Duke Students Show Keen Interest in Family Medicine

I am always impressed with the passion of medicalstudents and family medicine residents, and my recent trip to DukeUniversity was no exception.

Duke's Family Medicine Interest Group (FMIG) invited me to be a speaker at their annual awards meeting in Durham, N.C. This created an opportunity for me to meet with the school's chair of community and family medicine, Lloyd Michener, M.D., (who recently made news for his work on integrating primary care and public health) and to spend some time with family medicine residents.

This trip, however, was primarily about students. There was a great deal of excitement and enthusiasm about this years Match and what it may mean for Duke's future. The school had four students match into family medicine residencies, including one who will be staying on at Duke.

Although four may not sound like a big number, it doubled last year's total and matched the school's highest number of students matching into family medicine residencies during the past six years. (For some perspective, Duke produced zero family medicine residents out of a class of 112 students in 2009.)

The students asked good questions about ways to stimulate interest in family medicine and invigorate their FMIG. We talked extensively about leadership opportunities at the AAFP's National Conference of Family Medicine Residents and Medical Students,which is scheduled for Aug. 1-3 in Kansas City, Mo., and how this can extend to students regardless of career choice. However, once students come and participate in this event, it is hard not to get excited about family medicine.

We also talked about ways of handling the usual challenges students face in family medicine. Even early in their careers, students are hearing the usual refrain of "You are too smart to go into family medicine" from their faculty and peers. This is a very real issue for our students, and it is difficult to withstand over time.

We talked about one way of reframing the situation, which is to recognize that family medicine is the largest specialty. Second, most folks who go into internal medicine, for example, subspecialize. Another way of looking at that choice would be to talk about becoming a limited practice specialist. This allows an opportunity for students interested in family medicine to say how they truly don't want to limit themselves. They want the excitement and the challenge of doing more than "just" being an orthopedist. And they could praise their peers who recognize that they need to limit their options by subspecializing. It is good to know ones boundaries.

Most important, however, is a message that we all need to hear -- not just the students. What we have been doing for many years is critical to the creation of a true health care system in this country. It has been, and continues to, be difficult at times. People don't always understand what we do. However, for the first time, people in power are talking about primary care and the patient-centered medical home. Even if they don't fully understand what those terms mean, it is a start.

Winston Churchill once said, "You can always count on Americans to do the right thing -- after they've tried everything else." We are getting to the point where our country has tried everything else to create a health care system instead of a disease-management process.