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Shadowing a Family Medicine Physician

October 25th, 2013  |  Published in Pre-Med Tips  |  2 Comments

Stethoscope

Source: Flickr/Alex E. Promios

Amazingly in just 8 months my postbac will be over and the time to submit applications to medical school will be here. With less than a year to go, making myself the “total premed package” will be top prority. Of course I will need to have rocking grades since this was the major deficit in my application–this has been a serious struggle with me as I constantly battle pregnancy-induced fatigue. Despite this, I’ve been pushing through. I’ve continued to volunteer once-a-week at a free clinic in a position where I don’t really do anything “directly medical” but I put inquiring persons and patients in touch with resources that can help them through tough times. I really love my volunteering position  because of the hope I can give people by finding a starting point to tackle their struggles. But, to be a super premed I have to throw some shadowing in the mix, too. When I first moved to Richmond, I met an awesome family doc who I wanted to shadow but he didn’t have time to accomodate a shadow. Then life got busy and then crazy; finally though, I’ve had enough time to secure a shadowing position! I am still disappointed/horrified at the way my initial shadowing plan fell through (which you can read abuot here.) But I had to get over it and move onwards.

I did some frenzied google searching to find a DO family doc in the greater Richmond area which is not an easy task. However, when I started shadowing I learned that the only osteopathic medical school in Virginia–about 2 hours away–only opened in 2003 (10 years ago) so that probably explains the dearth of osteopathic representation among docs in the area. After quick email, the physician I found was more than willing to let me shadow her and was understanding of my hectic school schedule. I decided to come shadow on a day that all of my classes were recorded—so yes I skipped class, but a small sacrifice!

My day shadowing was really casual–which was great because my brain was basically fried from back-to-back exams this past weekend. I had a quick Q&A session with the doctor and found out she is great. She serves on the Virginia Board of Osteopathic Medicine which means she has great insight into the application process. I’ve found that even doctors who graduated medical school only 10 years ago have completely different application experiences than premeds today. Numerous times I have encounted other premeds who have false beliefs becuase they were led astray by a well-meaning physician who just has no idea how the application process has changed and what medical schools expect from applicants. This serves as to another great point–the best advice regarding medical school applications usually come from the medical schools, then your premed adviser, and then someone who is in medical school right now. But always take the advice of others with a grain of salt…every medical school has different expectations, and I’ve been very surprised in my discussions with admissions representatives to learn who they think is an ideal candidate.

I’ve been really interested in family medicine for a long time now for a few reasons:

  • I love seeing a diverse patient population (adults and kids)
  • You get to do some procedures
  • Complaints are pretty diverse
  • Working with underserved populations can be a greater part of your practice
  • Can provide prenatal care and sometimes do delivers (but this is complicated with insurance issues and practice restrictions by hospitals)
  • You get to be primary care provider!

From my first day in a family physician’s office, it was pretty much what I expected: a lot like Emergency Medicine (minus the acute cases like altered mental status, seziures, and myocardial infarctions obviously). I’m not sure if this is a reflection of medicine as a whole, where a lot of persons are using the Emergency Room for primary care (for a variety of reasons) or if I’m just crazy biased. Both Emergency Medicine and Family Medicine are oriented towards more “outpatient care,” although some family medicine departments do have in-patient care. However, in Virginia the only residency program that does this is somewhere in northern Virginia in the boonies—I think. I’m intrigued to see inpatient Family Medicine but I think that will have to wait until (a) I get back to Dallas (fingers-crossed) or until (b) medical school.

We saw a variety of cases, and I was surprised to see how much I had learned about medicine just by observation. By looking at a patient’s feet, for example, I could totally tell she had diabetes without looking at her chart and before my doc asked her anything about her sugar levels. I think that really speaks to the former medical education model when apprentices would learn from physicians in lieu of the more structured education we have today. However, no way do I feel ready to practice medicine any time soon!

Overall, I really enjoyed the day. The pace felt really slow to me (but I guess after being in a crazy ER for so long anything would feel slow.) I love the cool relationships my doctor had with her patients; she had known some of them for a long time and stayed in touch with most of them via text message (about their medical concerns) which was really interesting. All of the patients raved to me about how amazing of a physician she was which really made an impression on me. One drawback to Emergency Medicine is that you basically never follow-up on patients (unless they are frequent fliers) and any follow-up you do have is limited because there are some things you just cannot due in the ER because of the nature of the therapy required.

My shadowing day left a positive impression on me and I’m certain that family medicine is what I want to do. However, the autonomy I would want in my practice could be limited in certain settings. At this practice, for example, the practice is owned by a conglomerate that is self-insured and does not cover osteopathic manipulative treatment. OMT is such a cool benefit of learning osteopathic medicine and I think that going through all of that school and not being able to treat patients with it because of insurance would be irritating. Currently (projecting really far into the future) I could see myself being interested in incorporating some mild obstretics into practice of family medicine, but some hospitals do not allow family docs to deliver at their hospitals. I think that a lot of the autonomy I want in family medicine is better served for a rural environment, but I am not sure if I can commit myself to rural family medicine just yet. I thrive in medium-large cities that are culturally diverse and I feel like I would feel a little suffocated in a rural setting. But maybe I can live in the city and commute to a rural practice….all wishful thinking I think! I hate long drives.

Fortunately that is all in the future and for now I need to focus on my immediate goal of doing really well in this program so I can get into medical school and stop being premed/dreaming wistfull about my career choices. I’m going to continue shadowing this physician with an aim to hit the 32-hour mark so that I can potentially use my shadowing hours for course credit in my postbac program. I’m not completely sure that is the best move to boost my GPA, but I’m definitely considering it as a way to survive the postbac in the Spring with a newborn. (Less class time would mean better chances of maintaining my sanity!) Eventually I would like to find an osteopathic physician that is allowed to perform OMT in their practice, and possibly shadow a rural doc as well. Many medical school programs have rural medicine tracks which intrigues me but I want to feel more committed to rural medicine before applying to those tracks in June.

If you have any questions about shadowing or family medicine, let me know!