How competitive are non-psychology majors for psychiatry residencies?

[Instatewaiter]

I am happy that you chose to go with a profession you're passionate about rather than the profession that has a good pay relative to training years.
Maybe you're just angry because compensation is continuing to decrease for cardiologists (who knows what their future salary will become).
Dermatologists aren't the people you should be angry with though. I really hope our country takes better care of our specialists in the future. : (

Again it has nothing to do with compensation. It has nothing to do with training years. Training years and salaries are very similar between cards and derm. It has to do with the fact that some of the best and brightest of each med school class essentially sell their medical soul. People don't sit in the second year class room or on the wards and say, "damn rashes are sweet".

However they find out about the lifestyle and salary and suddenly rashes are awesome. They then proceed to act like it is was always their calling to do derm. It is a hollow attempt at self-rationalization and makes me sad. No other specialty is this bad.

As to my previous post about a potted plant matching psych- many specialties are like this including many of the most popular- im, peds, pm&r, neuro and psych. There is nothing wrong with something being easy to match into and at the top of these specialties it is competitive. And god love those people who do psych. It takes a special kind of patience to do that.

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[Instatewaiter]

Yeah, uh huh. But apparently you can stomach doing & reading cardiac imaging and stents.

I find cardiac imaging to be incredibly boring. If I wanted to do imaging I would have gone into radiology. But when a patient is crashing, it is nice to be able to slap a probe on the chest and tell people what is going on.

As to your snide comment about stents, it is an incredible thing to see someone come in on the verge of death, literally dying and open the artery and stabilize. I'm sure you get the same feeling when you write a prescription for topical steroids or give that woman the full lips she had been hoping for.

 

[Holmwood]

People don't sit in the second year class room or on the wards and say, "damn rashes are sweet".

However they find out about the lifestyle and salary and suddenly rashes are awesome. They then proceed to act like it is was always their calling to do derm. It is a hollow attempt at self-rationalization and makes me sad. No other specialty is this bad.

I don't know. There's the lighter side of dermarolling, but there's also the daunting side of seeing pediatric burn victims.

I do agree that sell-outs really have no business in a profession that demands self-sacrifice and altruism on a daily basis. Even if they do their job well and treat their patients with kindness and respect, they have a greater capacity for profiteering. If they have to lie to themselves that they love their job, then no amount of money will make them happy. And that's why I only have pity for sell-outs, even with their grandiose lifestyle. That's for every life-style specialty though, not just dermatology.

 

[DermViser]

I find cardiac imaging to be incredibly boring. If I wanted to do imaging I would have gone into radiology. But when a patient is crashing, it is nice to be able to slap a probe on the chest and tell people what is going on.

As to your snide comment about stents, it is an incredible thing to see someone come in on the verge of death, literally dying and open the artery and stabilize. I'm sure you get the same feeling when you write a prescription for topical steroids or give that woman the full lips she had been hoping for.

http://articles.baltimoresun.com/20...other-former-midei-patients-mark-midei-stents
You're right, even for people in whom it wasn't medically necessary to need stents. Why use actual pharmacotherapy when you can just stick stents in (with no greater improvement in overall mortality). Any wonder Cardiology is getting huge cuts for overutilization.

Yeah, yeah, we get it - every specialty, other than Cardiology, sucks.

 

[DarknightX]

I don't know. There's the lighter side of dermarolling, but there's also the daunting side of seeing pediatric burn victims.

I do agree that sell-outs really have no business in a profession that demands self-sacrifice and altruism on a daily basis. Even if they do their job well and treat their patients with kindness and respect, they have a greater capacity for profiteering. If they have to lie to themselves that they love their job, then no amount of money will make them happy. And that's why I only have pity for sell-outs, even with their grandiose lifestyle. That's for every life-style specialty though, not just dermatology.

LMAO at your idea that a dermatologist would have any clue what to do with a burn victim. Dermatologists have no clue how to manage a sick patient, let alone a burn patient. And they can't do jack for burn scars.

Burn surgeons and plastics are the people you are thinking of here.

 

[DermViser]

Again it has nothing to do with compensation. It has nothing to do with training years. Training years and salaries are very similar between cards and derm. It has to do with the fact that some of the best and brightest of each med school class essentially sell their medical soul. People don't sit in the second year class room or on the wards and say, "damn rashes are sweet".

However they find out about the lifestyle and salary and suddenly rashes are awesome. They then proceed to act like it is was always their calling to do derm. It is a hollow attempt at self-rationalization and makes me sad. No other specialty is this bad.

