Changing Specialties

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UserNameNeeded

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So you've got your degree and you're a doctor. You've finished up your residency in pediatrics. You practice for a year and decide it's impractical for you to practice pediatrics in that location (say it's a retirement community with few kids). You absolutely cannot (or don't want to) move from that location. How easy is it to make a lateral move to geriatrics?

What do you need to go through and do to go from being a pediatrician to a geriatrician? 😳
 
Young people are just smaller versions of the elderly. I don't think the switch will be impossible.
 
Well, I'm not talking about so much the knowledge base, but the more technical side. Like, do you have to do a geriatric residency, are there licensing issues, etc.?

And, really, I'm not even talking about peds versus ger. This can apply to changing from any specialty to another. In my (very limited) experience, I've never heard of a doctor changing specialties once they were in practice.

I've heard of a doctor who got his MD degree, than got a DO degree and then like 4 or 5 other things to put after his name. But he's never changed his specialty.
 
There was a surgeon - a neurosurgeon, I think - who got in a car wreck and couldn't do surgery anymore. He went back through residency for int med when he was like 45 or 48. I don't know if it was required for him to get board-certified or not, but it certainly seems likely. I spose if you don't want to be board certified in a different specialty then you could get away with no residency for that specialty. You're still a doctor after all.
 
UserNameNeeded said:
And, really, I'm not even talking about peds versus ger. This can apply to changing from any specialty to another. In my (very limited) experience, I've never heard of a doctor changing specialties once they were in practice.

It can be done by pursuing a fellowship. If you trained in Peds though and suddenly you don't have any pediatric patients you might have to do another residency. I have a friend who did three residencies. IM, Peds and Psych. A professor of mine did IM then Derm then Derm Path. And of course there are all the combined residencies like, IM/ER, IM/Psych, IM/Peds.

From Peds to Geriatrics would require at least a couple more years to get IM or FP.

That's the beauty of medicine.
 
apply to a FM residency and pursue geriatrics. IM would be just be unnecesssary torture.
 
twintiger32 said:
apply to a FM residency and pursue geriatrics. IM would be just be unnecesssary torture.

Why is it unnecessary torture?

So what's the broadest, most flexible residency to go for if you want to keep your options open for later, should you want to or need to change specialties?

Thanks for the info you guys (and girls). 👍
 
Well you need to make some decisions. Do you want to be a surgeon or not? That is the question. 🙂
 
UserNameNeeded said:
Why is it unnecessary torture?

So what's the broadest, most flexible residency to go for if you want to keep your options open for later, should you want to or need to change specialties?

Thanks for the info you guys (and girls). 👍

IM residency is torture because it's 80 hours a week. FM would be more in the 50-60 hours range.

Family medicine is by far the most broad of the specialties. However, I don't think that there is too much movement once you are in that field. IM was probably be the most flexible.
 
UserNameNeeded said:
I've heard of a doctor who got his MD degree, than got a DO degree .

Uhm - no, no you have not heard of this happening.
 
Flopotomist said:
Uhm - no, no you have not heard of this happening.

Yup. He has a joint practice with his wife and she puts the initials for all of her degrees on it, too, to parody him. :laugh:
 
UserNameNeeded said:
Yup. He has a joint practice with his wife and she puts the initials for all of her degrees on it, too, to parody him. :laugh:
When I was in the army, we used to have a flag in the office that we would throw if anybody was saying something too incredulous to believe. We called it the BS flag, and I throw it down now. There is no point in getting a DO after having an MD.
 
Flopotomist said:
When I was in the army, we used to have a flag in the office that we would throw if anybody was saying something too incredulous to believe. We called it the BS flag, and I throw it down now. There is no point in getting a DO after having an MD.

Actually the first DO was an MD...he's the only one...since he invented the DO after becoming a Medical Doctor, but that was more than 100 years ago.
 
UserNameNeeded said:
Why is it unnecessary torture?

So what's the broadest, most flexible residency to go for if you want to keep your options open for later, should you want to or need to change specialties?

Thanks for the info you guys (and girls). 👍

You can't go from peds to geri without additional training because in a pediatric residency you only see children. You would have no training at all in adults, let alone elderly adults. The most flexible residency in the way you're asking the question is probably family practice because you are trained to take care of patients of all ages. The good thing about FP is that you can tailor your practice to see the patients you want to see. Some FPs see lots of kids, some see mostly women, some see older adults or adolescents. The bad thing about Family Practice is that there are very few fellowships. That's why people often choose pediatrics or medicine over FP, at least in my experience.
 
golftrippy said:
Actually the first DO was an MD...he's the only one...since he invented the DO after becoming a Medical Doctor, but that was more than 100 years ago.
Hmm - well, assuming it wasn't that guy - I still throw the BS flag.
 
Flopotomist said:
When I was in the army, we used to have a flag in the office that we would throw if anybody was saying something too incredulous to believe. We called it the BS flag, and I throw it down now. There is no point in getting a DO after having an MD.

