with patients of all age ranges, and like Vin Diesel, you don't have friends, you got

與所有年齡段的病人一起，像文-迪塞爾一樣，你沒有朋友，你有

family. Let's debunk the public perception myths, and give it to you straight. This is

家庭。讓我們揭穿公眾認知的神話，並直接告訴你。這就是

the reality of family medicine. Dr. Jubbal, MedSchoolInsiders.com.

家庭醫學的現實。Jubbal醫生，MedSchoolInsiders.com。

Welcome to our next installment in So You Want to Be. In this series, we highlight a

歡迎來到《你想成為什麼樣的人》的下一期節目。在這個系列中，我們將重點介紹一個

specific specialty within medicine, such as family medicine, and help you decide if it's

醫學中的特定專業，如家庭醫學，並幫助你決定它是否是

a good fit for you. You can find the other specialties on our So You Want to Be playlist.

很適合你。你可以在我們的 "你想成為 "播放列表中找到其他專業。

If you want to vote in upcoming polls to decide what future specialties we cover, make sure

如果你想在即將舉行的投票中投票，以決定我們未來涵蓋的專業，請確保

you're subscribed. If you'd like to see what being a family

你已經訂閱了。如果你想看看作為一個家庭的

medicine doctor looks like, check out my second channel, Kevin Jubbal, M.D., where we'll have

醫學博士的樣子，請查看我的第二個頻道，Kevin Jubbal, M.D.，在那裡我們會有

day in the life episodes of family medicine doctors in the future.

在未來，家庭醫生的一天的生活劇情。

Family medicine is the center of primary care, the generalists of generalists. Unlike other

家庭醫學是初級保健的中心，是全科醫生中的全科醫生。不同於其他

specialties that are limited to a particular organ, disease, or age range, family physicians

專注於某一器官、疾病或年齡範圍的專業，家庭醫生

treat the broadest range of ailments and patients, from newborns to seniors, and everything between.

治療最廣泛的疾病和病人，從新生兒到老年人，以及之間的一切。

For most people, a family medicine clinic visit is their main input into the healthcare

對於大多數人來說，家庭醫學診所的訪問是他們對醫療保健的主要投入。

system, their first line of defense for non-urgent health concerns. From their family medicine

系統，是他們處理非緊急健康問題的第一道防線。從他們的家庭醫學

physician, they can either receive the necessary treatment, or be referred to the appropriate

醫師，他們可以接受必要的治療，或被轉介到適當的醫院。

specialist for more complex pathologies. The overwhelming majority of family medicine

複雜的病症則由專科醫生處理。絕大多數的家庭醫學

physicians practice in an outpatient clinical setting and the bread and butter pathologies

醫師在門診的臨床環境中工作，而麵包和黃油的病症

they deal with include diabetes, hypertension, hyperlipidemia, and preventive medicine and

他們處理的問題包括糖尿病、高血壓、高脂血症、預防醫學和

health screenings. But there's much more to the specialty than

健康檢查。但這個專業的內容遠不止這些。

that. You'll never have as many procedures as a surgeon, but if you want to be more procedure

這一點。你永遠不會有外科醫生那樣多的程序，但如果你想有更多的程序

heavy, you can set aside a day in the week for steroid injections, wart removal, colposcopies,

重要的是，你可以在一週內留出一天時間來注射類固醇，去除疣體，進行陰道鏡檢查。

vasectomies, frenulectomies, circumcisions, and more. Or if you want to tailor your patient

輸精管切除術、輸卵管切除術、包皮環切術，以及更多。或者，如果你想為你的病人定製

population, you can do that too. Maybe you want to focus on pregnant women and delivering

人口，你也可以這樣做。也許你想把重點放在孕婦和分娩上

babies, or older patients through geriatrics, or keep it broad and include all patients

嬰幼兒，或老年病人，或保持寬泛，包括所有病人。

from cradle to grave. Family medicine is often compared to internal

從搖籃到墳墓。家庭醫學經常被比作內科

medicine as they have a large degree of overlap, as both often serve in primary care roles

