"Are you sure you want to go into family?"

[sangria]

At the end of a surgery rotation, my preceptor said the above. This was in the context of me answering pimp questions and then later at my eval. I just laughed it off, but it bummed me out a bit, so forgive me now that I feel a little weak. It was meant as a compliment (?) and I want to take it as such. I'm sure that it happens ALL THE TIME to other people. How do you handle it (externally and internally)?

I eventually replied that I want to go into FM because of its flexibility and scope of practice. He said the flexibility in practice location is overblown for FM, and new grads have trouble finding FHO/FHTs in their desired locations and a lot resort to locums. How true is that? 

Earlier on in the year, I've been back and forth between many other specialties, but since I have been enjoying all of my rotations as a M3, and I like the relationship you form with patients, I thought FM is a logical choice. I still think so, but now I feel like I have an uneasy feeling I can't shake. 

[hero147]

If you want to go into family medicine, go into family medicine. Don't let your preceptor dissuade you. I am not in family, but even if family was less flexible than in the past and FHO/FHTs are harder to obtain in desirable locations, it is still relatively easier to do so in family than most specialties except maybe derm and geriatrics. You may have done very well in your surgery rotation and likely would have become an excellent surgeon, but if it's not in line with your interests and values, I would recommend you not pursue it.

[Intrepid86]

There are many specialists who feel at least slightly offended when someone chooses family medicine over their specialty, mostly because of their pre-existing low opinion of the latter. Just keep in mind that their bruised ego is temporary, but your choice is permanent.

[ellorie]

Yeah this happened to me a lot as a clerk. People would ask me why I would choose to go into something as not-competitive as psychiatry when I was clearly “smart enough to do something else”. 

I honestly just shrugged it off. Dealing with stigma is part of working in mental health. I know that my specialty is challenging and not an easy way out and I know that it’s right for me, so I honestly don’t really care what anybody thinks about it. 

I would just say “oh thanks but I’m committed to psych” and move on. 

[Lactic Folly]

No surgeon I worked with ever tried to convince me to go into surgery. Although when I was on surgery as an off-service PGY-1, I was mistaken for an on-service resident and placed in charge of the team when the chief was away...

[Wachaa]

Medicine attracts many egotistic people and I believe that many FM preceptors are thinking the same thing about people wanting to go into specialties.

Why in the world would someone choose to punish themselves by choosing a career where you have to study for a Royal College exam, and even when you're done all that training (which is brutal and dehumanizing to begin with), you then begin a "life" of work longer hours than 99% people in the world, doing overnight call shifts, feeling like you have to "earn" your place among people who already think they're better than everyone else... when you could have started with a six-figure salary and a much cushier lifestyle in FM.

If it's about money, I know that I already make more in FM than I need to live comfortably. If it's about status, what's better: being in your dirty scrubs in the hospital at 3AM, or staying in a king bed during a vacation I can take whenever I want?

Just take it as a compliment and move on.

[brady23]

I picture FM being the new "EM" in 20 years (EM wasn't competitive 20 years ago but now it's a totally different story)

The flexibility and lifestyle of FM is so underrated 

[LittleDaisy]

7 hours ago, sangria said:

At the end of a surgery rotation, my preceptor said the above. This was in the context of me answering pimp questions and then later at my eval. I just laughed it off, but it bummed me out a bit, so forgive me now that I feel a little weak. It was meant as a compliment (?) and I want to take it as such. I'm sure that it happens ALL THE TIME to other people. How do you handle it (externally and internally)?

I eventually replied that I want to go into FM because of its flexibility and scope of practice. He said the flexibility in practice location is overblown for FM, and new grads have trouble finding FHO/FHTs in their desired locations and a lot resort to locums. How true is that? 

Earlier on in the year, I've been back and forth between many other specialties, but since I have been enjoying all of my rotations as a M3, and I like the relationship you form with patients, I thought FM is a logical choice. I still think so, but now I feel like I have an uneasy feeling I can't shake. 

Hey Sangria,

 I am a FM resident about to finish my training. I could comment a bit more. I have a few friends in subspecialty IM and surgery who wish that they had chosen FM initially as now they are stuck with 1-2 year of fellowship with uncertainty of job market.

With regard to family medicine, people want to join FHO & FHT for the higher potential pay, but there are so many jobs in GTA that I got approached as a R2 by preceptors and by new grads. If you exclusively want to work in FHO & FHT, there are limited positions, but I am sure that there are ways to work around it.

