with patients of all age ranges, and like Vin Diesel, you don't have friends, you got

family. Let's debunk the public perception myths, and give it to you straight. This is

the reality of family medicine. Dr. Jubbal, MedSchoolInsiders.com.

Welcome to our next installment in So You Want to Be. In this series, we highlight a

specific specialty within medicine, such as family medicine, and help you decide if it's

a good fit for you. You can find the other specialties on our So You Want to Be playlist.

If you want to vote in upcoming polls to decide what future specialties we cover, make sure

you're subscribed. If you'd like to see what being a family

medicine doctor looks like, check out my second channel, Kevin Jubbal, M.D., where we'll have

day in the life episodes of family medicine doctors in the future.

Family medicine is the center of primary care, the generalists of generalists. Unlike other

specialties that are limited to a particular organ, disease, or age range, family physicians

treat the broadest range of ailments and patients, from newborns to seniors, and everything between.

For most people, a family medicine clinic visit is their main input into the healthcare

system, their first line of defense for non-urgent health concerns. From their family medicine

physician, they can either receive the necessary treatment, or be referred to the appropriate

specialist for more complex pathologies. The overwhelming majority of family medicine

physicians practice in an outpatient clinical setting and the bread and butter pathologies

they deal with include diabetes, hypertension, hyperlipidemia, and preventive medicine and

health screenings. But there's much more to the specialty than

that. You'll never have as many procedures as a surgeon, but if you want to be more procedure

heavy, you can set aside a day in the week for steroid injections, wart removal, colposcopies,

vasectomies, frenulectomies, circumcisions, and more. Or if you want to tailor your patient

population, you can do that too. Maybe you want to focus on pregnant women and delivering

babies, or older patients through geriatrics, or keep it broad and include all patients

from cradle to grave. Family medicine is often compared to internal

medicine as they have a large degree of overlap, as both often serve in primary care roles

in the outpatient clinic, but they have substantial differences. With internal medicine, you're

only dealing with adult patients, but have greater flexibility in specializing in various

organ systems, like cardiology, gastroenterology, infectious disease, and others, which are

usually 3 year fellowships. With family medicine, you don't have the same organ-specific options

for specialization, serving more as a generalist, but you do have various 1 year fellowship

options, which we'll cover shortly. There are a few ways to categorize the specialty.

As a general family medicine doctor, meaning you haven't completed a fellowship, you'll

be focusing on preventive health and simple concerns in an outpatient clinic for the broad

population. Your hours will be regular 9 to 5, and compensation is on the lower end compared

to those who specialized. As a specialized family medicine doctor, you're

fellowship trained, and your lifestyle will vary based on your specialization. With sports

medicine, you'll see some athletes, but probably still have your regular family practice too.

If you go into obstetrics, you'll spend some of your time on call in the hospital delivering

babies. And if you go into emergency medicine, you'll have the lifestyle of an EM doctor.

Most family medicine doctors practice in a community setting, either a smaller group

or something larger like Kaiser. In this setting, your job first and foremost is to be a family

medicine physician, while research and teaching are not primary responsibilities.

In academia, you'll not only handle patient care, but also teach medical students and

residents while also tending to some research responsibilities on the side. Of the three,

this generally has the lowest compensation. Finally, private practice is the least common,

but offers the most flexibility. You'll be your own boss, running your own practice,

and have the highest ceiling in terms of compensation. You are running a business, however, and there

will be more hassle and usually longer hours as well.

There are a few misconceptions we need to set straight about the specialty.

First, some say that family medicine doctors don't know much and are constantly sending

referrals to specialists to handle what they can't. The truth is that family medicine doctors

are some of the best when it comes to handling common presenting concerns, but need to know

where their capabilities are and where to draw the line in seeking help from a specialist.

They are often screening and finding conditions that allow for early intervention, like being

the first person to find an arrhythmia and referring that patient to a cardiologist.

Additionally, family medicine doctors are the specialists of complexity, the quarterback

of the patient's healthcare needs. Because they have to know a little bit about everything,

they can be the best to handle complex situations where a patient is receiving multiple treatments

from multiple specialists, some of which may be conflicting. In line with this, family

medicine docs are often well suited at approaching each patient holistically and as an individual

instead of as the sum of individual organs or chief complaints.

Last, most equate family medicine with outpatient primary care. While most family medicine doctors

do practice in a clinical setting and see patients of all age ranges, there is more

flexibility to the specialty and you can narrow it down based on your particular interests,

whether that's being a hospitalist, obstetrician, or something else.

After medical school, family medicine residency is 3 years. It's categorical, meaning you

match into one program and complete all three years there, including your intern year.

During your intern year, or PGY1, you'll rotate on many services, including family medicine,

obstetrics, pediatrics, internal medicine, ICU, and others.

During PGY2 and PGY3, you'll still rotate on various specialties, which is unique to

family medicine. In most other residencies, PGY2 and onward are usually dedicated to rotating

on just your own specialty's services. The reason is that family medicine physicians

are the generalists' generalists, and they need to know what they can handle on their

own versus what they should refer out or request a specialist consult for.

In terms of competitiveness, family medicine is attainable, with a match rate around 96%,

USMLE Step 1 average of 220 and Step 2CK average of 236. In our Med School Insiders Competitive

Index, which takes into account match rate, Step scores, publication, AOA, and top 40

NIH schools, it ranks at the bottom of the list with 13 points.