As to my previous post about a potted plant matching psych- many specialties are like this including many of the most popular- im, peds, pm&r, neuro and psych. There is nothing wrong with something being easy to match into and at the top of these specialties it is competitive. And god love those people who do psych. It takes a special kind of patience to do that.

Wrong. There are many students who like Derm after covering skin histology or skin pathology in basic science coursework. There are many rotators who do Derm as an elective in their 4th year (and aren't going into Derm) who see exactly what it entails (vs. a preconcieved notion like you have), and although they aren't going for it, they can see why the variety of pathology and see why it's so "cool". Many of them like it bc it's very visual and when treatments are given it's easy for the patient and you as a provider to see a vast improvement, unlike say a clogged artery, which even in looking at a scan is just an image.

Maybe during your 3 year IM residency at Hopkins, you should have rotated in Hopkins Derm for a month. Oh wait, that's bc IM residency was only a pitstop on the way to the big bucks in Cards.

 

[DermViser]

LMAO at your idea that a dermatologist would have any clue what to do with a burn victim. Dermatologists have no clue how to manage a sick patient, let alone a burn patient. And they can't do jack for burn scars.

Burn surgeons and plastics are the people you are thinking of here.

Burn surgeons and Plastics are free to treat Cutaneous T-cell Lymphoma patients. Oh wait, they don't.

 

[DarknightX]

Burn surgeons and Plastics are free to treat Cutaneous T-cell Lymphoma patients. Oh wait, they don't.

No kidding. Never said they did.

Poster I replied to was discussing the "daunting side of seeing pediatric burn victims."

Please stop trying to compare dermatology to surgery.

One is a demanding residency that takes care of acutely sick patients, the other is primarily outpatient. Derm is known for it's good pay and great lifestyle. Don't go into an easy speciality and expect the same respect from those in one of the most demanding.

 

[Instatewaiter]

http://articles.baltimoresun.com/20...other-former-midei-patients-mark-midei-stents
You're right, even for people in whom it wasn't medically necessary to need stents. Why use actual pharmacotherapy when you can just stick stents in (with no greater improvement in overall mortality). Any wonder Cardiology is getting huge cuts for overutilization.

Yeah, yeah, we get it - every specialty, other than Cardiology, sucks.

In ACS, ESP STEMI, stents save lives.
For those with severe angina not controlled with meds it is debilitating. They become cardiac cripples and stenting improves angina better than meds as I'm sure you knew. Not everyone is unscrupulous as the midei case shows. What you probably didn't know is that none of the patients in the previous cases with midei had bad outcomes. They basically sued him for pain and suffering.


Actually, I don't think every specialty but cards sucks. My rancor is really only directed at derm. Dont get me wrong, there are specialties that id never do, but thats why i didnt go into them. But derm has a special place in my heart

 

[Holmwood]

LMAO at your idea that a dermatologist would have any clue what to do with a burn victim. Dermatologists have no clue how to manage a sick patient, let alone a burn patient. And they can't do jack for burn scars.

Burn surgeons and plastics are the people you are thinking of here.

Well I am certainly enlightened. I know dermatologists can do skin grafting, but that's about all I know. : (

You can definitely quote me on premeds-say-darndest-things thread.

 

[DarknightX]

Well I am certainly enlightened. I know dermatologists can do skin grafting, but that's about all I know. : (

They don't do skin grafting, either. Skin grafting happens in the OR, and dermatologists don't operate. Plus skin graft patients are admitted to the hospital, which means the surgeon who does the procedure has to take care of the patient during that time.

Again, burn surgeons or plastic surgeons do skin grafts. Dermatologists have no interest in having any inpatients, and see most of their patients in an outpatient clinic.

Generally, the less time you spend in the inpatient setting, the better your lifestyle.

 

[Instatewaiter]

Wrong. There are many students who like Derm after covering skin histology or skin pathology in basic science coursework.

No there aren't.

There are many rotators who do Derm as an elective in their 4th year (and aren't going into Derm) who see exactly what it entails (vs. a preconcieved notion like you have), and although they aren't going for it, they can see why the variety of pathology and see why it's so "cool". Many of them like it bc it's very visual and when treatments are given it's easy for the patient and you as a provider to see a vast improvement, unlike say a clogged artery, which even in looking at a scan is just an image.

Keep rationalizing. You are the stock character of the derm resident I was talking about above.

