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Family Medicine Popularity


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Depends on the +1 and the kind of practice it leads to. Generally speaking I'd say no it doesn't, +1s are more about tailoring the practice of the FM doc than they are about increasing earning power, but there are exceptions. For example, a +1 in Emerg leads to a salary pretty much on par with RCPSC-trained ER docs, which is a bit higher than that of the typical FP. No +1 will vault you to the higher ends of an FP's potential salary though.

 

I would agree with that - a lot of true fellowships in any field really is just to advance your scope and let you work in the area you want to. They usually don't really increase your income much - they just let you get a job in the first place.

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Perhaps it is time to review this HARVARD Study:

 

Robert Waldinger is the Director of the Harvard 75 year Study of Adult Development, one of the most comprehensive longitudinal studies in history.

 

https://www.ted.com/talks/robert_waldinger_what_makes_a_good_life_lessons_from_the_longest_study_on_happiness

 

As a member of a 4 generation medical family :

ADVICE:

Chase the job you love, not the money. There is a price tag for everything.

 

Good luck.

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ha - you certainly won't hear as much from me I am sure by that point - I won't have a choice with that :) The radiology preparation schedule is pretty intense. One guy last year had every minute scheduled for studying except 30 mins a day (that meant he bought all meals, paid for cleaning and laundry etc) - I mean literally he was studying or on service all the time except for 30 minutes - ate meals at rounds (lunch, breakfast), ate bought dinner while studying, was driven to and from work........ for 10 straight months.

 

it sounds nuts! although probably our year won't be that extreme (when you hear your colleague is working that hard you probably will be as well - culture of work ha).

 

first rule of any position you hold - find a way to be replaced :) I think the forum collectively is more knowledgeable than the past because there is just that much more history out there.

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ha - you certainly won't hear as much from me I am sure by that point - I won't have a choice with that :) The radiology preparation schedule is pretty intense. One guy last year had every minute scheduled for studying except 30 mins a day (that meant he bought all meals, paid for cleaning and laundry etc) - I mean literally he was studying or on service all the time except for 30 minutes - ate meals at rounds (lunch, breakfast), ate bought dinner while studying, was driven to and from work........ for 10 straight months.

 

it sounds nuts! although probably our year won't be that extreme (when you hear your colleague is working that hard you probably will be as well - culture of work ha).

That's probably excessive. That's the most intense schedule I've ever heard for any specialty.

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I'm probably averaging 6-7 hours a weekday studying (some days I'm in a big case all day so no daytime studying, some days I'm only operating part of the day). About 3 hours after supper before bed included in the weekday time. 8 hours each weekend day.

 

That's enough for me. It's exhausting and life consuming. I'll crank it up a bit more for the last 2 months but I can't imagine doing more than that for the whole year.

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It's not how much you study, but how much you retain... which of course is related to the amount of studying, but I wonder when diminishing returns will set in even for the most focused people, if they don't take a break to refresh.

 

when i was exhausted from new material, i found taking Anki "breaks" refreshing [sorta], but also productive. 

 

my study schedule was also very intense... i started wishing i had a bed in the library because it felt like there was no point in going home other than to sleep. It was nice to cook at home again post-exam -- but still working on losing my exam weight!

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I think med students are also keen on jobs and geographic flexibility, and many above have already discussed this in detail.

 

Finally I wonder if many people are just fed up with calls, school and exams. Like other said it's nice to just "move on" with life's other priorities and not worry about studying for massive multiple choice exams when you are in your 30s. 

 

I suspect what you mention above plays a major role. Likewise, I don't think many clerks fully appreciate how grueling a FRCP residency can be. Such residency programs are a lot more than just a longer training period. There is a different culture and different expectations whilst a senior trainee. Most FRCP programs have an entire year dedicated to an exam and during that year you become a study hermit. I know a lot of family docs as friends, they don't study for their CCFP exam like the FRCP folks... Totally different beast. For these various reasons mentioned in this thread plus others every year a minority of FRCP residents switch into CCFP. 

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Just out of curiosity, why has family med suddenly become so popular? There are a lot of grads now that are applying only to family med. I understand that there are many lifestyle benefits that come with family practice, but what about pay? Can't an MD make significantly more as a specialist than a family doctor, and in addition to that many specialties offer the same lifestyle benefits as family, like radiology, dermatology, etc. But with significantly higher pay.

 

I think its because for a lot of people making a lot of money isn't that useful. Like for me personally nothing I've ever wanted in life needed me to make 500k instead of 250k. So apart from perhaps the rest of my family spending that extra money or it just being nice to have money so you can leave it to someone or just donate it, the extra money is just for naught.  

