Wednesday, January 24, 2007

Family Medicine - Yours To Discover

Wow. I just came back from the GREATEST family medicine talk. We had a couple who are married and both family docs come in to talk to our family medicine interest group about their lives. It was so enlightening. Did you know that with a Canadian family medicine certification you can be licensed to work almost anywhere in the world without taking a test? You can go do locums is many interesting places. They've been to New Zealand, St. Lucia, Bosnia, Serbia and lots of places in Canada including Iqaluit and Sioux Lookout. They both have extra qualifications in anesthesia, the husband does lots of obstetrics including sections and they both do ER in small towns they visit including medevac. I can't explain how much this makes me want to do my family medicine residency RIGHT NOW and just get out there and practice. The opportunities seem endless. This is what makes medicine the best profession in the world.

I think I've pretty much decided that I want to do family medicine. The lifestyle and the flexibility are so appealing to me. Maybe I'll do a PGY3 in obstetrics to fulfill my desire to be involved in pregnancies and deliveries - but then again, you can do that just having your 2 year cert too. Man, I'm so high on family med right now! My new difficulty - urban or rural program for residency???


The Angry Medic said...

Feels good knowing what you want to do in life, doesn't it? Makes life worth living. I wish I could feel that. But it's a little hard with all these biochemistry lectures being stuffed down your brain over here...

Also I said this in the comment on your previous post, but DUDE! What's with the weird profile pic?

Nathan said...

The angry medic is right, it is nice. I've had almost daily confirmation of my choice of medicine now that I'm rotating through surgery.

And I vote urban. You'll see a lot more, and handle sicker patients. Then you can take those skills to the rural scene.

Liana said...

Yay, another family medicine convert!

I'll politely play devil's advocate to nathan and vote rural. I did medical school in Calgary, so I have a pretty good idea of what urban residents see and how that compares to what I see in Red Deer. I see more patients because I'm the only resident on any given rotation at a time, so I get lots of volume and I also get the benefit of seeing all the interesting cases on the service, not just the ones my preceptor assigns to me. We have a 15-bed ICU, and at one point I was involved in the care of almost every single one. I even get to see interesting/useful cases when I'm no longer officially on a rotation... examples include doing epidurals while on obs/gyn, and reducing broken wrists and dislocated hips while on anesthesia.

I will admit that I don't get to see things like angioplasties (those go to Calgary) but I won't be managing those as a family doc anyway.

I think if you're planning to be an urban family doc, by all means, do an urban residency. If you seriously want to be a rural doc, you should train rural... there's definitely a different emphasis in the training, and I think it's easier to go urban from a rural program than vice versa. For example, depending how rural you go, you may not be able to get a CT scan or even a CBC in the middle of the night. You might have only one nurse in the ER with you, and no resp techs or pharmacists. I'd prefer to learn how to deal with those situations while a preceptor has my back.

Plus, rural medicine is fun. I know rural residents in my program who have done burr holes and lateral cantherotomies in the ER because the nearest specialists were more than 3 hours away. I can't think of any urban famiy med residents who've done that (short of doing an elective in optho or neurosurgery).