Just family

You’re just doing family medicine? Is that residency really going to give you enough training to do anything useful?” Those were the first words out of the mouth of Dr X—my staff person for 1 very long week in January 2006. My first rotation of that year was in a department where the regular attending physicians were on vacation, and I was left to work with 2 locum physicians. Before I had barely said a word, Dr X made it painfully clear that she didn’t think I was the sharpest tool in the shed. After all, she must have reasoned, I was just a family medicine resident in Thunder Bay, Ont, and I surely must have arrived there by failing to match to my first, second, and third Canadian Resident Matching Service choices. Because of her bias, I was rarely even rewarded with the privilege of writing in patients’ charts that week. What Dr X failed to realize was that her disrespect for family practice typified the behaviour that had led me to the Thunder Bay program in the first place.

At the start of medical school, I wanted to be an academic neurologist. Over the course of the first year or two, I came to realize that I would not be happy in that specialty. Three factors influenced my decision. First off, I was not (and never will be) a left-handed man. (Picture your local neurologist—see I’m right!) Second, I wondered what the point of a detailed neurologic examination was when you could get the answer from magnetic resonance imaging. (To emphasize this, I would like to point out that every patient I have ever referred to neurology has ended up getting magnetic resonance imaging at the neurologist’s request—isn’t that cheating?) Finally, I found hour-long consultations too long and repetitive to keep my attention.

When I decided that family medicine was more exciting, more challenging, and better suited to my personality than neurology, I initially had difficulty making the psychological adjustment to my new career path. This trouble largely stemmed from hearing classmates and professors say such things as, “You only want to do family?” and, “A good family doctor—isn’t that an oxymoron?” Worse still, I began to hear family medicine residents referring to their career path as “just doing family.” I’m not sure why family medicine residents referred to (and continue to refer to) their residency choice as “just family.” I can only speculate it’s their intrinsic humility or their desire not to make the Royal College residents jealous!

As time has progressed, I have come to realize that, yes, I am just going to become a family doctor. I am just going to deal with patients who present with vague but potentially life-threatening symptoms. I am just going to have to learn to manage all types of postoperative patients. I am just going to have obstetric, emergency, and geriatric medicine within my scope of practice. I have decided that the varied practice of a family doctor is the only sort of medicine that appeals to me. I am going to be a real doctor. I will know more than one tiny pocket of subspecialty medicine. I will know my patients and their families and I will love my job. I firmly believe that family medicine is the easiest job to do poorly and the hardest job to do well.

That awful week spent under Dr X was a rare exception in my residency training. I have been spoiled working in Thunder Bay, a place where the specialists value the family medicine residents and go out of their way to make us the best doctors possible—despite our decision to pursue careers outside of their areas of interest. After all, I’m sure the specialists understand that if we do a good job in the future as family doctors we will cut down their case loads! Thunder Bay is certainly not a place where we are made to feel as though we are just family practice residents.

I love a challenge and I can think of no other career in medicine more challenging than that of a rural family doctor. I am a family medicine resident: Hear me roar!

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