EM or Radiology?

[stud247]

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Hey could you tell me the pros/cons of each? I am applying to medical schools this year. And I think it will be an uphill battle to get into MD (i am going to start SMP in august) but I'll get into DO easily. I know that DO grads can easily match into EM if they do well on Step1(i would make sure to study 24/7). But I've read about how you need 240+ to even have a shot at radiology out of DO(it is necessary but not sufficient).
So taking that aside please tell me more about these specialties?

Here is my impression: as a radiologist or cardiologist you are a true specialist. People come to you and have nobody else to go to at the hospital. They can even call you and you'd be able to give them over the phone better advice than some other doctor would in person. As a perfectionist with a big ego I strive for such level of respect. EM do a lot of procedures, but they cannot even perform a surgery.
On the other hand I always had a fantasy to be a ship doctor.. Perhaps on a ship cruise. I havent been able to find much info on the ship doctors. But I know that EM are the best trained (or at least on par with FM or cardiology) for this job.

And of course both specialties appeal to me because they are lifestyle specialties and I like to have a life outside of school.

 

[dragonfly99]

Here is my impression: as a radiologist or cardiologist you are a true specialist. People come to you and have nobody else to go to at the hospital. They can even call you and you'd be able to give them over the phone better advice than some other doctor would in person. As a perfectionist with a big ego I strive for such level of respect. EM do a lot of procedures, but they cannot even perform a surgery.
On the other hand I always had a fantasy to be a ship doctor.. Perhaps on a ship cruise. I havent been able to find much info on the ship doctors. But I know that EM are the best trained (or at least on par with FM or cardiology) for this job.

And of course both specialties appeal to me because they are lifestyle specialties and I like to have a life outside of school.

ER docs specialize in quickly diagnosing (as well as they can) getting sick patients stabilized and triaging them appropriately (i.e. to home, to ICU, to regular hospital floor). As far as not being able to perform a surgery, neither can radiology, cardiology, or any other doctors besides surgeons. ER docs do a lot of hands on stuff, though, like sewing up cuts, etc. They are probably the most hands on docs other than surgeons...

Cardiology is a subspecialty of internal medicine, which you would do after doing 3 years of internal medicine residency. IM residency is not very hard to get, but cardiology is. Some DO hospitals have their own cards fellowships, but I don't have much knowledge of those...I know that for the MD residents, cardiology is one of the hardest specialties to get coming from internal medicine. GI and allergy/immuno are a bit harder, because there are fewer spots available than for cards. I wouldn't necessarily say cardiologists are more of a specialist than ER docs...it's just a different field. A cardiologist would not be a cruise ship doctor because cards docs don't really deal with food poisoning, sewing up cuts, etc. Also, they could make >> $ practicing cardiology.

It is untrue that a radiologist can give better advice over the phone than another doctor can in person. Sometimes they can "make" the diagnosis when others could not, based on the imaging, but more often they read the study and the doc who ordered the study interprets the result based on the clinical presentation of the patient.

A ship's doctor would likely be a family practice doc, or med/peds, b/c they want you to handle all ages. Also you could do it as an ER doc, but I doubt most would, because they tend to like more action, and could likely make more $$ on shore.

Radiology is hard to get even for MD students, and a 240 board score would not be uncommon at all for a MD student applying to radiology...a number of people with this score won't even match into radiology.

 

[peppy]

As a perfectionist with a big ego I strive for such level of respect. EM do a lot of procedures, but they cannot even perform a surgery.

It sounds to me like we have a future surgeon here! 🙂

Being more serious...

Here is my impression: as a radiologist or cardiologist you are a true specialist. People come to you and have nobody else to go to at the hospital. They can even call you and you'd be able to give them over the phone better advice than some other doctor would in person.

It doesn't sound like you would enjoy radiology if it's important to you to get validation from others. Radiologists occasionally do talk to other docs about a study or are present when a study is being done on a patient, but most of their day is spent sitting at a desk in a dark room by themselves looking at images. They often do play an important role in making a diagnosis but they don't get much credit for it since they never meet or talk to the majority of patients whose studies they are looking at.
Radiology is so competitive nowadays that I don't think you can count on getting it and I don't really advise going to med school if you think you would only be happy if you matched in a hard to get specialty like that.
Even though rads is so desired, it does have trade-offs. Radiologists get sued relatively often, and there is some concern about future job security with the possibility that computers can be used to send radiology images to other countries to be read by foreign docs cheaper.

