College

Residents’ Page

One year later

Starting a family medicine Student Interest Group

Eric Cadesky, MD, CM

One year ago I was a short-coated medical student who felt lucky to have discovered the little-known rewards of family medicine. Although I now sport the title and dress of physician, I feel even more privileged to be in this field. What follows is an account of my journey and subsequent attempts to disclose the truth that true happiness can be found in family medicine.

I found such professional pleasure through a series of fortunate events: happenstance encounters with mentors-to-be, rotations with preceptors who encouraged me, and honest advice from students and residents ahead of me. My classmates did not seem to share my enthusiasm, however; just 24% of Canadian graduating students, and only 16% of McGill University graduates, chose family medicine.

In the 2003 CaRMS match, 139 family medicine positions went unmatched in the first round. As I reflected on my own experiences, several reasons for this became apparent: poor exposure to family medicine during training, relatively low prestige, badmouthing from subspecialty supervisors, and too great a variety of practice for students to have a strong image of a family physician. Students were not choosing family medicine because they simply did not know what it was.

Searching for a way to overcome such systemic factors, I attended the 2003 Family Medicine Forum in Calgary, Alta. A poster presentation about a series of monthly pro–family medicine meetings run by students at the University of Saskatchewan struck me as a model that could be adapted to emphasize certain aspects of medical and career education at McGill. I set the following goals for what would become the family medicine Student Interest Group (FaMSIG) at McGill.

• Increasing the profile of family medicine early in medical education

• Educating all medical students about family medicine training and careers

• Exposing medical students to a variety of family medicine role models

• Demonstrating the diversity of family medicine

• Supporting medical students who are interested in family medicine

• Fostering mentoring relationships between family physicians and medical students

• Fostering mentoring relationships between upper- and lower-year medical students

• Having fun

With administrative support from medical school deans and the Department of Family Medicine, I created an interactive, animated 20-minute presentation that I hoped would spark debate about the definition of family medicine. I booked an amphitheatre and purchased enough food to feed 100 people. I wanted to excite the student body; if I could expose them to the realities of family medicine, the rest would take care of itself. (With a free lunch to offer, I knew that I would be speaking to receptive ears.) I made class announcements, sent e-mail invitations, and personally replied to all responses. Now all that remained was for students to come to my talk, the first-ever FaMSIG meeting.

And come they did! I gave the inaugural presentation to about 150 students. Eyes were scrunched, “Hmms” were muttered, and myths were broken down as students in the audience recognized family physicians as versatile, caring, competent, and highly valued. Over the next few days, I received grateful e-mail messages, including the following:

I want to thank you again for your great talk yesterday. It is frustrating how family medicine has such a stigma attached to it. . . . I find it amazing that, in your short presentation yesterday, you were able to completely turn that around and inspire people about family medicine. . . . Thanks so much, and I will see you at the next FaMSIG meeting.

Spurred on by the momentum of the first meeting, I set about arranging monthly meetings at which students could meet the real luminaries: family physicians. Each month a dynamic speaker addressed the group about a different aspect of family medicine, such as emergency medicine, maternal and child care, adolescent and student health, and academic medicine. These special guests spoke for 10 to 15 minutes about what drew them to family medicine and what they enjoyed most and least about their practice. In the question-and-answer period that followed, candid and sincere discussions usually lasted well past the 45 minutes left in students’ lunch hour. (This caused some inquisitive students to be late for their afternoon classes—I never said that FaMSIG was a harm-free intervention.)

Was FaMSIG worth the effort? The response has been overwhelming: an average attendance of 100 people, physicians eager to speak, students clamouring for more meetings. Respect for family medicine at McGill is increasing among students and faculty members. I am excited that “McGill’s newest tradition” will carry on: FaMSIG now has leadership from dedicated medical students Fleure Gallant and Vanessa Berjat and an executive council with representatives from all 4 years. Personally, I hope to continue developing through my new role as resident advisor, learning to balance active guidance of the group with encouragement of student independence.

This new group will work with others across the country to create new programming to further our goals. The lecture series will expand to include more family medicine “subspecialties,” institute more formal mentoring programs, take charge of hands-on skills workshops (such as casts and biopsies), and start a branch for family medicine research. Success is measured not by the position in which one stands, but rather the direction that one faces; FaMSIG—an initiative founded by students, run by students, and for the benefit of students—looks toward a bright future.

Editor’s Note: If your medical school has an established FaMSIG or is interested in starting one, please send contact information to the Residents’ Page editor, Dr Elizabeth Haney, via e-mail at ehaney@dal.ca. Several resources might be available to you, including copies of Canadian Family Physician.

Dr Cadesky is a first-year resident in family medicine and serves as the resident advisor for the family medicine Student Interest Group at McGill University in Montreal, Que. He has received a Medical Student Leadership Award from the College of Family Physicians of Canada and the Tomorrow’s Leader Award from the American Academy of Family Medicine.