Category Archive: Family Medicine Rotation

Spotlight Interview: How to Match in Family Medicine (Oregon Resident)

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Choosing a Specialty, Family Medicine, Family Medicine Rotation, How to match in....?, The Match

June 1, 2012

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family medicine1 Spotlight Interview: How to Match in Family Medicine (Oregon Resident)

A Family Medicine Resident’s Perspective:  From an interview with a family medicine resident at the Oregon Health Science University Hospital in Portland, Oregon.

Part of an interview series entitled, “Specialty Spotlights“, which asks medical students’ most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • How competitive is the Family Medicine match?

Family medicine is not very competitive. I was offered interviews at every school I applied. I ended up turning down many of the interviews I received. I interviewed at 11 residencies and got my first choice.

 

  •  What must a student do to match well in Family Medicine?

The usual stuff, good board scores, good clerkship grades, some research. Interviewing well may be even more important in FP because the specialty is so focused on personal relationships. Networking can be helpful as well, so you should try to get to know people early.

 

  • What are residencies looking for in a Family Medicine applicant?
I really think they are looking for just two things: 1- competency: they need to know you can do the work, w- personality fit: they are going to be working with you for 3+ years, they need to know you will fit in.

 

  • What should students look for in a Family Medicine residency?

A program that is interested in allowing you to be sane and healthy.

 

  • Do you have any advice on the application, letters of recommendation, personal statements, or how to rank programs?

Most people rank according to geography and then dive into specifics. Family medicine residencies are very different from one another, even more so that other specialties. For instance, at one program where I interviewed, the interns do 5 months of surgery their first year! That is kind of weird.  Because the field is so broad (peds, surgery, OB/GYN, hospital, outpatient) there is a great diversity in training programs.

 

  • What do you wish you knew before application/interview season?  

The Northwest is probably the best place to do family medicine. Lots of space, lots of prestige for family medicine residents and a great place to live.

 

  • What other advice do you have for students applying to Family Medicine residency?

Feel out the resident “culture” as much as possible, it wil have a significant effect on your health.  

 

Editor’s Note: Applying for residency or preparing for your interviews? I highly recommend First Aid for the Match Spotlight Interview: How to Match in Family Medicine (Oregon Resident) and The Successful Match: 200 Rules to Succeed in the Residency Match Spotlight Interview: How to Match in Family Medicine (Oregon Resident).







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Spotlight Interview: Why Did You Choose Family Medicine? (Oregon Resident)

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Choosing a Specialty, Family Medicine, Family Medicine Rotation, Why did you choose....?

June 1, 2012

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family medicine Spotlight Interview: Why Did You Choose Family Medicine? (Oregon Resident)

 

A Family Medicine Resident’s Perspective: From an interview with a family practice resident at Oregon Health Sciences University in Portland, OR.

Part of an interview series entitled, “Specialty Spotlights“, which asks medical students’ most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • What attracted you to Family Medicine?
Autonomy. Mobility. I wanted the sense that I was choosing a specialty that would allow me to work as much or as little as I wanted and that would allow me to place my family in a town of our choosing (likely a small town).
I also love the tradition in family medicine of trying to manage a patient by yourself as much as possible. There are a lot of efficiencies and preventative virtues in this approach to care. I feel like so much can be done in a small community that keeps thousands of people from ever having to be admitted to a hospital.
I love the intellectual challenge of receiving a patient into my office and managing all of their complaints. The situation demands that I be fluent on a variety of medical topics and able to comment on the current state of the medical literature. I really enjoy the challenge to read broadly and competently on a range of medical issues, it allows me to possess a synthesized view of medicine and patient care, to be sure I am not engrossed in too many minute details.

 

  • Describe a Family Physician’s typical work day?

Most days will start at 8:00 am. We see patients until 11:00 and then break for Lunch until 12:30. We see patients after lunch until 4:30. A large number of family docs will have a half-day on Friday.

 

  • What type of lifestyle can a Family Doctor expect?  

Your lifestyle will be pretty good. Weekends are virtually always free if you do not do hospital work. You will have regular call, but you rarely have to go in.  Most problems while you are on call are resolved over the telephone.

 

  • What is the average salary of a Family Practice Physician?

