How can I not settle down

In the country or in the city?

In the flat country there are ever increasing gaps in primary care. Almost all federal states now offer incentive systems to attract young doctors. But what are the advantages of a family doctor in the country? And why are so many people more drawn to the city? We have 2 prospective general practitioners explain why they have decided on what. It turns out that the reasons are usually very individual.

Julia Friedel: adopted home "country" - not a contradiction even as a young general practitioner

I like working in the country because I appreciate the peace and quiet and the wide open spaces right on my doorstep. However, this is a very individual motivation. An additional advantage in the country are the lower rents, which enable more spacious living. When choosing where to live, it is not just a question of medical practice, but also of your own interests.

From the medical point of view of the country, I like the close ties to the patients and their families. Personally, I am happy to say hello to familiar faces in the supermarket. This creates a sense of community. But that doesn't mean that patients seek advice privately. This is not customary for any of our colleagues in our locality and is therefore not a problem. My private life can also belong to me in the country. The family doctors no longer have to be available 24 hours a day. We also have the medical on-call service, which we refer to in the evening or on the weekend.

Of course, the "country doctor" is very much appreciated because she can no longer be taken for granted. In the past year, many patients have asked me how happy they are to have a young doctor working in the practice again. The general high level of acceptance for a young doctor made my career start very easy. I was also very touched by the fact that after a short time in the practice I was already "their general practitioner" for some patients and they thought it was a shame that I had to switch to the clinic.

has lived in Kirchberg im Wald, a small town in the Bavarian Forest with around 4,000 inhabitants, since the beginning of 2016. She has been a doctor in further training for over a year and worked for one of the two general practitioners' practices in Kirchberg for the first year. She is currently an assistant doctor for 18 months in internal medicine at the Arberlandklinik Viechtach, a regional hospital with 157 beds and 4 wards. Then she would like to work in general surgery for 6 months. Julia Friedel did not grow up in the country, but actively moved away from the city and decided to live in the country. She is an active member of JADE in the area of ​​press and public relations.

I cannot confirm the prejudice that only old patients or flu infections are treated in rural areas. Patients come with a variety of different medical conditions. From banal occasions such as a lumbago to acute heart attacks to palliative patients, everything is included. Many children are also treated in the practice, as there is no pediatrician on site. I would even say that there is a wider range of counseling opportunities in the country than in the city, as the specialists are further away and the patients appreciate care close to their home.

However, I have found the quality of care to be very good thanks to the close cooperation with specialist colleagues in the area. Since the patients do not always have the direct opportunity to see the specialist themselves, it is the task of the family doctor and his team to ensure good care. This also requires a broad knowledge of the general practitioner in the various specialist areas. This holistic approach is what makes the work so interesting for me. So that I can keep this claim, I take part in a quality circle in the region. In addition, the practice in which I worked in the first year of further training created various further training concepts for the doctors, which I can also take part in during my time in the clinic. So once a week a practical topic such as B. Dealing with shoulder pain, discussed and once a month we meet at a so-called "journal club", where we discuss the current studies from the relevant, drug-free medical sources. The latest project is the expansion of the journal club to include doctors in the district (general practitioners and other specialists as well as doctors working in hospitals) so that everyone is up to date and uniform regional patient care can take place.

For the reasons already outlined, I would like to continue working in the country after my specialist examination. This is supported by the fact that it is generally easier to establish one's own practice in rural areas, as there is a high level of acceptance for new doctors and many seats are becoming vacant. An additional bonus is the current financial support when taking over a practice in areas of shortage of care.

For me personally, it is already clear that I feel very comfortable in my adopted home. I don't want to miss out on being together anymore. In addition, I see great potential in the further development of the training structures in our region for a strong health region in which all disciplines work together and outpatient and inpatient treatment also merges more smoothly.

For me, it is not just the medical structures or the medical content that are the crucial point in my decision. It's the way of life in the country. I think you can't turn city people into country people and vice versa. But I believe that there are enough doctors who could imagine working in the country. We just have to point out that the country is fun, that there need not be any horror scenarios of 24-hour availability, 7 days a week and that adequate, high-quality work is also possible in the country.

My appeal to young colleagues: Dare to go to the country! We are not bored, not just old patients, but many different consultation occasions. In addition, there can be good opportunities for further training and great networking with the doctors on site.