DOs can definitely get into EM, since there are many, many osteopathic EM residencies that are of good quality. EM certainly requires a lot more patient contact than rads. Again, though, you may be disappointed if you're expecting patients to feed your ego and give you respect. EM docs deal with a lot of homeless people and drug addicts who have a sense of entitlement and may lash out if you don't give them what they want (free bed and meals or narcotics). Other docs may look down on EM docs for missing a diagnosis even though the role of the EM is just to rule out imminently life threatening problems.

Family Medicine is not considered prestigious in the opinion of doctors, but FM docs often have long-term patients who adore them, which could be gratifying. There is some question about the future of FM due to the nurse practitioners and physician assistants taking over a lot of primary care, but the field does offer a ton of flexibility so I could definitely see it being used to get into something like working on a cruise ship.

The bottom line is your best bet is to do rotations or shadow a doc to see what the specialties are truly like. Trying to choose based on prestige and lifestyle may lead to disappointment.

 

[BobA]

Hey could you tell me the pros/cons of each? I am applying to medical schools this year. And I think it will be an uphill battle to get into MD (i am going to start SMP in august) but I'll get into DO easily. I know that DO grads can easily match into EM if they do well on Step1(i would make sure to study 24/7). But I've read about how you need 240+ to even have a shot at radiology out of DO(it is necessary but not sufficient).
So taking that aside please tell me more about these specialties?

Here is my impression: as a radiologist or cardiologist you are a true specialist. People come to you and have nobody else to go to at the hospital. They can even call you and you'd be able to give them over the phone better advice than some other doctor would in person. As a perfectionist with a big ego I strive for such level of respect. EM do a lot of procedures, but they cannot even perform a surgery.
On the other hand I always had a fantasy to be a ship doctor.. Perhaps on a ship cruise. I havent been able to find much info on the ship doctors. But I know that EM are the best trained (or at least on par with FM or cardiology) for this job.

And of course both specialties appeal to me because they are lifestyle specialties and I like to have a life outside of school.

It is very difficult to get into Radiology as a DO. Not impossible, but very difficult. Some DO schools are better than others - some have absolutely great local reputations (UNE, many others) and you might have a better shot from one of the better DO schools.

But you'd have a better chance at getting into Rads from an MD. This would be especially true if the MD school had research opportunities you could get involved in and a strong Rads dept.

Personally, I find radiology to be boring as all get out. IR might be a little different, but I don't find fluro to be that exciting.

I think the bottom line is that you should try your darnedest to get into an American MD school and if you can't then go to the best DO school you can.

I would also STRONGLY urge you to try to go to your state school even that that means an extra year. I wish I had done that, but now have so much debt it's guiding my career decisions.

 

[stud247]

Thank you all. I shadowed some doctors but obviously not enough to know what specialty I would go into. I can say with certainty that if I go to a DO school I will aim for the best EM residency I can get into. If I go into MD, I am not sure. I would certainly consider radiology.

I understand cruiseship drs dont make much. But I'd be interested to learn more about them. From what I've read they certainly get a lot of respect on the ship and a lot of time off. Of course they can be FM, EM, or Internists. I gave this as an example where EM would be considered more of an expert than a radiologist. But at any hospital a radiologist is definitely more of a specialist. If someone has pancreatis or sprained foot, who is going to give the expert advice? While radiologists often don't interact with patients or doctors, it seems that on the complicated cases the surgeon does ask them whether to operate and what he should expect if he operates. If radiologists are not bothered on the easy cases, it just adds to their lifestyle, it doesnt take away from their self-validation. Of course it's probably not entirely like that. I observed an orthopedist. And I feel that the lack of lifestyle would really keep me away from this field. I've seen guys who were much more passionate/interested while observing the surgery... Thats why I would only consider EM or Radiology(either way Ortho is at least as competitive as radiology). I feel in EM I would feel very much inferior to both a surgeon and an internist specialist. But as a radiologist those people would be asking for my expert opinion.

