 So you want to be a doctor but you can't decide between internal medicine and family medicine, which is the better choice for you. Let's break it down. Hey friends, today we're going to break down all the differences between being an internal medicine doctor like myself and being a family medicine physician. We're going to be breaking down a lot in today's episode including the length of training, the job descriptions between the two, obviously the salaries and the hours but also things like the job outlook as well as probably the most important for me and probably the most important for you is overall happiness. Let's get into it. So let's break down the biggest differences between being an internal medicine doctor again like myself and a family medicine physician. Let's just start with the level of training because it's exactly the same. After four years of medical school you're going to go into a three-year residency program either in internal medicine or family medicine respectively. After this point you can choose to be a full time internist like myself or a family medicine physician or you can choose to go into further training into both of them which are called a fellowship like myself who's going to go into cardiology next year or the various options that will break down later in today's episode in the field of family medicine. Now to help understand the biggest differences we'll break down both of the fields in regards to the patients you take care of, where your work site primarily is, your role within those sites as well as the opportunities you have in your career as well as things like procedure and finally your admin responsibility. Now let's start with patients. Now in the field of internal medicine which is the care of adult patients you're going to be taking care of patients 18 years or older of age but somebody like myself can see anyone who is 18 or older my oldest patient was 104. Now comparing that with family medicine your age range is very broad because family medicine covers pretty much everyone in the family everyone from babies to the elderly and so you can be taking care of a brand new infant within your clinic as well as their grandparent at the same time. Now your distribution of age groups will depend on what kind of clinic you're working at but most family medicine physicians if they see all age groups will see about 10 to 15 percent kids and pretty much everyone else just like an internal medicine doctor would. Next let's talk about the work site now for somebody in internal medicine it's usually going to be a very hospital-based inpatient kind of job myself as a hospitalist that's the only place I work at I don't have a clinic of my own I only see patients that get admitted to the hospital and then my job is to discharge them. Now in the field of internal medicine the work site can be on any side of the spectrum somebody like myself can be entirely hospital somebody on the other end of the spectrum may choose to be very much like a PCP with internal medicine training and they'd be completely in the clinic or somebody like a consultant for example in three years I'll be a cardiologist I'll likely be working in the hospital seeing consults as well as having my own patients from those hospital stays they see me in clinic on a weekly basis. I compare that to family medicine which is going to be much more common on the clinic setting there are going to be some hybrid options where somebody is working in the hospital maybe taking care of patients who are admitted from their clinic group and then while not as common there are family medicine physicians who are hired by groups well they work very much like a hospitalist admitting patients like I do to the hospital. Next let's talk about roles now in internal medicine it is going to depend on if you're a generalist like I am right now as a hospitalist or as a specialist like I'm going to be in three years as a cardiologist now as a hospitalist my role right now is pretty much admit and discharge take care of patients when they're sick from the emergency room or transfer and then I discharge them when they're ready to go home now as a consultant as a specialist my role is going to be very consult heavy when I'm in the hospital I am probably will going to be less spending time admitting patients and more time answering calls from other doctors who need help in the field of cardiology on their specific patients so again I will see patients just for that one problem they're having answer those questions and then once I feel like that patient has been taken care of sign off even if the patient's still in the hospital and move on to the other questions from other providers in the hospital so that's the role of a consultant but if I have my own clinic like we talked about before I may choose to see that patient as a follow-up so if I was a cardiologist seeing somebody for a fast heart rate I may want to follow up with them and then be their primary cardiologist for that problem going forward so now I have the role of being their primary provider within that specialty so again so far we have a general admitter discharter somebody who's consultant somebody who is a primary specialist and then finally you have internal medicine doctors that choose just to be a PCP their training may have been very clinic focused and then you are well equipped to take care of an adult again 18 all the way up to the age of 104 like myself but in a very outpatient setting doing all the same things that a family medicine doctor would be doing and then compare that to a role of the family medicine physician which is predominantly going to be in a primary care provider role somebody who is your PCP this is going to be the doctor that your patients will go to to be able to do their annual visits come back to if they have a illness or some kind of question about medication psychiatric illness ophthalmologic injuries that they may have somebody they just need to be able to say this is my doctor that's the role of family medicine care doctor will play as well as a few things that we'll talk about in the job opportunity session so breaking down the opportunities