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Advice to prospective family medicine residents

Allen Perkins, MD
Education
February 7, 2012
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I don’t like selecting colleagues through the Match. The process was established to allow students to get the best opportunity available and I feel that our program (and our patients who rely on our trainees to provide care) is in jeopardy every year. It always turns out better than I anticipate, so I shouldn’t complain. However, we have to interview 60 prospective residents to fill our six slots so I have a lot of conversations with prospective applicants. Our interviews are about 20 minutes (we have each applicant have a discussion with about 6 faculty, staff, and residents). Most of these interviews are very pleasant and informative to me (and I hope to the applicant). Others, not so much.

In order to give you, the applicant, more “bang for your buck,” here is some unsolicited advice to those interested in a family medicine position in our program.

1. Avoid the “If it’s Tuesday, this must be Belgium” phenomena. I know that you are under a lot of pressure to obtain a position and have applied to a number of programs but it isn’t like we are one big program. Just a little time on Google and you can find out some information regarding Mobile, Alabama, the South, and even more specific information about our program. This way, when I ask the question “Why our program?” we can have a conversation and not just stare silently across the desk at each other.

2. Understand the specialty of family medicine and our unique training environment. We are the only specialty that offers extensive training in the outpatient setting. We offer experiences in the broader community. This means that the broader community is important ot our programs. While you may ask about the hospital, please ask about the community, the population we serve, and the unique activities our residents have the privilege to participate in.

3. Be able to articulate a vision for 3 years in the future. A three year training program is very concentrated. You will be expected to enter into training with an understanding of what the future will hold for you upon completion as that will help us. If you know what experiences you may want, I can tell you if we can provide the training environment. “I want to go to a third world country and do surgery as well as primary care” requires different training than “I want to work with patients with chronic illness in a suburban practice.” I am happy to have this discussion but ask that you be able to initiate it when I ask, “Where do you see yourself three years from now?”

4. Understand family medicine “fellowships”. We are different than internal medicine. Our “fellowships” are intended to enhance our generalist skill set, not limit our practice. More importantly, you can’t get into an internal medicine fellowship such as cardiology from a family medicine training program. If you tell me you want to be a cardiologist, I have trouble believing you really want to be in my program.

5. If you don’t want to be here, don’t come. There are over 2700 family medicine entry level positions. Almost everyone that wants one has gotten one in their top three for the last 10 years. Pick three places and programs you really want to be at and work on impressing those program directors. Applying to and interviewing at 30 programs makes you tired and makes me tired as well.

Allen Perkins is Professor and Chair, Department of Family Medicine, University of South Alabama.  He blogs at Training Family Doctors.

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Advice to prospective family medicine residents
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