As for DO schools, I plan to apply to 2-3. But since I would no longer shoot for the competitive specialties, I'd like to pick them by location. I thought PCOM had the best reputation among DO schools? Either way I dont like philadelphia. I thought UNE had the same climate as Boston. How can people say it's an outdoorman's paradise if it rains all year? So I would consider NOVA, but I am a bit fed up with the ocean. I am afraid of sharks and it's always hot here. I would consider my best cities geographically Greece, followed by Montreal followed by Milwaukee. But no DO schools there.

 

[medsRus]

These RADIOLOGY programs takes so many IMGs/DOs:

Hospital of Saint Raphael in CT

University of Arkansas

There are a bunch more too! Radiology is very achievable provided you apply broadly geographically. Bye!

 

[Ed Bob]

Stroking your ego is not a good reason to go into medicine. Medicine is very humbling. You will spend a decade of your life as a med student/resident/young attending where you will be at the bottom of the totom pole and will feel very uncertain and inexperienced. There is very little ego stroking even when you are an attending. Patients want what they want and are not afraid to demand it, and everyone else is more likely to criticsize every little mistake you make than praise you for the good stuff you did.

The specialists are just one part of the team that cares for a patient. (in fact too many specialists may just mean fragmented care where no one really sees the big picture on the patient). And when specialists are consulted, no one bows down to them and begs them in their infinite knowledge to save the day. They just put in an order to consult cards.

All fields of medicine take a lot of dedication and knowledge. While some fields do work harder than others, they all work hard, require 7+ years of training, and they all have skills and knowledge that are valuable contributions to patient care. Family medicine is not a particularly prestigious field at this time, but I have a ton of respect for the family doc who can convince someone to take a blood pressure pill, rule/out serious causes of chest pain, diagnose pneumonia by auscultation, pick up on the subtle signs of depression, etc - all during a 15 minute visit. Likewise radiology is good at reading films, emergency is good at stabilizing, ortho is good at bone stuff, cards is good at the heart, psych is good at mental illness, etc. Everyone has their area of expertese and the areas they arent as strong in. The radiologist is good at reading films, but they rely on the emergency doc or primary care doc too. They rely on receiving a clinical picture from the referring doc before they can read - ie "22 yo RLQ pain @ Mcburneys point, positive rebound, WBC 18.8, Temp 99.9"

Ultimately you will be miserable in medicine if your satisfaction comes only from the praise of others. You should only do it if you like caring for people, like the science, like the challenge, and can tolerate all the hard parts. And ultimatelt that guy who goes into medicine to stroke his ego and demands respect and high position, is the guy that everyone makes fun of behind his back. To get respect be honest, be caring, be compassionate, and work hard - and you will get true respect, regardless of what field you go into.

 

[Rendar5]

Thank you all. I shadowed some doctors but obviously not enough to know what specialty I would go into. I can say with certainty that if I go to a DO school I will aim for the best EM residency I can get into. If I go into MD, I am not sure. I would certainly consider radiology.

I understand cruiseship drs dont make much. But I'd be interested to learn more about them. From what I've read they certainly get a lot of respect on the ship and a lot of time off. Of course they can be FM, EM, or Internists. I gave this as an example where EM would be considered more of an expert than a radiologist. But at any hospital a radiologist is definitely more of a specialist. If someone has pancreatis or sprained foot, who is going to give the expert advice? While radiologists often don't interact with patients or doctors, it seems that on the complicated cases the surgeon does ask them whether to operate and what he should expect if he operates. If radiologists are not bothered on the easy cases, it just adds to their lifestyle, it doesnt take away from their self-validation. Of course it's probably not entirely like that. I observed an orthopedist. And I feel that the lack of lifestyle would really keep me away from this field. I've seen guys who were much more passionate/interested while observing the surgery... Thats why I would only consider EM or Radiology(either way Ortho is at least as competitive as radiology). I feel in EM I would feel very much inferior to both a surgeon and an internist specialist. But as a radiologist those people would be asking for my expert opinion.