醫學，因為它們有很大程度的重合，因為兩者都經常擔任初級保健的角色。

in the outpatient clinic, but they have substantial differences. With internal medicine, you're

在門診中，它們有很大的不同。對於內科，你是

only dealing with adult patients, but have greater flexibility in specializing in various

只處理成人病人，但在專門處理各種疾病方面有更大的靈活性。

organ systems, like cardiology, gastroenterology, infectious disease, and others, which are

臟器系統，如心臟病學、胃腸病學、傳染病學和其他，這些系統是

usually 3 year fellowships. With family medicine, you don't have the same organ-specific options

通常是3年的研究金。在家庭醫學方面，你沒有同樣的特定器官選擇。

for specialization, serving more as a generalist, but you do have various 1 year fellowship

為專業化服務，更多的是作為一個普通人，但你確實有各種1年的獎學金

options, which we'll cover shortly. There are a few ways to categorize the specialty.

選項，我們很快就會介紹。有幾種方法可以對專業進行分類。

As a general family medicine doctor, meaning you haven't completed a fellowship, you'll

作為一名普通的家庭醫生，也就是說你還沒有完成獎學金，你會

be focusing on preventive health and simple concerns in an outpatient clinic for the broad

在門診中重點關注預防保健和簡單的問題，為廣大患者服務。

population. Your hours will be regular 9 to 5, and compensation is on the lower end compared

人口。你的工作時間將是正常的朝九晚五，而報酬與之相比則較低。

to those who specialized. As a specialized family medicine doctor, you're

到那些專業的人。作為一名專業的家庭醫生，你是

fellowship trained, and your lifestyle will vary based on your specialization. With sports

訓練有素的研究員，你的生活方式將根據你的專業而有所不同。隨著體育

medicine, you'll see some athletes, but probably still have your regular family practice too.

醫學，你會看到一些運動員，但可能也有你的常規家庭診所。

If you go into obstetrics, you'll spend some of your time on call in the hospital delivering

如果你進入產科，你會花一些時間在醫院裡待命接生。

babies. And if you go into emergency medicine, you'll have the lifestyle of an EM doctor.

嬰兒。如果你進入急診科，你會有一個EM醫生的生活方式。

Most family medicine doctors practice in a community setting, either a smaller group

大多數家庭醫生在社區環境中執業，要麼是一個較小的團體

or something larger like Kaiser. In this setting, your job first and foremost is to be a family

或像凱撒這樣的大公司。在這種環境下，你的工作首先是要成為一個家庭

medicine physician, while research and teaching are not primary responsibilities.

醫學醫生，而研究和教學並不是主要職責。

In academia, you'll not only handle patient care, but also teach medical students and

在學術界，你不僅要處理病人的護理，還要教授醫學生和

residents while also tending to some research responsibilities on the side. Of the three,

鄰居，同時也兼顧一些研究責任。這三個人中。

this generally has the lowest compensation. Finally, private practice is the least common,

這通常有最低的報酬。最後，私人執業是最不常見的。

but offers the most flexibility. You'll be your own boss, running your own practice,

但提供了最大的靈活性。你將是你自己的老闆，經營你自己的診所。

and have the highest ceiling in terms of compensation. You are running a business, however, and there

並且在報酬方面有最高的上限。然而，你是在經營一個企業，而且有

will be more hassle and usually longer hours as well.

將會有更多的麻煩，通常時間也更長。

There are a few misconceptions we need to set straight about the specialty.

關於這個專業，我們需要澄清一些誤解。

First, some say that family medicine doctors don't know much and are constantly sending

首先，有人說，家庭醫生並不瞭解情況，而且不斷地發送

referrals to specialists to handle what they can't. The truth is that family medicine doctors

轉介給專家處理他們不能處理的問題。事實是，家庭醫生

are some of the best when it comes to handling common presenting concerns, but need to know

在處理常見的呈報問題時，他們是一些最好的，但需要知道

where their capabilities are and where to draw the line in seeking help from a specialist.

