Why I switched from neurosurgery and chose family medicine

To my fellow family medicine residents, I am writing to say congratulations. We are part of a medical specialty that touches the lives of Canadians like no other. A specialty that affords flexibility and plentiful opportunities.I am a former neurosurgery resident who persevered through three years of clinical training and two years of research before finding family medicine. It is not unfamiliar to me to field questions about my decision to “step down” from neurosurgery into family medicine. “You’ll make so much less money!” “You’re wasting your potential!” “You’ll be doing the scut work of other doctors!”Don’t get me wrong, I loved the automatic prestige of brain surgery. The seemingly large impact I could make on people’s lives and the drama of it all. For many reasons, I started to explore other career paths that would better fit with the values that drove me to be a doctor in the first place and also fit my family’s needs. Read: The challenges facing new family physiciansIt was during my high school careers class that I met a family physician who had said to me: “Even if AI takes over all aspects of medicine, patients will always need to talk to their doctor and feel that someone—a physical other person sitting in front of them—is on their side.”There is a unique fulfilment that comes from being part of someone’s life story over years, decades or generations. More than any other specialty, family medicine allows for the care of the individual from cradle to coffin.Perhaps it is my nosy nature that drove me into family medicine; a need to know the next chapter. A patient’s story doesn’t end when the last staple is placed to close an incision. There are weeks of rehabilitation, pain management and modified work hours (and therefore forms). Often, it is the family doctor who is there to guide patients through. Comprehensive care family doctors are experts in the patient, an expertise that could save the healthcare system an incredible amount of time and money. Understanding a patient’s 50-year struggle with anxiety as the real reason behind a complaint of dizziness could save many health care dollars. A CT scan is no substitute for a patient’s life story.While I, too, am saddened to agree that family medicine is in crisis, I am hopeful about a future career in family medicine in Ontario. Yes, it is a shame that family medicine does not receive the respect that it deserves. It is a shame that we, as resident doctors, will have to grapple with administrative burdens, overheads and the fear of being poorly compensated compared to our peers. It is a shame that some of our physician leaders feel the need to warn us to step away from comprehensive family medicine and the virtues that drove us to apply to medical school.Ontario needs comprehensive family doctors. And yet, after almost seven years of residency, I (and many of my peers) feel the burden and fear a potential salary that has not matched inflation. Nonetheless, for my own career, I plan on providing comprehensive care while incorporating obstetrics, palliative care and perhaps even psychotherapy into my practice. Such is the joy of a career as diverse as family medicine.As an overworked neurosurgery resident, when burnout appeared after 30 or more hours in the hospital, I still answered my pager. As a family doctor, when burnout will undoubtedly arise after hours of paperwork, I intend to be there to provide the necessary compassionate comprehensive care Ontarians need. The journey will not be easy, but we are the future of family medicine. Together, I hope we will find new and disruptive solutions to the real problems we, and our patients, face. As for me, I am proud of choosing family medicine. Alongside my peers—current and future family medicine residents—I look forward to advocating for the value and practical worth of family medicine as we, hopefully, continue to choose our profession and our patients.Dr. Han Yan is a family medicine resident in Toronto. This item previously ran in the Toronto Star.

Why I switched from neurosurgery and chose family medicine

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