Choosing family medicine

As a third-year medical student trying to choose a specialty, I was interested in your recent article on the residency match.¹ I am attracted to family medicine's breadth and its emphasis on the total care of the patient. I recognize the value of continuity of care: by knowing your patients, you can see their medical problems in context. In other words, you can treat the patient, not just the disease.

However, to a person in his 20s, the concept of continuity of care can seem stifling: “For the good of your patients, you must never leave!” What if you are a family physician who ends up in an underserviced community and after a few years you are miserable? If you pack up and leave, you betray your patients. Furthermore, the energy (and money) you invested in your practice may be lost.

Sadly, most family physicians must become business managers as well as doctors: they must buy their equipment, hire staff, recruit patients, struggle with office expenses and hope that their practice stays afloat. Sometimes it seems much more attractive to work as an internist in a hospital because the office, the equipment and even the patients may be provided. Thus, you are free to practise medicine instead of trying to run a business. You are also surrounded by colleagues with whom you can discuss cases, socialize and engage in research projects.

On one hand, being a family doctor who provides total care seems exciting. On the other hand, I am scared that in doing so I will be trapped forever in some isolated community, cut off from the world of research and buried under a mountain of office expenses and paperwork.

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Colin Stevenson
Medical student Faculty of Health Sciences Queen's University Kingston, Ont.