What do you think?

[dr_sax_29]

I'm an MSII, soon to begin rotations, so understandibly I'm not at a point where I need to quickly resolve my dilemma but I'm curious to see what others think who have more experience.

I've always been interested in FP but in the last year I've developed a strong interest in endocrinology. My question is: where do you draw the line or make the decision to stay with FP or to specialize? I have no interest in general IM, so it's either subspecialize or bust. The thoughts of an IM residency also make me cringe. Is there anything I should do or consider aside from just doing rotations in each speciality and seeing which one I prefer?

Thanks

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[DOtobe]

Are you the dr_sax LECOMer, just with a new screenname?

I also had the same feelings as you for a while. I had a lot of interest in doing both endocrine and FP, until I did a rotation in endocrine. I liked the rotation, but knowing that 90% of my patient population would be diabetic was too monotonous for me. I think the best way to decide would be to do an endocrine rotation, either as an elective or as a segment of your IM rotation...the hospital I did my IM rotation at let me spend some time in the different subspecialties.

I guess it depends on how much variety you would like in your practice. I like the variety of FP, so I chose to apply for FP. You can handle your patients' endocrine problems as an FP...more and more FP's are handling their diabetic, hypothyroid patients.

Good luck!

 

[lowbudget]

Hey there. No need to rush, you have plenty of time to decide even though it doesn't feel like it, so keep an open mind while you go through your 3rd year rotations.

A couple of considerations:
1) Rotations- These are the best ways to gain first hand impressions, although they are very much attending dependent and environment dependent.
2) Talk to FP and Endocrine attendings/advisors/program director/chairman at your school about your dilemma
3) Read more about what each one does through their respective specialty societies.
4) Consider salary surveys
5) If you can, talk to private practice FPs and Endos for their point of views
6) Surf through the net and look at curriculum from various FP residencies, IM residencies, and Endo fellowships.
7) Consider if you like the other aspects of FP outside of IM and its subspecialties (such as Pedi, Psych, Ortho, Uro, Ophtho, Surg, Derm, OB/Gyn)
8) Also consider where you like to be in terms of the medical food chain.

Remember, the distinction between FP and specialists are fairly arbitrary. FP's who see a lot of endocrine patients, who studied a lot of endocrine during med school/residency/outside reading, can do a lot of the work that endocrine specialists do. At the same time, endocrinologists typically double board in Gen IM, so as a specialist, many provide primary care as well. Typically specialists, like endocrinologists, who spend only seeing a certain patient population will tend to be most up to date with literature, latest guidelines, and research, mostly because they are more intimately involved (with research, conferences, specialty literature). The news then trickles down to FPs via specialists (unless the FP actively seeks out the latest news). The specialist also tends to see patients who are refractory to all treatments the FP doc might throw at a patient, so the specialists are supposed to know all the zebras (and may see a high volume of zebras) and be able to have alternative 3rd or 4th line therapies to offer patients.

 

[dr_sax_29]

Thanks for the responses. Yes, I am the notorious dr_sax of LECOM. Had to get a new screename for stupid reasons.
I do plan on doing rotations in each area and I am currently doing a lot of research on the specialities. I've just entered that swaying back and forth part of my career and I'm sure rotations will lead me toward the right direction.
Thanks again.