Last month, we held a special webinar on choosing your medical specialty, with a focus on family medicine. The event, held by Ron Gagne, MD—the faculty advisor for AUC’s student-led family medicine interest group—gave attendees an inside look at what it’s like to be a family physician. Missed the webinar? Listen to a recorded version here.
Attendees also got to ask questions, which were answered live during the event. Some weren’t able to have their questions answered during the webinar, though. Our own executive dean, Heidi Chumley, MD (pictured)—a family physician herself—took some time to comb through these questions and respond to them. We’ve collected the questions, and her answers, below.
Q: Can you subspecialize as a family medicine practitioner?
Dean Chumley: Because a key principle of family medicine is caring for the whole person, family medicine doesn’t have subspecialties like the ones you’d find in internal medicine. However, family physicians can complete fellowships in areas like adolescent medicine, emergency medicine, geriatrics, sports medicine, women’s health, and many others. As a family physician, you typically won’t need to complete a fellowship to have a broad scope of practice that touches these, and other, areas of medicine.
Q: On that note, suppose you decide to complete a family medicine residency, but decide later that you’d like to specialize in something like dermatology. Would you have to go back to square one, get the internist background, and then do the derm residency?
Dean Chumley: If you want to be board certified as a dermatologist, you’ll have to complete a dermatology residency. However, if you want to have a practice that emphasizes the diagnosis and management of skin problems, you can do that as a family physician. In fact, a former colleague of mine—Richard Usatine, MD, over at the University of Texas Health Science Center at San Antonio—leads a dermatology fellowship that focuses on care of the underserved.
Q: With the influx of physician’s assistants (PAs) and nurse practitioners (NPs) joining physician groups, where do you see the field of family medicine heading? Do family physicians still see the same number of patients, or is a significant part of their time spent overseeing mid-level providers?
Dean Chumley: In a highly functioning primary care system, all members are working at the top of their license. PAs and NPs are well trained to manage many types of patient presentations in primary care. This frees up family physicians to work at the top of their training, leading a team to work with the very complicated patients. The family physician then has more time to spend face to face with the most challenging patients.
Q: Can I be a family physician and an anesthesiologist at the same time?
Dean Chumley: Technically, you could complete a family medicine residency and then an anesthesiology residency (or vice versa), but this is fairly uncommon. Usually, when students are considering very different specialties, it is good to determine which parts of those specialties would be most rewarding and then make a selection. For example, if you liked office visits and conducting procedures in the office, family medicine may be the better choice. If you liked being in the operating room, putting people under anesthesia, then anesthesiology may be the better choice for you.
Q: I noticed on this chart that there are more residencies being offered each year in family medicine—but I just received an email from the Association of American Medical Colleges (AAMC) that Congress hasn’t been approving funding increases for residency positions, which could limit the number of physicians in the near future. Do you have any thoughts on that?
Dean Chumley: Although Congress funds the majority of positions in the US residency match, they don’t fund them all. In fact, many hospitals fund positions over the “cap” given to them by the government, and other hospital systems fund entire residency programs. The number of first-year residency positions continues to increase each year. You can find the actual numbers at the National Resident Matching Program® (NRMP) website.
Q: What are the differences between learning family medicine at a Caribbean medical school versus a US medical school?
Dean Chumley: AUC clinical students complete rotations in family medicine in the United States with physicians involved in family medicine residency training—in other words, they have the same experience as students who go to medical school in the US. I believe that a school like AUC offers special opportunities of great benefit to future family physicians—most notably, living internationally widens your worldview, exposing you to different cultures and healthcare systems.
Q: How and when did you decide to go into family medicine?
Dean Chumley: During my fourth year of medical school. I didn’t really understand what it was before then—but as soon as I discovered it, it felt like home.
Q: Is the business side (ie, building a practice) taught during a family medicine residency?
Dean Chumley: Yes—it’s a required topic in a family medicine residency.
Q: What are some of the opportunities for research in family medicine?
Dean Chumley: There are many—often on diseases commonly seen by primary care physicians, health disparities, preventive care, access to care, and much more.
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Posted November 30, 2015 10:15 AM