他們的能力在哪裡，在向專家尋求幫助時在哪裡劃線。

They are often screening and finding conditions that allow for early intervention, like being

他們經常篩查和發現一些條件，以便進行早期干預，如被

the first person to find an arrhythmia and referring that patient to a cardiologist.

第一個發現心律失常的人，並將該病人轉給心臟病專家。

Additionally, family medicine doctors are the specialists of complexity, the quarterback

此外，家庭醫生是複雜的專家，是四分衛。

of the patient's healthcare needs. Because they have to know a little bit about everything,

病人的保健需求。因為他們必須對所有的事情都知道一點兒。

they can be the best to handle complex situations where a patient is receiving multiple treatments

他們可以是處理病人接受多種治療的複雜情況的最佳人選。

from multiple specialists, some of which may be conflicting. In line with this, family

來自多個專家的資訊，其中一些可能是相互矛盾的。與此相適應，家庭

medicine docs are often well suited at approaching each patient holistically and as an individual

醫學博士通常很適合從整體上把每個病人作為一個個體來對待。

instead of as the sum of individual organs or chief complaints.

而不是作為個別器官或主要投訴的總和。

Last, most equate family medicine with outpatient primary care. While most family medicine doctors

最後，大多數人將家庭醫學等同於門診初級保健。雖然大多數家庭醫學醫生

do practice in a clinical setting and see patients of all age ranges, there is more

在臨床實踐中，看到所有年齡段的病人，有更多的

flexibility to the specialty and you can narrow it down based on your particular interests,

對專業的靈活性，你可以根據你的特殊興趣來縮小範圍。

whether that's being a hospitalist, obstetrician, or something else.

不管是做住院醫生、產科醫生，還是其他什麼。

After medical school, family medicine residency is 3 years. It's categorical, meaning you

醫學院畢業後，家庭醫學住院醫師是3年。它是分類的，意味著你

match into one program and complete all three years there, including your intern year.

匹配到一個項目，並在那裡完成所有三年的學習，包括你的實習年。

During your intern year, or PGY1, you'll rotate on many services, including family medicine,

在你的實習期，即PGY1期間，你將在許多服務部門輪換，包括家庭醫學。

obstetrics, pediatrics, internal medicine, ICU, and others.

產科、兒科、內科、ICU和其他。

During PGY2 and PGY3, you'll still rotate on various specialties, which is unique to

在PGY2和PGY3期間，你仍然會在不同的專科上輪換，這是本醫院特有的。

family medicine. In most other residencies, PGY2 and onward are usually dedicated to rotating

家庭醫學。在大多數其他住院醫師中，PGY2和以後的時間通常專門用於輪換

on just your own specialty's services. The reason is that family medicine physicians

就你自己的專業服務。原因是，家庭醫學醫生

are the generalists' generalists, and they need to know what they can handle on their

他們是通才的通才，他們需要知道自己能處理什麼。

own versus what they should refer out or request a specialist consult for.

哪些是他們自己的問題，哪些是他們應該轉診或請求專家會診的問題。

In terms of competitiveness, family medicine is attainable, with a match rate around 96%,

就競爭力而言，家庭醫學是可以達到的，其匹配率約為96%。

USMLE Step 1 average of 220 and Step 2CK average of 236. In our Med School Insiders Competitive

USMLE第1步平均成績為220分，第2步CK平均成績為236分。在我們的醫學院內部人士競爭中

Index, which takes into account match rate, Step scores, publication, AOA, and top 40

指數，考慮到了匹配率、步驟分數、出版品、AOA和前40名

NIH schools, it ranks at the bottom of the list with 13 points.