 

I would definitely choose my specialty on my interest in the job and my interest in research.  I'm not interested in family medicine but from what I know, I believe family and peds incomes are understated by the number of physicians who work part time. Family docs easily take home 250-300k and if you look at Derm its not that much higher its only like 350-400k. Asking a plastics resident, they said that if you are ok with family, 100% do family. 

 

I really think you are overestimating earnings by dermatologists. Ophtho might be a different story but also, at any time the Ontario government could cut the earnings for ophtho like that and lets be honest there is almost zero sympathy for ophthalmologists right now. I doubt the OMA would even defend them much if they got cut. Training for ophthalmology is not just 5 years you'll probably want to do a fellowship and at any point in that 10 year long training things could change. Its happened before and its likely to happen again. 

 

Also, lets be honest here how many people actually like managing the eye and the skin? It really isn't that many people. If all you love was money its just so hard to imagine you actually ending up in medicine, Medicine is probably one of the slowest and hardest pay offs ever and it gets slower and slower every year.

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In my opinion, Family Medicine is increasing in popularity mainly because of increasing debt loads that can start being paid off big time after only 2 years of residency. Also you have so much freedom. I completed a 2-week Family Med placement 20 minutes outside of a larger urban center and they were struggling to find a full-time family doc. They said so many people now want to start off doing locum work and travelling! 

Everyday I ask myself 'could I see myself doing Family Med?" sadly the answer is always no!

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In my opinion, Family Medicine is increasing in popularity mainly because of increasing debt loads that can start being paid off big time after only 2 years of residency. Also you have so much freedom. I completed a 2-week Family Med placement 20 minutes outside of a larger urban center and they were struggling to find a full-time family doc. They said so many people now want to start off doing locum work and travelling! 

 

Everyday I ask myself 'could I see myself doing Family Med?" sadly the answer is always no!

 

Ha, I am actually disappointed I wasn't interested in it. It has a lot going for it. 

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Same! Wish I was, really.

 

Adding to the train of this line of thinking as well, wish I was actually interested in FM. FM in Canada =/= FM in the States, FMs are actually gatekeepers here, you can't just see a specialist without seeing a FM first and on top of that FMs have a lot of diversity in how they practice. With more and more people entering medical school at later ages, FM's added benefit of having jobs available as well as easy job portability (i.e. you can pretty much live wherever), easy configurability (you can easily work part-time and switch or mix your practice with EM or tailor your practice) and starting to earn money earlier are serious pluses. 

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Adding to the train of this line of thinking as well, wish I was actually interested in FM. FM in Canada =/= FM in the States, FMs are actually gatekeepers here, you can't just see a specialist without seeing a FM first and on top of that FMs have a lot of diversity in how they practice. With more and more people entering medical school at later ages, FM's added benefit of having jobs available as well as easy job portability (i.e. you can pretty much live wherever), easy configurability (you can easily work part-time and switch or mix your practice with EM or tailor your practice) and starting to earn money earlier are serious pluses.

Yah. There are a whole lot of pluses. I usually have an episode once every few weeks where I panic and try to convince myself I like family med.

 

The hard part is that I (and likely most people) could probably carve out a FM practice that I'd be happy doing. It's tempting. I'm just much more passionate about my chosen specialty (which also has a lot of flexibility, but much more training).

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Yah. There are a whole lot of pluses. I usually have an episode once every few weeks where I panic and try to convince myself I like family med.

 

The hard part is that I (and likely most people) could probably carve out a FM practice that I'd be happy doing. It's tempting. I'm just much more passionate about my chosen specialty (which also has a lot of flexibility, but much more training).

Yeah, i'm a bit torn about EM(5 year) versus just doing FM and get the +1 in EM later.

 

The big turn off about the 5 year EM for me, is that later down the line I can't just choose to do FM shifts. Whereas with the +1, if i get tired of doing EM shifts, I can go part time FM. 

 

I'm not as yet aware of the part-time availability of EM proper, but from what older mentors have said that it really depends on the centre, but less easily configurable. 

 

Lots of variability and things that will change in the next decade ha!

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Yeah, i'm a bit torn about EM(5 year) versus just doing FM and get the +1 in EM later.

 

The big turn off about the 5 year EM for me, is that later down the line I can't just choose to do FM shifts. Whereas with the +1, if i get tired of doing EM shifts, I can go part time FM.

 

I'm not as yet aware of the part-time availability of EM proper, but from what older mentors have said that it really depends on the centre, but less easily configurable.

 

Lots of variability and things that will change in the next decade ha!

