Are there any "lifestyle" specialties left?

[drizzt3117]

PA school is 2 years...

Where do you think that knowledge comes from? The first two years of medical school are all but forgotten, the third is key, and the fourth is mainly for interviews and vacation.

Most of the real training is in residency. An intern is far more worthless than a good PA, and so are many R2's or even R3's.

I'm not incredibly familiar with the PA curriculum, but they get most of the same courses we do, they basically just miss out on 4th year (which is mostly a waste anyway). So unlike NPs, PAs actually do get a foundation in basic science.

So personally, (and this is coming from an MD), if I had my choice I would definitely rather be treated by a PA than an intern.

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[xanthomondo]

Where do you think that knowledge comes from? The first two years of medical school are all but forgotten, the third is key, and the fourth is mainly for interviews and vacation.

Most of the real training is in residency. An intern is far more worthless than a good PA, and so are many R2's or even R3's.

I'm not incredibly familiar with the PA curriculum, but they get most of the same courses we do, they basically just miss out on 4th year (which is mostly a waste anyway). So unlike NPs, PAs actually do get a foundation in basic science.

So personally, (and this is coming from an MD), if I had my choice I would definitely rather be treated by a PA than an intern.

Are you a resident? What year?

PAs (as drizzt stated) only go to school for 2 years. Their basic science curriculum is 1 year. Everything that we learn (at an absolute ultra-fast pace) they do in half the time, which really means they cut a significant portion out. If you don't have a foundation in the basic sciences can you really build a deep understanding of pathophysiology in the future?

You might say that we forget the first two years, but I would argue that this is not true. You might not remember every equation or every little detail, but I'll bet you still have all of the big picture concepts and could easily refresh and topic from MS1/2 in your head with the click of wikipedia.

Here is the curriculum of a local PA program:

First Year - Fall Quarter

Advanced Anatomy 4
Patient Communication 2
Ethical Issues in Physician Assistant Practice 2
Clinical Assessment 5
Physician Assistant Practice 2
Total 15

First Year - Winter Quarter
Epidemiology for Practice & Prevention 3
Principles of Medical Science I 2
Pharmacology and Therapeutics I 3
Clinical Medicine I 5
Clinical Skills I 2
Total 15

First Year - Spring Quarter
Principles of Medical Science II 2
Pharmacology and Therapeutics II 2
Biopsychosocial Issues in Patient Care 5
Clinical Medicine II 5
Clinical Skills II 2
Total 16

First Year - Summer Quarter
Health Policy for Physician Assistant Practice 2
Principles of Medical Science III 2
Pharmacology and Therapeutics III 2
Special Topics in Clinical Medicine 5
Clinical Skills III 4
Total 15

Second Year - Fall Quarter
Rotation I 5
Rotation II 5
Total 10

Second Year - Winter Quarter
Rotation III 5
Rotation IV 5
Graduate Project I 3
Total 13

Second Year - Spring Quarter
Rotation IV 5
Rotation VI 5
Total 10

Second Year - Summer Quarter
PA 635 Primary Care Practicum I 10
PA 638 Graduate Project II 3
Total 13
Third Year - Fall Quarter
Course Course Title Credits
PA 637 Primary Care Practicum II 10
Total 10

I don't see biochemistry, genetics, physiology, microbiology, immunology, embryology, nutrition, neuroscience. You really believe that the 2 credit courses of "Medical science" and pharm cover everything necessary to build a solid knowledge base upon?

PAs being looked at as "permanent residents" seems pretty accurate. But there's a reason they're permanently there - because they have no knowledge base to build upon (they just do pattern recognition) and because they usually perform the scut work that residents usually have to do but is not educational. Not to mention that PAs usually work 3-4 days a week. You can't compare a PA in practice for 10 years with a newly minted intern. But I would take a senior resident or fellow over a PA anyday.

Not to mention that all of fourth year really isn't a vacation. I worked pretty damn hard on all of my sub-i, research, and away rotations. Even my radiology rotation, which admittedly was easy, taught me a lot about radiology (much more than if I never had it at all like a PA).