 

[Instatewaiter]

Well I am certainly enlightened. I know dermatologists can do skin grafting, but that's about all I know. : (

You can definitely quote me on premeds-say-darndest-things thread.

I think you are thinking about plastic surgeons. They do skin grafting. The dermatologist take care of that kid's pimples when he reaches puberty.

 

[mik30102]

Bear Grylls is gonna be lapping up this thread

 

[DarknightX]

Even the sick "derm" patients with TENS and SJS usually get admitted to a surgical service. The surgeons do all the wound care, critical care management, and surgeries.

The derm guys come by, write a note, maybe do a punch biopsy, and call it a day. Their recs (if any) are utterly useless.

 

[Instatewaiter]

Bear Grylls is gonna be lapping up this thread

Sometimes you just need to put people in their place

 

[Holmwood]

They don't do skin grafting, either. Skin grafting happens in the OR, and dermatologists don't operate. Plus skin graft patients are admitted to the hospital, which means the surgeon who does the procedure has to take care of the patient during that time.

Again, burn surgeons or plastic surgeons do skin grafts. Dermatologists have no interest in having any inpatients, and see most of their patients in an outpatient clinic.

Generally, the less time you spend in the inpatient setting, the better your lifestyle.

Okay! Good rule of thumb.

I just googled and it seems they do minor skin grafts, but usually refer to plastic surgeons for larger problems. Thanks. : (

 

[DarknightX]

Okay! Good rule of thumb.

I just googled and it seems they do minor skin grafts, but usually refer to plastic surgeons for larger problems. Thanks. : (

Google is lying to you.

Dermatologists don't do skin grafts, period. They would be utterly lost in the operating room.

 

[DermViser]

Sometimes you just need to put people in their place

Well then you aren't doing a good job at it. If you think there is no possible way that ANY physician in derm can like it bc of the actual diseases in the specialty, then you are wrong. Based on your grievances towards Derm, it's no different in that respect with PM&R. Not some narrow suburbia focused diseases of acne, that you seem to think all of Derm is.

Yeah, of course the Midei patients didn't sue him for "bad outcome", he did an invasive procedure that WASN'T medically necessary, just fine. If that doesn't irk you, from a moral standpoint then you have no conscience. There are medical guidelines as to when a stent is reasonable and when it's not. He did it to make a quick buck and then through a type of peer review he was seen to have done procedures on people who didn't need it.

Yeah, we get it, you're super angry at Derm. Don't worry, there are many IM residents who hate the fellows/attendings in Cards bc of their superiority complexes and think they rule the entire IM Department. Yeah, we know it's the heart so there's no organ more important than that, blah, blah, blah.

 

[DermViser]

Generally, the less time you spend in the inpatient setting, the better your lifestyle.

PM&R has inpatient rehab, Rads is also inpatient at hospitals, Path can also be inpatient, Anesthesiology is inpatient.

 

[DarknightX]

PM&R has inpatient rehab, Rads is also inpatient at hospitals, Path can also be inpatient, Anesthesiology is inpatient.

How many patients are on the Anesthesia service?

How about the Radiology service?

 

[DermViser]

How many patients are on the Anesthesia service?

How about the Radiology service?

What's your point? They are inpatient services and work inside a hospital usually. They aren't "outpatient" specialties. By your logic a Surgeon who works outpatient has a fantastic lifestyle. Outpatient is a practice model.

 

[Holmwood]

Google is lying to you.

Dermatologists don't do skin grafts, period. They would be utterly lost in the operating room.

I'll just shut up now. : P

Ah well, it's fine. I still respect what dermatologists do. They may not bring people back from the dead, but you know self-consciousness about outer appearances can easily drive people over the edge. Especially the elderly...

 

[DermViser]

I'll just shut up now. : P

Ah well, it's fine. I still respect what dermatologists do. They may not bring people back from the dead, but you know self-consciousness about outer appearances can easily drive people over the edge. Especially the elderly...

Google is lying to you.

Dermatologists don't do skin grafts, period. They would be utterly lost in the operating room.

Um, yeah they actually do - Mohs surgeons do: https://www.advancedderm.com/conditions-treatment/clinical-dermatology/skin-cancer/mohs.aspx

 

[DarknightX]

What's your point? They are inpatient services and work inside a hospital usually. They aren't "outpatient" specialties. By your logic a Surgeon who works outpatient has a fantastic lifestyle. Outpatient is a practice model.

Surgeons who work outpatient only do have fantastic lifestyle. Either you're trolling or you've never been inside a hospital.