NIH學校，它以13分的成績排名墊底。

Medical students that choose family medicine are stereotypically the ones who loved everything

選擇家庭醫學的醫學生是刻板的，他們熱愛一切。

during their third year rotations, except maybe surgery, and couldn't find themselves

在他們第三年的輪換中，也許除了外科，他們無法發現自己

committing to one specialty at the exclusion of others. With family medicine they can truly

執著於一個專業而忽視其他專業。通過家庭醫學，他們可以真正

get a little bit of everything. After completing 3 years of family medicine

得到一點兒東西。在完成了3年的家庭醫學課程後

residency, you can choose to specialize with an optional fellowship, each of which are

住院醫師，你可以選擇專攻一個可選的獎學金，每一個獎學金都是

1 year in duration. Sports medicine is for the bros and jocks

1年的時間。運動醫學是為兄弟們和運動員服務的。

of family medicine. You'll be doing various office procedures. Think of orthopedics but

的家庭醫生。你會做各種辦公室程序。想想骨科，但

without any of the surgery. You can learn more about sports medicine in our So You Want

沒有任何手術。你可以在我們的 "你想要 "中瞭解更多關於運動醫學的資訊。

to Be a Sports Medicine Doctor episode. After completing an obstetrics fellowship,

成為一名運動醫學醫生的情節。在完成了產科獎學金後。

you are a full scope general OB doctor. You can deliver babies, just like OBGYN doctors,

你是一個全範圍的普通產科醫生。你可以為嬰兒接生，就像婦產科醫生一樣。

although those who completed an OBGYN residency will have more options for further specialization.

儘管那些完成了婦產科住院醫師培訓的人將有更多的選擇來進一步專業化。

It's an intense specialty that is often polarizing, and people either love it or hate it. You

這是一個激烈的專業，往往是兩極化的，人們要麼愛它，要麼恨它。你

can learn more about OBGYN on our So You Want to Be an OBGYN episode.

可以在我們的《你想成為一名婦產科醫生》節目中瞭解更多關於婦產科的資訊。

A hospitalist fellowship allows you to practice as a hospitalist, admitting patients to the

住院醫生獎學金允許你作為住院醫生執業，將病人送入醫院。

hospital and handling their medical management while they are inpatient. Stereotypically,

在他們住院期間，處理他們的醫療管理。刻板印象。

this is for the family medicine doctors that have personality tendencies of internal medicine

這是為那些有內科個性傾向的家庭醫生準備的。

doctors, namely they love geeking out over the minutiae of medical management.

醫生，即他們喜歡對醫療管理的細枝末節進行研究。

Emergency medicine gives the option for family medicine doctors to practice as emergency

急診醫學為家庭醫生提供了作為急診醫生的選擇。

medicine physicians, the same as those who completed EM residency. This is for the family

醫學醫生，與完成EM住院醫生的人一樣。這是為家庭

medicine doctors who decide they don't want longitudinal care and prefer shift work and

那些決定不想要縱向護理而喜歡輪班工作的醫生，以及那些決定不想要縱向護理而喜歡輪班工作的醫生。

acuity. You can learn more about the field in our So You Want to Be an EM doctor episode.

敏銳度。你可以在我們的《你想成為一名EM醫生》中瞭解更多關於這個領域的資訊。

Rural and international are two separate fellowships with substantial overlap. Both are focused

農村和國際是兩個獨立的獎學金，有很大的重疊性。兩者的重點都是

on underserved populations that have issues in accessing healthcare. These doctors usually

對那些在獲得醫療保健方面有問題的服務不足的人群。這些醫生通常

practice a wider scope of medicine, as there are fewer specialists around, and are also

由於周圍的專家較少，所以他們的醫療範圍更廣，而且也是

focused on improving access on a systemic level in these regions. These fellowships

著重於在這些地區的系統層面上改善獲取機會。這些研究金

are for the highly altruistic and selfless family medicine doctors.

是為高度利他主義和無私的家庭醫生。

There are additional fellowships you can pursue as well, including geriatrics, adolescent

你還可以追求更多的獎學金，包括老年病學、青少年病學，以及兒童病學。

medicine, sleep medicine, palliative medicine, preventative, HIV medicine, and addiction

醫學、睡眠醫學、姑息醫學、預防醫學、HIV醫學和成癮醫學。

medicine. There's a lot to love about family medicine.