Medical students that choose family medicine are stereotypically the ones who loved everything

during their third year rotations, except maybe surgery, and couldn't find themselves

committing to one specialty at the exclusion of others. With family medicine they can truly

get a little bit of everything. After completing 3 years of family medicine

residency, you can choose to specialize with an optional fellowship, each of which are

1 year in duration. Sports medicine is for the bros and jocks

of family medicine. You'll be doing various office procedures. Think of orthopedics but

without any of the surgery. You can learn more about sports medicine in our So You Want

to Be a Sports Medicine Doctor episode. After completing an obstetrics fellowship,

you are a full scope general OB doctor. You can deliver babies, just like OBGYN doctors,

although those who completed an OBGYN residency will have more options for further specialization.

It's an intense specialty that is often polarizing, and people either love it or hate it. You

can learn more about OBGYN on our So You Want to Be an OBGYN episode.

A hospitalist fellowship allows you to practice as a hospitalist, admitting patients to the

hospital and handling their medical management while they are inpatient. Stereotypically,

this is for the family medicine doctors that have personality tendencies of internal medicine

doctors, namely they love geeking out over the minutiae of medical management.

Emergency medicine gives the option for family medicine doctors to practice as emergency

medicine physicians, the same as those who completed EM residency. This is for the family

medicine doctors who decide they don't want longitudinal care and prefer shift work and

acuity. You can learn more about the field in our So You Want to Be an EM doctor episode.

Rural and international are two separate fellowships with substantial overlap. Both are focused

on underserved populations that have issues in accessing healthcare. These doctors usually

practice a wider scope of medicine, as there are fewer specialists around, and are also

focused on improving access on a systemic level in these regions. These fellowships

are for the highly altruistic and selfless family medicine doctors.

There are additional fellowships you can pursue as well, including geriatrics, adolescent

medicine, sleep medicine, palliative medicine, preventative, HIV medicine, and addiction

medicine. There's a lot to love about family medicine.

Most obviously, FM provides a great deal of flexibility, beyond what most aspiring physicians

realize. If you want to deliver babies all day, you can do that. If you want to practice

in the emergency department, you can do that too. Or maybe you want to practice inpatient

as a hospitalist. All these and more are possible with family medicine.

Family physicians have a desirable schedule, usually working regular 9 to 5 office hours

and minimal, if any, call. Note that if you specialize in OB or EM or hospitalist medicine,

then your hours will more closely approximate what's normal for that specialty.

If you enjoy getting to know your patients and building relationships, family medicine

offers amazing access to longitudinal care, as you can see patients from the time they're

born through adulthood. Family doctors also maintain their level of

medicine knowledge. Medical students in their later years know what I'm talking about. You

spend thousands of hours and incredible effort learning about the various organ systems and

their pathologies, only to forget much of it as you narrow down with your specialty.

I definitely felt that way with plastic surgery. Family medicine is one of the few specialties

where you continue to develop that broad knowledge. There's an inherent satisfaction in knowing

you're able to manage most anything that walks through the door to some extent.

While family medicine is an awesome specialty, it's not for everyone.

In terms of compensation, family physicians are bottom of the list, averaging $236,000

per year. Specialists, on the other hand, average $344,000 per year.

Compared to some other specialties, there's a great deal of charting and computer work.

Documentation and billing become an increasingly large part of your day to day, as that dictates

how much reimbursement or compensation is received from the insurance companies.

FM doctors are also often juggling social issues with patients, such as access to care,

insurance coverage, and more, although this does depend on your patient population.

Last, a small number of medical students look down on the specialty, which is backwards

and often ego-driven. Many medical students are type A, competitive personalities that

often seek some level of prestige. Because family medicine is less competitive, some

say if you score well on USMLE that you should aim higher. There have even been recent posts

about this on SDN and Reddit, where a high scoring student seeks input from others, as

their own mentors or classmates advised them to go into another specialty that pays better

or is more prestigious. This is nonsensical, and not a valid reason to look down on the

specialty. You should pursue the specialty that's most appealing to you without such

superficial considerations. I know several brilliant family medicine physicians who could

have pursued far more competitive specialties, but they chose FM because they were able to

separate the signal from the noise. If you're the medical student who went through

third year and loved everything non-surgical and didn't want to give any of it up, including

not only organ systems but also age, then family medicine may be a good fit for you.

If your life outside of medicine is important to you, family medicine provides the flexibility

to practice as a physician while still having time for your own family and interests.

Big thanks to Dr. Ethan Jose, family medicine resident and YouTuber in Oklahoma City, for

helping me in the creation of this video. Show him some love and go check out his YouTube

channel, link in the description. Special thanks to Dr. JP Valette as well, my good

friend from medical school and current family medicine and sports medicine attending physician

in San Francisco. Are you hoping to become a family medicine

doctor? To get into medical school and match into a great FM residency, you'll need to

score well on your class tests and standardized exams. As you look at resources and companies

to work with, seek out those who are actual MD physicians, not PhD or other types of doctors

that didn't go to medical school. Look for those who have achieved stellar results themselves,

a track record of success with positive ratings from customers, and a systematic approach

so you know you'll always receive high quality service. If you decide on Med School Insiders,

we'd love to be a part of your journey in becoming a future physician. Visit us on MedSchoolInsiders.com.

Thank you all so much for watching! If you enjoyed this video, check out our So You Want

to Be an Internist video, or another specialty on our So You Want to Be playlist. Much love,

and I'll see you guys there.