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Q&A with Dr. Farrah Fong, Family Medicine

Dr. Farrah Fong is a third year family medicine resident at Rutger’s/Robert Wood Johnson Medical School. Outside of busy resident duties, she enjoys traveling, volunteering, and fitness. She attended undergrad at University of California- Davis and double-majored in Exercise Biology and Music Performance (Piano). Dr. Fong is also the co-founder of FM Student, a website for 3rd- and 4th-year medical students who are interested in family medicine.

What is your favorite aspect of being a primary care provider?

From when I started volunteering as a medical interpreter to now, what’s always drawn me to primary care is the fact that you get to build a relationship with your patients and their families. I’m currently in my last year of my family medicine residency program, and my most enjoyable days are the ones where I get to see my regular patients, especially when I get to see the healthy improvements they’ve been making in their lives!

What is the most challenging aspect of being a primary care provider?

The pressure to see as many patients as possible and to keep visits to 15-20 minutes is something that I really wish would change. Unless I’m on urgent care, the vast majority of my patients don’t come in with only one issue (and even then, there are multiple conditions they’d like addressed). I know it can be difficult for them to schedule an appointment and take time off work to come in, so I often feel like I’m doing a disservice to them if I can’t address all their concerns while they’re at the office, but being able to appropriately manage all their conditions really requires a lot more time.

What do you think would draw more students towards choosing primary care?

I’m obviously a biased party, but honestly, I think just learning more about primary care and all the different options you can pursue within it would be a good start. You can narrow/widen the scope of your practice and also tailor it to the type of population you want to keep seeing, which isn’t something that very many specialties can truly do. 

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You can have as diverse a practice as you’d like, from seeing patients from “the womb to the tomb” (prenatal care, obstetrics, pediatrics, adolescents, adults, geriatrics…). If you want further training within family medicine, the American Board of Family Medicine currently offers Certificates of Added Qualifications (CAQs) in adolescent medicine, geriatric medicine, hospice and palliative medicine, pain medicine, sleep medicine, and sports medicine. I have co-residents who did/are doing a fellowship in women’s health, and another who will be doing a fellowship in obstetrics after finishing residency.

Providing more support would also be helpful, as I’ve heard of a lot of students who were initially interested in primary care who were talked out of it by fellow peers/mentors. I experienced that as well, although probably not to the extent that I’ve since seen.

Did a rotation during your 3rd or 4th year of medical school spark your interest in becoming a primary care provider?

I was already interested prior to starting medical school, but my rotations in medical school did help to affirm that I really did want to pursue family medicine.

Did you anticipate becoming a primary care physician when you were a pre-medical or medical student?

I spent a few years in college (and shortly after I graduated from college) volunteering at Paul Hom Asian Clinic, a student-run free clinic providing primary care services to a predominantly Cantonese-speaking population. I loved getting to know our patients and building a relationship with them over the years, so I was already fairly certain that I wanted to pursue primary care when I started medical school. I tried to keep an open mind throughout medical school, but I never did end up finding another specialty that I loved more.

What misconceptions did you have about being a primary care provider before you became a resident?

I don’t know that I really had any misconceptions, but I thought (hoped?) I’d have more time to spend with each of my patients. I did realize as a medical student that I had much more free time to talk with my assigned patients, but I definitely underestimated how much that would change as a resident (and as an attending in the future). I really wish there was less emphasis on number of patients seen, and more on quality of care.

What type of practice do you plan to have? Do you plan to work in a clinic, hospital, or both?

I prefer working in an outpatient setting and plan to work in a clinic after I finish residency–either at a Federally Qualified Health Center (FQHC) or in a more academic setting where I’d get to do outpatient work and still work with medical students and residents.

Would you ever consider doing direct or concierge primary care?

Although it does have its merits and can be a convenient service to many people, it isn’t one that I really see myself going into. I wanted to become a physician so I could continue to help under-served populations, but this is generally the population that direct/concierge primary care tends to omit since they often lack or don’t have the right “type” of insurance. I love that they’re able to spend more time with their patients though–that’s something I really wish the “traditional” model could do.

What is your opinion on accelerated/3-year tracks for students who are committed to primary care prior to beginning medical school/3rd year rotations?

I was vaguely aware that the accelerated tracks existed when I was applying to medical school, and I definitely like that the option exists, particularly because there’s such a shortage of primary care physicians in our country. (One less year would also mean being in less student debt, which would be wonderful!)

That being said, having never experienced it, I don’t know enough about them to know if I would feel quite as prepared if I were missing an entire year of education. (I applied only to osteopathic medical schools because I liked their focus on primary care.)

What is your favorite procedure to perform as a primary care physician?

One of my greatest loves within family medicine is sports medicine, so I enjoy getting to do joint injections since it often provides so much relief to my patients and helps them to get back to living their lives and participating in the activities they love.

I also like doing IUD insertions/implants because it’s such a simple way to provide long-term but reversible birth control for my patients.

How many patients do you see in a day? How many hours on average do you work per week?

Currently, I typically see 9-10 patients per half session (or 10-11 on urgent care sessions), and I work anywhere from 50-80 hours per week. (This doesn’t always encompass the time spent on paperwork.) The weeks where I work 70-80 are when I’m working inpatient, but despite this, I’ve still been able to make time for things I enjoy—work-life balance is important!

Any advice for a student who is interested in primary care to make a good impression during their family medicine rotation?

I’ve actually written an article about this in the past! It’s not specific to family medicine but the tips provided should be helpful for doing well in any clinical rotation.

What is your opinion on telemedicine? How is this changing the face of primary care?

I first learned about the concept of telemedicine 8 years ago when I took a “Health Care for Underserved Populations” course at UC Davis, and I’m glad it exists! I think it provides an important and much-needed service, especially to rural communities and to populations that have difficulty coming in for an office visit.

We (the residents at my program) currently cover the emergency phone line for our office after-hours and on the weekends, and through it we’ve been able to provide medical advice to prevent unnecessary visits to the ER and also to urge patients who do warrant further evaluation to come in for appropriate management.

What has been your favorite part of residency?

My favorite part has really been just having the opportunity to develop and refine the skills that I’ll need in my future practice and also getting to further pursue certain interests I have within family medicine (sports medicine, preventive care, community medicine + working with under-served populations).

What has been the most challenging part of residency?

This probably goes back to #2—I have a tendency to want to do everything for everyone, but I’m continuing to improve my skills in working with my patients to address their most pressing concerns first, and, if need be, having them follow up on their other issues in order to give them the time that they deserve.

What advice would you give to a student who is interested in primary care?

Keep an open mind, but don’t let people talk you out of what you love. Throughout college and medical school, I had so many people telling me that I should pursue something other than primary care and/or that it didn’t pay as well as other specialties. 

You don’t go into medicine for the money (or at least, I’d strongly advise against that). Even on my most difficult days, I haven’t regretted choosing family medicine because it’s the specialty I’ve always loved most and it’s what I want to do with my life. Take advice from those whose opinions you trust/respect, but take it with a grain of salt—the decision is ultimately yours to make and the input they give you doesn’t really affect their life, so choose something you yourself will enjoy.