see how it works out for you.


You want real advice? Ask cabinbuilder how many people truly understand rural fm before they experience it. Go ahead. Or better yet, ask how many backup specialties youll have if you have an application suited for it.

 

[kenjixshadow]

Rural medicine. Access to care is limited. People do not have money. You cannot prescribe the latest hot drug, you stay with the standard and the cheapest. People don't have money for gas so you can't send them to the specialist who is 100 miles away because they will never get there. You put a shot of rocephin in the butt of every child who comes through who is filthy and in rags because that is probably THE ONLY medication he will receive for days until payday. Rural people are very tough and only come in as a last resort when something that has been tolerable for the past 2 months is now a huge raging problem that is interfering with the horse ranching, or farming, or fishing. You better be pretty savvy with improvising with what you have, it may not be the latest equipment, etc. You better be good at cutting things open, draining pus, taking out cysts, setting bone, splinting, casting. You need to know when someone needs to be in the hospital and you better be pretty damned convincing when money is tight and going to work is more important that being well. Know that people don't trust the ER in rural places, will come to urgent care death warmed over. You better be good at your belly exams. Be able to read your own CT and xrays because you may not have a radiologist on site and it may take many hours to get a report. Better be up on your derm because the nearest one is 8 hours drive away. Be able to do your own biopsies. No rheumatology or nephrology either usually.

QFT

 

[costales]

Upside: You can see patients in the morning and go hunting in the afternoon. People will recognize you in public, and you will never get a speeding ticket.

 

[cabinbuilder]

QFT

I don't even know what this means?

 

[IslandStyle808]

I don't even know what this means? WTF???

QFT = Quoted for the Truth

My hometown is not nearly as rural as some of those place where there are barely any doctors. However, they do travel miles just to see one in my hometown. I have few friends from those areas tell me stories that scared the s*** out of me. Getting comprehensive healthcare is very difficult in the really rural parts.

 

[FutureDO2016]

Family medicine is still a respectable specialty. Correct me if I'm wrong, but I thought they still make around $180-250K depending on where they work? If you have a spouse that makes similar or even less, that's more than enough money to raise a family of 4, go on vacations and have a steady job working 40-60 hours a week with most weekends off. Most of the family practice docs I know have weekends off or work like 1 or 2 Saturday mornings a month.

 

[cabinbuilder]

QFT = Quoted for the Truth

My hometown is not nearly as rural as some of those place where there are barely any doctors. However, they do travel miles just to see one in my hometown. I have few friends from those areas tell me stories that scared the s*** out of me. Getting comprehensive healthcare is very difficult in the really rural parts.

K, thanks

 

[Yoda DO]

@YankeeCandle1141

Listen kid, and yes I do mean kid, I've got more experience in rural medicine than you have post-high school education. I been in the field for over a decade doing all that crap you deem undesirable. I know what poverty is, I've lived it. I know I'm not like most, but I came back to school to help out the rural communties I've lived in. Everything @cabinbuilder just said sounds just like my home town and like it or not that's where I'm headed. Now let's agree to disagree and move along.

 

[YankeeCandle1141]

@YankeeCandle1141

Listen kid, and yes I do mean kid, I've got more experience in rural medicine than you have post-high school education. I been in the field for over a decade doing all that crap you deem undesirable. I know what poverty is, I've lived it. I know I'm not like most, but I came back to school to help out the rural communties I've lived in. Everything @cabinbuilder just said sounds just like my home town and like it or not that's where I'm headed. Now let's agree to disagree and move along.

Lol i should have known you were a nontrad. And for the record, I am from a town of 47 people, 6 of whom are my family, with a median income well below 40k. i never once said rural was undesirable. I just dont have my head so far up my own ass to think that everybody is out to get me.


Have a great life with your so open and agreeable personality. Im sure it will be great.

 

[YankeeCandle1141]

@YankeeCandle1141

Listen kid, and yes I do mean kid, I've got more experience in rural medicine than you have post-high school education. I been in the field for over a decade doing all that crap you deem undesirable. I know what poverty is, I've lived it. I know I'm not like most, but I came back to school to help out the rural communties I've lived in. Everything @cabinbuilder just said sounds just like my home town and like it or not that's where I'm headed. Now let's agree to disagree and move along.

And on more thing. 3 years experience as a lab tech in a hospital is far from "decades in the field."



Im just gonna quote this then block you.

I don't know anything about being a physician yet, but I am the technical supervisor for a large reference lab. As far as the method goes, the rapid strep performs pretty well when compared to cultures.