It makes a huge difference in terms of lifestyle if you have inpatients or not. Anesthesiologist still have to take in house call, something derms never have to do, even during their residency, so I would argue that the lifestyle isn't that great.

Rads isn't really an inpatient speciality. You could do that from your home if you have a high def monitor.

I don't know what your point is here. If you can get paged to work in the middle of the night, it's not a great lifestyle. For derm, there's no emergencies and no inpatients, hence great lifestyle.

 

[DarknightX]

Um, yeah they actually do - Mohs surgeons do: https://www.advancedderm.com/conditions-treatment/clinical-dermatology/skin-cancer/mohs.aspx

Yawn. Not real surgeons. Wake me when you can close your own wounds or learn to manage your own wound infections

 

[DermViser]

Surgeons who work outpatient only do have fantastic lifestyle. Either you're trolling or you've never been inside a hospital.

It makes a huge difference in terms of lifestyle if you have inpatients or not. Anesthesiologist still have to take in house call, something derms never have to do, even during their residency, so I would argue that the lifestyle isn't that great.

Rads isn't really an inpatient speciality. You could do that from your home if you have a high def monitor.

I don't know what your point is here. If you can get paged to work in the middle of the night, it's not a great lifestyle. For derm, there's no emergencies and no inpatients, hence great lifestyle.

Neither does PM&R or Path (and Path is on call as well). Anesthesiology is on call, but only work if there is a non-scheduled Surgery happening.

 

[DermViser]

Yawn. Not real surgeons. Wake me when you can close your own wounds or learn to manage your own wound infections

Again you said they don't do skin grafts. Clearly they do. It's ok, you were wrong.

 

[Ismet]

Bear Grylls is gonna be lapping up this thread

Nothing like grown men having an off-topic pissing contest in pre-allo.

 

[DermViser]

Nothing like grown men having an off-topic pissing contest in pre-allo.

You didn't get the memo? Only cardiologists are important apparently. A "potted plant could match into psychiatry", derms are sellouts, etc.

 

[Holmwood]

Surgeons who work outpatient only do have fantastic lifestyle. Either you're trolling or you've never been inside a hospital.

It makes a huge difference in terms of lifestyle if you have inpatients or not. Anesthesiologist still have to take in house call, something derms never have to do, even during their residency, so I would argue that the lifestyle isn't that great.

Rads isn't really an inpatient speciality. You could do that from your home if you have a high def monitor.

I don't know what your point is here. If you can get paged to work in the middle of the night, it's not a great lifestyle. For derm, there's no emergencies and no inpatients, hence great lifestyle.

Clueless premed here.
How come some specialists have to do in-house calls anyway? Can't they just have one person man the mornings and have someone else do night-time shifts?

I don't really have much experience with the lifestyles of other specialties as I shadowed an ER doc.

 

[DermViser]

Clueless premed here.
How come some specialists have to do in-house calls anyway? Can't they just have one person man the mornings and have someone else do night-time shifts?

Bc the hospital makes them be on call. It's part of their contract. Hardly out of the goodness of their heart.

 

[Instatewaiter]

Based on your grievances towards Derm, it's no different in that respect with PM&R. Not some narrow suburbia focused diseases of acne, that you seem to think all of Derm is.

I can't think of something more different. PM&R could at least interesting in terms of physiology and mechanics. It isnt very high paying so the people who go into PMR actually like the subject matter.

Yeah, of course the Midei patients didn't sue him for "bad outcome", he did an invasive procedure that WASN'T medically necessary, just fine. If that doesn't irk you, from a moral standpoint then you have no conscience. There are medical guidelines as to when a stent is reasonable and when it's not. He did it to make a quick buck and then through a type of peer review he was seen to have done procedures on people who didn't need it.

He was salaried. He didn't make extra money on those stents he placed. Perhaps you should re-read what I previously posted to realize I wasnt supporting his decisions. You are now just posting strawmen because you have no way to support your decision to go into derm... you know, other than the true, indefensible reasons

 

[DarknightX]

Not real surgeons. Call me when you can close your own wounds.

Again you said they don't do skin grafts. Clearly they do. It's ok, you were wrong.

Lol. I have a hard time believing you are not a troll.

I've never seen a derm do a graft, and if their wounds need one, you can bet they are calling someone else to do it.

You tried pulling this "derms are surgeons" crap in the surgery board and got owned. So I guess your next step was to convince the clueless premeds that derms are surgeons so you can feel better about yourself.

