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Your choice of a residency after medical school has a profound impact on your future career as a physician. If you want to become a primary care doctor, your choices include family practice, internal medicine or pediatrics. If you want to treat only children and perhaps teens, you must choose pediatrics. On the other hand, family practitioners treat patients of all ages, while specialists in internal medicine treat only adults and adolescents.
Family Practitioner Duties
Specialists in family medicine work with a broader population than internal medicine doctors because they care for infants, children and adults of all ages. They provide preventive care, such as regular check-ups and immunizations. They also treat acute conditions, such as ear or bladder infections.
Other services they provide may include well-woman care, family planning, X-rays and mental health care. They care for patients in emergencies -- for example, in case of a sprain. Family practitioners perform minor surgery, such as lancing an infection. The care of chronic conditions such as diabetes also comes under their expertise. When necessary, family practitioners refer patients to specialists.
Internal medicine specialists are also called internists. General internists treat a wide range of illnesses and see adult patients of any age. Some also treat teenagers, especially older teens. In addition to providing preventive services, they treat problems of the internal organs and common diseases. For example, they treat diseases of the skin, eyes and ears and of the circulatory system and reproductive system.
Internists are expert diagnosticians, well-qualified to find the cause of a patient's complaints. Although they're prepared to treat many illnesses through medications and other means, they don't perform surgery. They give referrals to patients who require surgery or the expertise of another specialist.
After four years of medical school, physicians complete a residency ranging from three to eight years and take licensing exams. Both family practitioners and internists have a three-year residency.
Residents in family medicine rotate through specialties such as in-patient care, surgery, obstetrics, gynecology, pediatrics and geriatrics.
The rotations for internal medicine focus on the needs of adults and include endocrinology, gastroenterology, rheumatology and cardiology.
The time spent in each rotation typically ranges between four and eight weeks, depending on the specialty.
Board Certification and Subspecialties
Although not required, board certification is available for both specialties. Family doctors must pass exams from the American Board of Family Medicine, while internists take exams from the the American Board of Internal Medicine. Subspecialty training and certifications are also available for both family practitioners and internists, but more internists pursue a subspecialty.
Family practitioners can choose from among six subspecialties, including sports medicine, adolescent medicine, sleep medicine, pain medicine, geriatric medicine and hospice medicine, according to the American Board of Family Medicine.
Depending on how programs are configured, internists can choose among ten or more subspecialties. Similar to family practitioners, they can choose sleep medicine, adolescent medicine or sports medicine, but they can also select geriatric medicine, infectious diseases, medical oncology and cardiovascular disease, among others.
Completion of a subspecialty in internal medicine typically takes one to three years, but some cardiology programs take an additional year. Specialty programs for family practice vary, but they normally take 12 months.
As of 2013, the average annual income of family and general practitioners was $183,940, according to the U.S. Bureau of Labor Statistics. Those working in doctors' offices averaged $189,800 annually, while those employed in hospitals averaged $169,270.
General internists nationwide averaged $188,440 per year in 2013. Those in physicians' offices received an average of $206,660 annually, while hospital internists averaged $147,890 per year.
2016 Salary Information for Physicians and Surgeons
Physicians and surgeons earned a median annual salary of $204,950 in 2016, according to the U.S. Bureau of Labor Statistics. On the low end, physicians and surgeons earned a 25th percentile salary of $131,980, meaning 75 percent earned more than this amount. The 75th percentile salary is $261,170, meaning 25 percent earn more. In 2016, 713,800 people were employed in the U.S. as physicians and surgeons.
- American College of Physicians: About Internal Medicine
- U.S. Bureau of Labor Statistics: Occupational Outlook Handbook -- Physicians and Surgeons
- FamilyDoctor.org: What Is a Family Doctor?
- Eisenhower Medical Center: Internal Medicine Residency Core Rotations
- The University of Alabama: Family Medicine -- Rotations, Curriculum and Electives
- American Board of Medical Specialties: Specialty and Subspecialty Certificates
- U.S. Bureau of Labor Statistics: Occupational Employment and Wages, May 2013: Family and General Practitioners
- U.S. Bureau of Labor Statistics: Occupational Employment and Wages, May 2013: Internists, General
- U.S. Bureau of Labor Statistics: Occupational Outlook Handbook: Physicians and Surgeons
- Career Trend: Physicians and Surgeons
- Teen's Health: Primary Care Doctors
- The American Board of Family Medicine
- The American Board of Internal Medicine
- American Medical Association
- Association of American Medical Colleges
- American College of Physicians: Subspecialist
- American Board of Family Medicine: Certificate of Added Qualifications
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