Having said that, it happened to me as a clerk as well, then I see how unhappy the staff attending is in General Surgery and G.I, being called to the hospital at 2-3 am, their interpersonal relationships fall apart with 1-3 alimonies to pay off, I am pretty happy that I chose family medicine.

I don't think that there is any other specialty beside family medicine where there are so many job offers, and you could pick your schedule (part time vs full time) and scope of practice (obs, addictions, EM, palliative care). The other specialties do get paid more and have more "prestige" associated with it, but people neglect the longer duration of training, the tightness of job market and how competitive it is just to stay in the city, and people often have to relocate to a smaller town or working as IM locums only for a few night shifts in the month as they are unable to leave the city. 

[ecobeco]

The prestige of specialty medicine is absolute nonsense. No one is gonna applaud your efforts for lysing some adhesions at 3 AM, it's all in your head. The ego is a dangerous thing and has tricked many people into pursuing a career that they did not think long about. I'm obviously biased but for me, getting proper sleep and have a normal routine trumps any amount of added money or prestige that a 5+ year program would offer. You work like a dog and become a slave to the hospital - no thanks.

[bearded frog]

I think you're reading this wrong, and it might have nothing to do with prestige, its just how people complement you. Like I'm sure if there was a surgery gunner who did well on their family med rotation and the family doc attending said "sure you don't want to do family" with a smile as a complement then nobody would get offended by it. It's just another way of saying you did a good job, as good as a job as someone who would want to do this as a career. I've been told that multiple times in med school and on subspeciality rotations in residency.

[ellorie]

I don’t know, there’s a subtle difference between “you would be good at my specialty” and “why would you pick your specialty when you’re so smart/good/whatever”. There are definitely some specialties that get looked down on in that way. 

[#YOLO]

its all good....ill be whippin the lambo while my med school classmates are applying for fellowships and still some1s b!tch

[GH0ST]

On 3/24/2019 at 7:05 AM, sangria said:

At the end of a surgery rotation, my preceptor said the above. This was in the context of me answering pimp questions and then later at my eval. I just laughed it off, but it bummed me out a bit, so forgive me now that I feel a little weak. It was meant as a compliment (?) and I want to take it as such. I'm sure that it happens ALL THE TIME to other people. How do you handle it (externally and internally)?

I eventually replied that I want to go into FM because of its flexibility and scope of practice. He said the flexibility in practice location is overblown for FM, and new grads have trouble finding FHO/FHTs in their desired locations and a lot resort to locums. How true is that? 

Earlier on in the year, I've been back and forth between many other specialties, but since I have been enjoying all of my rotations as a M3, and I like the relationship you form with patients, I thought FM is a logical choice. I still think so, but now I feel like I have an uneasy feeling I can't shake. 

 

On 3/24/2019 at 10:02 AM, ellorie said:

Yeah this happened to me a lot as a clerk. People would ask me why I would choose to go into something as not-competitive as psychiatry when I was clearly “smart enough to do something else”. 

I honestly just shrugged it off. Dealing with stigma is part of working in mental health. I know that my specialty is challenging and not an easy way out and I know that it’s right for me, so I honestly don’t really care what anybody thinks about it. 

I would just say “oh thanks but I’m committed to psych” and move on. 

Lol I matched to public health and preventative med including family med and although many people understood the greater societal need, some staff literally challenged me on why I entered medicine if I'm not going to spend my entire time doing purely clinical things...

Imagine trying to explain to people that god forbid addressing large scale societal health concerns doesn't always involve pathophysiology or procedures ... you'd think some of the staff would have an aneurysm.

I'm more than happy to get a chance to do not only general practice (and potentially tailor it towards public health specific clinics) and also getting a chance to work with the community and government/organizations to address and prevent challenging medical problems before they begin or reduce their impacts on health burden and improve quality of life. Knowing medicine and public health and putting both to use gets me fired up!

To @sangria you have to just think of whether or not you love a specialty enough to go through the rigors of the training without the thoughts of prestige and/or ego being a factor into the decision. People s$%# on FM so much and yet FM contribute significantly to the care of the general population and also have substantial impact in society (arguably more so than a subspecialty). 

At the end of the day we need all types of doctors in the world but we don't need another salty one...

