When we refer to primary care physicians, we usually refer to physicians who either trained in Family Medicine or Internal Medicine. But what is the difference?
Education and Training
Pre-Medical Education
I personally am board certified in Family Medicine, which means that I completed 4 years of college (Bachelor’s in Biology and Associate’s degree in Chemistry), followed by another 4 years of medical school.
Medical School
During medical school, a failing grade is considered anything less than a C. We also have to complete national standardized testing called STEP exams, of which there are three. During the 3rd and 4th years of medical school, we rotate through various primary care and specialty services for a month at a time, where we also audition for residency positions. We then apply to these residency positions and hope to be accepted to one (there are medical students who graduate and never actually get into a residency due to residency position shortages or STEP scores).
Residency Training
Family Medicine Residency
I matched into Family Medicine residency, which is a 3-year residency at NYU Lutheran in Brooklyn, NY. Residency working hours are now limited to 80 hours per week averaged over 4 weeks, and we cannot work more than 24 hours straight without a break.
Comparison with Internal Medicine Residency
Family Medicine and Internal Medicine are both three-year residencies but have some key differences. Family Medicine also includes rotations in OBGYN, and we have a minimum number of babies that we actually have to deliver (I delivered over 20). We also have training in pediatrics and taking care of children in the hospital. Similar to Internal Medicine, we also do month-long rotations with hospitalists, cardiology, surgery, endocrinology, nephrology, podiatry, pulmonology, rheumatology, and others.
Ongoing Assessments
Throughout residency, we are regularly tested with knowledge assessments. As we near the end of our residency, usually in the spring, we then take our board exams. These are standardized across the country, and if/when you pass, you can then call yourself a board-certified physician. I am currently board certified with the allopathic (MD) and Osteopathic (DO) branches.
Practicing Family Medicine
What I really enjoy about Family Medicine is the diversity in the conditions I see on a day-to-day basis. My first patient might have diabetes, my next might have a concern about new heart palpitations or high blood pressure, and then I might have to drain and inject steroids into a knee.
Special Interests
One of my favorite conditions to treat is diabetes, especially with the newer medications such as Mounjaro (trizepatide) or Ozempic (semaglutide). I have been able to actually take patients off of daily insulin because of how well these new medications work and the associated weight loss.
Continuing Medical Education
Medicine is always changing, and we also have to do continuing medical education (CME), which is required and comes out to approximately 50 CME credits per year. We can earn these credits mainly through journals and virtual/in-person events (lectures typically accrue roughly 1 CME per hour).
I truly enjoy what I do and love spending time with my patients. Especially now that I have a Direct Primary Care (DPC) clinic in San Antonio, I can give patients the attention they deserve.
Dr. Manuel Vogt