Choosing family medicine

I was surprised your article on the 2001 residency match¹ did not mention the introduction of the 2-year family medicine residency, albeit almost 10 years ago, as a factor in the declining popularity of family medicine among medical students.

I graduated from Dalhousie in 2000 and am currently a first-year resident in anesthesia. During medical school I considered a career in family medicine and enjoyed my rotations in it during clerkship. I would love to have had a chance to practise it for a few years before ultimately deciding whether to specialize further. However, my decision to apply only to anesthesia was based, among other reasons, on the belief that it would not be worth losing 1 to 2 years of training (which is the cost of doing a 2-year family medicine residency and later beginning in another specialty program and having to repeat PGY-1 or PGY-2 or both). This and the uncertainty that a position would be available in the specialty of my choice after several years in family practice were the 2 main reasons I did not choose family medicine.

We should consider reintroducing a 1-year rotating internship as qualification for practising family medicine. Many students finishing medical school feel they are not ready to choose a specialty, and it is likely that more of them would try family medicine if they knew they could later enter a different training program without losing time. Presumably, many of the students trying family medicine would enjoy their work experience and stay. If some chose to do further training after a few years in family practice, they would be better physicians because of the experience. In addition, at any given time the total workforce of family physicians would be larger, helping to alleviate at least some of the shortages we're currently experiencing.

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Gillian R. Hamilton
PGY-1, Anesthesia Dalhousie University Halifax, NS