Adieu to Family Practice

13 11 2011

It’s been a while since my last post, and since that time three things have happened:

  1. Finished my family medicine clerkship (and passed the shelf!)
  2. Took a phenomenal break that included a few days in DC
  3. Began—and, yesterday, completed—my first two weeks of internal medicine, working the night shift

A post on item #3 will follow.

So, first things first, family medicine is over.  The only thing to say about this is thank goodness.  I’m sure everyone around me is excited about this, too, because looking back, it seems that all I did was complain about the experience.

I always try to see the bright side of my experiences because, let’s face it, I likely would have spiraled into depression last year if not.  But there’s a very fine line in these clerkships between honest evaluation of my learning experience for the purpose of getting the most out of my short stint in each specialty, and ruminating on the negative aspects of my rotations.  It is especially difficult because medical students must decide whether to enter a specialty based on having only 2-12 weeks of exposure, and I really am starting to feel the pressure of getting the most out of each experience because more likely than not, this is the only time I will be able to experience that life before I choose a career path.

Here’s the issue that I had: I really, truly wanted to like family medicine, because there are so many things you can do with it.  Family med docs can do everything from OB to sports medicine to geriatrics, palliative care, and even cruise ship medicine (an how awesome would that be?).  And our country needs a ton of them.  That’s a big chunk of the reason I chose this profession, to be able to bring better health to people who need it.

Unfortunately, with the advent of nurse practitioners and physician’s assistants, it’s hard to see why anyone would want to hire more than maybe one FP for each practice to act in a supervisory role.  Sure, they know less than the average MD, but they know enough to take care of the preventative medicine, know when to prescribe most medications, know when a patient needs to be referred to a specialist, and they are much less of a liability.  Let’s face it: nobody sues nurses or assistants unless they really did exhibit some sort of blatant misconduct.

Either way, 6 weeks of family practice may not have been enough to convince me not to enter the field, but unfortunately it’s enough for me to consider not looking into it further.  When medical students are forced to make their final career decisions after fewer than 15 months—9, if you take into account that 4th-year schedules are made in April of 3rd year, and students must have a clear idea of what they want to do at that time—there’s no time to ruminate on the “what-ifs” of a clerkship.  It really is more prudent to look further into the things you did like than try to force yourself to fall in love with a specialty you were lukewarm about.

For me, it’s safe to say that unless something drastically changes in the next 10 months or so, I won’t be a family practitioner.

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