Do I need research in medical school if I am pursuing family medicine?

[Rooks]

I'm not obsessed with prestige and eventually want to just be a primary care doctor.

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[ontiquicuo]

You'll need enough research experience to understand that Wakefield is a fraud.

 

[LizzyM]

There is family medicine research. Not wet lab research but studies of cost effectiveness of different approaches to common conditions, strategies for persuading patients to adopt health behavior changes, and even attitudes, beliefs and behaviors of family medicine physicians themselves.

 

[Med Ed]

I'm not obsessed with prestige and eventually want to just be a primary care doctor.

You don't need research for family medicine. FM programs are far more interested in matching people who genuinely love the specialty. Their program directors can smell lack of sincerity a mile away.

 

[allseasons]

You don't need research for family medicine. FM programs are far more interested in matching people who genuinely love the specialty. Their program directors can smell lack of sincerity a mile away.

You probs just need it to match top FM programs

https://www.nrmp.org/wp-content/upl...in-the-Match-2020_MD-Senior_final.pdf#page=69
Successful (matched senior MD) to FM programs had an a Mean number of abstracts, presentations, and publications at 3.3 (n=1,341) while unmatched (n=44) had 2.2. Each had a mean of about 2,2 for research experiences.

https://www.nrmp.org/wp-content/upl...in-the-Match-2020_DO-Senior_final.pdf#page=74
Both successful (n=1,167) and unmatched (n=67) Senior DO to FM had Mean number of abstracts, presentations, and publications of about 2.1 and mean of 1.5 for research experiences

https://www.nrmp.org/wp-content/upl...comes-in-the-Match-2020_IMG_final.pdf#page=88
Interestingly, for both Citizens and non-citizens for IMG had lower mean for matched applicants in both abstracts, presentations, and publications as well as number of research experiences. I would speculate this is due to FM being the "back-up" specialty and an artifact of the research methodology as below

It is important to note that for purposes of this report, Match success is defined as a match to the specialty of the applican t’s first-ranked
program, or "preferred specialty," because that is assumed to be the specialty of choice. Lack of success includes matching to a nother
specialty as well as failure to match at all. No distincti on was made based on whether applicants matched to the first, second, third, or
lower choice program.

I'm not sure if the averages are that relevant to answer this question, as many med schools have mandatory research experiences. In other words, applicants just happened to have that level of research rather than needing it to match.

 

[seeinghowitgoes]

Do you need research to match FM?

Short answer: nope

Longer answer: coming from an MD institution, nope.

Do it if you want (as pointed out above there are plenty of questions in Gen med/Gen peds/gen OBGYN that you can ask), but you absolutely do NOT need it.

 

[allseasons]

But it is the level of competition that you will be facing. The difference in number of abstracts/pubs in matched versus non-matched should be noted

does level of competition really even apply here as FM is considered one of the easiest residencies to match into? 97% of applicants matched.
because I would really bet that the reason those 44 were unmatched is for reasons unrelated to their research output. maybe they outright failed step, have disciplinary actions or other massive red flags.

 

[Med Ed]

does level of competition really even apply here as FM is considered one of the easiest residencies to match into? 97% of applicants matched.
because I would really bet that the reason those 44 were unmatched is for reasons unrelated to their research output. maybe they outright failed step, have disciplinary actions or other massive red flags.

Agreed. If you look at page 12 of the 2020 Charting Outcomes it is clear that FM applicants have the lowest research productivity of any specialty pool (3.3 matched/2.5 not matched).

Look at the 174 US MD seniors who applied with Step 1 scores of 200 or less. 161 (92.5%) matched.

In 2021 there were 4,823 FM positions in the NRMP match and only 1,837 US MD seniors applying. That means every US MD senior could match and there would still be almost 3,000 positions left over.

Overall FM is not competitive, which is odd considering it's one of the more challenging fields to be truly good at.

 

[KnightDoc]

In 2021 there were 4,823 FM positions in the NRMP match and only 1,837 US MD seniors applying. That means every US MD senior could match and there would still be almost 3,000 positions left over.

Overall FM is not competitive, which is odd considering it's one of the more challenging fields to be truly good at.

Is it really odd, if it's one of the more challenging fields while not being one of the more highly compensated? I enjoy a good challenge as much as anyone but, given a choice, I'd choose more money for less challenge. So would most other people, given the time and money most people have to invest to get to the match. Those embracing challenge at the expense of money tend to pursue academia and research rather than FM residencies, don't they?