If you want to be called a surgeon so badly, do a surgery residency.

 

[DermViser]

I can't think of something more different. PM&R could at least interesting in terms of physiology and mechanics. It isnt very high paying so the people who go into PMR actually like the subject matter.

He was salaried. He didn't make extra money on those stents he placed. Perhaps you should re-read what I previously posted to realize I wasnt supporting his decisions. You are now just posting strawmen because you have no way to support your decision to go into derm... you know, other than the true, indefensible reasons

PM&R have fellowships to do procedures. So you're wrong about that.

Salaried indeed: http://www.forbes.com/sites/larryhu...get-a-job-taking-blood-pressure-at-a-walmart/
“They were paying me like a fricking baseball player.”
Even salaried doctors have to crank out a certain number of RVUs. Like I said, there's a good reason why Cardiology has gotten huge cuts due to overutilization.

 

[DermViser]

Lol. I have a hard time believing you are not a troll.

I've never seen a derm do a graft, and if their wounds need one, you can bet they are calling someone else to do it.

You tried pulling this "derms are surgeons" crap in the surgery board and got owned. So I guess your next step was to convince the clueless premeds that derms are surgeons so you can feel better about yourself.

If you want to be called a surgeon so badly, do a surgery residency.

I'm not the one who brought up derms being surgeons here. You said derms don't do skin grafts. Mohs surgeons who do a fellowship after Dermatology do skin grafts. (I never said I'm a Mohs surgeon so I could care less).

 

[Holmwood]

Bc the hospital makes them be on call. It's part of their contract. Hardly out of the goodness of their heart.

Seems like a dangerous way to do things. Cost-effective, maybe. But having someone half-awake and having them operate on patients is a terrible idea.
The idealistic pre-med in me feels that it's time for someone to come up with a better system.

 

[Instatewaiter]

Clueless premed here.
How come some specialists have to do in-house calls anyway? Can't they just have one person man the mornings and have someone else do night-time shifts?

Many hospitalists do this (ie the IM/Peds/Ob) where there is a person for the day and another at night. Specialists usually take home call and are called in when they are needed (for instance a bad GI bleed that needs to be scoped the same night or an acute abdomen that needs to go to the OR). It is rare for a specialist to be in house unless it is a high volume trauma center.

 

[DermViser]

Seems like a dangerous way to do things. Cost-effective, maybe. But having someone half-awake and having them operate on patients is a terrible idea. The idealistic pre-med in me feels that it's time for someone to come up with a better system.

The hospital doesn't care about your sleep patterns. If there are patients who need operations, they want someone to see them and do so without messing up. If you want to do operations in a hospital and thus need admitting privileges, you have to play by the hospital rules. Don't like it? Don't work for a hospital.

Yeah, there's a reason idealistic premeds shouldn't go to medical school. That's what volunteering experiences are for so that you have a better idea of what you're getting into.

 

[Holmwood]

The hospital doesn't care about your sleep patterns. If there are patients who need operations, they want someone to see them and do so without messing up. If you want to do operations in a hospital and thus need admitting privileges, you have to play by the hospital rules. Don't like it? Don't work for a hospital.

Well I read an article about how specialists are now refusing to respond to calls from emergency departments. Seems terrible to run away from your problems like that since people's lives are on the line. There's got to be a better way to do this... : (

 

[DermViser]

Well I read an article about how specialists are now refusing to respond to calls. Seems terrible to run away from your problems like that since people's lives are on the line. There's got to be a better way to do this... : (

Wrong. If you are on for hospital and it's part of your contract for call and to be called in, you have to do it. You can be sued. What you're referring to is Optho, Derm, ENT, etc. not taking call in the ER in the first place bc it isn't worth it, especially from a malpractice liability standpoint.

 

[DarknightX]

Not sure how you're critiquing a system you've never seen firsthand.

And as said above, you can't refuse to see a consult. You can write a note saying no intervention indicated, but that's after you've come in and evaluated the patient.

 

[Holmwood]

Wrong. If you are on for hospital and it's part of your contract for call and to be called in, you have to do it. You can be sued. What you're referring to is Optho, Derm, ENT, etc. not taking call in the ER in the first place bc it isn't worth it, especially from a malpractice liability standpoint.

Thanks for clarifying that. Anyway, I was reading this and feel terrified... http://www.cnn.com/2012/06/26/health/youn-doctors-fall-asleep/

And yeah, I don't know much about the system. I don't know if residency is worse than the actual practice itself.