Flag him:

http://www.worldhealth.net/p/142.html 🙂

And there are other examples, I'm sure. Some people do like to get multiple degrees, whether it be during their undergrad or at the most advanced stage of higher education. I know if I had all the time and money in the world, I'd get as educated as possible. Get a degree, apply that degree for mankind until I'm bored in a few yeras, get another degree, work with the new and old knowledge for a few years, get another degree and so on and on.

Wednesday said:
You can't go from peds to geri without additional training because in a pediatric residency you only see children. You would have no training at all in adults, let alone elderly adults. The most flexible residency in the way you're asking the question is probably family practice because you are trained to take care of patients of all ages. The good thing about FP is that you can tailor your practice to see the patients you want to see. Some FPs see lots of kids, some see mostly women, some see older adults or adolescents. The bad thing about Family Practice is that there are very few fellowships. That's why people often choose pediatrics or medicine over FP, at least in my experience.

Thanks! I really don't have good feelings toward Family medicine (and I have no particular reason as to why I feel that way or why twintiger32 said to go for FM over IM-- I would love to hear his reasons), but I think I'm most comfortable with primary care so that leaves Internal medicine to give me the broadest patient range, huh? Pediatrics and Geriatrics would be the alternatives, either or. Hmm...

Is it true that Family Practice is being phased out and won't exist in a decade or two? Someone told me this, but they never explained why.
 
UserNameNeeded said:
Flag him:

http://www.worldhealth.net/p/142.html 🙂

And there are other examples, I'm sure. Some people do like to get multiple degrees, whether it be during their undergrad or at the most advanced stage of higher education. I know if I had all the time and money in the world, I'd get as educated as possible. Get a degree, apply that degree for mankind until I'm bored in a few yeras, get another degree, work with the new and old knowledge for a few years, get another degree and so on and on.

Uhm - he got a DO after his "MD" because his "MD" came from a bogus school that was not recognized in the US. I am all for furthering your education, but out of respect for the DO community, would not suggest that an MD is so dramatically different that anybody should get both degrees.
 
Wednesday said:
The bad thing about Family Practice is that there are very few fellowships. That's why people often choose pediatrics or medicine over FP, at least in my experience.

What is so great about fellowships?
 
yposhelley said:
What is so great about fellowships?

Well if you want to specialize in Cardiology, Rheumatology, Gastroenterology, Pulmonology, Oncology, Hematology, or Infectious Diseases, you need a fellowship. And you may not be able to get one with a residency in Family Practice.
 
skypilot said:
Well if you want to specialize in Cardiology, Rheumatology, Gastroenterology, Pulmonology, Oncology, Hematology, or Infectious Diseases, you need a fellowship. And you may not be able to get one with a residency in Family Practice.

Thanks. I asked this question before several weeks ago, but I forget what fellowship is. The way it was explained to me was that its like a subspecialty. Is that right?
 
yposhelley said:
Thanks. I asked this question before several weeks ago, but I forget what fellowship is. The way it was explained to me was that its like a subspecialty. Is that right?

Yeah the terminology is a little confusing. Medicine has gotten so specialized that lots of people do a residency and then a fellowship which is just another residency on top of your base residency!

Your residency might be something like general surgery or internal medicine or radiology and your fellowship might be cardiothoracic surgery, or gastroenterology, or neuroradiology. 🙂
 
UserNameNeeded said:
Thanks! I really don't have good feelings toward Family medicine (and I have no particular reason as to why I feel that way or why twintiger32 said to go for FM over IM-- I would love to hear his reasons), but I think I'm most comfortable with primary care so that leaves Internal medicine to give me the broadest patient range, huh? Pediatrics and Geriatrics would be the alternatives, either or. Hmm...

Is it true that Family Practice is being phased out and won't exist in a decade or two? Someone told me this, but they never explained why.

Always keep an open mind.

The reason to go for FP if you want to stay completely flexible along the lines of ages of patients because they are trained in primary care to take care of patients of all ages. Internal medicine physicians are only trained to take care of adults and pediatricians are only trained to take care of children. So if you were in FP and wanted to change from taking care of kids to taking care of a geriatric population, you could without any additional training. If you chose IM or Peds you would not be able to be that flexible. Make sense?
 
Wednesday said:
Always keep an open mind.

Always good advice! 👍

So if you were in FP and wanted to change from taking care of kids to taking care of a geriatric population, you could without any additional training. If you chose IM or Peds you would not be able to be that flexible. Make sense?

Thank you. Totally makes sense now. So what are the drawbacks/cons of practicing FM?

I've seen a lot of physicians practicing FM in rural settings, but very few in urban and suburban areas. I understand why there would be a ton of FPs in the country, but why are there so few in sub\urban areas? Is it because urban-dwellers prefer specialized generalists like Peds, IMs, Ger? Did that question make sense? :laugh:
 
I totally disagree with doing FP. FP is a dead end specialty, if you want to change and do something else you have to repeat the entire residency. If you are unsure of peds or geriatrics then do Med/Peds residency, you will be boarded in peds and IM.

Skialta MSIII
 
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