A few points, as EM is a very young field, there is no "best" EM program. As far as a case of pancreatitis, the EM doc and the internists are gonna be more expert in its management than a radiologist. The role of the radiologist is to assist in classifying the pancreatitis (e.g. telling if hemorrhagic and if/% of necrosis). AS for stuff like sprained feet, the ED doc is gonna determine if there's a need for X-rays or not (if there aren't specific clinical criteria, it's kind of pointless to X-ray an ankle). The radiologist is gonna catch the subtle fractures if they're there, but ED still catches the obvious ones. The ED doc will reduce most of them in the community and plaster them and give crutches. At an academic hospital theo rthopod will be consulted. If it's complex and needs surgery, then the orthopod does it there or sees the pt as an outpatient.

As someone going into EM, I do not feel inferior in the least to a surgeon or an internist. I'm a specialist in dealing with the undifferentiated patient and getting them where they need to be, I'm a specialist in managing the crashing patient, I'm a specialist in resuscitation, I'm a specialist in ruling out life-threatening illness. And when I'm not being a specialist in something I specializing in, I get to be a jack-of-all-trades. Of course, what I don't always get are nice patients (neither does any field for that matter), including drunk patients and combatitive patients, I don't always get respect from consults (at least in academic fields where consulting them means giving them extra work). But it's fine. I love the field. If you want your ego stroked though, this is not the field for you at all. You get to feel good when you know you saved the patient, not when someone told you you did or when the patient comes and thanks you after recovering (with some rare exceptions)

But the surgeons and the internists are more expert than I am in stuff I don't do, which obviously includes elective and life-saving surgeries, catching none-life threatening zebras, dealing with chronic care, seeing patients through to the end of their illness course, and making subtle diiagnoses after following the illness for a couple to few days.

 

[dragonfly99]

excellent posts by Ed Bob and Rendar.
I agree 100%.
I also am concerned about the tone of the OP's posts, and what seems to be a preoccupation with respect and status. If the OP really feels like that, he/she might end up disappointed with a medical career. Any field that requires that many years of training (i.e. being an underling) might cause him/her a lot of angst if prestige is that important. Also, any field that has direct patient care is going to involve taking a lot more crapola from people (other doctors, patients and their families, nurses, etc.). In that sense, radiology might be better for the OP. However, I don't think the OP should have the perception that radiologists are more respected by patients or other physicians than are other specialties.

If someone asks me which docs I respect the most, I'm probably gonna say neurosurgeons because their training is hellish and long, and most of them have very high IQ's and a great work ethic, or they'd never have gotten into neurosurg residency. Radiology and derm, while hard to get in, have some slackers (not that I'm saying most people in those fields are slackers...I'm just saying there are some, whereas in neurosurg or traums surg or something, there basically are no slackers b/c they'd just wash out of the residency). I also have a lot of respect for a good primary care physician or geriatrician, just because what they do is hard and requires a lot of time, etc.

 

[Winged Scapula]

The OP has a fair number of misconceptions in his post. As DF notes, respect for physicians is at an all time low and will likely get worse. I cannot tell you the number of pts who call me by my first name and in discussing this with colleagues, I am not alone. Perhaps its gender or age based but I find it disrespectful.

Additionally while I appreciate radiologists and utilize them frequently, they are not making the diagnosis for me nor are they telling me when to operate. Surgical disease is often a clinical diagnosis and regardless of what the study shows/doesnt show, a patient with a PE exam consistent with appendicitis, pancreatitis or a breast malignancy is going to be treated in the appropriate surgical fashion. To state that radiologists TELL surgeons when to operate is to grossly misunderstand the contributions of both specialties.

 

[mercaptovizadeh]

The OP has a fair number of misconceptions in his post. As DF notes, respect for physicians is at an all time low and will likely get worse. I cannot tell you the number of pts who call me by my first name and in discussing this with colleagues, I am not alone. Perhaps its gender or age based but I find it disrespectful.

Additionally while I appreciate radiologists and utilize them frequently, they are not making the diagnosis for me nor are they telling me when to operate. Surgical disease is often a clinical diagnosis and regardless of what the study shows/doesnt show, a patient with a PE exam consistent with appendicitis, pancreatitis or a breast malignancy is going to be treated in the appropriate surgical fashion. To state that radiologists TELL surgeons when to operate is to grossly misunderstand the contributions of both specialties.

