My Support Forums - View Single Post - "Dear Doctor": what would you tell your doctor?

bipolarmedstudent · Apr 21, 2012, 01:13 PM

Quote:

Originally Posted by nonightowl

I've heard a disturbing trend about how not enough medical students are becoming primary or family pratice doctors. That's where preventive care is, and that can go a long way for a healthy population. So, there's a shortage of them.

Speaking as a med student...

Yes, I want to become a specialist. I don't want to be a primary/family practice doctor. Why? Four things: 1. It's boring (intellectually) 2. There is little research in it 3. Once I choose to become a family doctor I'm stuck. I can't specialize later. 4. I'm very ambitious.

There are a few trends that are really important.
1. It used to be that EVERYONE would first do a year of residency (called the 'rotating internship') so all doctors could be GPs. If you stopped training after that year of rotating internship, all you could be was a GP unless you went back and specialized. But even specialists could moonlight as GPs. But they got rid of the rotating internship year, and now family practice is a separate 2-year residency. That forces you to decided earlier (during med school) whether you want to do family practice, and once you go down that route you are stuck. You can't later specialize. Also, the specialists can't moonlight as GPs anymore. Getting rid of the rotating internship was a HUGE mistake, imo, and is a big cause for the shortage of family care physicians now.

2. The cost of medical school tuition is astronomical now. Decades ago, students would graduate with no debt. Now students regularly graduate with $200,000 of debt, which they need to quickly pay off, at the same time that they need to establish a practice and start a family.

3. The process for getting into med school has become SO competitive. The only people who get into med school now are extremely ambitious, bright students who have done a lot of research during university. Such people are used to being overachievers, and 'settling' for something 'boring' and 'easy' like family practice is just NOT in our blood. We can't imagine doing it. Med school now selects for students who NEED to be challenged, and NEED positions that are intellectually stimulating and involve research. One way to fix this is to expand the research programs in family medicine, which is being done.

What do I want to be? I want to do either psychiatry or oncology. Neither are particularly high-paying specialties, so for me it has NOTHING to do with money. It's about the challenge, the intellectual stimulation, etc.

If you have any other questions, feel free to ask!