Category Archive: Family Medicine

Best Books and Resources for the Family Medicine Rotation

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Third Year, Family Medicine, Family Medicine Rotation

July 13, 2015

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This post is part of our series on the best books and resources to help you perform well on your third year rotations and shelf exams. Also check out our lists for clerkships in Internal Medicine, Family Medicine, OB/GYN, General Surgery, Neurology, Psychiatry, Pediatrics, and Emergency Medicine. You can also check out our complete list of "Best Books" lists for medical students here. 

Background: Clerkship Grades

At the beginning of each of these clerkship lists there are a few things I must say. First, your grade on clinical rotations will depend on both your clinical performance and your performance on a shelf exam at the end of the rotation. While it is true that how you work with your teams and patients will play into your evaluation, there is no denying that your knowledge of the subject matter is, by far, the most important part of your final grade because it directly affects both of these two areas of evaluation. As a resident, I currently find myself filling out medical student evaluations every week. There are very few 'incredible' medical students and very few 'terrible' medical students. The vast majority of you (~95%) fit into the "good and easy to work with" group; the only thing you have to set you apart from others is your knowledge base. You have no alternative but to study! First Aid for the Wards is a great resource to understand the dynamics of your clinical rotations, I highly recommend it.

Essential Resources

The resources I will describe in the clerkship lists are books and online question banks. From the onset let me point out two indespesible resources that I will not list for each rotation individually.

  • First, I consider a great online question bank essential. Both Kaplan and USMLE World are very good products. I highly recommend purchasing a one year subscription to one of these USMLE Step 2 question banks. As you complete your third year rotations, these question banks will prepare you for 1- your clinical duties, 2- your rotation shelf exam, and 3- the USMLE Step 2 during your fourth year.  
  • Second, online review materials (e.g. Medscape, UpToDate, etc.) are essential resources to prepare for your patients in the hospital. The books and question banks can never provide the type of in-depth detail about disease processes that you will need to learn how to properly take care of your specific patients. To be a great medical student, you must prepare more profoundly for the diseases you are encountering personally in the hospital.

Book Series for Third Year

Medical students are not all made the same; we are all very different learners. There are a number of companies producing review materials for third year medical students, each with a slightly different focus. Each of these companies produce a different book for each clerkship. Interestingly, some companies' books are rated higher in some clerkships than others. If you find a product that works for you, consider sticking with it during your third year even if that product is not 'rated' as highly for a specific clerkship. Below are a few of the review products and their features.

  1. The Case Files Series: A unique teaching model; the Case Files series introduces a number of important clinical cases and follows them up with clinical pearls and important concepts. For students who need vivid clinical situations to remember factoids and concepts, this is a great series. (Case Files Family Medicine)
  2. The PreTest Series: The PreTest series is a classic question bank format with questions and detailed explanations. As I previously mentioned, I believe there is no substitute for a great question bank. While an online resource (USMLE World or Kaplan) can be more robust and mobile, a good question book is still a great option. The PreTest series produces a couple fantastic question banks. (PreTest Family Medicine).
  3. The BluePrints Series: The BluePrints series has a beautiful format that is very easy to read. The text is laid out in a bulleted lists, but with more details and descriptions than the First Aid series with which most students are familiar. I think very highly of these review books. (Blueprints Family Medicine).
  4. First Aid Clerkship Series: The First Aid series well known to most students also produces review books for third year clerkships. The content is similar to what students are used to, bulleted lists of high yield information. While I highly recommend many of the First Aid review books for USMLE Step preparation, the books are not quite as widely read and recommended for clerkships. (There is no First Aid book for the Family Medicine rotation).

Best Books for Family Medicine Rotation

So, we can agree that books are not sufficient for success on your clerkships, but they are still an incredible resource that you should tap into. Let's review the best books and resources for your Family Medicine rotation. These lists come from both my experience and also from one medical school's annual survey of its 250 graduating medical students who try to detail which resources were the most useful on their rotations.