A side question, but how much diagnosis do you make as a surgeon? I was under the impression that most diagnoses are made by medicine/peds/subspecialties in concert with radiology and pathology, and that surgeons primarily fixed things that were already known. Obviously that's an ill-founded impression...

 

[Rendar5]

I would guess it really depends on the type of surgery. From my limited experiences, Vascular surg was very much surgeons making the final dx. Gen surg was a mix with usually ED suspicion and surgical finalization of dx's for the more emergent GI issues. Cancers seemed to have a pretty solid mixture of how the initial diagnosis was made (with pathologists having final say at certain points on the exact nature of the cancer).

I guess exceptions would be the occasional chole that I saw on medicine. But by and large, I didn't see surgical patients on the medical service. Only in the ED and surgical floors.

 

[mercaptovizadeh]

I would guess it really depends on the type of surgery. From my limited experiences, Vascular surg was very much surgeons making the final dx. Gen surg was a mix with usually ED suspicion and surgical finalization of dx's for the more emergent GI issues. Cancers seemed to have a pretty solid mixture of how the initial diagnosis was made (with pathologists having final say at certain points on the exact nature of the cancer).

I guess exceptions would be the occasional chole that I saw on medicine. But by and large, I didn't see surgical patients on the medical service. Only in the ED and surgical floors.

So if an internist/pediatrician sees something that is likely going to need surgical intervention, does he just refer the patient over to surgery and let them make the diagnosis, or is it his job to work up the diagnosis and transfer the patient with an established diagnosis to surgery?

Also, how much medicine do general surgeons know? Is it just managing post-op and pre-op or do they know things like managing chronic stuff like thyroid disease, diabetes, CHF, COPD, etc. The only general surgeon I knew (at a mission hospital) was making medical diagnoses just like the family medicine docs (possibly even a better medical diagnostician, to be honest), and then he did surgeries. But that doesn't seem to be a norm that would carry over in the US.

 

[Rendar5]

So if an internist/pediatrician sees something that is likely going to need surgical intervention, does he just refer the patient over to surgery and let them make the diagnosis, or is it his job to work up the diagnosis and transfer the patient with an established diagnosis to surgery?

Also, how much medicine do general surgeons know? Is it just managing post-op and pre-op or do they know things like managing chronic stuff like thyroid disease, diabetes, CHF, COPD, etc. The only general surgeon I knew (at a mission hospital) was making medical diagnoses just like the family medicine docs (possibly even a better medical diagnostician, to be honest), and then he did surgeries. But that doesn't seem to be a norm that would carry over in the US.

Well in the first case from what I've seen, they usually consult the surgeon while working the patient up unless they're concerned it's an emergent issue in which case they would just send straight to surgery. Surgeons need to know the disease from the surgical perspective since they're more equipped to know if the patient needs surgery or not. When i was on surgery rotation, the really good ones told me the most important role of the surgeon is to know when not to cut someone open. BTW, if that happens that they get mistriaged like that, bad on me, lol

As for the second question, yeah that norm doesnt' seem to carry over to the US. At least in academics, and surgery residenyts seemed ill-equipped to know how to manage diabetes, hypertension, and other chronic health issues that don't relate directly to their expertise since this isn't what they train in. (not a dig at surgeons. I know a bit beyond the basics of day-to-day diabetes and htn management as a sub-I, and I'm sure I will forget it within a year since I won't be training in that.)

 

[Winged Scapula]

A side question, but how much diagnosis do you make as a surgeon? I was under the impression that most diagnoses are made by medicine/peds/subspecialties in concert with radiology and pathology, and that surgeons primarily fixed things that were already known. Obviously that's an ill-founded impression...

It is ill founded.

I suppose you could get into semantic details and say that because the pathologist definitively makes the diagnosis based on the biopsy or surgery results, they are the diagnostician. However, what you are neglecting that this and radiology are confirmatory studies in many cases. It doesn't take a radiologist or pathologist to tell me that a 50 year old woman with skin retraction, a palpable breast mass and a hypoechoic irregular mass with shadowing and spectral reflectors on my ultrasound has a breast cancer.