- G

[sangria]

5 hours ago, GH0ST said:

To @sangria you have to just think of whether or not you love a specialty enough to go through the rigors of the training without the thoughts of prestige and/or ego being a factor into the decision. People s$%# on FM so much and yet FM contribute significantly to the care of the general population and also have substantial impact in society (arguably more so than a subspecialty). 

Thank you to everyone for your responses. The more I think about it, the more I think I am suitable for family. I like the patient population. I like the longitudinal relationship you build with patients. I like the undifferentiated (and mostly low acuity) problems.

Prestige has never been a factor of consideration. I'm nontrad. I've done this enough times to not give a damn what people think about me. My reaction over the weekend as I hummed and hawed was from a place of cARMs/job market/career outlook uncertainty and anxiety. My two cents is instead of lamenting over a supposed lack of prestige, we should be thinking about how we can grow as a field and attract more dedicated candidates.  Be hard to replace, and let the actions speak for themselves.

 

Thanks again.

[F508]

There definitely is a culture of putting down family medicine, stronger at certain schools than others. There is also a culture of every specialty putting down some other specialty. When you gather a group of people who have been used to being the best of their class, it is inevitable that most people want to find a way to distinguish themselves. Given that almost half of the residency spots are allocated to family medicine, it's inevitable that it's considered a back up. However, I really think that mindset is more prevalent at the medical school level. I find it's like a high school popularity game. Once you're in residency, you see your staff family physicians that are leading amazing careers. You also really feel the value of being a family physician in residency. You spend more time with family physicians and you realize those feelings are not that prevalent in the community.

I love being a generalist. I like having some knowledge about everything. I like being able to answer questions and having an approach to issues that my family and friends are presenting. I would hate to be a neonatologist and not know anything about adult medicine. I would hate being a nuclear medicine specialist and being the only doctor present when there's an acute issue on the plane. I would hate to be a urologist and have to consult internal medicine to start my patient on anti-hypertensives.

Don't get me wrong, I think specialists do amazing things and I respect the work and the dedication that they have for their profession. However, I think being a generalist is undervalued. We have an important role in the health care system and I love the breadth of the knowledge we acquire.

 

[Birdy]

I got this too, but I’m very happy with my choice to go into family medicine.

The OR is awesome and all, but so is having a day that starts at 8:45 and ends at 4:30, after having had a full nights sleep.

[Edict]

On 3/24/2019 at 9:05 PM, sangria said:

At the end of a surgery rotation, my preceptor said the above. This was in the context of me answering pimp questions and then later at my eval. I just laughed it off, but it bummed me out a bit, so forgive me now that I feel a little weak. It was meant as a compliment (?) and I want to take it as such. I'm sure that it happens ALL THE TIME to other people. How do you handle it (externally and internally)?

I eventually replied that I want to go into FM because of its flexibility and scope of practice. He said the flexibility in practice location is overblown for FM, and new grads have trouble finding FHO/FHTs in their desired locations and a lot resort to locums. How true is that? 

Earlier on in the year, I've been back and forth between many other specialties, but since I have been enjoying all of my rotations as a M3, and I like the relationship you form with patients, I thought FM is a logical choice. I still think so, but now I feel like I have an uneasy feeling I can't shake. 

Take it fully as a compliment. People ask me "why I chose my specialty" all the time. Sometimes people say it in a "how could u brutalize yourself like that?". In med school it made me question a lot, but ultimately I think it made me think as well, and I'm glad that I spent the time then to go through in great detail to find out the person I was and why or why not each specialty was right for me. In the end theres also a bit of inertia involved which kind of pushes you to make that final decision, which I think is totally fine. In the end, if push came to shove we could all do different jobs, but sometimes the chips just fall in the right way to make you choose a certain one. 

It is also normal to have some uneasiness about your specialty. If its not too late, really think about your personality, your personal goals in life, your interests, your life situation and go through each specialty and see which ones fit and which don't. If at the end family medicine is in the short list, you are probably choosing the right specialty. 

All in all, I wouldn't listen to a surgeon about the job market for family medicine. If I listened to non surgeons about what a surgical job market is like I would be incredibly misinformed. 

 

[blah1234]

I think I had more friends that wish they did FM than the reverse once we were deep into residency. The job market and flexibility is great as peoples priorities change. Graduating early and being free is also great. 

However I don't think it's a good fit for everyone. Too bad we don't have general liscensure anymore to give people flexibility to change.