There is a great range of earning potential in FP.  The average salary is around $150,000.  However, you can see fewer patients in a day, or work fewer days in a week and earn less than this. If, however, you see patients quickly, become medical director of a nursing home or two, work extra on the weekends, etc, it is very possible to make much more than this.

 

  • What is the job market like for Family Medicine?

Honestly, it couldn’t be better. Family docs can go anywhere they want. Lots of recruiters will call you throughout your residency. There is a great need of primary care docs in every corner of this country.

 

  • What can you tell us about Family Medicine Sub-specialties?

There are a few options as a family medicine physician. Some of the fellowships include hospital medicine (i.e. become a ‘hospitalist’), geriatrics, adolescent care, and Sports medicine. For the most part, fellowships are one year in length. Sports medicine doctors end up making a bit more money than a generalist and the other sub-specialties.

 

  • What are the potential downsides of Family Medicine that students should be aware of?

In family medicine there is a lot to the business side of things. You will be responsible for managing much of the business side. If you are not a good businessperson, not organized, or dislike that type of thing, this part of the job could be a real drain. The salary is on the lower end for physicians, but it is still a very good living.

 

  • What else would you tell medical students who are considering Family Medicine?

If you want to do outpatient care in a small community, this is a great field.

 

Editor’s Note: For more help choosing a specialty in medicine, I highly recommend The Ultimate Guide to Choosing a Medical Specialty Spotlight Interview: Why Did You Choose Family Medicine? (Oregon Resident).


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Top Ten Books for Third Year Medical Students

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Books, Emergency Medicine Rotation, Family Medicine Rotation, General Surgery Rotation, Internal Medicine Rotation, Neurology Rotation, OB/GYN Rotation, Pediatrics Rotation, Psychiatry Rotation, Third Year

April 27, 2012

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This list is part of a series of articles about the best books for medical students. Click on the Med School Books Main Page to see other lists including the best books for each year in medical school, the best books for each clinical rotation, and the best books for USMLE Steps 1, 2, and 3. 

1. First Aid for the Wards:

Beginning the third year of medical school is a daunting task. I shook like a little kid the first time I had to present on rounds. In retrospect, I wish I had read this book before I ever started third year. It provides great advice about prerounding, rounding, presenting patients, and working with your clinical team. It also gives rotation specific advice for each of the main third year clinical clerkships.

2. Pocket Medicine:

I consider pocket medicine a must-have for all students and residents. I used it during medical school and am still using it in residency. It highlights all the most common clinical illnesses and presentations. For each illness it describes the clinical presentation, signs and symptoms, diagnostic tools, and treatment plan.

3. Maxwell Quick Medical Reference:

A small book with a big role. Nearly every medical student I know carries this book in their white coat. It contains clinical pearls and references that are very high yield. Additionally, it contains sample notes (progress, transfer, procedure, admission, etc).  It is about the best $10 you can spend.

4. Case Files:

The Case Files Series Top Ten Books for Third Year Medical Students (Amazon link) is my favorite clerkship study series. Similar to the Pretest Series (#5) and the Blueprint Series (#6), Case Files publishes one book for each medical student clerkship. The book teaches principles through a series of 50-60 cases.  After each case is presented, the relevant clinical teaching points are discussed and followed with a series of questions. For my style of learning, this was the ultimate study tool during third year. I particularly recommend Case Files Neurology Top Ten Books for Third Year Medical Studentsand Case Files Family Medicine Top Ten Books for Third Year Medical Students.
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5. PreTest:

Another series of books for each medical student rotation, the PreTest Series Top Ten Books for Third Year Medical Students (Amazon Link) are simply question banks in print form. Their questions are very good and hit on relevant material. Although I prefer USMLEworld as a straight question bank tool, the Pretest books allow you to always have questions at your side for bus rides, downtime at the hospital, etc. Along with many medical students, I particularly recommend PreTest Pediatrics Top Ten Books for Third Year Medical Students, which was eerily similar to the shelf exam.

6. BluePrints:

The Blueprints Series (Amazon link) Top Ten Books for Third Year Medical Students is a third series with one book for each medical school clerkship. Unlike the case-based presentation of Case Files and the q-bank format of PreTest, the Blueprints series are more like textbooks. They aim to teach the most pertinent clinical facts without becoming too dense. Each book is about 300 pages and contains a wealth of information…if you can get through it. Blueprints Obstetrics and Gynecology Top Ten Books for Third Year Medical Students
is widely considered the most useful; I used it and did very well on the shelf.