 

[allseasons]

Is it really odd, if it's one of the more challenging fields while not being one of the more highly compensated? I enjoy a good challenge as much as anyone but, given a choice, I'd choose more money for less challenge. So would most other people, given the time and money most people have to invest to get to the match. Those embracing challenge at the expense of money tend to pursue academia and research rather than FM residencies, don't they?

No, I'm actually per$uing derm becau$e I love $kin care

Agreed. If you look at page 12 of the 2020 Charting Outcomes it is clear that FM applicants have the lowest research productivity of any specialty pool (3.3 matched/2.5 not matched).

Look at the 174 US MD seniors who applied with Step 1 scores of 200 or less. 161 (92.5%) matched.

In 2021 there were 4,823 FM positions in the NRMP match and only 1,837 US MD seniors applying. That means every US MD senior could match and there would still be almost 3,000 positions left over.

Overall FM is not competitive, which is odd considering it's one of the more challenging fields to be truly good at.

Wait what. That's insane. I was always told that the reason we don't have more med schools is because of residency limits.
Also how do carribean grads even struggle to get into FM residency in the US then??
Are you sure these numbers are true?

Edit: I had no idea that just how many DO's graduated each year nor the percentage of them that went to FM residencies.
We as a country know that we need more PCP physicians, so why don't we just increase the residency slots available there and they can be filled with IMGs and FMGs? Seems like a quick/easy solution. There's a ton of demand there.

 

[KnightDoc]

No, I'm actually per$uing derm becau$e I love $kin care


Wait what. That's insane. I was always told that the reason we don't have more med schools is because of residency limits.
Also how do carribean grads even struggle to get into FM residency in the US then??
Are you sure these numbers are true?

Edit: I had no idea that just how many DO's graduated each year nor the percentage of them that went to FM residencies.
We as a country know that we need more PCP physicians, so why don't we just increase the residency slots available there and they can be filled with IMGs and FMGs? Seems like a quick/easy solution. There's a ton of demand there.

The numbers are true. They are why pretty much all US MDs and DOs match. They don't all get what they want, and some take research years and reapply because they don't want to settle. Also, many of the slots are sucky situations in sucky locations that US doctors don't want, but there are more than enough slots for everyone, BEFORE taking foreign trained doctors into account.

Be careful what you wish for. Law and business don't have the same barriers to entry that doctors do and, as a result, they are a dime a dozen and don't command the average salaries doctors do, while top people in all fields do very well. Creating a lot more residency slots would solve the match problem for IMGs and FMGs at the expense of driving down salaries for everyone, even dermatologists.

 

[allseasons]

The numbers are true. They are why pretty much all US MDs and DOs match. They don't all get what they want, and some take research years and reapply because they don't want to settle. Also, many of the slots are sucky situations in sucky locations that US doctors don't want, but there are more than enough slots for everyone, BEFORE taking foreign trained doctors into account.

Be careful what you wish for. Law and business don't have the same barriers to entry that doctors do and, as a result, they are a dime a dozen and don't command the average salaries doctors do, while top people in all fields do very well. Creating a lot more residency slots would solve the match problem for IMGs and FMGs at the expense of driving down salaries for everyone, even dermatologists.

I don't think there's much of specialty shortage in the US. I mainly just hear about PCP shortage. Increasing just PCP residencies may alleviate the problems faced while minimizing salary differences.

 

[KnightDoc]

I don't think there's much of specialty shortage in the US. I mainly just hear about PCP shortage. Increasing just PCP residencies may alleviate the problems faced while minimizing salary differences.

I don't understand. If there is no specialty shortage, what explains the disproportionate relative salaries?

There is no "shortage" per se, as there are plenty of doctors in nice places to live, while not so many in less desirable areas. But this is because doctors still make plenty of money, no matter where they are, so they have no economic incentive to relocate to less desirable places just to make a little more. Increasing the number of residencies will just drive incomes down in the places doctors already are, without necessarily addressing shortages in under served areas.

I don't know about you, but, where I live I can see a PCP generally within a day or two, no matter what, but have to wait weeks or months to see a specialist. And I am certainly not in an under served part of the country. Increasing PCP residencies would make absolutely no sense, since there are already plenty of slots that go unfilled by US grads every year. Asking Congress to increase funding to create more slots for foreign grads, who would then drive down US salaries, would be a nonstarter for most interested parties, but would be GREAT for Caribbean med schools!

