[QUOTE=ENugent]
Yes, I’m at a startup, and most of my co-workers are also relatively new to the area (or they live a ways in the opposite direction from my workplace). Thanks for the tip on Bellevue Family Medicine, though. I’ve never been to a “family doctor” - can you say anything on how you think it’s different from seeing an internist or GP?
[/QUOTE]
This is better referred to Qadgop the Mercotan, who is not only a family doctor but a Fellow of that prestigious academy.
Here’s the basic dope. When we docs get out of the four years of medical school, we get an MD, but no hospital in the world will allow us privileges with our basic training, and we aren’t even allowed to get a license to prescribe drugs until we do one more year of post-graduate training. Many years ago this year was called an “internship”. Docs in their first year after medical school are still colloquially called “interns” though no program formally uses the name.
When people leave medical school, they go directly into a three-, four-, or five-year post-graduate training program. The post-graduate training programs are called residencies, and a doctor training in one is called a resident. If a medical student is like a recruit going through four years of basic training, a resident is like a lieutenant, third class: newly minted officer, not yet trusted with serious responsibility. I am now a program director (equivalent of officer over a small training school) and I have to swear to the education authority that my resident is never out of supervision. This doesn’t mean always under my eyeball; general supervision means I am responsible for that resident’s decisions, even if not watching her (him). As you can guess this makes me rather nervous at times.
But that’s a side tangent. Sorry. If a person chooses the three-year family practice residency, when they graduate it, they become eligible (permitted) to take a grueling exam called the Boards in Family Practice. If they prefer to take the three-year internal medicine residency, then they will not be eligible for the Family Practice test, but they will be eligible for the Internal Medicine test. The main difference is Family covers children and adults, while Internal covers only adults, but may go deeper into some adult diseases. In the same way, Pediatrics covers only children, and may go deeper into some childhood diseases. FPs do it all.
The surgery residencies are mostly five years long because they have to spend a long time training the hands as well as the head. (The family practice docs do a good bit with their hands, but less specialized maneuvers, more like general human dexterity.) My field, pathology, because it’s the odd man out and never does anything like anyone else, goes for four years.
Once a person has their residency done and over with, they can either go into practice with privileges at any hospital, or they can go on for another year or even two more years of subspecialty training. The program I direct takes four-year residents from pathology and trains them in the subspecialty of forensic pathology. There are also subspecialty residencies in surgical pathology, cytopathology, neuropathology… you get the idea. A person who has his Boards in family practice can go on for a year of training in some special subset of diseases like allergy and immunology, kidney, heart, etc. Then they are eligible to sit for an even more grueling Boards. I remember when I told a non-doctor friend that I had passed my first set of Boards, but had another set to pass, she looked at me funny and said, “That must have hurt. Did it take a lot of laxatives?”
A person who has subspecialty training is likely to be more expert in their area, but not necessarily a better doctor. You wouldn’t expect someone with special training in eye diseases to miss iriditis, but they still could if they weren’t paying attention that day, or if they already made up their mind what your disease is and weren’t noticing subtle indications that they were wrng. Sounds to me like your doc is a loser. I would abandon him/her. Good luck.