Robert Bowman's been writing an essay called Family Physicians Are Different. It's a compelling reminder. Fall is the time of year that our students start to think about what/who they want to be when they grow up.
For some the choise is easy. For others, they feel like a push-me-pull-you. Such a struggle ... their Internist mentors whisper in their ears about the opportunities to subspecialize. OB/GYN describes "comprehensive women's healthcare" (oh puleeze!) and the Family physician is often left explaining how we are different .. without maligning the other specialties .. despite the fact that they all mailign us. Yeh yeh .. I'm whining a bit. But any family doc will back me up here. Our students hear this every day. "Oh .. you don't want to go into family medicine .. you're too smart for that. You should be a _____ ." I heard it all 10 years ago .. and unfortunately, not much has changed.
Last week, a student we've worked with for years confided that she is likely to apply to Internal Medicine residencies. She was scared I would be mad at her.
Of course I'm not mad. But I am a bit disappointed. She reminds me of the student from 3 or 4 years ago who made the same decision - influenced by a very nice, charismatic pulmonologist (who is a friend of mine) to abandon her plans for Family Medicine in order to pursue a "more academic" career. The student was miserable in Internal Medicine.
The limited attention to the social context of the patient's condition, the focus on developing a long differential diagnosis .. etc etc. She transferred after her first year and .. as she reported to me a few years ago .. "Family Medicine Fits like a glove." Family Medicine is very hard to do well, and when I see a student who seems to know the secret handshake, and will fit this specialty well, it does disappoint me that they get enticed by other specialties. But I do my very best to support them and respect their decisions. We don't "win" by having more students go into our specialty .. so we needn't fight over them!