This is simple supply and demand. If the AMA really wanted this, at the expense of the income of its members, I think it's safe to assume it would have happened after all these years.

 

[allseasons]

I don't understand. If there is no specialty shortage, what explains the disproportionate relative salaries?

There is no "shortage" per se, as there are plenty of doctors in nice places to live, while not so many in less desirable areas. But this is because doctors still make plenty of money, no matter where they are, so they have no economic incentive to relocate to less desirable places just to make a little more. Increasing the number of residencies will just drive incomes down in the places doctors already are, without necessarily addressing shortages in under served areas.

I don't know about you, but, where I live I can see a PCP generally within a day or two, no matter what, but have to wait weeks or months to see a specialist. And I am certainly not in an under served part of the country. Increasing PCP residencies would make absolutely no sense, since there are already plenty of slots that go unfilled by US grads every year. Asking Congress to increase funding to create more slots for foreign grads, who would then drive down US salaries, would be a nonstarter for most interested parties, but would be GREAT for Caribbean med schools!

This is simple supply and demand. If the AMA really wanted this, at the expense of the income of its members, I think it's safe to assume it would have happened after all these years.

yea fair enough.
I've just always heard about PCP shortages in the USA, almost never specialty shortages. Personally haven't experienced it, but I figured that was just my particular home region (pretty high income) and university location (major city).

 

[Rooks]

Thanks for the informative and interesting discussion everyone! I'm glad to hear that for me, the most selective/competitive part of the process will be getting into a medical school, and while medical school and residency are challenging, the match rate is very high for MD to family medicine. I feel like this will allow me to pursue meaningful activities in medical school without stressing!

Now I have one more question: what is the job outlook like for family medicine doctors? Can they work anywhere in the country? Are USMD family medicine doctors allowed to work in other countries? I'm an EU dual citizen (of Germany) and someday I might want to work there again, and the process there in my home region is passing a verbal test and doing a few months of unpaid work at a hospital. But I'm curious to hear about other countries - such as Ireland, Scotland, etc.

 

[Med Ed]

Now I have one more question: what is the job outlook like for family medicine doctors? Can they work anywhere in the country?

The job outlook for FM is always extremely positive. You would be hard pressed to find a single area of the country where there isn't demand.

Without getting into the weeds, with the passage of the ACA, the body that recommends fee schedule changes to Medicare (called MedPAC) began slowly reversing decades of inertia on payments to primary care vs. specialist physicians. This, combined with market pressures, has had the effect of increasing FM salaries pretty consistently.

 

[Med Ed]

I don't understand. If there is no specialty shortage, what explains the disproportionate relative salaries?

The salary disparities are largely a result of how fee-for-service (FFS) payment schemes were set up in this country. For decades they were more concerned about covering costs than providing value. This made procedures and treatments more lucrative than cognition and prevention.

 

[Med Ed]

yea fair enough.
I've just always heard about PCP shortages in the USA, almost never specialty shortages. Personally haven't experienced it, but I figured that was just my particular home region (pretty high income) and university location (major city).

This is a difficult question to answer, in part because the line between "shortage" and "non-shortage" is somewhat arbitrary. Some outfits have been predicting looming shortages for decades, which has led others to accuse them of crying wolf. Others have confidently said that distribution is the real problem, not raw numbers, which sounds plausible but doesn't necessarily capture the whole picture.

I suggest you have a peek at the OECD data, which shows that the US now has fewer physicians per capita than Canada, a country that we synonymize with healthcare rationing and wait times. Factor in the aging demographics of the baby boomers, and the number of physicians exiting practice because of COVID, and it's difficult to see how things won't get worse in the near future.

Interestingly, if you look at the AAMC's latest prognostication, they estimate by 2034 the larger shortage will be in non-primary care fields.

 

[Keratosis_P]

I'm not obsessed with prestige and eventually want to just be a primary care doctor.

This was me - now I'm a primary care doc. Looking back now as an attending in primary care, I have seen that research will open doors for you. I do encourage you to explore research options but maybe you're focussed too much on the lab stuff and there are so many other types of research that are relevant. Consider public health/population health research as that is highly relevant to primary care and the concepts will aid you when you learn more in medical school. Can you get into medical school without it? Sure - there are many examples. I recommend premeds shoot for the stars to open as many doors as they can so they don't limit themselves down the road if, for any reason, you change your mind about what you want (and I did after 3rd year rotations).