Family Medicine is a difficult rotation to study for because it emcompasses nearly all of medicine. It would be a reasonable expectation to receive questions on this shelf exam about basic general surgery and post-operative concepts, OB/GYN, pediatrics, internal medicine, and emergency medicine. As such, it is difficult to narrow down resources to study from. My best advice is to focus on the medical aspects of family medicine. You can not learn all of OB/GYN and Pediatrics and Family Med on one rotation; you must focus your time to some degree.

 

1. AAFP Board Review Questions:

The American Academy of Family Physicians provides free membership to all medical students. With membership, you have access to great online board review questions.These are certainly not a sufficient study tool, but they are very good questions.

 

aafp
 

2. Ambulatory Section of StepUp to Medicine:

If you have not yet purchased this book for your Internal Medicine rotation, you probably will as it is the most highly recommended for that clerkship. In it there is a great section on ambulatory medicine that is highly relevant to the Family Medicine rotation. Likewise, the "General Internal Medicine" section of the MKSAP Book or digital edition are also very relevant to family medicine. 

3. Case Files Family Medicine:

The Family Medicine book from the CaseFiles series is very highly rated by medical students. I found the cases to be broad in their categories but deep in their explanations. I recommend it highly.

 


 

4. PreTest Family Medicine:

The Family Medicine rotation is one instance where the PreTest Series does a very good job. This is probably the best available question bank that will prepare you for the breadth and depth of the Family Medicine shelf exam.

 


 

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

Categories:

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

June 1, 2012

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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, The Successful Match: 200 Rules to Succeed in the Residency Match, and The Residency Interview: How To Make the Best Possible Impression .


 

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

Categories:

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

June 1, 2012

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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 one or both of these two great books. I found both very useful.

 

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Physician Satisfaction by Specialty

Categories:

Choosing a Specialty, Dermatology, Emergency Medicine, Family Medicine, General Surgery, Internal Medicine, Neurology, Ophthalmology, Pathology, Pediatrics, Psychiatry, Radiology, Urology

April 26, 2012

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The most recent installment of the Medscape Physician Compensation Report was recently published. Along with some of the best information on the web about physician salaries by specialty, the new Medscape report also reports which specialties are the most satisfied with their jobs (click here to view the entire Medscape Report). The results may surprise you. There is no correlation with salary and satisfaction.  The highest paid specialties (orthopedics and anesthesia for example) are found in the middle of the list while pediatrics, ID/HIV, and pathology are all found at the top of the list.  Interestingly, plastic surgery is–by far–the least satisfying specialty. So, the most competitive specialty is by far the least satisfying…that’s odd!

 

From the 2012 Medscape Compensation Report

 

My conclusions from the Physician Satisfaction Survey:

  1. The age old adage is correct: Money does NOT buy happiness.
  2. Just because a specialty is desirable to match into does not mean it is desirable to practice in [plastics].
  3. I can find only one thing that links the most satisfying specialties: LIFESTYLE.  If you look at dermatology, psychiatry, emergency medicine, infectious disease, pathology, and ophthalmology they have a great lifestyle in common. They all have minimal call, good salary (but they are not the big earners), and few emergencies.  They all lend themselves well to family, recreation, and other hobbies outside of medicine.

 

My unsolicited advice:

  • I am sure there are my internists and plastic surgeons who are very satisfied with their jobs. I would bet that they knew exactly what there were getting into before they choose their specialty. Satisfaction in the workplace has lots to do with managing your expectations (and the expectations of your family and friends!)  If you really love some of the specialties that do not have the best lifestyle, that is great, just make sure you know that this will be an issue before you go into he specialty. Once you have made that decision, you will not be shocked (and neither will your family/friends) when you work a lot more than those around you.