醫學。家庭醫學有很多值得喜愛的地方。

Most obviously, FM provides a great deal of flexibility, beyond what most aspiring physicians

最明顯的是，調頻提供了大量的靈活性，超出了大多數有抱負的醫生的範圍。

realize. If you want to deliver babies all day, you can do that. If you want to practice

實現。如果你想整天給嬰兒接生，你可以這麼做。如果你想練習

in the emergency department, you can do that too. Or maybe you want to practice inpatient

在急診科，你也可以這樣做。或者你想在住院部實習

as a hospitalist. All these and more are possible with family medicine.

作為一名住院醫生。所有這些以及更多都可以通過家庭醫學來實現。

Family physicians have a desirable schedule, usually working regular 9 to 5 office hours

家庭醫生有一個理想的時間表，通常在正常的9點到5點的辦公時間工作。

and minimal, if any, call. Note that if you specialize in OB or EM or hospitalist medicine,

和最小的，如果有的話，呼叫。請注意，如果你的專業是產科或EM或住院醫生的醫學。

then your hours will more closely approximate what's normal for that specialty.

那麼你的工作時間將更接近於該專業的正常時間。

If you enjoy getting to know your patients and building relationships, family medicine

如果你喜歡瞭解你的病人並建立關係，家庭醫學

offers amazing access to longitudinal care, as you can see patients from the time they're

提供了令人驚訝的縱向護理，因為你可以從病人出生時就看到他們。

born through adulthood. Family doctors also maintain their level of

出生到成年。家庭醫生還保持他們的水準

medicine knowledge. Medical students in their later years know what I'm talking about. You

醫學知識。晚年的醫學生知道我在說什麼。你

spend thousands of hours and incredible effort learning about the various organ systems and

花費數千小時和令人難以置信的努力來學習各種器官系統的知識。

their pathologies, only to forget much of it as you narrow down with your specialty.

他們的病症，只是當你用你的專業縮小範圍時，就會忘記很多東西。

I definitely felt that way with plastic surgery. Family medicine is one of the few specialties

我對整形外科絕對有這種感覺。家庭醫學是少數幾個專業之一

where you continue to develop that broad knowledge. There's an inherent satisfaction in knowing

在那裡你繼續發展這種廣泛的知識。有一種內在的滿足感，那就是知道

you're able to manage most anything that walks through the door to some extent.

你能夠在某種程度上管理大多數走過門的東西。

While family medicine is an awesome specialty, it's not for everyone.

雖然家庭醫學是一個了不起的專業，但它並不適合所有人。

In terms of compensation, family physicians are bottom of the list, averaging $236,000

在報酬方面，家庭醫生排名墊底，平均為236,000美元。

per year. Specialists, on the other hand, average $344,000 per year.

每年。另一方面，專家們的年平均工資為34.4萬美元。

Compared to some other specialties, there's a great deal of charting and computer work.

與其他一些專業相比，有大量的製圖和計算機工作。

Documentation and billing become an increasingly large part of your day to day, as that dictates

文件和賬單成為你日常工作中越來越大的一部分，因為這決定了

how much reimbursement or compensation is received from the insurance companies.

從保險公司獲得多少報帳或賠償。

FM doctors are also often juggling social issues with patients, such as access to care,

調頻醫生還經常與病人一起處理社會問題，如獲得護理的機會。

insurance coverage, and more, although this does depend on your patient population.