I love primary care and am so happy with my choice

 

[Medscigirl]

Not necessarily. It really depends on the residency program and what they are looking for. I have plenty of classmates that went into FM and did not have research. I’d it’s not something you are passionate about, I wouldn’t waste the time. With that said, find something you are passionate about and do it whether that be community service, helping at church etc. You will need something else on your application outside of class

 

[JeodonJam]

I'm not obsessed with prestige and eventually want to just be a primary care doctor.

Research is valuable for ANY field of medicine. It’s not just about “getting in”, but also about moving said field forward and making a contribution to your field. I’m a psychiatrist and I’ve don’t plenty of research in psychiatry and now sleep medicine. It’s not about “prestige”. Do you want to leave a small contribution to your field and make it better than when you found it? Primary care is prestigious and so is surgery, and so is OBGyn as is PM&R, Psychiatry and Anesthesia. It may be useful to consider being more mindful of how you refer to your field. You don’t “just wanna be a primary care doctor Bc you’re not obsessed with prestige.” You are obsessed with becoming a primary care physician bc it’s prestigious, they’re the frontline, they’re the doctors’ doctor, they’re great with procedures, great with their hands, a well rounded jack of all trades, and hard workers who are obsessed and diligent in their craft. Show enthusiasm for your career choice - don’t say “I just wanna be XYZ Bc I’m not I obsessed with prestige”. There’s no desire or passion in that statement.

 

[Rooks]

Research is valuable for ANY field of medicine. It’s not just about “getting in”, but also about moving said field forward and making a contribution to your field. I’m a psychiatrist and I’ve don’t plenty of research in psychiatry and now sleep medicine. It’s not about “prestige”. Do you want to leave a small contribution to your field and make it better than when you found it? Primary care is prestigious and so is surgery, and so is OBGyn as is PM&R, Psychiatry and Anesthesia. It may be useful to consider being more mindful of how you refer to your field. You don’t “just wanna be a primary care doctor Bc you’re not obsessed with prestige.” You are obsessed with becoming a primary care physician bc it’s prestigious, they’re the frontline, they’re the doctors’ doctor, they’re great with procedures, great with their hands, a well rounded jack of all trades, and hard workers who are obsessed and diligent in their craft. Show enthusiasm for your career choice - don’t say “I just wanna be XYZ Bc I’m not I obsessed with prestige”. There’s no desire or passion in that statement.

I think you misunderstood what I was saying! I'm very passionate and enthusiastic about it, I would consider it an honor to take care of people and be well-rounded. I don't think every single doctor needs to be pushing out research... I would much rather spend time taking care of patients directly. And I said "just" because some people are really ambitious and go for competitive fields, but I'm happy with excelling in family medicine. I'm disappointed you got that impression, because I think the specialty is awesome.

 

[voxveritatisetlucis]

If you want to do your residency somewhere like Penn or UPMC, then it probably matters. I’m guessing the mission of the program is more important than the specific residency in determining amount of research that you’ll need.

 

[Med Ed]

If you want to do your residency somewhere like Penn or UPMC, then it probably matters. I’m guessing the mission of the program is more important than the specific residency in determining amount of research that you’ll need.

Selection criteria for Penn's FM program:

We employ a holistic review process to identify qualified candidates who are prepared to understand and address the unique challenges facing our West Philadelphia community. We have no absolute requirements or cutoffs, but applicants who are invited to interview generally exhibit:

• strong clinical skills
• excellence in clinical rotations in settings comparable to ours
• solid fund of medical knowledge
• strong interpersonal skills
• commitment to health equity and social justice
• interest in full-spectrum family medicine; and
• passion for clinical areas prioritized in our training program

FM research obviously exists, and some places do more of it than others, but it won't pay to miss the forest while fixating on the research tree. If you want to match at Penn you'll probably get more mileage out of demonstrating a strong commitment to serving the predominantly Black community of West Philadelphia than you will out of publishing an abstract or two.

For a better example of a FM program that may prioritize those with research backgrounds, try the UC Davis Family Medicine Physician-Scientist Pathway Program.

 

[Med Ed]

Research is valuable for ANY field of medicine. It’s not just about “getting in”, but also about moving said field forward and making a contribution to your field.

Moving a field forward typically takes years of sustained effort. Most of the scholarly output from medical students comes in the form of case reports (which are technically not even research) and small dry lab projects. They either get presented at conferences (sandcastle style) or published in open-access journals that no one reads. The main value is derived from seeing a project through to completion.