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Allied Health Salaries

Categories:

General, Choosing a Specialty, Compensation, Family Medicine, Internal Medicine, Pediatrics

April 25, 2012

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The new Medscape Physician Compensation Report identified internal medicine, family medicine, and pediatrics as the lowest earners in medicine (each with an average of less than $165,000 per year).  I wanted to compare these results to the updated information from the Cejka Search group who publish data on the salaries of allied health professionals. The Cejka Database is the best place I have found for reliable information about the salaries of allied health practitioners. The list of allied health workers is long and includes:

  • Nurse Practitioners (NP)
  • Certified Nurse Aneasthatists (CRNA)
  • Physicians Assistant (PA)
  • Podiatrist (DPM)
  • Occupational Therapist (OT)
  • Physical Therapist (PT)
  • Optomotrist (OD)
  • Psychologist (PhD)
  • Dentist (DMD or DDS)
  • Midwife

Cejka reports the following salary information for these allied health professionals.  As you can see, CRNAs and Dentists earn more money than our country’s primary care physicians (pediatricians, family physicians, general internists).  This is just the yearly salary information, not taking into account the number of hours worked. Very few allied health professionals work the average hours per week worked by primary care physicians in the US (60 hours is a very conservative estimate for our PCPs). This means the dollars per hour is vastly different between some allied health practitioners and our primary care doctors. How do you feel about this?

From Cejka Search

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The Most Recruited Medical Specialties

Categories:

Residency, Choosing a Specialty, Dermatology, Emergency Medicine, Family Medicine, General Surgery, Internal Medicine, Neurology, Ophthalmology, Pediatrics, Psychiatry, Radiology, The Match, Urology

April 25, 2012

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Now that I am in the first year of residency I am beginning to think about landing that first real job.  As a Transitional Year resident I am heavily involved with the Internal Medicine residents at my hospital.  I found out very quickly that these internal medicine residents are HIGHLY sought after. In fact, many of them receive job offers on a weekly, or even daily basis.  The jobs that are in highest demand for internists are outpatient primary care and inpatient hospitality.  Many of my senior residents are being offered salaries between $200,000 and $300,000 along with many benefits including loan repayment. There are even some offers higher than $300,000 for less desirable locations! This is in a stark contrast to the ophthalmology job market that I will face, where starting salaries are low and it is terribly difficult to get your foot in the door.

Recently, I came across the Merritt Hawkins database.  Merritt Hawkins obtains information about starting salaries and benefits for newly graduated residents. I speak about their great physician salary database in my Ultimate Guide to Physician Salaries. However, their database also contains a list of the 20 most recruited specialties in medicine. The list may shock you!  The ability to find a well paying job right out of residency is NOT AT ALL correlated with the competitiveness of the specialty.  Case in point: family physicians and general internists are the two most highly recruited specialists in medicine!

From Merritt Hawkins

 

This list represents the Top 20 most ‘requested physician searches by medical specialty.’ The numbers represent the number of times Merritt Hawkins was used to recruit a person from the respective specialties (Merritt Hawkins full PDF including physician compensation data is available here for free). So, when you are deciding on a specialty, don’t forget that competitive does not equal good job placement.  In fact, many of the least competitive specialties are very high on this list (pediatrics, psychiatry, family medicine)

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Spotlight Interview: Matching in Family Medicine (Ohio Resident)

Categories:

Family Medicine, How to match in....?, The Match

April 5, 2012

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A Family Medicine Resident’s Perspective:

From an interview with a family medicine resident from Columbus, OH

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?

Not so much.  If you want to go out West you'll need a higher score on USMLE Step 1, but matching in Family Medicine is much less stressful than some fields.  It's more focused on determing where you fit well in terms of residency.

 

  • What are residencies looking for in a family medicine applicant?
Good work ethic, intelligence, compassion, and passion for the field they've chosen.

