Specialty talk for medical students: Family Medicine

This is just a brief article discussing Family medicine for those medical students and FMGs who are still considering which medical specialty to enter. We’ll have these articles occasionally to act as a resource for anyone trying to make the most informed decision.

What to expect from Family Practice

Family practice is a broad ranging specialty that focuses on the idea of treating a patient through all facets of his or her life. Sometimes referred to as a general practitioner or primary care physician, this doctor will attend to conditions both acute and chronic as well as providing a wide array of medical advice, from preventive issues to opinions on major procedures. Some family practitioners will even perform minor surgical procedures and handle obstetric matters up to and sometimes including childbirth.

While this choice of specialty has seen a decline in selection in the last decade, many physicians find it to be one of the most rewarding specialties, both professionally and personally.

Training in Family Medicine

A family physician will undertake a three-year residency after completing their doctoral studies. During these three years, the candidate will complete training in diverse fields of care. Intensive in-hospital training will cover the care of infants, the elderly and everything in-between and in all potential situations, from acute care to emergency services. The family practice resident will also receive extensive training in outpatient situations. Through this manner of training, a resident can find themselves treating a large percentage of a single family, or seeing a number of families on a recurring basis, and learn to develop the talents needed in providing continuous care.

Another side to this all-embracing form of study is learning the ability to manage a patient’s or a family’s medical issues in a comprehensive manner. The ability to handle these multiple problems, not only technically but also in terms of developing and maintaining a relationship with the patient, is one of the most important aspects of this specialty’s training.

Many family practice programs will provide residents opportunities in research and in teaching medical students or junior residents. There is also some variance in the level of technical training across the array of areas required.

This leads to a common perception that influences the choice of this specialty by medical students. A study by the American Association of Family Practitioners revealed the opinion among some medical school faculty, residents and students that the “content of family practice is too broad and cannot be mastered.” In some cases, medical students are actively discouraged from selecting the specialty, taking the view that FP programs are insufficient training for a doctor who will be forced to face such a broad scope of medical problems.

The specialty continues to grow in terms of training. Newer programs have taken to including training in rural areas to address specific issues that arise in such settings, as well as addressing ethnic and racial training issues. Continuing education will also be a big part of the family physician’s career.

Additionally, fellowships are available in such diverse areas as faculty development, sports medicine, preventive medicine and rural medicine.

The life of the Family Practitioner

The lifestyle of a family physician is dependent on many factors, not the least of which is the setting on one’s practice. There are numerous options, from setting out to build one’s own practice to joining with an established medical group.

Joining a medical group will allow for more regular hours and the ability to fix those hours to a desirable schedule. The average family physician will work a little over 50 hours a week, with about 80% of that time spent in direct patient interaction.

Solo practice can be much more demanding, beyond the financial risk from setting out one’s own shingle. Such practitioners often find themselves on call for their patents after normal office hours, a disruption that is minimize in group practice.

There is also a need for specialists from this category in the fields of academia and primary care research. While this may provide a stable schedule and regulated income, it may come at the cost of the satisfaction of seeing immediate results in treating patients.

One consideration is selecting the family care specialty is the need for continuing medical education (CME). Family practice was the first specialty to require periodic certification. While originally set in periods of six to ten years, dependent on the type of CME chosen (as credits can be obtained by more than just coursework), the process is being converted to annual competency tests in different areas. This process is expected to be fully in place by the end of the decade. Additionally, The American Board of Family Medicine, though a program called the Maintenance of Certification Program for Family Physicians, is requiring continuous demonstration of proficiency in areas such as cognitive experience, practice performance and self-assessment.

With additional training, Certificates of Added Qualifications are available in such fields as geriatric and sports medicine.

CME is vital to this specialty, given its broad nature, as each family practitioner must keep abreast on a wide variety of procedures in many areas of medicine.

The average compensation in family practice is over $140,000 annually after the first three years of practice. The high end of the scale comes in just under $200,000 while the lower end settles in at just over $110,000. These figures have gradually risen as the specialty is less often selected and an increasing number of match slots go unfilled translating to fewer new family care practitioners entering the field. Many new family physicians find the compensation sufficient to pay off student loans early.

Time off in this field averages at about four weeks per year, this time can be allocated toward vacations or toward efforts in continuing education.

With many suburban areas experiencing rapid growth from the effect of urban sprawl, a qualified family practitioner can establish himself or herself in any area of the country they choose. Underserved communities that offer loan repayment or loan forgiveness programs in exchange for serving that community for a predetermined minimum time period.

Is Family Medicine for You?

Family care is the only specialty that finds itself geographically distributed as the population is distributed. It is the most visible specialty to the public eye and the first line of medical defense for the majority of the population. These doctors routinely see to the care of the nation on a daily basis and are very much the physicians of the people.