Saturday, January 2, 2016

3rd Year Chronicles: Family Medicine

My family medicine rotation ended about a week and a half ago and I’m now officially half-way through third year, which is crazy. As preclinical students in our first two years, I feel like we always heard about how hard third year can be and how terrible some people’s experiences are as they get into the hospital or spend more time in clinics. So far, though, I’ve actually had a great time and have enjoyed third year more than the first two years (which I also enjoyed, mostly because of the ability to more or less set my own schedule).

Stolen from here
Part of that, of course, is that the “worst” of third year is yet to come. So far, I’ve completed pediatrics, OB/GYN, psychiatry, and family medicine. With the exception of OB/GYN, all of these are potentially difficult but overall pleasant rotations. As we welcome in the New Year, though, I have four months of surgery and internal medicine staring me in the face. So that should be interesting. Perhaps I’ll find that I’ve spoken too soon about this whole “third year isn’t so bad thing.”

Hopefully not.

In any case, back to family medicine. I completed this six-week rotation at a local family medicine residency program. This means that I spent a lot of time seeing patients and presenting to residents. After that, the resident would come say hi to the patient and then we would go present the patient to the attending physician. Over the course of the rotation, I also was able to spend some time in a dermatology clinic, spend some time on the family medicine inpatient service (I honestly didn’t know this was a thing before this rotation), shadow a home health nurse for a day (which was an interesting side of medicine I really hadn’t had much exposure to), and visit a nursing home.

Of course, one of the best parts of the rotation was the hours. Since family medicine is by-and-large an office-based specialty, the hours were pretty much office hours – 8 am to 5 pm most days. Which was beautiful. The days generally went by fairly quickly, too, as there were lots of patients to be seen.

The Verdict

As medical students progress through third year and spend some time in various specialties, we get a chance to try and pick out the things we enjoy (or don’t enjoy) about each specialty and – hopefully – have at least an idea of what we’d like to do when we grow up by the end of third year (if not sooner). I was actually really surprised by how much I enjoyed family medicine. I knew that I’d likely enjoy it – I’ve enjoyed most of my rotations so far – if only because I was looking forward to getting back to the broader field of medicine after my psychiatry rotation. Psych was fun, and I actually found myself considering the field, but I really missed using my stethoscope.

Something that the family medicine rotation helped me realize is that I enjoy the broader medical fields. Pediatrics was pretty broad, although I don’t know that I want to deal exclusively with kids. I certainly see the appeal of being very familiar with a well-defined and limited (but certainly not small) body of knowledge (as in psychiatry or OB/GYN), but something like family medicine was a bit closer to what I envision when I picture myself as a doctor – someone who is moderately comfortable with the majority of medicine. No one person can be an expert in everything, which is why specialists are necessary, but I just don’t see myself being a “knee guy” or a “liver guy” when it’s all said and done.

Does that mean I’ll do family medicine? Who knows. Emergency medicine is still high up on my list, but this rotation reinforced why – I like the idea of being able to handle most things. One doctor I was talking with about career choices said something to the effect of, “Family medicine and emergency medicine are sort of on the same spectrum – it’s really just a matter of how bloody you like your patients.” In particular, emergency medicine’s unofficial motto – “anyone, anything, anytime” – appeals to me.

Of course, that’s a fairly romanticized way of going about choosing what field you are going to work in for most of the rest of your life. There are obviously many other considerations in choosing a field. Time invested in training, hours worked, what hours you work, what you actually do on a day-to-day basis, etc. are all things to think about. Also, I’ve still got two of the biggest rotations of third year ahead of me, so I can’t put my foot down now and say exactly what I’ll end up doing. Who knows – maybe I’ll end up loving surgery (probably not). We shall see. In any case, it should be a rather… interesting… next eight weeks. Surgery, here I come.

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