The classic example is a male patient with RLQ pain, fever, elevated white count but with a normal CT scan (if one was obtained - which it may be by the ED). This is clinically appendicitis and the patient goes to the OR for surgery without a pre-operative diagnosis as the vast majority of the time the surgeon's clinical impression of appendicitis will be correct. The same is true for pancreatic masses - the patient is operated on without a tissue diagnosis - and many other presentations.

In fellowship I looked under the microscope myself right then and there while the patient was in the office and gave them the provisional diagnosis on my biopsies.

I am not discounting the value of these specialists. It is true that in many cases the patient does come to the office of the surgeon already biopsied, already studied, already diagnosed. Sometimes all that is left is for the patient to go to the operating room (if necessary and able to tolerate), sometimes the wrong work-up was done, or an incomplete one. However, surgery, like all medicine, is clinical. In this day and age of very fancy imaging techniques, students and residents tend to forget this and assume the diagnosis cannot be made. In most cases, there is enough clinical signs and symptoms that when coupled with the history, that the clinical suspicion is very high (and accurate). I HAVE seen surgeons who let others do the work-up and diagnosis for them and are simply happy to be told what to do. I consider these inadequate surgeons who are not assuming the responsibility of care for their patients and are simply relegating themselves to a technician.

My response is no different than it would be (or should be) from an internist when you assume the diagnosis of (let's say) pneumonia is made by others. The diagnosis has already been made by the internist when he/she sees the patient with a productive cough, rales, etc.. The chest xray is confirmatory, not diagnostic. The EP doesn't need a CT head to tell him/her that the elderly hypertensive with hemiplegia and slurred speech has had a stroke. And so on...

Surgeons do manage peri-operative medical conditions. This is mostly true in academic hospitals; I find in the community there is a greater push to consult medicine for these issues. Frankly, surgeons, in most cases, are quite capable (having spent a number of months to over a year in ICUs) managing these issues and it is necessary that we can. As opposed to Rendar's statement, you don't forget how to do these things because you are writing for your patient's diabetes management, for acute changes in blood pressure, etc. Chronic disease management is however the forte of medicine and not something most surgeons do (with the exception of some surgical diseases requiring long term medical management, and yes, thyroid disease, even when not surgical is fair game for the surgical boards, so we have to know that).

 

[BobA]

Stroking your ego is not a good reason to go into medicine. Medicine is very humbling. You will spend a decade of your life as a med student/resident/young attending where you will be at the bottom of the totom pole and will feel very uncertain and inexperienced. There is very little ego stroking even when you are an attending. Patients want what they want and are not afraid to demand it, and everyone else is more likely to criticsize every little mistake you make than praise you for the good stuff you did.





Ultimately you will be miserable in medicine if your satisfaction comes only from the praise of others. You should only do it if you like caring for people, like the science, like the challenge, and can tolerate all the hard parts. And ultimatelt that guy who goes into medicine to stroke his ego and demands respect and high position, is the guy that everyone makes fun of behind his back. To get respect be honest, be caring, be compassionate, and work hard - and you will get true respect, regardless of what field you go into.

👍👍

 

[michaelrack]

So if an internist/pediatrician sees something that is likely going to need surgical intervention, does he just refer the patient over to surgery and let them make the diagnosis, or is it his job to work up the diagnosis and transfer the patient with an established diagnosis to surgery?

.

This varies a lot depending on type of surgeon and setting (academic vs community). An academic or resident internist is typically going to do more of a workup than a community internist.

As a community internal medicine subspecialist in the field of sleep medicine, I refer a lot of patients to my ENT colleagues for nasal/sinus issues related to cpap. I rely on them to do the work up (CT/endoscopy), make the diagonosis, and treat- which may include nasal sprays, removal of nasal polyps, reduction of turbinates, etc... (usually I will try things within the realm of my specialty, including steroid nasal sprays, adjustment of the cpap heated humidifier, switching mask type before sending them to ENT). So it's a partnership between the internist and surgeon. If I was in an academic setting, I might do a little bit more of the work up myself, such as sticking those metal things (forgot the name) in the nose and taking a closer look myself.

