Unlike many specialties which focus on a given organ system, Family Physicians consider the whole person and the context of the community in which they live. Family Physicians recognize that wellness depends not only on the proper function of organ systems but on a person’s overall situation and worldview. As such, individuals who choose the practice of Family Medicine are those who have realized they have excellent insight and empathy for others, outstanding interpersonal skills, and the ability to understand how systems work rather than just components of systems in isolation. They possess these skills in addition to the curiosity and intellectual ability necessary to master the diagnosis and treatment of illness and wellness of individuals of any age, gender, communication style, or socioeconomic means.
Family Physicians do specialize—we specialize in people. Anything that makes a physician well-rounded also makes him or her a better doctor. It enhances his or her ability to understand and connect with his or her patients patients and thus strengthens a therapeutic relationship over the years.
Family Medicine residency lasts for three years after medical school. Programs distinguish themselves by existing in either an academic setting such as within a university and medical school, or being based within an (independent) community hospital. Our Penn State program is distinctive in that we offer training in an academic setting with strong involvement and educational opportunities in a local community hospital in Lebanon, PA. Our residents thus have access to outstanding resources and talented faculty who serve as educators and role models but also get to see what practice is like in a more “typical” setting outside academia.
Family Physicians specialize in people and recognize that each person exists in a social world that is tremendously important to their wellness and important for their physician to recognize and appreciate. We place a great emphasis on continuity of care meaning that we go to lengths to try to ensure that a given patient sustains a relationship with a given doctor over the long-term. That Family Physicians are competent in caring for adults and children in health and wellness as well as delivering babies means that we have the ability to come to know our patients very well, meeting their needs and building trust that helps us make a positive impact on their health. Family Physicians recognize the need for and talent of colleagues in other specialties and enjoy collaborating with them for the best outcome for our mutual patients.
After mastering the fundamentals of Family Medicine, some residents choose to pursue additional training in a particular area of Family Medicine. Fellowships are typically one year in duration and focus on additional training in Sports Medicine, Geriatrics, Hospice/Palliative Care, Research, Faculty Development, Obstetrics, Substance Abuse, Emergency Medicine, Adolescent Medicine and other areas. Penn State offers two Sports Medicine Fellowships – one based in Hershey and the other in State College, PA.
Those who choose Family Medicine value leading a balanced life and typically work with colleagues who self-selected the specialty for the same reasons and who possess similar interpersonal skills. Practice atmospheres are thus distinguished by an appreciation of the need to care for patients as well as oneself. In most Family Medicine programs, residents spend much of the first year of training mastering inpatient skills by working in the hospital. They will provide care to hospitalized adults and children, deliver babies under supervision of faculty and other residents, and establish their personal panel of patients who see them as “my doctor.” Over the next two years, residents spend time doing rotations in other specialties to acquire additional skills such as in orthopedics, ophthalmology, and dermatology. They spend progressively more time in their outpatient clinic taking care of their own patient panel. Hours spent at work vary widely from 40 hours per week up to 80 hours per week on a busy month when they may deliver dozens of babies. Of course, like any residency hours are restricted by duty hours regulations to ensure resident health and safety.
There is no “U.S. News and World Report” rankings of Family Medicine residency programs. All programs are required to adhere to a basic set of national rules that ensure that residents achieve a certain level of training and have a common training experience across all residencies. Students should consider the number and skills of the residency faculty, what type of practice program graduates do after graduation, whether a given program offers broad training opportunities, if the residents are contentand whether the program is located in a place in which they (and anyone with whom they may live) would enjoy residing during and possibly after residency. The third year of medical school is a great time to begin asking Family Physicians about where they trained and what to look for in a Program.
Ask a Family Physician! As you decide on a specialty, pay attention to whether the physicians you observe are happy doing what they are doing. Although the subject matter of a given specialty may be fascinating, consider the day to day life of a physician in that specialty and whether it would provide the balance of lifestyle, intellectual challenge and fulfillment that you wish for yourself two years – and thirty years from now. You’ll find that most Family Physicians are quite happy with their work.
You should consider whether a given specialty will allow you financial freedom beyond a minimum. If you’ve made it this far into medical training, you have undoubtedly pushed yourself to be the best for years on end. But you are reaching a point in life when definitions of “the best” become more nuanced. Class ranks and grades will cease to become measures of success, and you may seek other measures. Salary seems a very salient measure of success in our culture. But success measured in terms of money, coupled with a drive to be “the best” can lead an individual down a road that can never be satisfied. It may be wiser to be content with a salary that allows you a comfortable lifestyle (certainly an average salary in Family Medicine of $165,000 easily provides that) while redefining success in terms of time spent with one’s family, strong bonds with a wide group of friends or efforts channeled into building a better world.
The American Academy of Family Physicians has lots of information on its website about choosing Family Medicine as a career. Penn State’s Department of Family and Community Medicine has about 80 Family Physicians on staff—one of the largest in the country. Whatever your area of interest in Family Medicine might be, we probably have someone who is an expert in the field. Stop by Room C-1626 or send an email to me, Daniel Schlegel, M.D., the Residency Program Director and I’ll be happy to talk with you or get you in touch with another Family Physician to answer your questions or pursue your interest.
*Page provided by Scott Paradise*