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Family Practice Applicant
Arch Fam Med. 1998;7:211.
Chief Complaint
Student wishes to obtain a position as a family practice resident.
History of Present Illness
Mr Garretson is a 25-year-old white male who presents with a 3-year history of medical study at the Medical College of Virginia, Richmond, with the intent to practice family medicine. This condition has been refractory to treatment by various internists and pediatricians at the Medical College of Virginia, and it is the persistence of this condition that has brought the student to seek an interview with this institution.
Medical History
The student was previously seen in the Emergency Department at Virginia Beach General Hospital in the position of volunteer from October 1992 through June 1993. At this time the student was diagnosed with an intractable desire to practice medicine, albeit in a poorly differentiated stage, and he was referred to the Medical College of Virginia for further workup and education.
Surgical History
The student recently spent 2 months on surgical services at the Medical College of Virginia, where he was found to be a poor surgical candidate and was referred back to family practice.
Family History
Positive for medical condition—student's mother is a speech pathologist, currently rehabilitation director for a nationwide company. Student has 1 brother, who is healthy and unaffected.
Review of Systems
HEENT: Occ headaches from reading or concentrating on photography. Hoarse voice from singing a cappella and in class band. Listens well, good taste usually intact.
Pulmonary: No SOB, able to speak in complete sentences.
Cardiac: Reported cardiomegaly, no dextrocardia (seems to be in the right place . . . ).
GI: Occ dyspepsia secondary to gourmet cooking (esp. spicy dishes).
GU: Deferred.
Extremities: Pedal edema from attempting to hike in every national park. No clubbing or cyanosis, but seasonal green thumb.
Skin: Freckled, mainly secondary to studying geology x 4 yr.
Assessment/Plan
Self-diagnosis is one of the most difficult (and frowned-upon) practices in medicine; however, the decision to pursue a given specialty must be based on careful reflection on one's own abilities, interests, and goals. Family practice appeals to me as a medical specialty for the same reasons that medicine first intrigued me: to learn the intricate workings of the body, to understand its changes in health and disease, and to know enough to help in the process.
The family practitioner has been derided by subspecialists as "jack-of-all-trades, master of none." I see this as the unique challenge of family medicine and my principal reason for choosing this course. What other field allows one to study the entire breadth of human health and sickness and deal with patients in every stage of life? I suspect it is too large an undertaking for which a 3-year residency can prepare one; however, learning does not and must not stop after residency. One's entire career is an opportunity to continuously improve in both the scientific understanding of and the personal attention to patients and their illnesses. This is the challenge of family practice. It is the challenge I have given myself and that I am eager to answer.
My career path to medicine has been a winding road traveling through various fields and interests. I have had many dreams and goals for the future, such as acting on a professional stage, studying geology throughout the country, owning and running a farm, and becoming a superior physician. As I come closer to reaching my goal of becoming a physician, I realize that more career choices lie ahead. My main interest is in clinical practice, but I am also drawn to teaching and research to further improve medicine. I hope that I can find an environment where all of this is possible. As if that were not enough to occupy one for a lifetime, I believe strongly in the importance of maintaining other interests. I have been fortunate in being able to continue my extracurricular pursuits during medical school and would like to maintain a well-rounded lifestyle by practicing medicine as well as pursuing my hobbies and dreams. You may ask if it is possible for one to successfully focus on so many different facets of life at once. Not for the average specialist, perhaps, but for a jack-of-all-trades, what else would you expect?
AUTHOR INFORMATION
Corresponding author: Adam D. Garretson, MD, Family and Community Medicine, Lancaster General Hospital, PO Box 3555, 555 N Duke St, Lancaster, PA 17604-3555.
Adam D. Garretson, MD
Lancaster, Pa
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