 

[DermViser]

Not sure how you're critiquing a system you've never seen firsthand.

And as said above, you can't refuse to see a consult. You can write a note saying no intervention indicated, but that's after you've come in and evaluated the patient.

Actually I have. Like I said, if you don't want to take call and see a consult in the ER, you don't sign up for privileges in a hospital. I never said you sign up for hospital privileges and then refuse a consult. Holwood was talking about "specialists are now refusing to respond to calls from emergency departments." That's not true, in general, unless the specialist has refused to do ER consults in the first place, as part of their contract, in which case there is no actual issue.

 

[DermViser]

Thanks for clarifying that. Anyway, I was reading this and feel terrified... http://www.cnn.com/2012/06/26/health/youn-doctors-fall-asleep/

Yes, Youn is a plastic surgeon and he was talking about residency. If sleep deprivation is a problem for you, then 1) don't do medicine (do Dentistry, PA, whatever) or 2) head into a specialty that doesn't have much of it (although you will have to do one year of internship that has it). Depends a lot on the specialty in question after residency.

Regardless, your MS-3 year will have some element of sleep deprivation in it, so either way you'll have to do it.

 

[Instatewaiter]

PM&R have fellowships to do procedures. So you're wrong about that.

Just because a specialty has (what I'm assuming are) lucrative fellowships, means that people can't like the physiology or mechanics behind the specialty? Look just because there is no conceivable way people could be excited about acne and rashes, doesn't mean this is the case for any other specialty. I know you're trying to portray other specialties as equal sellouts but it's just not going to happen.

 

[Holmwood]

Yes, Youn is a plastic surgeon and he was talking about residency. If sleep deprivation is a problem for you, then 1) don't do medicine (do Dentistry, PA, whatever) or 2) head into a specialty that doesn't have much of it (although you will have to do one year of internship that has it). Depends a lot on the specialty in question after residency.

Regardless, your MS-3 year will have some element of sleep deprivation in it, so either way you'll have to do it.

Everyone suffers from sleep deprivation though! We're only human. : *(
It gets even worse when you're older too. . .


Anyway, this was the article I was talking about for the on-call: http://www.hschange.com/CONTENT/956/. Looks like specialists are refusing on-call coverage, and not so much not responding to calls. So yeah, thanks for the clarification. : )

 

[Ismet]

You didn't get the memo? Only cardiologists are important apparently. A "potted plant could match into psychiatry", derms are sellouts, etc.

The key is to not play into it. That's what he wants. Like a high school bully.

Let it goooooooo. This thread is so far off topic.

 

[DermViser]

Just because a specialty has (what I'm assuming are) lucrative fellowships, means that people can't like the physiology or mechanics behind the specialty? Look just because there is no conceivable way people could be excited about acne and rashes, doesn't mean this is the case for any other specialty. I know you're trying to portray other specialties as equal sellouts but it's just not going to happen.

You said, "It isnt very high paying so the people who go into PMR actually like the subject matter." Considering that PM&R is jokingly called "Plenty of Money and Relaxation" you are wrong. My comment on procedures they do was relating to that

Derm is more than just "acne and rashes", but if you can't see ANY reason why someone would be excited about Dermatology, other than lifestyle and preconceived (wrongly) notions on salary, then I can't help you. Of course, this is from a person who believes that even a potted plant could get into Psychiatry, so I don't have much hope of having a real, serious discussion with you.

Maybe you should have rotated in Derm at Hopkins for a month when you were doing IM, when you had the chance, to see why the Derm attendings at Hopkins do extensive research in skin disease.

 

[DermViser]

Everyone suffers from sleep deprivation though! We're only human. : *(
It gets even worse when you're older too. . .


Anyway, this was the article I was talking about for the on-call: http://www.hschange.com/CONTENT/956/. Looks like specialists are refusing on-call coverage, and not so much not responding to calls. So yeah, thanks for the clarification. : )

It's part of the deal that is baked into the cake of medicine. If you don't like sleep deprivation then medical education is not inherently for you and you'll experience it at various points, regardless of your end specialty.

Your article proves my point: "The diminished willingness of specialist physicians to provide on-call coverage is occurring as hospital emergency departments confront an ever-increasing demand for services." -- meaning they don't sign up for on-call coverage in the first place. Not to mention these are community hospitals. Factors influencing physician reluctance to provide on-call coverage include decreased dependence on hospital admitting privileges as more services shift to non-hospital settings; payment for emergency care, especially for uninsured patients; and medical liability concerns.