 

[pinipig523]

24 weekers? Not too often. Any newborn infant, especially a preterm, who needs intubation, etc? Fairly commonly. Giving birth in the ER to an apneic baby isn't a rarity at all.

My point was not to disagree with the overall idea that EM docs are the best at resuscitation of the overwhelming majority of patients, only that there might be a few patients, including preterm infants, for whom there are others in the hospital, such as neonatologists, who have the most expertise. It wasn't a big point so you can ignore it if it troubles you.

Protocol:
1. Clear secretions
2. Warm and stimulate
3. If HR <100 then apply ppv or deep suction
4. If HR<100 still, then intubate
5. If HR <100 still, then compressions

If access is needed, use umbilical vein - the smiley part of the smiley face. Send to NICU.

 

[oldbearprofessor]

Protocol:
1. Clear secretions
2. Warm and stimulate
3. If HR <100 then apply ppv or deep suction
4. If HR<100 still, then intubate
5. If HR <100 still, then compressions

If access is needed, use umbilical vein - the smiley part of the smiley face. Send to NICU.

With all due respect, you might wish to review the AHA guidelines related to chest compressions in this setting (Pediatrics 2010).

 

[Silent Cool]

Actually, dentistry is becoming more and more female. Most current dental schools have approximately a 50-50 breakdown of male to female ratio (similar to medical schools). But hey, don't let pesky things like "facts" get in the way of your posts.

LOL. Slack3r, I like your style.

 

[jlescher]

My college roommate is currently in his second year of law school at Marquette. He is number one in the class (as of last year) and he was saying his typical day was 7AM - 1AM (with food and maybe some gym time). So law is far from a cake-walk. Top of his class and he just landed a job for 130k. They don't make that much, and he will no doubt be working 80+ hours a week when he starts. Just my 2 cents about other professions. I don't think there is any easy way to make lots of money and be lazy.

 

[circulus vitios]

FM is pretty lifestyle friendly if you don't mind making $175k/year.

 

[10g Pentobarbital]

Oceans rise, cities fall, dermatology survives...

 

[ncide]

Dentistry is chill.

Hire your own staff. Work your own hours in your own practice. Decide whether you want to take insurance or not... and the time flies. You sit down next to a patient, catch up with them, then do some work on their teeth and walk out proud of your work. You see patients every few months and get close with them. I played Destiny with a few of my patients, had dinner with others, and just enjoyed the time we spent together in the chair. You meet so many people that you go to work with a smile. Having 3 day weekends when I was an assistant was great too.

We get paid like doctors in FM starting out, but you can make 200-400k when you own your own practice. The debt is high, but it's a fun job.

 

[CommyO]

Dentistry is chill.

Hire your own staff. Work your own hours in your own practice. Decide whether you want to take insurance or not... and the time flies. You sit down next to a patient, catch up with them, then do some work on their teeth and walk out proud of your work. You see patients every few months and get close with them. I played Destiny with a few of my patients, had dinner with others, and just enjoyed the time we spent together in the chair. You meet so many people that you go to work with a smile. Having 3 day weekends when I was an assistant was great too.

We get paid like doctors in FM starting out, but you can make 200-400k when you own your own practice. The debt is high, but it's a fun job.

Your own practice is much easier said than done buddy

 

[Anti-PD1]

Of course. Just work fewer hours.

 

[Warderino92]

Agreed. I wonder if this field will ever take a hit in the near future. I mean, I can't believe it hasn't yet. I know there is always cosmetics (if you're into that), but spraying liquid nitrogen on a wart or AK pays $ since it is a "procedure" and takes 2s to do so. These are things that could easily be handled by primary care docs too IMHO..

Simple reason derm won't take a hit is because their business model is to see 2x as many patients a day as a PCP would, and they bill the same for each visit. The cosmetic offices of course make more money from procedures that are paid out of pocket and wouldn't be hurt by insurance reimbursement cuts anyway.