Upon entering med school, every student has a vision of what type of doctor they want to be. Sitting in class and observing my colleagues walk in, was an exciting time of my day. The girl wearing glasses who always has a pocketbook and is leaning intently in lectures already has her mindset on internal medicine. The guy that cycles to class and has the latest smartwatch on his wrist is probably eyeing emergency medicine. Another who rolls to class with a duffle bag after a gym session is ready to break bones as an orthopedic surgeon.

By Michelle Au

    According to AAMC (Association of American Medical Colleges), 

“United States could see an estimated shortage of between 37,800 and 124,000 physicians by 2034, including shortfalls in both primary and specialty care”

    With the expanding job market and Covid-19, it is likely that primary care would be one of the most commonly sought-after residencies in the near future. In the following points, we will discuss why you should consider primary care.

1. Doctor-Patient relationship
2. Directly contributing to a healthier population 
3. Education
4. Always on your toes
5. Variety of practice experience

• Long term doctor-patient relationship

Primary care doctors often grow old whilst treating patients for chronic illnesses over the span of years and even decades. It becomes very satisfying when your patient walks into your office for a check-up and you realize the plan you have set and the commitment they made to their health is yielding positive effects and allowing them to live a comfortable life.  

• Directly contributing to a healthier population 

In a study conducted by Barbara Starfield in 2005, it concluded that areas served by a greater number of primary physicians correlated with longer lifetime survival. 

Studying medicine in Khartoum, Sudan, the capital of a third-world country with decades of waves of war and poverty, I can attest to this study. During our rounds, the vast majority of our patients came from underserved areas of the country seeking primary care.  Because of the prevalence of primary care practitioners, Khartoum continues to be the fastest expanding city. 

• Education

Primary care is intellectually demanding. Whether you work in inpatient or outpatient care, you will constantly be exposed to a breadth of diseases. Not only that, but in the era of tech we live in, it becomes vital to keep up with medical advances and research. This means expanding your knowledge will continue even after med school. To add to that, jobs in academic programs can be a point of interest to many primary physicians. 

• Always on your toes

Every disease you studied in med school is a fair game in clinical practice. 

I remember in one of my rotations in med school, a patient walked in complaining of pain in his big toe. Our attending analyzed the patient with history and examination. While she was assessing the patient, my classmates and I had already had “gout attack” as a primary diagnosis. While the reason for the visit was indeed having a gout attack, our attending had us re-examine the patient from head to toe. By doing that, we discovered he had abnormal lymph node enlargement. After several tests, we discovered he had lymphatic cancer. A serious diagnosis that required a high index of suspicion. 

Ever since, it’s evident to me that treating patients as a whole and asking yourself “Is this normal?” in the examination can quite literally save a life.  

• Variety of practice options

Primary care physicians enjoy a wide variety of practices that fit their interests, lifestyle, and career goals. 

1.       Private practice: this involves practicing medicine in a local community. This provides direct patient care. Private practice exposes you to a variety of cases if the location is rural.
2.       Multispecialty group: is a private practice that involves multiple physicians with various specialties coming together under one roof.
3.       Locum tenens: involves practicing medicine per call. This means you’re not tied to a contract under a hospital but through a recruiting agency. Your job involves answering calls to shifts/cases in your practice and covering absent doctors’ shifts.

Choosing a medical specialty is not easy. Given the breadth of opportunities in networking, it becomes helpful to explore. If the above rationale seems appealing to you, you should seriously consider primary care. Attending conferences, shadowing doctors, and reaching out to physicians will help you have a different perspective and solidify your interest in primary care.