Family medicine and Internal medicine certification

[Majestic82]

Hey everyone,

 

I recently started medical school and have been doing a lot of thinking as to what specialty would be best suited for me. Right now, I am torn between doing a family medicine or internal medicine specialty. As a result, I am wondering if its possible to become certified as both a family doctor and an internal medicine specialist (say, general internal medicine), and obtain both the CCFP and FRCPC designations?

 

Does anyone know if this is possible in Canada? Any help would be greatly appreciated.

[Kuantum]

The advice I keep getting told is to get into the hospital/clinics and find out there. Don't rely on classroom material to make your decision. I have no idea what you've done, but I thought I'd let you know. I'm also in the process of trying to figure out what I like since there is so much in medicine. Good luck.

[Majestic82]

Hey guys, thanks for your input.

 

I was thinking of doing both family medicine and internal medicine because I like the variety of family medicine, but I also am attracted to teaching medical students and residents on internal medicine topics. I envision myself having a family medicine practice that I would work at 3-4 days/week and do some university teaching 1-2 days/week.

 

Is this feasible?

[Satsuma]

An internal medicine residency is alot to put yourself through just to teach.

 

If you like family med why not do family med and take students ... there are lots of opportunities to teach in family med. We had quite a few fam med as tutors for our PBLs as well.

[Nephets]

You can definately teach in family medicine. FPs teach lectures and small groups, work with clerks, and train FP residents all the time. They also do research. Some of the best teachers are family docs. If teaching is the only reason you want internal, I don't think it's worth it.

N.

[Blake]

Another vote for family medicine. I don't know, I figure if you love 2 things equally, you should go for the ''easier on your life'' path. Good luck !

[svp2k5]

You could probably do both family medicine and hospital work in an internal medicine type field. BUT, you will have to do it in a smaller community.

 

In places such as North Bay, and other communities up north, many family doctors have a family practice and are also acting as an internal medicine specialist in the local hospital. I have talked to three different family docs who have done this. All of whom take on many students.

 

The issue I guess, is whether living up north or in a small community is worth doing this.

[ploughboy]

I think there's now a "hospitalist" fellowship available for CCFP grads, if that takes your fancy.

 

And as others have said, in smaller communities family docs do act as general internists pretty much by default.

[BlackJack]

Doing both a CCFP and FRCPC is exceptionally unlikely due to funding concerns. CCFP comes with 2 years of residency funding. FRCPC comes with a potential 5. Huge difference.

 

Buffy Pool makes a really good point: Going from CCFP to FRCPC will present a few hurdles(what with the funding and all), and going the other way probably doesn't give much of an advantage unless of couse you desire a CCFP faculty position at a very stubborn department.

 

As for money, although FRCPC GIM on average make more than a CCFP, some CCFPs know their way around the system enough to bill a half-million dollars a year. Whether or not this entails a lot of cosmo or McMedicine, I'm not sure. One thing's for certain is that you will make more money if you live out in a rural area as an FP. Do you think that would be right for you? It does not sound like it would be given your desire to teach at a university.

 

So which to do? It would all depend on what you see yourself doing for the future. Keep in mind that FM and GIM both deal with the elderly population the majority of the time. FM caters to the population that isn't hospitalized (checkups, preventative/social medicine, medication adjustments), whereas GIM caters to the hospitalized population (fluids, code-status, acute drugs).

 

Both fields do see the occasional non-elderly patient: FM for things like peds and OCP, and GIM for odd things that the FP cannot figure out.

 

Teaching is possible in both fields, although you are more likely to get a faculty lecturer position if you go the FRCPC route. CCFPs do primarily clerkship teaching, from my experience.

 

My opinion is for you to keep an open mind but prepare for the possibility that you may want to match to something competitive, since neither FP nor GIM are considered competitive. Start looking into ER, plastics, ENT, radio, and the like - its better to get started early than later.

[Darla]

Here's a list of the third year options ass'd with family med residency. http://www.cfpc.ca/English/cfpc/education/section%20of%20residents/resource/sor3-rdyear/default.asp?s=1

They may help you direct where you want to get your experiences from.

 

No advice from me though

[Majestic82]

Does anyone know if, say, a general internal medicine doctor can later practice primary care/"family medicine" later on in their career, if they decide that internal medicine is not their thing anymore?

 

In other, say I go into general internal medicine, practice it for 10 years, and then decide I want to practice a primary care/"family medicine" type of medicine. Can I just open up my own clinic in the community and see patients there as their primary care physician?

 

I realize that by doing this, I wont be able to officially call myself a "family doctor" because I wont be registered with the College of Family Physicians of Canada. I also realize that I wont be able to charge my specialist/RCPSC fees for patient visits, since I am seeing patients without a referral from a family doctor. But besides these points, is there anything stopping me from essentially practicing as a "de-facto" family doctor?

[Satsuma]

I realize that by doing this, I wont be able to officially call myself a "family doctor" because I wont be registered with the College of Family Physicians of Canada. I also realize that I wont be able to charge my specialist/RCPSC fees for patient visits, since I am seeing patients without a referral from a family doctor. But besides these points, is there anything stopping me from essentially practicing as a "de-facto" family doctor?

 

I think you answered your own question!

 

You wouldn`t be a family physician .... so no you can`t practice as a family physician if what you are is an internist. The skill sets the 2 physicians have are different.

 

If you really hated internal though, you could go back and do your residency or whatever part of it they would require for you to actually become a family physician.