7. Surgical Recall:

If you are interested in surgery or even interested in obtaining a good grade in your surgery rotation, you need to know what is going on in the OR. Surgical Recall provides step-by-step details of surgical procedures including surgical indications, pre-operative management, intra-operative management including a walk-through of the surgery, and post-op management. It will really help you shine in the OR.

8. First Aid for the USMLE Step 2 CK:

Yes, you will probably find a ‘First Aid’ book in each of my Top Ten book lists. This is because I have found them to be the best tool at solidifying the most important points of each phase of medical school. During third year the First Aid for Step 2 CK (Clinical Knowledge) was a great way to make sure I knew the most important facts. It is certainly not sufficient to study alone.

9. MKSAP for Students:

MKSAP is a resource produced by the American College of Physicians and used by nearly every internal medicine resident in the country. The book series is huge (15 volumes?) and not for student use. However, their question book for students is incredible. Next to USMLEworld there is no better question bank to prepare for shelf exams like internal medicine and family medicine.

10. Step-Up to Medicine:

You will also find this book at the top of my list for the the internal medicine rotation. However, it is so good that I thought I should mention it here too. The book comes highly recommended by nearly every student that has ever used it. It will give you a great base to study from and find out what you need to study more.
Honorable Mention:
  1. I can not create a list of study tools for third year medical students without mentioning USMLEworld.  After using many Q-banks, many question books, and other resources, I have concluded that USMLEworld provides questions most consistently similar to the real shelf exams and boards as well as provided the clearest explanations.
  2. The Pestana Notes are an absolutely necessary resource for students on the Surgery rotation.
  3. Success on the Wards: 250 Rules for Clerkship Success Top Ten Books for Third Year Medical Studentsis a highly rated book for third year students
  4. 250 Biggest Mistakes 3rd Year Medical Students Make and How to Avoid Them Top Ten Books for Third Year Medical Students is written as the same authors as “Success on the Wards” and also comes highly recommended.
  5. The Ultimate Guide to Choosing a Medical Specialty: Top Ten Books for Third Year Medical Students Really, this books should be in the Top Ten.  I left it off because it is not specifically for third year medical students. However, it is one of the best resources available for deciding what is important to you in a specialty, and comparing variables across all medical specialties. I highly recommend it.
  • Updated April 27, 2012

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Pre-operative Clearance Checklist

Categories:

Family Medicine Rotation, General Surgery Rotation, Residency

February 6, 2012

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hopkins Pre operative Clearance ChecklistA frequent question in the outpatient setting is whether or not a patient is optimized for surgery. There are a number of things that a physician must check in order to properly send a patient back to a surgeon with a gold star. I recently used the Johns Hopkins Internet Learning Center (HopkinsILC) to study the basic pre-operative evaluation and I highly recommend it (requires access from your school or hospital, many hospitals have access, ask your librarian).  There is a great review pdf available from HopkinsILC which details some of the highlights of the lesson.  Below I will summarize some points from the pdf. To learn more, you should ask for access to HopkinsILC, it is a great resource.

 

  1. If the patient has any active cardiac issues, surgery should be postponed.  This includes…
    1. Recent myocardial infarction (<30 days)
    2. Active cardiac disease (unstable angina or worse)
    3. An uncorrected arrhythmia
    4. Severe aortic stenosis

 

  1. The patient must be able to complete 4 or more ‘metabolic equivalents of task’ (METS).  This includes
    1. Climbing a flight of stairs
    2. Walk for 30 minutes
    3. Play tennis, bowling, or other more intense sports
    4. Able to vigorously clean a house (scrub floor, move furniture)

 

  1. There are a few medications that must be stopped prior to surgery. Some examples (not an exhaustive list) include…
    1. If the patient is on blood thinners (coumadin) or anti-platelet drugs (plavix, lovenox, etc) these may have to be stopped and the surgeon will have to be part of the discussion
    2. Diuretics, ACE-inhibitors, and ARBS are usually held
    3. Oral hypoglycemics are usually held for 1-2 days
    4. Insulin is usually decreased by 50%
    5. Sedatives are usually held

 

Again, here is the link to the pdf explaining the above points. And here is the link to the HopkinsILC website.

 

 

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