To be or not to be.....a generalist

Hello MiMers!

I'm nearing the end of my Family Medicine residency and am struggling with the age-old question: To be or not to be?....a generalist.

I've always loved the variety and scope of FM. To me, there is such great appeal of being a jack-of-all-trades kind of doctor. I love being the first point of care, collaborating with specialists, seeing new and unfamiliar problems, and flying by the seat of my pants. Growing up in Canada and being surrounded by a culture of Family Medicine has undoubtedly shaped my love for general practice.

That being said, after countless hours of studying, rotations, patient care, and hard work, I am sometimes weighed down by the questions, "What am I GOOD at? What's my area of EXPERTISE?" Sure, there are the things that I see everyday and feel pretty comfortable with: Diabetes, high blood pressure, back/shoulder/knee pain, asthma, preventive care to name a few. But this always comes with the knowledge that I'm not necessarily an EXPERT in those fields. Can I really be giving my patients the best care for their problems if I'm not an endocrinologist (diabetes)? orthopod (shoulder pain)? pulmonologist (asthma)? Could I give a thoughtful, professional-level lecture on any of those subjects?

I've been seduced many times during residency into doing a fellowship. At one point, I've seriously considered a fellowship in geriatrics, OB, EM, sports med, palliative care, dermatology and HIV/AIDS (to name a few). But I can never seem to commit myself to narrowing down to one subject. I find myself getting back to the same fear of getting pigeonholed into one area and losing my ability to be a generalist. It is quite a humorous mind-loop that I get into time and time again.

Ladies, lets discuss. What do you love about being a specialist? Or a generalist? I'd love to hear your thoughts.

Sincerely,
HulaMed