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On 6/30/2020 at 11:06 PM, Intrepid86 said:

As one of my old FM preceptors put it, family medicine is as easy or difficult as you make it. As a practicing family doctor, I agree with that.

As with many other jobs, it's relatively easy to be adequate, harder to be good, and challenging to be excellent /exceptional. A two year FM residency is short. Everyone knows that. Like all other residencies, you get out what you put in. More effort up front usually means less needed later. Because there's an eventual range of interests, ability, and practice preferences, there also exists an abundance of clinical resources, transition advice (e.g., First five years of practice), mentorship networks etc. for those seeking it. By far the most important thing is to have a positive attitude towards self learning and improvement that will serve you well throughout your career, no matter what stage of career you're in.

As a family doctor, if a patient likes you, that is already more than half the battle, even if you did nothing else. That might sound dumb, perplexing, and possibly even wrong, but it's not. If your patient doesn't like you as their primary care provider, then the chance of them taking your preventative advice is low, as will be their engagement on any investigation and treatment plans proposed. Clearly, the more you can do for the patient on your own, the better. However, if you need to refer out, then refer out, because doing something that's not within your comfort or ability will be even worse. If you need to refer out all the time for something that most of your colleagues are not, then you might be falling below the standards of knowledge for your specialty, so the onus would be on you to rectify that.

Given that we will be competing with midlevels, I don't think taking the easy simple approach is the way to go. As a profession anyway. We need to offer a valuable service that NPs and PAs cannot provide.  And trust me, midlevels can do basic stuff/refer out. 

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Every time somebody says that, I like to point to the example of Switzerland which has residencies of comparable length to ours in most specialties while abiding by EU work hour restrictions (48h/week

NPs can do patient communication and referrals just as well as we can. I mean, if you're not offering much more than an NP - how do we justify our pay compared to them? Doctors are being displaced by

This is strictly for family med - but given the duration (2 years), if it's an "easier" residency then how in the world are you supposed to become competent? There's just no way to train someone to do

Residency was a rough time. Possibly the worst years of my life. There are bright spots such as the warmth of a thankful patient or the highs of solving a difficult case. However, the long hours and constant studying does drag on you. I enjoy what I do now but it doesn't wash away the difficulty of that time period.

Things do get better as a staff (for most people) but the grind of medicine never truly ends. I think this disconnect between perception and reality is what causes a lot of disillusionment and burnout. We all know of preceptors and colleagues that do not enjoy how their life turned out and it's a huge tragedy in my eyes.

Reflect on what you need out of life to be happy and choose a path in medicine that will get you there. Otherwise, before you know it you'll be a decade older with even less ability to find an alternative.

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On 6/28/2020 at 7:50 PM, Intrepid86 said:

Residency is temporary. I suggest you focus on what area of medicine you ultimately want to practice in, rather than the quality of life during your training program. That being said, it would be hard to beat a Family Medicine residency for work life balance.

Could you please elaborate more on that? I heard FM residency can be really difficult especially 1st year.  I'm not that familiar with how different FM residency is (1st year) vs other residency programs. Any information would be great :)

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36 minutes ago, Iamokayyyyyy said:

Could you please elaborate more on that? I heard FM residency can be really difficult especially 1st year.  I'm not that familiar with how different FM residency is (1st year) vs other residency programs. Any information would be great :)

I think you have to take a lot of these comments with a grain of salt...

I definitely value having a more challenging residency... but there are days where I question why I am even there and what utility will I get from the education provided off-service (particularly on busy call days). This is especially true given that I will only likely practice FM either part-time while working full-time in a public health capacity, or practice in a specialized discipline within public health. 

Residency I'm sure is difficult for everyone in their 1st year because there's tons of off-service rotations and you're just starting out in the learning process... honestly the knowledge difference you attain year by year is vast. Sometimes I think back to my early R1 days and wonder how I put on a shirt in the morning with my limited intelligence. 

I'm sure programs like FM definitely have more flexibility but let's be fair... this only emphasizes the importance of knowing what you walked into during the CaRMS match and the realities of the residency program before you go into it. I have huge respect to my colleagues in other fields but I knew well ahead of time that despite loving numerous specialities I'd never want to do that training or be the attending for those specialties. Whether or not the program should be changed to promote more work/life balance is a different discussion I won't go into right now.

To go back to the original question... I would consider myself above average content... not too happy or ecstatic, not sad or depressed. I've definitely had some great experiences out here in the North and met some great people along the way. Both the medicine and the people are different than what I experienced in Alberta but it makes me really appreciate the importance of being well-rounded in areas with limited physician access and serving the community. You really do have to wear multiple hats and I appreciate all of the roles that FM graduates have here in Northern Ontario. It's also a place that poses an interesting public health challenge. 

Well regardless I do hope that everyone takes care of themselves during these tough times. Take care!

- G 

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On 10/22/2020 at 1:46 AM, Iamokayyyyyy said:

Could you please elaborate more on that? I heard FM residency can be really difficult especially 1st year.  I'm not that familiar with how different FM residency is (1st year) vs other residency programs. Any information would be great :)

It is difficult, but people are mostly speaking relatively to their 2nd year. Other specialty residency 1st years are typically even more work/stress. Internal medicine, surgery, radiology all spend essentially all of their first year doing inpatient rotations in medicine/surgery/ER.

In contrast most FM programs have eliminated surgical rotations from mandatory curriculum so as long as you're comfortable with some inpatient medicine/ER/OBGYN you'll be fine. If you do end up in one of the few programs that still mandates a surgical rotation or two, it'll be a bit tougher but it's the same with what other off-service residents also have to put up with.

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