Friday, June 27, 2008

Family and Community Medicine

As a whole, I had a remarkably great experience in family medicine. I didn't think I'd like it very much, but the rotation really grew on me, and I was sad to leave just when I had figured everything out and felt comfortable with the rotation. While Santa Rosa was not incredibly exciting, it was nice to get out of the city and be in a different place. The residency program there is fantastic with dedicated teachers and residents. I was pleasantly surprised by the quality of the didactics. The diversity of clinics was great, and I got a lot of hands-on independence for a first rotation. This site focused more on acute care rather than chronic disease management, but I actually preferred that.

Here is how I feel about different specialties:
1. Family Practice / Primary Care - I have a better impression of primary care, but it still probably isn't what I'm going to do. I thoroughly enjoy working with both adults and children, I like outpatient acute care, and the breadth of material is fascinating, from derm to infectious disease to orthopedics. However, common things are common, and it's not too intellectually challenging. The appeal of primary care is working with families rather than doing procedures or figuring out medical mysteries.
2. Emergency Medicine - I've become a little less interested in emergency medicine. I had a great time in the emergency department and enjoy a lot of the diagnosis, acuteness, and action. There's a certain thrill to having anything walk through the door and being called to figure it out. The procedures are fun. However, emergency medicine does a lot of triage and stabilization and doesn't always see patients through to the diagnosis and treatment. There's a lot of defensive medicine and resource inefficiency. I also think it has more trauma and orthopedics than I want.
3. Pediatrics - This has gone up on the list. I really had a good time working with kids. They're emotionally uplifting and fun to play with. Outpatient pediatrics has less diagnostic challenge, but the patients make up for it. I never had any problems with parents. I'd see myself in a subspecialty rather than general pediatrics though.
4. Family Planning / Gyn - This is certainly interesting as a medical student, but probably not what I want to do with the rest of my life.
5. Dermatology - I got a better impression of dermatology, but don't see it as a career. Derm requires a lot of visual pattern recognition and has a decent amount of diagnosis. It has fun procedures and a wide distribution of patients. However, I think I like medicine too much to focus just on skin.

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