in the field of internal medicine you can be that generalist as a hospitalist like myself or a primary care provider or you can be a specialist in the field of cardiology nephrology hematology oncology infectious disease rheumatology there's so many different areas that you can just say this is the organ system or the body system that I want to focus on and then be able to take care of patients of and you have tons of opportunities yes most family medicine physicians will play some kind of role of a primary care provider taking care of all kinds of patients but you'll have some providers who will choose to just work with OB-GYN patients they'll work with pregnant females just to guide related problems or you have family medicine physicians who do extra training in fellowships and things like addiction psych addiction medicine or things like sports medicine where those are the areas that they want to focus the most on but you'll also have opportunities and things like rural medicine maybe you want to be the doctor of one town and be able to take care of a variety of problems all the way from emergency medicine to basic medicine to OB-GYN related issues to doing some minor procedures that would be awesome or maybe you're somebody who just says even though I'm trained of all aspects I can take care of an infant I don't really want to take care of them in my clinic you can just do adult only medicine and being a primary care provider or you can choose to say I will take care of babies but maybe not pregnant females because that's not an area that I'm interested in I'll take care of infants I'll take care of adults but I'll refer out anything to an OB-GYN if my patient is pregnant for that regarded care maybe I only want to take care of older populations I want to be a geriatrician that's an option or maybe you can open up a male's only clinic and deal with the problems that only males or females have there's tons of options for you in the field of family medicine next let's talk about procedures now in the field of internal medicine procedures is something that you're very well trained to do in residency I did like hundreds of procedures in my three years of residency but if you're a generalist like myself unless your institution requires it you may not be doing any in my last several months as being a hospitalist I pretty much will refer out every procedure that I need to do even if they're basic ones that I feel comfortable in doing there's just a team to do it while I spend taking care of lots of patients as a specialist if I choose to be a critical care doctor or a cardiologist like myself I will do tons of procedures within that specific field compare that to the field of family medicine again it depends on what kind of clinic you have you may be very well trained but choose to do no procedures in your clinic or you may be a family medicine physician who does basic things like abscess drainage or doing very minor stitches to avoid your patients having to go to the emergency room all the way to doing things like joint injections for patients with arthritis to being able to do things like deliver a baby or doing a C-section if needed and then finally let's break down the admin roles now both of these honestly suck this requires a lot of our time in internal medicine definitely requires a lot of your time in family medicine but internal medicine a lot of my admin time is spent just calling for example an insurance company that may have denied a patient who really needed to go to rehab but the insurance company doesn't see it that way based off the documentation I may have to spend a lot of time to get that patient approved but I also have a team of social workers to help me get through that process but compare that to the field of family medicine which I would argue it has a lot more admin responsibility depending on the clinic you're at because yes you'll have to deal with insurance companies we also have to deal with the patients you are the primary doctors you'll be dealing with insurance companies where a patient may have had a medication denied and you have to call them to try to get an authorization done for maybe something even they've taken for years but for some odd reason their medications are now no longer approved based on your documentation so you have to spend the time calling them but you also have to spend time answering calls from patients and who consider you to be their primary doctor maybe they have a question about a medication maybe they need a refill maybe they're upset about something you're gonna have to take care of patients outside of the time that you're taking care of them and again I would argue that is a lot more than I spend in internal medicine now those happen to be the main differences within the field but let's break down the things like hours salaries job outlook and also overall happiness first let's get into the hours and again this gets to be very variable in the field of internal medicine because you can be somebody like me who has a seven on seven off schedule that means that I work seven days in a row as a hospitalist and then I have seven days off like I do right now and then the field of internal medicine your schedule can be very flexible and again this also depends on if you're a generalist or a specialist in the field of internal medicine like a hospitalist you can have a schedule that's very popular like the seven on seven off says a hospitalist I'll work seven days in a row have seven days off but as a specialist you may have something where you work five days a week Monday to Friday often you'll have your weekends off but sometimes you may have one weekend or a late evening where you're covering for your colleagues that way if any questions come in that field so if I was a cardiologist I may have a patient from a clinic call and to avoid having everybody available to answer phone calls from all patients I may be able to go ahead on a Wednesday of answering all calls from my colleagues and then the rest of the week they're answering questions for me that may be an option and there's always hybrid models of these depending again up here in