Allopathic medical students don’t like to match in family medicine. The match data for the last 10 years has shown this conclusively. The average Step 1 and 2 scores for students matching into family medicine are significantly lower than the more lucrative specialties. The reasons for this aversion to family medicine are interesting. The 2 main reasons for this trend are a lack of money and a lack of “sexiness”. Family medicine is seen as boring and relatively low paying. Osteopathic and Foreign medical students gladly fill in the family medicine vacuum left by Allopathic students.
I can’t blame Allopathic medical students for not embracing family medicine. When you have your pick of specialties, family medicine seems very dull. Family medicine is vitally important but most of it is routine check ups. In the future family medicine physicians will have to compete with mid-level providers like Physician Assistants and Nurse Practitioners. Both can provide similar services ( with less expertise) at a cheaper cost. Salary is also a huge factor. Most people get into medicine for the money. Family medicine physicians make a lot less than other specialties. Why be a family practice doctor making $180,000 a year when you can be an Orthopedic surgeon making $500,000 a year?
This trend is beneficial to Osteopathic graduates and FMG’s. Osteopathic students embrace Primary Care/ Family Practice because it is a cornerstone of their training. FMG’s embrace Family medicine because they really cant be too picky. I predict that in the future Family Medicine will be a field dominated by DO and FMG’s while the other specialties experience a glut of Allopaths.
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Many pre-med’s ask me if they will be able to academically prosper in medical school. I have identified two skills that one must posses in order to do well. Those that have been through the process of medical school should feel free to add more. This list is no way comprehensive. It represents my humble opinion.
1.) The ability to memorize vast amounts of material is crucial. Medical school is the memorization Olympics. Memorizing minutiae will be your life. Mnemonics will be your best friend. Learn to love mnemonics! Much of the minutiae is about molecular biology. The memorized information may or may not be clinically relevant but it will show up on exams. Memorization was so important that i knew students that would play online memorization games in order to get a better memory. These students often scored the highest on exams.
2.) The ability to associate symptoms presented with a memorized disease is the 2nd most important skill to have. What you memorized is like a pond with fish. The more information you memorize, the more fish will be in your pond. Your ability to associate clues in a question to a pathology is your fishing rod. This is a horrible analogy but i hope you get the picture. You need a good pond and a good fishing rod in order to catch the most fish. A medical student has to be able to make split second associations based on context clues. Many times a buzzword will trigger an association. The hardest questions have no buzzwords. Those type of questions are what separate the great students from the average students.
We secretly believe that if only we achieve some elusive goal – fitting into a pair of skinny jeans, or redoing our kitchen or getting that promotion – that it will make us happy. But the pain of our insecurity is hidden in all that racing around.…Dani Shapiro
Being insecure is at the root of most of my self destructive behavior. I have learned that this is true for most people. I spent a third of my life studying in order to enter a high paying profession because of an insecurity called status anxiety ( my parents status anxiety really). I would feel depressed when a person i liked romantically did not show an equal amount of interest. This was due to insecurity (if i was secure with myself rejection would not phase me). I would try hard to be accepted by the “cool kids”. This was due to insecurity. I would also have to get into debates in order to prove how smart i was. This was because of insecurity. I spent months trying to get as many sexual conquests as possible. That was definitely due to insecurity.
Most odd social behavior exhibited by humans is due to insecurity. Insecurity may manifest itself as envy. It may also manifest itself as excessive gossiping. A common manifestation is an obsession with ones muscle mass. There are so many ways that it can present. Insecurity is that devil on everyone’s shoulder. Being human is to struggle with this demon even if you don’t realize that you are struggling with it.
Over the last couple of years i have become much more comfortable with myself. This has allowed me to quell most of my insecurities. I have become more self aware. I have learned to be proud of my strengths and accept my shortcomings. I would like to challenge everyone reading this blog to think about their insecurities. I would also challenge you to attempt to defeat your insecurities. I promise that your life will be much more fulfilling once you claim victory over your insecurities.
1.) Asking your parents for money really sucks. Borrowing money from the government sucks even more. Medical school in the USA is synonymous with massive debt. Not being able to work and make money has a way of making an adult feel like a child. Think long and hard about entering this journey.
2.) The main reason parents want their children to go into medicine is because of the “large” salaries they will be making in their 30’s. I have realized that this is misguided. They would be much better off teaching their children how to manage money. Learning how to manage money is a wonderful thing. Learning not to blow ones money on status symbols is another wonderful thing. Once you don’t need expensive status symbols in your life, the need to make a lot of money disappears.
3.) Money only really matters when you have a family to feed. It is shocking how little a person can live on when they are single.
4.) Medical students hardly ever bring up the issue of money but it is always on their mind. They are constantly ruminating about what specialty will pay them the most. Most medical students are in this profession primarily for the money and prestige. If they say otherwise they are probably lying. I can’t fault them for this type of thinking. I partially agree with it.
5.) It is better to be making a small amount of money early in life than to make a large amount of money later in life. I would much rather be making 40 grand a year at 22 years old versus making 150 grand at the age of 33. The average age of a medical student is 25 yrs old. That 25 yr old will not be getting a substantial income until they are at least 32 years old ( medical school is 4 years and residency is at least 3 yrs). You are a decade behind your peers. It’s no feeling better than to be financially independent in your youthful 20’s.
6.) People judge a person more on their image than on their bank account statement. The public can not see what is in your checking account. What the public can see is how your present yourself. Image is everything (almost). One has to be careful not to fall into the trap of status symbols though.
7.) You don’t want to be around people who like you for your earning potential
8.) Retirement is a scary thing. This is especially true when you didn’t start earning money until your mid thirties.
9.) Medical school is only a cash cow if you get in early and get out early. Don’t do it solely for the money.
10.) When you have no money, hospital food tastes great…………….because its free.
11.) Many doctors make a lot of money but have to work a lot of hours because they spend so much money in their personal lives. They have over extended their income on fancy houses and fancy cars. Many don’t even enjoy their money because they are working just to keep up with the proverbial Jone’s. It’s not how much you make that matters. Its how much you keep that matters.
Cardiac electrophysiology is a medical sub specialty of Cardiology. They treat rhythm disorders of the heart. Why do we need a subspecialty just for rhythm disorders? Shouldn’t a regular cardiologist be enough? Does the rest of the world have as much specialization as the United States medical system? Does increased specialization even increase patient outcome?
One of my fellow students was arguing that there are too many subspecialties in the US medical system. They mentioned that the rest of world relied more on general practitioners with a larger breadth of knowledge as opposed to specialist with a more narrow focus. I would love to see studies about this topic.
In general females have better bedside manner than males. They just have an aura of caring. Maybe they are more comfortable in expressing emotion. Maybe it is the nurturing instinct. I have noticed that many male physicians are very competent, but they seem too stoic in the presence of an emotional patient. Society discourages emotional displays in men. Sometimes that emotional touch is all you can do for a patient. They just need to know that you care. Displays of empathy from the physician also greatly increases patient compliance. As men we need to take a playbook from the women and master competence and compassion. Some times we need to tone down our machismo. Check out the link below http://news.bbc.co.uk/2/hi/uk_news/education/6618603.stm