 

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

Family Medicine interviews are more like wining and dining.  Residency programs have one real goal, and that is to figure out if you would be a good fit for their program.  With this in mind, the best thing you can do is be yourself.  Wherever you interview, ask yourself, "Would I be happy living here and working with these people for the next three years?"

 

  • What should students look for in a family medicine residency?

It depends on if you know what type of Family Physician you want to be.  If you want to practice OB when you're finished with residency you should find a program that emphasizes OB/GYN training.  If you want to work in a rural area than a rural FM residency would likely be a good fit because that's where you'd be most likely to be "the only doc in town."  Location is a very important consideration and should not be discounted either.  You need to find a place where you will be happy living.

 

  • What other advice do you have for students applying to family medicine residency?

Be excited.  Family Medicine is a great field that will provide you with incredibly rewarding experiences on an almost daily basis.  You will also be able to make a very respectable living and have a great lifestyle.  What more could you ask for?

 

 

 

Editor's Note: Applying for residency or preparing for your interviews? I highly recommend First Aid for the Match, The Successful Match: 200 Rules to Succeed in the Residency Match, and The Residency Interview: How To Make the Best Possible Impression .


 

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

Categories:

Family Medicine, Why did you choose....?

April 5, 2012

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A Family Medicine Resident’s Perspective: From an interview with a family medicine resident from Columbus, Ohio.

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?

I grew up wanting to be a doctor because of the influence of my own family doctor in my life.  I love the emphasis that Family Medicine places on developing long term relationships with patients.  This provides a daily reminder that behind every disease is a person with hopes, dreams, and fears.  I also have a passion for nutrition and fitness and I have found that developing great rapport with my patients is an essential step before they will trust me enough to make dramatic and important lifestyle changes.  I really enjoy the breadth of knowledge that my field requires.  It excites me to realize that, of necessity, I will be learning for the rest of my life.

 

  • Describe a Family Physician's typical work day?

This depends on what type of work you choose to do.  Family Physicians can choose to work in an outpatient setting only, as a hospitalist, in an ER, or in an urgent care center just to name a few possibilities.  A typical Family Physician who works in an outpatient setting will work from 8:00 or 8:30 am until 5:00 or 5:30 pm, M-F.

 

  • What type of lifestyle can a Family Physician expect?  

Again, this largely depends on how you choose to practice.  Call responsibilities range from no call at all to one weekend in 8 to call every other day.  If you're interested in providing OB care or in working in a very rural area your call responsibilities are likely going to increase.

 

  • What is the potential salary of a Family Physician?

There's a lot of regional variation, but across the country most FPs make somewhere between $130k and $350k with the average being somewhere around $200k for most FPs in their peak years.  That being said, I know one FP that makes $50k per year and one that makes $500k per year.  Again, there's a wide amount of variation.  Also, many locations will offer loan repayment to family physicians that practice in their communities.

 

  • What is the job market like for Family Medicine Doctors?

In a word, excellent.  Family physicians are needed everywhere and residents are recruited heavily starting in their first year of residency.

 

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

There are some negative misconceptions about Family Medicine that come out strongly in most academic institutions (e.g., you can't go into FM if you rock the USMLE because it would be a waste of your talent, FM offers very little opportunity for research, etc.).  Also, your compensation can depend in large part on how business-savvy you are and how efficiently you organize your office.  This is becoming less of an issue as more FPs are employed by hospitals or HMOs, but is still a consideration for most small groups.

 

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

Family Medicine is a wonderful field.  As a Family Physician you will have the opportunity to impact the lives of your patients in ways that almost no other physician can.  You will see your patients at some of the best and worst moments of their lives, and they will come to greatly trust and value your advice.  Daily patient encounters as a Family Physician can be incredibly rewarding.  Family Physicians have almost limitless career opportunities both in terms of where they want to practice and in terms of how they set up their practice.  This amount of freedom is amazing.

 

 

Editor's Note: For more help choosing a specialty in medicine, I highly recommend one or both of these two great books. I found both very useful.

 

 

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