I am a fourth year medical student that attends an institution that does not have a department of family medicine.
Currently there are only 10 such allopathic institutions in the country. When I tell colleagues and friends that I intend to enter family medicine they say, “oh primary care?” While yes, it is true that family physicians obviously practice primary care, I am disheartened that my colleagues do not know or understand what family medicine is.
At my medical school we are required to do a 8 week “primary care rotation” but not with a family physician or in a family medicine inpatient unit, since we do not have a department. Most students are paired with internists and only see adults. Some students are allowed to be with primary care pediatricians, which is excellent, however they already were able to experience this during their pediatrics rotation. It is also permissible to be with a specialist for part of the time, with the argument that even if one goes on to study primary care, they will have to rotate through the various subspecialties.
By not exposing students to full spectrum family doctors, I think the school is performing a disservice, and not allowing students to be exposed to the specialty. When I inform students that family doctors provide prenatal care, deliver babies, do procedures, have to do a surgery rotation, and in some areas can even man the ICU and ER, they look at me dumbfounded.
When I tell specialists that I want to enter family medicine it’s either an, “oh that’s interesting,” “good luck,” or, “how did you wind up being interested in that.”
I have had only one true family physician role model throughout my almost four years of training. I have had to take two weeks of anesthesia as a graduation requirement, but not family medicine. In a class of 180 students, when 8 choose to go into family medicine it is considered a “good year.” Not even 5%.
This is the true future of primary care, and as a past public health practitioner and future family doctor, it frightens me. That medical students can graduate from medical school not having a knowledge of family medicine, the second largest specialty that students enter (although only half of match spots are filled by US graduates because no one wants to enter primary care).
The National Resident Matching Program likes to fictitiously report that there were “more matches then ever” in primary care, however they consider anyone matching into pediatrics, family medicine and internal medicine as a primary care entry, when in reality only a small fraction of the internal medicine and pediatric residents will go on to practice primary care. The high majority will subspecialize.
As I embark on interview season as an orphan, I hope that I can make it apparent how much of a passion I have for providing patient centered primary care to patients of all ages, even though this was not a mandatory part of my medical curriculum.
Seth Rosenblatt is a medical student.