In the country, there doesn't have to be any horror scenarios of 24-hour availability, 7 days a week. Julia Friedelle has been living in Kirchberg im Wald, a small town in the Bavarian Forest with around 4,000 inhabitants, since the beginning of 2016. She has been a doctor in further training for over a year and worked for one of the two general practitioners' practices in Kirchberg for the first year. She is currently an assistant doctor for 18 months in internal medicine at the Arberlandklinik Viechtach, a regional hospital with 157 beds and 4 wards. Then she would like to work in general surgery for 6 months. Julia Friedel did not grow up in the country, but actively moved away from the city and decided to live in the country. She is an active member of JADE in the area of ​​press and public relations.An article on a similar topic can be found here:

Catharina Escales: As a young general practitioner in town

I like working in the city because it offers a wide variety of possibilities: colorful patient clientele from all professions, all walks of life and from all over the world. Interdisciplinary networking with colleagues from all medical fields. The opportunities for further training are immense, among other things through the committed associations and the proximity to an active university clinic institute. The local young general practitioner has an excellent network and offers excellent training and mutual support. I can use the "short official channels" in the city for my patients and also convey and support those with special needs and questions in an optimally coordinated manner. The task of gatekeeping and protection against oversupply is particularly exciting. Because in the city in particular, the many specialist disciplines are close at hand and there is a lack of networked and coordinating general practitioners. In the big city, I particularly appreciate the abundance of further training options from which I can choose: outpatient surgery and pediatrics, university research and teaching, emergency medicine and additional rehabilitation qualifications and much more. m.

For the reasons mentioned, I would like to continue working in the city after my specialist examination. As a specialist in general medicine, I can work clinically and on an outpatient basis, self-employed or employed, with various employment options and working time models. So I could z. B. in addition to the practical work in university research and teaching or promote projects for people with disabilities. Everything "is close". At the same time, daycare centers, schools, supermarkets, leisure opportunities and diverse career prospects are practically next door.

has lived in the Hanseatic city of Hamburg since she was 15. She not only studied there, but also started her training to become a general practitioner 3 years ago. First she worked in outpatient pediatrics for 9 months, followed by a combination of research and internal medicine at the University Clinic Hamburg-Eppendorf. She is currently working for six months in a surgery practice that offers a wide range of general and trauma surgery, orthopedics, sports medicine and much more. In the near future, she wants to move to a clinic that specializes in acute and long-term care for seriously injured people. Colleagues from various disciplines work hand in hand there, including many specialists in general medicine. Catharina Escales has been active in JADE for 4 years and supports the public relations and international exchange groups there. JADE The Young General Medicine Germany (JADE) is a network for doctors in further training in general medicine and specialists up to 5 years after their examination. The exchange in JADE takes place via an online forum, regional groups and annual supraregional meetings. Interested parties are cordially invited to get to know JADE at http://www.jungeallgemeinmedizin.de.

For me, the main argument against moving to the country is the poorer work-life balance. In rural areas, children often cannot go to school, leisure activities or friends without an adult chauffeur. Special needs can usually be met more difficultly or only with a lot of driving effort by the parents. In addition, there would be the travel effort for the partner, who would have significantly poorer work opportunities in the country and would have to commute. In the city we can pursue various interests in art, culture, sport and much more without having to travel long distances. I appreciate and use this offer a lot.

I also value my privacy. I appreciate a clear evening without patients who ask me about their illnesses in the supermarket, ring the doorbell in the evening and gossip about it when they see me having coffee with my cousin or when I go into a wine shop. In the city, I just have to live in a different neighborhood than the one in which I work, and then I can enjoy the distance to the patients and at the same time the integration into my neighborhood and my household. In fact, I can very well imagine myself being a country doctor for some time. Not least because my second home and my family attract people to the country. But this will probably only come into question for me in the last decade of work, when the children are out of the house and the wishes for further training, professional development and leisure activities for us as a couple may shift in favor of life in the country.

In conclusion, I can say that I really enjoy the diversity and development opportunities in the city, both professionally and privately, for myself, as a couple and in the long term with all the kids. Before I retire, I could perhaps dream of life in the country, in the mountains or by the sea. Until then, I'll be happy in the pearl of the north.