 

[stud247]

Hey thanks for all the info but I haven't read anything new in this thread! The job of EM has been discussed in many previous threads. And well I still feel I were EM I would be a surgeon's or a cardiologist's bitch. I don't mean it literally, but I think EM are much more replaceable by other doctors. Also, I've shadowed EM and Surgeons. But Ive never shadowed a radiologist or a pathologist. And I don't see the point of shadowing them if they just look at an image or at a microscope. If I don't know what the image represents, then I cannot determine the extent to which their job is "intellectual" or useful.

I think it is important for me to know if Radiology or EM is best for me. Because if I am shooting for EM, I will try army hpsp. But if I'm doing radiology then I will try navy hpsp(that way I'll take 3yrs of gmo tour before residency but it will help me match but i will be much older). Is there any way to pick the specialty before matriculating at a med school? I know some people are certain they want to be surgeons just after watching 1 surgery or dissecting a cadaver. I've done both and it hasn't sold me on surgery.

 

[Winged Scapula]

Hey thanks for all the info but I haven't read anything new in this thread! The job of EM has been discussed in many previous threads. And well I still feel I were EM I would be a surgeon's or a cardiologist's bitch. I don't mean it literally, but I think EM are much more replaceable by other doctors. Also, I've shadowed EM and Surgeons. But Ive never shadowed a radiologist or a pathologist. And I don't see the point of shadowing them if they just look at an image or at a microscope. If I don't know what the image represents, then I cannot determine the extent to which their job is "intellectual" or useful.

I think it is important for me to know if Radiology or EM is best for me. Because if I am shooting for EM, I will try army hpsp. But if I'm doing radiology then I will try navy hpsp(that way I'll take 3yrs of gmo tour before residency but it will help me match but i will be much older). Is there any way to pick the specialty before matriculating at a med school? I know some people are certain they want to be surgeons just after watching 1 surgery or dissecting a cadaver. I've done both and it hasn't sold me on surgery.

Is there some pressing reason why you feel the need to decide on your specialty now, before experiencing any clinical rotations? Seems a bit premature to me, and the fact that you continue to describe very important and interesting fields in medicine as being someone's "bitch" honestly tells me you have no idea what goes on in medicine.

The EP is no one's bitch. They serve a different job than the surgeon or the cardiologist, a very important one for which they are not very well respected or appreciated by the medical community (which is contrasted by the general public who seem to think that being an EP is amongst the most glamourous og jobs).

Radiologists do more than sit around and look at films; I keep mine pretty active doing localization of tumors and biopsies. Pathologists also do more than just look down the microscope..in many hospitals they are also responsible for doing biopsies.

Again, I'm not sure why you seem hell bent on figuring this all out as a pre-med. Nearly every medical student who makes up their mind before ever doing a single clinical rotation during medical school will change their mind. I suggest you focus on getting into medical school first and stop wondering which job will give you the most prestige and contributing to stereotypical views of the field.

 

[Dissonance]

As a perfectionist with a big ego I strive for such level of respect. EM do a lot of procedures, but they cannot even perform a surgery. "
And of course both specialties appeal to me because they are lifestyle specialties and I like to have a life outside of school.

Judging by this ill-informed statement, and the other irrational post you posted above, I would seriously consider yourself lucky that as many articulate and affluent SDN members even gave you the time of day for this one.

 

[stud247]

Is there some pressing reason why you feel the need to decide on your specialty now, before experiencing any clinical rotations? Seems a bit premature to me, and the fact that you continue to describe very important and interesting fields in medicine as being someone's "bitch" honestly tells me you have no idea what goes on in medicine.

The EP is no one's bitch. They serve a different job than the surgeon or the cardiologist, a very important one for which they are not very well respected or appreciated by the medical community (which is contrasted by the general public who seem to think that being an EP is amongst the most glamourous og jobs).

Radiologists do more than sit around and look at films; I keep mine pretty active doing localization of tumors and biopsies. Pathologists also do more than just look down the microscope..in many hospitals they are also responsible for doing biopsies.

Again, I'm not sure why you seem hell bent on figuring this all out as a pre-med. Nearly every medical student who makes up their mind before ever doing a single clinical rotation during medical school will change their mind. I suggest you focus on getting into medical school first and stop wondering which job will give you the most prestige and contributing to stereotypical views of the field.