I'm interested in peds and that's one of the reasons peds emerg is really cool. They are also pediatricians so can choose to do community, or work in some of the multidisciplinary programs like the asthma clinic if they want to cut down on emerg shifts. I know here in Calgary many of them work about 10 shifts per month which seems pretty decent to me. It's on my radar for sure.

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I'm interested in peds and that's one of the reasons peds emerg is really cool. They are also pediatricians so can choose to do community, or work in some of the multidisciplinary programs like the asthma clinic if they want to cut down on emerg shifts. I know here in Calgary many of them work about 10 shifts per month which seems pretty decent to me. It's on my radar for sure.

I like the thought of PEDs too. But figure if I still want it later in my career. I can do CME and just do a kids only FP ha. Not sure how feasible that actually is...

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Yeah, i'm a bit torn about EM(5 year) versus just doing FM and get the +1 in EM later.

 

The big turn off about the 5 year EM for me, is that later down the line I can't just choose to do FM shifts. Whereas with the +1, if i get tired of doing EM shifts, I can go part time FM.

 

I'm not as yet aware of the part-time availability of EM proper, but from what older mentors have said that it really depends on the centre, but less easily configurable.

 

Lots of variability and things that will change in the next decade ha!

Couple quick points...

 

If you have any intention of getting into the 5 year Emerg residency you will need to make that your focus. It's become so competitive that people gunning for it only got one or no interviews despite a number of Emerg electives and strong evals/letters.

 

Also, the extra year of Emerg isn't a guarantee in family... It's quite competitive.

 

Finally, migrating from Emerg to Family later on in your career isn't a simple feat. You'll be out of practice with respect to the guidelines and standard of care so it'll take some adjustment on your end of things.

 

Anyways, good luck. I'm sure you are already aware of these points, but thought I'd reiterate them for you and for others who might not be aware.

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Couple quick points...

 

If you have any intention of getting into the 5 year Emerg residency you will need to make that your focus. It's become so competitive that people gunning for it only got one or no interviews despite a number of Emerg electives and strong evals/letters.

 

Also, the extra year of Emerg isn't a guarantee in family... It's quite competitive.

 

Finally, migrating from Emerg to Family later on in your career isn't a simple feat. You'll be out of practice with respect to the guidelines and standard of care so it'll take some adjustment on your end of things.

 

Anyways, good luck. I'm sure you are already aware of these points, but thought I'd reiterate them for you and for others who might not be aware.

Yeah exactly my point, if you do the 5 year program in EM..you're stuck with EM.

 

Thanks for the insights though!

 

The +1 EM for FM is really competitive from what i've heard. I'd have no issue with just working as  FM doc in the mean time and just collecting the hours - then you can challenge the exam after gaining the appropriate experience over 5 years etc. 

 

 

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Yeah exactly my point, if you do the 5 year program in EM..you're stuck with EM.

 

Thanks for the insights though!

 

The +1 EM for FM is really competitive from what i've heard. I'd have no issue with just working as  FM doc in the mean time and just collecting the hours - then you can challenge the exam after gaining the appropriate experience over 5 years etc. 

 

 

 

I think hking03 is more getting at the fact that once you do the 2+1 and practice for a few years in EM only, transitioning back to traditional FM is not exactly easy. You may be technically qualified to work as an FP, but if you're out of that setting for even 5 years, you're probably not competent without a good amount of supplementary education, ideally with some supervision.

 

I also wouldn't count on being able to use the exam challenge route to do full EM care in most centres. To get the number of hours you need without a +1, you'd mostly be talking working at small community hospitals with a very different combination of resources, patient population and overall levels of acuity than Emergency Departments staffed only by Emerg Docs (whether 5-year or 2+1 certified). Unless a center is really hurting for EM docs, I don't see many of them taking on a practitioner who's only experience is in small community hospitals.

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I think hking03 is more getting at the fact that once you do the 2+1 and practice for a few years in EM only, transitioning back to traditional FM is not exactly easy. You may be technically qualified to work as an FP, but if you're out of that setting for even 5 years, you're probably not competent without a good amount of supplementary education, ideally with some supervision.

 

I also wouldn't count on being able to use the exam challenge route to do full EM care in most centres. To get the number of hours you need without a +1, you'd mostly be talking working at small community hospitals with a very different combination of resources, patient population and overall levels of acuity than Emergency Departments staffed only by Emerg Docs (whether 5-year or 2+1 certified). Unless a center is really hurting for EM docs, I don't see many of them taking on a practitioner who's only experience is in small community hospitals.

That is exactly what I was referring to.

 

Well put Ralk

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