Career Advisor's Background and Career Information

Background

Name: William B. Shore, M.D.
Career Advisor for: Family & Community Medicine
Title(s): Clinical Professor, FCM; Director of Program Development in Medical Education; Permanente Medical Group Endowed Chair for Primary Care Education
Best way to contact (e-mail, phone?): Email shorew@fcm.ucsf.edu
Undergraduate & Graduate Degrees/Institutions: Northwestern University - Undergraduate and Medical School University of Miami - Family Practice Residency UCSF - Fellowship in High-Risk Adolescent Medicine
Clinical Interests/Duties: Urban underserved, adolescent medicine in primary care
Research Interests/Duties: Medical education in underserved/prevention
Personal Notes or Comments: Would like to share with students the particular rewards and opportunities of working in family medicine/primary care with urban underserved populations as a career choice.

Career Information

1. What can students do in the 1st and 2nd years to explore and/or prepare for this career? FPC preceptorships, summer preceptorships with Family Physicians (scholarship stipends available), identify mentors in primary care, explore Family Medicine Interest Group activities, visit Family Medicine Residency Program at SFGH - tag along with a resident for a clinic session, keep options open about primary care in the context of a tertiary care institution.

2. What common variations exist in the length/content of residency programs for this career? Three years to become board eligible.

3. What common variations exist in this career after training? There are mini-fellowships in more invasive/operative OB, fellowships in Sports Medicine, Geriatrics, and Adolescent medicine, CAQs (Certificate of Added Qualification)in Geriatric Medicine and Adolescent Medicine.

4. What is a typical work day for you (or someone else representative)? A typical work week is usually about 50-60 hours For physicians in more full-time (non-academic) practices, the work week is about 50-60 hours, with OB call usually one weekend per month or every six weeks, with about 20 deliveries per year to maintain OB skills. For those with a hospital practice, there are on average 3-5 patients at any time.

5. What is the "culture" of this career? There is a culture of continuity of care, with an emphasis on and appreciation of long-term relationships, health promotion, and illness prevention. Family Medicine was approved by the American Board of Medical Specialties (ABMS) 30 years ago. Family Medicine is currently reviewing many aspects of the discipline in the context of our current healthcare delivery system. All of the Family Medicine organizations are currently involved in a project called "The Futuer of Family Medicine" to help address the definition and training needs of Family Medicine. Training in Family Medicine is often an excellent pathway to work in international health.

6. How compatible is this career with raising a family? How is this different for men and women? Very compatible. We attempt to practice what we preach to our patients about the importance of family life and time. Many women are attracted to and are supported in Family Medicine. Both women and men are supported in requests for maternity/paternity leave as needed at most programs. Many programs have more women than men.

-QUALIFICATIONS-

7. How important, individually, are each the following for admission to a competitive program:

a.Extra-curricular/volunteer work? Important if applying to programs with a particular focus/ mission to serve the underserved (e.g., rural, etc.)
b. Research/publications? Added plus, but not a requirement.
c. Honors in third year? Not an absolute; some of our best residents and future chief residents did not receive Honors on their FCM rotations.
d. AOA? A plus; not necessary.
e. A sub-internship? Not necessary; for those with a real interest in the SFGH program, doing the sub-I on our inpatient service can be very helpful and give students an opportunity to interact with Family Practice residents and faculty.
f. An externship? Not necessary.
g. (Other important elements to the application?) Ability to work well with a team and appreciation of cultural diversity.

8. What are the most important qualities or character traits for a person in this field? Ability to work and cope with uncertainty, flexibility, ability to establish long-term relationships, openness to integration of ideas (e.g., appreciation of Behavioral Sciences as an integral part of every patient's care).

9. How competitive are the residency programs in this field? In recent years, with the general decline in interest in primary care, there is less competition. UCSF students can almost always get their first choice.

10. How competitive is the job market after residency? Clinical Professor, FCM; Director of Predoctoral Education, FCM

11. What programs would you consider to be in the 1st tier, 2nd tier, and 3rd tier? With 498 Family Medicine residency programs, this is a difficult question for response. Different from other specialties, there are many excellent community-based programs that may, or may not, be directly affiliated with academic medical centers. Students interested in community practice should be encouraged to learn about those programs. Students interested in academic careers, teaching, and/or research, may want to explore programs affiliated with academic medical centers.

12. What resources (web, books, etc, besides the AMA and AAMC sites) would you recommend for students interested in learning more about this field? The American Academy of Family Physicians (AAFP) at www.aafp.org, and Society of Teachers of Family Medicine (STFM) at www.stfm.org are websites with a large amount of information. The AAFP publishes "Strolling Through the Match," a book with information about all Family Medicine residency programs in the U.S. The California Academy of Family Physicians (CAFP) publishes a handbook with information about residency programs in California. See www.familydocs.org for more information. Roy Johnston, administrative director for FCM student programs can be reached at JohnstonR@fcm.ucsf.edu or 476-2503. He can also guide students to resources. Interested students may also want to attend the annual AAFP student/residency conference. Many excellent sessions for students about residency in general, as well as a three-day residency "fair" with representatives from 250-300 residency programs are available.