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47 minutes ago, MedZZZ said:

If that's the case, wouldn't it be more reasonable to go into FM route and save yourself another 2-3 years of brutal residency to be a GIM doc since you are doing what a GIM does basically with a lot less complexity ... That's my internal dilemma for pursuing FM versus IM ...

If you know you enjoy and plan to do inpatient medicine, do IM. It's a longer and yes brutal residency that will better prepare you for inpatient medicine in the long run. FM is shorter at 2 years but it'll be mostly outpatient medicine which you may not enjoy for the full 2 years.

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12 hours ago, FrannieLydon said:

I see this mentioned a lot and I am wondering how rural is defined? Let's say you were working in a town with around 20,000 total population – would that qualify as rural? 

It actual depends on the community itself and who's working there, distance from major centre, etc. Bonuses etc depend on what the province classifies as rural and as far as I know there isn't any black/ white definition based on size; just a classification "list".

For example in BC, see here: https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/physician-compensation/rural-practice-programs/rural-retention-program

In the Eligibility part of the page you can go to the links for rural definitions, points system, premium % etc.

 

10 hours ago, MedZZZ said:

If that's the case, wouldn't it be more reasonable to go into FM route and save yourself another 2-3 years of brutal residency to be a GIM doc since you are doing what a GIM does basically with a lot less complexity ... That's my internal dilemma for pursuing FM versus IM ...

That's actually a very narrow view of what GIM does. GIM is there as a consultant as well as admitting patients on the wards. I would agree the rounding/ wards are similar. However the scope of the work is very different from that of a GP/ hospitalist. But yes, the argument for going to FM/ IM includes salary, residency training length...but also the scope of your future/ intended practice.

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14 hours ago, FrannieLydon said:

I see this mentioned a lot and I am wondering how rural is defined? Let's say you were working in a town with around 20,000 total population – would that qualify as rural? 

Rural is usually defined by the province that you are working in. But I would say 20,000 population would be considered rural.

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13 hours ago, MDinCanada said:

So the salary for a hospitalist is comparable to that of a GIM doctor?

I think GIM doctors will bill more (due to billing codes) or have a higher salary. This is a guess.

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11 hours ago, MedZZZ said:

If that's the case, wouldn't it be more reasonable to go into FM route and save yourself another 2-3 years of brutal residency to be a GIM doc since you are doing what a GIM does basically with a lot less complexity ... That's my internal dilemma for pursuing FM versus IM ...

I think IM will bill more. They will have different billing codes, which will pay higher. Also their salaries will be higher if the hospital is not FFS. This is all a guess because I am not familiar with IM billings.

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10 hours ago, 1029384756md said:

If you know you enjoy and plan to do inpatient medicine, do IM. It's a longer and yes brutal residency that will better prepare you for inpatient medicine in the long run. FM is shorter at 2 years but it'll be mostly outpatient medicine which you may not enjoy for the full 2 years.

Good advice.

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On 5/21/2020 at 1:12 PM, 1029384756md said:

If you know you enjoy and plan to do inpatient medicine, do IM. It's a longer and yes brutal residency that will better prepare you for inpatient medicine in the long run. FM is shorter at 2 years but it'll be mostly outpatient medicine which you may not enjoy for the full 2 years.

Can be residency and individual dependent too.

And I know USA FM programs (relevant with more American grads coming to Canada) are way more inpatient heavy and their graduates (sometimes, not usually) are definitely on par with Canadian GIM.

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I asked this in a separate post, but maybe it'll get more traction here: 

 

I'm still early in med school, but it seems that the bread and butter of family medicine is chronic diseases with little tangible evidence of benefit (e.g., HTN meds, diabetes management) or tenuous symptom management  (e.g., autoimmune conditions). Combining this with patients who may not always be grateful or questioning/not listening to your recommendations (e.g., lifestyle modification), I am wondering where you derive satisfaction? I don't mean to ask this in a critical way, and I also recognize that I'm probably painting a caricatured picture of the specialty. In fact, I am strongly considering family medicine and want to expand my awareness on what makes other family doctors excited and satisfied with their work.

 

Thanks!

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1 hour ago, gogogo said:

I asked this in a separate post, but maybe it'll get more traction here: 

 

I'm still early in med school, but it seems that the bread and butter of family medicine is chronic diseases with little tangible evidence of benefit (e.g., HTN meds, diabetes management) or tenuous symptom management  (e.g., autoimmune conditions). Combining this with patients who may not always be grateful or questioning/not listening to your recommendations (e.g., lifestyle modification), I am wondering where you derive satisfaction? I don't mean to ask this in a critical way, and I also recognize that I'm probably painting a caricatured picture of the specialty. In fact, I am strongly considering family medicine and want to expand my awareness on what makes other family doctors excited and satisfied with their work.

 

Thanks!

You can mix it up and not just do chronic disease. Pick up the skills and also do ED with clinic. Or do inpatient medicine with your clinic set up or whatever else you like. Maybe deliver babies. You don't need to limit yourself to an outpatient practice. 

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22 hours ago, gogogo said:

I asked this in a separate post, but maybe it'll get more traction here: 

 

I'm still early in med school, but it seems that the bread and butter of family medicine is chronic diseases with little tangible evidence of benefit (e.g., HTN meds, diabetes management) or tenuous symptom management  (e.g., autoimmune conditions). Combining this with patients who may not always be grateful or questioning/not listening to your recommendations (e.g., lifestyle modification), I am wondering where you derive satisfaction? I don't mean to ask this in a critical way, and I also recognize that I'm probably painting a caricatured picture of the specialty. In fact, I am strongly considering family medicine and want to expand my awareness on what makes other family doctors excited and satisfied with their work.

 

Thanks!

Traditional family medicine is more about the patient than the disease. Check out the writings of family doctors who share their patients' stories, and how they have built relationships with entire families and cared for them over a lifetime.

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2 minutes ago, Lactic Folly said:

Traditional family medicine is more about the patient than the disease. Check out the writings of family doctors who share their patients' stories, and how they have built relationships with entire families and cared for them over a lifetime.

Thanks for answering. I completely understand that satisfaction may emerge from the relationship building (trust, connection, respect, etc.), but what about the care? I suppose you could argue that developing a relationship is in itself therapeutic. But besides that, do family doctors find satisfaction in making incremental decreases to HbA1c or BP? Do patients appreciate that? I guess I'm trying to understand whether any of the satisfaction in family medicine comes from the medicine/disease side, or if it is exclusively on the communication/relationship/patient side of things. 

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I'm not sure that such a distinction can actually be made. But I do envision dedicated family physicians working to facilitate positive lifestyle changes, help their patients obtain necessary resources and supports (especially those who are underprivileged), detect early signs of disease, and coordinate multiple aspects of a patient's care, and that these are important aspects of medical care and prevention that help patients navigate the often fragmented healthcare system and reduce the burden of disease.

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