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Best specialty for international exposure/travel

Winged Scapula

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  1. Attending Physician
    So what do you guys think is the best specialty for international travel? ID? Academic medicine on the lecture circuit? Rural medicine and a serious case of wanderlust?


    What is it you want to do?

    If you want to take time off and work with something like Doctors with Borders - they want general and trauma surgeons, EM trained physicians and occ. FP with OB experience.

    If you want to move to another country and work, hard to do without moving there, training there and passing exams. However, if you are an internationally recognized expert in your field, it becomes somewhat easier as most governments have provisions for such people.

    You can always apply to do something like Tropical medicine in Africa or the top end of Australia as a fellowship and then come back to the US, but staying does become difficult unless you do it with a charity or missionary group.
     
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    AmoryBlaine

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      Solid FP program with good OB training - you'd be head and shoulders above any other specialty.

      I think people tend to equate "international work" with "disaster relief" but the 2 are totally different. If you're going to drop into some danger zone the day after a tsunami or an 8.9 earthquake then yeah, maybe that "wilderness medicine" (whatever the heII that is) training will help you.

      I would guess that out of 1000 students who want to do "international medicine" fewer than 100 will ever actually do anything and maybe 2 of them will work in true disaster settings. If you really want to help out go over and do health education/promotion with your preventative health (FP!) training.
       
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      deleted77919

        Anesthesia or rads. You get lots of vacation time and have a salary that will allow you to spend a lot of time in Paris, Waikiki Beach (I know, Hawaii isn't international, but still far away and beautiful!), Phuket, Sydney, wherever your little heart desires.

        Unless you mean you want to do medicine internationally in which case, yeah, typically not so easy. You see that many people are suggesting FM. If you are in FM it isn't so easy to send a mailer out to your patients that says "Dr. Dakota will be away from the office for the next six months. Should any medical emergency arise please refer yourself to the nearest emergency department." Well, I suppose you could but you won't have any pts upon your return and the ED physicians will hate you.
         

        SocialistMD

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          All medical missions/trips don't have to be for an extended period of time. In medical school, one ID attending would take interested medical students to Guatemala for six weeks. A neurosurgeon I know goes to Central America every year for 2-4 weeks to operate. The transplant surgeons at the University of Pittsburgh have their own hospital in Italy where they go for a month each year to perform many transplants. Baylor College of Medicine has a similar hospital in Romania established for the treatment of HIV.
          In short, every specialty is needed for overseas work. Decide what you enjoy most and do that; the work abroad will be there regardless of what you choose.
           
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          deleted77919

            As a clarification, we have several surgical faculty here who do international work (I'm sure other departments do as well, I'm just not as familiar with them). Essentially these people take their vacation time and go to developing countries to operate pro-bono, bring supplies they got donated, etc. The most active faculty member (who I swear doesn't require sleep) suggests if you are interested in international medicine to not mention it to a residency program, and certainly don't mention it when looking for a job. After you've secured a spot, then figure out how to get done what you want. Just that faculty member's $0.02.
             

            NewmansOwn

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              I second ID. There was a story on NPR this morning about an ID doctor who worked for the Peru field office of the Johns Hopkins School of Public Health. She trekked through the forest all day long documented the effects of deforestation on the spread of disease.
               

              crazy4clana

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                I saw a poster for Doctors Without Borders and it said they wanted any type of physicians and aneisthesiologists <- not even trying to spell that right.

                You're good with any general specialty as long as it isn't TOO specific.
                 

                roja

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                  Winged Scapula has illustrated one of the most important points: you need to define what you mean by international medicine. Do you just want a specialty that will allow you every year or two to go work in a clinic or hospital in the third world? You can do almost anything and do that. Its called tourism medicine by most international health people.

                  Do you want to just be able to go cool places? becoming an expert with an eye on an international speaking career can get you there.

                  Do you want to do disaster relief (ie UN types of missions going into kenya when it becomes politically unstable?) or do you want to work with organizations trying to impact the health of third world countries?

                  I actually just spent time talking to a MS4 who has done extensive international work and wants to work with organizations like unicef etc to affect the health in third world (this tends to be the true meaning of 'international medicine' by those that practice it).

                  There are several major fields you can go into: EM, Peds, or FP. Look for fellowships with MPH's and see which ones have the bent you are interested in. ID is not bad, but we have an international guy (he works with the UN, goes all over the world, has built hospitals, etc) and he is triple boarded: IM/ID/EM. He did an EM residency because he realized ID didn't really prepare him for international medicine. However, he does still enjoy it because he does travel medicine.

                  Start looking for people who are practicing it and talk to them.
                   
                  I am planning on doing EM because I think it gives the best flexibility for international work. FP would be good, except as another poster mentioned, it's not so easy to just take time away from your clinic if you expect to come back to find patients. With EM you don't have a history with your patients (unless you count the local junkie who comes in 5 times a week to get out of the cold/get pain pills). Plus with EM you get a good general knowledge of medicine and acute care.

                  That's my thinking.
                   

                  Drogba

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                    ID seems to be overrepresented in international and "activist" (going beyond biomedicine and addressing political, institutional and economic structures) medicine. I think this is because infectious diseases really place socieconomic disparities into sharp relief. Also, mortality from communicable diseases represents a interventional/institutional failure more than they represent an absence of effective treatment. AIDS and TB, for example, are so intimately linked with the social geography of an area that its almost disingenous to say the cause of AIDS is HIV or the cause of TB is Myobacterium tuberculosis.

                    Like Roja said its important that you have a clear idea of what you mean by "international work." PIH (www.pih.org) represents the model I'm personally most interested in.
                     
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