I feel that if I were set on EM, I could go to a DO school. But Radiology would not be realistic. Also whether I go to MD or DO school, I would consider HPSP. But even if I have strong boards I would never match into military radiology. I would have to do 3yrs gmo +5yrs residency before I became a radiologist(and they also do fellowships?) while in EM it is possible to go straight through. EM is not perfect but I have some idea of what theyre doing. I would be even more insecure if other doctors disrespected me than if patients disrespected me. And while patients may respect ER(because of tv), unless they are ignorant, they know that EM are not specialists. That you would never go half way across the country to see an EM(that's ultimate respect). But regarding radiologists, I cannot tell whether looking at a film is interesting or boring.

 

[mercaptovizadeh]

I feel that if I were set on EM, I could go to a DO school. But Radiology would not be realistic. Also whether I go to MD or DO school, I would consider HPSP. But even if I have strong boards I would never match into military radiology. I would have to do 3yrs gmo +5yrs residency before I became a radiologist(and they also do fellowships?) while in EM it is possible to go straight through. EM is not perfect but I have some idea of what theyre doing. I would be even more insecure if other doctors disrespected me than if patients disrespected me. And while patients may respect ER(because of tv), unless they are ignorant, they know that EM are not specialists. That you would never go half way across the country to see an EM(that's ultimate respect). But regarding radiologists, I cannot tell whether looking at a film is interesting or boring.

The only way you are going to become someone whom patients come to see from across the country and world is if you super-super-specialize in something and become the best person in it. For example, there's a guy called Michael Pranzatelli in Illinois who claims to be an expert in opsoclonus myoclonus and in fact he does get patients from around the country coming to him, which then bolsters his claims of having unique expertise. Do you realize how rare OMS is? If you want people to come to you as if you were the Pythia of Delphi, you need to superspecialize in something rare.

 

[Winged Scapula]

I feel that if I were set on EM, I could go to a DO school. But Radiology would not be realistic. Also whether I go to MD or DO school, I would consider HPSP. But even if I have strong boards I would never match into military radiology. I would have to do 3yrs gmo +5yrs residency before I became a radiologist(and they also do fellowships?) while in EM it is possible to go straight through. EM is not perfect but I have some idea of what theyre doing. I would be even more insecure if other doctors disrespected me than if patients disrespected me. And while patients may respect ER(because of tv), unless they are ignorant, they know that EM are not specialists. That you would never go half way across the country to see an EM(that's ultimate respect). But regarding radiologists, I cannot tell whether looking at a film is interesting or boring.

You're trying to do the unrealistic and unreasonable. Life is not this controllable and what you want at age 20 is not necessarily what will interest you at 30, 45 or 60. You are trying to make a decision without a shred of experience to allow you to do so. NO ONE here can tell you that you should be <insert speciality X> nor should you be making these decisions based on where you go to medical school.

There is no way you can know what you will be interested in at this stage of the game. Even if you decided now that you want to be a radiologist, you may find that you don't enjoy it as much as you thought, or you may find something else you like better.

Please go to the best medical school you can get in to; enjoy your clinical rotations and pick something which satisfies your intellectual curiosity and will make you happy for the next 35 years. As noted above, a physician whom others cross state or country lines for is exceedingly rare and often treats the zebras. You cannot plan your life out like this in advance.

 

[Cp22kjer]

Great info in the first half of this thread. Thanks to those who contributed.

 

[doc4life95]

You're trying to do the unrealistic and unreasonable. Life is not this controllable and what you want at age 20 is not necessarily what will interest you at 30, 45 or 60. You are trying to make a decision without a shred of experience to allow you to do so. NO ONE here can tell you that you should be <insert speciality X> nor should you be making these decisions based on where you go to medical school.

There is no way you can know what you will be interested in at this stage of the game. Even if you decided now that you want to be a radiologist, you may find that you don't enjoy it as much as you thought, or you may find something else you like better.

Please go to the best medical school you can get in to; enjoy your clinical rotations and pick something which satisfies your intellectual curiosity and will make you happy for the next 35 years. As noted above, a physician whom others cross state or country lines for is exceedingly rare and often treats the zebras. You cannot plan your life out like this in advance.

On the other hand, plans are an important way to realize your goals.