Med Student with a question. I always found the challenge of coming with the diagnosis on a patient as the most interesting part of medicine. Yes, treatments and long term relationships are nice, but the diagnosis is what is really stimulating to me. That said, what specialties do you feel really do the most diagnostic work. Medicine? ER? Family Practice? Subspecialists?
Diagnosticians
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Every field diagnoses patients and after you practice long enough, you'll start to see the same things over and over again. If you love the pure art of diagnosing without having to deal with treatment, I would say diagnostic radiology is probably the field that involves just pure intellectual firepower all day long to make diagnoses as fast as possible without needing to dabble in next step care or long term management.
If your question becomes "what field can avoid long term relationships" then probably EM
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Agreed, and if you want to actually see patients a close second to diagnostic radiology would probably be neurology, at least in terms of practicing the "art of diagnosis".
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What about ID, assuming he/she doesn't go the HIV route?
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Rheum is usually consulted when we have weird stuff no one knows what the heck is going on.
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Genetics! If you'd like playing diagnostician with babies.
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What about pathology?
+1 for path.
ID and Rheum both have a variety of weird stuff, but the reality is that every specialty has weird stuff and after long enough, all the weird stuff won't be all that weird.
Path and radiology probably have the most variety...you'll see things that cross specialties.
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Podiatry. Podiatrists are obssessed BIG TIME with conducting a thorough history on new patients in the HPI about their chief complaint and constructing a DDx. I had a foot problem and the podiatrist asked me so many questions to the point of getting nosy. I mean, come on, it is only my foot, not my heart! I asked other people if they noticed this with their podiatrist. They said yes.
IM and Endocrinology as well (my realm)
IM and Endocrinology as well (my realm)
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CL psychiatry/psychosomatic sees really wild zebra cases if your at an academic center. But I don't think I would advise doing any kind of psych if your not into building rapport with patients.
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In my experience the ED, FP, and IM actually make very few definitive diagnosis of the interesting kind.
If you want to make interesting diagnoses, you need to pick a medical sub-specialty IMHO. Rheum, endo, pulm, and ID regularly have cases where you'll have to connect the dots between the history, physical exam, lab, and radiology to make the definitive dx.
If you want to make interesting diagnoses, you need to pick a medical sub-specialty IMHO. Rheum, endo, pulm, and ID regularly have cases where you'll have to connect the dots between the history, physical exam, lab, and radiology to make the definitive dx.
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The best zebra hunter at our hospital can be found in allergy, http://www.austinallergy.com/dr.edwardj.peter.html.
He's board certified in IM and three sub-specialties. Jeez did he want to be a professional student or what
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Considering that podiatry isn't something one goes to medical school for...
Most 'attendings' I know are aware of this fact.
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Well, podiatrists themselves state with pride that they graduated from podiatric MEDICAL SCHOOL, or they say medical school, and they claim that they apply general internal medicine in their practice. Podiatrists also have residencies like us allopaths, I guess that is why they consider their schooling medical school. I mean, they take the same basic science courses as we do in the first two years, with the exception of embryology, neuroanatomy lab, and bahavioral science. I already had a crazy encounter with two of them on the Podiatry SDN, in the Podiatric Residents and Physicians section under the "Patient Case" thread and "Case" thread. Nuts those two....
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Not EM.
We diagnose some things like fractures, MIs, PEs and so on. But we also admit a lot of stuff without a diagnosis like intractable abdominal pain or altered mental status. We certainly don't have the time to sit and go through exhaustive differentials on patients. A lot of what we do is to determine if a patient is at enough risk that they need admission or not.
We diagnose some things like fractures, MIs, PEs and so on. But we also admit a lot of stuff without a diagnosis like intractable abdominal pain or altered mental status. We certainly don't have the time to sit and go through exhaustive differentials on patients. A lot of what we do is to determine if a patient is at enough risk that they need admission or not.
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I think you're missing the point yet again, doctor. Put it this way, you might as well chime in that civil engineers are good diagnosticians, which may be true but nobody cares because medical students don't specialize in civil engineering.