保險範圍，以及更多，儘管這確實取決於你的病人群體。

Last, a small number of medical students look down on the specialty, which is backwards

最後，少數醫學生看不起這個專業，這是倒退。

and often ego-driven. Many medical students are type A, competitive personalities that

而且往往是自我驅動的。許多醫學生是A型人，具有競爭性的性格，他們

often seek some level of prestige. Because family medicine is less competitive, some

往往尋求某種程度的聲望。由於家庭醫學的競爭較小，一些

say if you score well on USMLE that you should aim higher. There have even been recent posts

說如果你在USMLE考試中取得好成績，你應該把目標定得更高。最近甚至有一些帖子

about this on SDN and Reddit, where a high scoring student seeks input from others, as

關於這一點，在SDN和Reddit上，一位高分學生向其他人徵求意見，因為

their own mentors or classmates advised them to go into another specialty that pays better

他們自己的導師或同學建議他們進入另一個報酬更高的專業。

or is more prestigious. This is nonsensical, and not a valid reason to look down on the

或更有聲望。這是無稽之談，並不是看不起的正當理由。

specialty. You should pursue the specialty that's most appealing to you without such

專業。你應該追求對你最有吸引力的專業，而不需要這樣的

superficial considerations. I know several brilliant family medicine physicians who could

膚淺的考慮。我認識幾個出色的家庭醫生，他們可以

have pursued far more competitive specialties, but they chose FM because they were able to

追求更具競爭力的專業，但他們選擇了調頻，因為他們能夠

separate the signal from the noise. If you're the medical student who went through

把信號和噪音分開。如果你是經歷過的醫學生

third year and loved everything non-surgical and didn't want to give any of it up, including

第三年，喜歡一切非手術治療，不想放棄任何東西，包括

not only organ systems but also age, then family medicine may be a good fit for you.

不僅是器官系統，還有年齡，那麼家庭醫學可能很適合你。

If your life outside of medicine is important to you, family medicine provides the flexibility

如果你的醫學以外的生活對你很重要，家庭醫學提供了靈活性。

to practice as a physician while still having time for your own family and interests.

作為一名醫生，同時仍有時間照顧自己的家庭和興趣。

Big thanks to Dr. Ethan Jose, family medicine resident and YouTuber in Oklahoma City, for

非常感謝俄克拉荷馬城的家庭醫學住院醫生和優酷網友Ethan Jose博士。

helping me in the creation of this video. Show him some love and go check out his YouTube

在這個視頻的創作中幫助我。給他一些愛，去看看他的YouTube

channel, link in the description. Special thanks to Dr. JP Valette as well, my good

頻道，鏈接在描述中。特別感謝JP Valette博士，我的好朋友。

friend from medical school and current family medicine and sports medicine attending physician

醫學院的朋友，目前是家庭醫學和運動醫學的主治醫生

in San Francisco. Are you hoping to become a family medicine

在舊金山。你是否希望成為一名家庭醫生？

doctor? To get into medical school and match into a great FM residency, you'll need to

醫生？要想進入醫學院並匹配到一個優秀的調頻住院醫生，你需要

score well on your class tests and standardized exams. As you look at resources and companies

在你的班級測試和標準化考試中取得好成績。當你看了資源和公司

to work with, seek out those who are actual MD physicians, not PhD or other types of doctors

與之合作，尋找那些真正的醫學博士醫生，而不是博士或其他類型的醫生。

that didn't go to medical school. Look for those who have achieved stellar results themselves,

沒有上過醫學院的人。尋找那些自己取得過輝煌成績的人。

a track record of success with positive ratings from customers, and a systematic approach

有成功的記錄，有客戶的積極評價，有系統的方法

so you know you'll always receive high quality service. If you decide on Med School Insiders,

所以你知道你將永遠得到高質量的服務。如果你決定選擇醫學院內部人士。

we'd love to be a part of your journey in becoming a future physician. Visit us on MedSchoolInsiders.com.

我們很樂意成為你成為未來醫生旅程的一部分。請訪問我們的MedSchoolInsiders.com。

Thank you all so much for watching! If you enjoyed this video, check out our So You Want

非常感謝大家的觀看!如果你喜歡這個視頻，請查看我們的 "你想要什麼？

to Be an Internist video, or another specialty on our So You Want to Be playlist. Much love,

成為一名內科醫生的視頻，或我們的 "你想成為 "播放列表中的其他專業。非常愛你。

and I'll see you guys there.

我將在那裡見到你們。