Internal vs family medicine

[Carmsthrowaway7]

I’m a 4th year student at UofManitoba who’s applied to both family and IM and having a tough time making a decision about which one will end up being my top choice as I like many aspects of both fields.

For IM, I found the day to day medicine more interesting. I liked looking after acutely ill patients with active issues that required work up and management when compared to many of the “non-issues” patients present with in a family medicine clinic. I also liked working with a team on ctu but I understand that team dynamics are very variable and can make work harder if there’s a bad mix. I know the residency is more difficult but I was so impressed with how strong and knowledgeable IM residents are and I feel like the training, although brutal at times, makes for excellent physicians. The biggest consideration for me with IM is work life balance. At the moment, if I were to pursue IM, I think I would end up in GIM or possibly critical care as I like the diversity in pathologies seen and managed and I think sub-specializing would end up getting boring but I wouldn’t rule it out (I did like my nephrology selective quite a bit). I’m not currently in a relationship (24y/o) but hope to one day start a family and having time to be present and involved at home is important to me. I’ve talked to a few of my GIM attendings who’ve told me what a typical year is like for then (on average 20ish weeks of ctu, one to two half days of clinic on weeks off, some weeks on consult service, etc) but would appreciate if some other people could give some perspective on what their average year looks like. They’ve also told me GIM in MB is not like other provinces so would be curious to hear about what it looks like in other provinces.
 

In terms of family medicine, I am by far mostly interested in rural family due to the broad scope of practice. A clinic heavy urban practice doesn’t seem very appealing to me. My ideal practice would be heavier with emergency, inpatient/hospitalist, possibly some ICU hmo as I like procedures such as lines and intubations, and a smaller family clinic practice. I’m also interested in pursuing the +1 in emerg if I went with family. The flexibility of family is the biggest draw as I can scale up or down my practice and do/stop doing things based on my interests and commitments outside of work. The issue with family for me is although I’ve grown up rurally, I prefer to live in a city and am not sure how realistic having this type of practice would be in a city (maybe community hospitals would allow me to do emerg and hospitalist?). Again, would be interested to hear what practice diversity can look like in cities in other provinces.

sorry for the long post, appreciate any advice, info, or help that is offered!