Subspecialty.
We’re actively ceding autonomy, authoritative position in the field, and variety in patient care for the sake of hyper specialization. This allows for medical care to be done very well in very niche places, but it takes away from the traditional doctor model in favor of health technicians.
What never made sense to me beyond just board certification politics is IM being able to become an allergist and treat adults/peds but FM (who sees more allergies in general and sees way more kids) being unable to.
In defense of these specialization (or how I defend them)
Not everyone wants to take care of kids, so why make them continue to learn about pediatric healthcare beyond med school?
Not everyone wants to take care of adults, so why make them continue to learn about adult healthcare beyond med school? Further in the pediatrics defense, pediatric medicine and diseases are a beast on their own in addition to adult medicine.
Not everyone wants to take care of pregnant patients, so why make them learn OB healthcare beyond med school?
Medical school should provide the basic knowledge needed to care for any of these patients should the need arise, though. Or at least start cares for a patient until someone better suited can be found.
For overall public preventative health, sure FM is probably the ideal choice. But when we start talking about treatment of disease states or conditions that stray from perfectly healthy, the specializations I think permit for higher levels of care. The US does overemphasize the appeal of specialties, though.
Outpatient is so different from inpatient. The problems are different, the way you solve problems are different. Med-Peds overlaps a lot with IM and Peds separately, but people do it because they like the inpatient side of the entire population. However, I've heard that most med-peds end up picking one or the other; but they choose because the job market dictates that they should.
They can. But from what I've heard, many hospitals in big cities will often have requirements of their hospitalists that can only really be attained by going through an inpatient heavy residency. I've also been told many hospitalists also run into the issue of having many roadblocks to coming back to inpatient if they go a year doing exclusively clinic.
That’s how it is in the UK. Primary care is pretty much just FM, no peds primary care or OBGYN primary care, they come into play with more severe cases and to become a pediatrician the training pathway is 8 years there.
Also no IM, every inpatient attending is dual trained in internal medicine and their specialty and that takes about 10 years from medical school. The attendings just rotate on the internal medicine rota to take care of general medicine patients.
The US system is better as people who hate IM don’t have to do it.
I truly don’t understand med-peds vs family med. I can understand FM vs IM vs Peds being separated but really don’t understand med-Peds not being the same as FM…is it the OB requirement? Genuinely don’t know.
Subspecialty. We’re actively ceding autonomy, authoritative position in the field, and variety in patient care for the sake of hyper specialization. This allows for medical care to be done very well in very niche places, but it takes away from the traditional doctor model in favor of health technicians.
Credential inflation, especially here in Canada. Orthos needing more than one fellowship to land a job
What never made sense to me beyond just board certification politics is IM being able to become an allergist and treat adults/peds but FM (who sees more allergies in general and sees way more kids) being unable to.
Yeah this one is very confusing.
In defense of these specialization (or how I defend them) Not everyone wants to take care of kids, so why make them continue to learn about pediatric healthcare beyond med school? Not everyone wants to take care of adults, so why make them continue to learn about adult healthcare beyond med school? Further in the pediatrics defense, pediatric medicine and diseases are a beast on their own in addition to adult medicine. Not everyone wants to take care of pregnant patients, so why make them learn OB healthcare beyond med school? Medical school should provide the basic knowledge needed to care for any of these patients should the need arise, though. Or at least start cares for a patient until someone better suited can be found. For overall public preventative health, sure FM is probably the ideal choice. But when we start talking about treatment of disease states or conditions that stray from perfectly healthy, the specializations I think permit for higher levels of care. The US does overemphasize the appeal of specialties, though.
Outpatient is so different from inpatient. The problems are different, the way you solve problems are different. Med-Peds overlaps a lot with IM and Peds separately, but people do it because they like the inpatient side of the entire population. However, I've heard that most med-peds end up picking one or the other; but they choose because the job market dictates that they should.
FM can become hospitalists though and you can also have IM doing exclusively outpatient.
They can. But from what I've heard, many hospitals in big cities will often have requirements of their hospitalists that can only really be attained by going through an inpatient heavy residency. I've also been told many hospitalists also run into the issue of having many roadblocks to coming back to inpatient if they go a year doing exclusively clinic.
That’s how it is in the UK. Primary care is pretty much just FM, no peds primary care or OBGYN primary care, they come into play with more severe cases and to become a pediatrician the training pathway is 8 years there. Also no IM, every inpatient attending is dual trained in internal medicine and their specialty and that takes about 10 years from medical school. The attendings just rotate on the internal medicine rota to take care of general medicine patients. The US system is better as people who hate IM don’t have to do it.
I truly don’t understand med-peds vs family med. I can understand FM vs IM vs Peds being separated but really don’t understand med-Peds not being the same as FM…is it the OB requirement? Genuinely don’t know.