internal medicine generalists or a specialist and then comparing that to family medicine which seems on the surface of being a very typical Monday to Friday clinic is open from 8 to 5 that's going to be by work hours but tons of family medicine physicians are working outside of those hours to read about their patients before clinic as well as answering questions from insurances calling insurances dealing with voicemails that their patients are leaving as well as writing all those notes from all those patients they've seen throughout the day now next let's talk about salary now this is the thing that surprised me the most because even though I had this data before they're actually a lot similar than I was expecting so this is the doximity report from 2021 on doctor compensation and if we look at the two fields of both internal medicine as well as family medicine you can see that family medicine has an average salary of 273 thousand dollars and internal medicine has an average salary of 295 thousand dollars now this will vary depending on where you're looking on the country so for example if you looked at somewhere like Houston Texas your average salary of a family medicine physician may be 230 but if you go somewhere in the middle for example of Indiana you may have a salary of average of 298 now this was actually a little bit higher than I was expecting for my family medicine colleagues but it makes sense depending on the way your clinic is set how many patients you're seeing there's going to be a lot of variety in your salary as well as where you're located in the country and if we compare that to internal medicine if we again we look at somewhere like Houston Texas you may find that your salary is about 285 to 221 just within the two different counties and if you go somewhere for example like Virginia you may be in the 250s and then if you go in areas like for example here as a Montana you may be going at the 300 thousands now keep in mind these are both salaries within general internal medicine and family medicine but if I wanted to go into something like for example in cardiology like I will be in a few years the salary can be on average of 530 thousand something for example like oncology maybe 440 thousand so again it depends again on generalists versus specialists within both of those fields next let's talk about job outlook now the biggest takeaway is that both jobs are in necessity and depending on where you're working are going to always be looking for a pcp your primary care doctor in the field of family medicine or an internal medicine doctor to take a spot within the hospital there wasn't a great resource or percentage of growth that I could find for the purposes of today's episode but the main thing is at our primary provider either in the hospital or within the clinic highly needed and depending on the institution that are hiring you likely won't have an issue of finding a job in either of these two fields it was actually one of the biggest reasons that I picked internal medicine because I knew that my wife and I wanted to move back closer to family and I didn't want the specialty that I ultimately picked to be a reason that we couldn't live close to our loved ones finally let's break down probably the most important part about both these specialties which is their happiness level now before I share the numbers take this report with the grain of salt because one it's from 2017 two it's one report out of many but this is honestly and unfortunately a very similar trend in medicine which is that after doctors have gone through their various years of training they're not as happy as they wish they could have been so for example if we're looking at happiness at work you'll find that some of the specialties with the lowest scores include internal medicine at 28% and family medicine at 29% they're pretty similar also scary is that cardiology like I'm going into in a few years is 31% keep in mind this is at work and also again doctors may not be as happy in medicine after going through all those years of training that doesn't mean that they're not enjoying their life outside so for example here is the result of how happy they are outside of work and again they tend to still be on the lower end but it's very similar internal medicine is at 48% family medicine is at 50% now while these numbers initially may be scary the main takeaway for me is that your happiness is probably not going to be determined on whether you choose to go into internal medicine versus family medicine both of them have excellent flexibility in terms of what kind of doctor you can be kind of patients you can take care of where in the country you can work and having tons of job opportunities depending on the part of the country that you're interested in residing in for you and your family so I don't think that deciding between IM or FM is going to make the decision on how happy you are they have tons of opportunities for you to be able to create the life that you ultimately want but that guys is my breakdown of internal medicine versus family medicine there's tons that we talked about in this episode I'm sure there's tons of questions you have left make sure you drop those in the comment section down below but also let me know what careers you want me to compare in medicine going forward this is ideally a series that we'd love to continue for you guys on the podcast as well as a youtube channel so let me know in the comment section what fields you'd like me to compare whether it's internal medicine versus something like cardiology internal medicine versus surgery or find the combination that you'd love to hear a video or a podcast episode about and we'll do our due diligence to make sure that we do right by that comparison so let me know in the comment section down below and if you enjoyed this episode then you'll enjoy these two episodes in my full-time job as a hospital is what it's like what it was like in my first month go ahead and check those out if you guys are interested and as always thanks for being a part of my journey hopefully I was a little helped to you guys I'm yours I'll catch you guys in the next one peace