Equal work for equal pay

[swamprat]

Do you really not see the difference? Internal Medicine is a specialty - think of it like a tree. The subspecialties: Cards, GI, Heme/Onc, are the branches. Same with Surgery - think of it like a tree. The subspecialties: Surg Onc, CT, Plastics, Endocrine, etc. are the branches. In order to get to those branches, you have to go thru the tree. Even a generalist IM, generalist Surgeon, generalist Peds doctor has a certain unique fund of base knowledge that can't be replicated.

The fund of knowledge in EM can be easily replicated and for the longest time was.

Well according to everything you have said in this thread previously in regards to EM, they can. We didn't always have all these sub-specialists either. They got created because someone found a better way to do something that required a unique skill set. I guess dermatology shouldn't be a real specialty either because it doesn't apply to your tree theory since you guys don't do internal medicine first. And wait! Before you talk about how you have to do a prelim year I give you an anecdote: My friend is doing derm and is at the most JOKE TY program there is - its basically MS5. There is no requirement for doing a preliminary medicine or surgery year before going into derm, a TY will suffice and most derm residents want those easy, cush years. EM was created because internists, family docs etc weren't that great at taking care of sick, undifferentiated patients. End of story. That is what we do. No specialty is better at this than ER doctors. From cradle to grave, pregnant or not, we deal with it all. In my short few months as a resident I've done 10 central lines, have been involved in numerous codes and resuscitations, have intubated half a dozen or so crashing patients etc. No specialty trains likes this. My internal medicine colleagues maybe have done a central line or 2 by this point. Your opinion about any specialty in the medical field is really worth **** since you've been out of the trenches of real medicine for sometime.

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[DermViser]

Well according to everything you have said in this thread previously in regards to EM, they can. We didn't always have all these sub-specialists either. They got created because someone found a better way to do something that required a unique skill set. I guess dermatology shouldn't be a real specialty either because it doesn't apply to your tree theory since you guys don't do internal medicine first. And wait! Before you talk about how you have to do a prelim year I give you an anecdote: My friend is doing derm and is at the most JOKE TY program there is - its basically MS5. There is no requirement for doing a preliminary medicine or surgery year before going into derm, a TY will suffice and most derm residents want those easy, cush years. EM was created because internists, family docs etc weren't that great at taking care of sick, undifferentiated patients. End of story. That is what we do. No specialty is better at this than ER doctors. From cradle to grave, pregnant or not, we deal with it all. In my short few months as a resident I've done 10 central lines, have been involved in numerous codes and resuscitations, have intubated half a dozen or so crashing patients etc. No specialty trains likes this. My internal medicine colleagues maybe have done a central line or 2 by this point. Your opinion about any specialty in the medical field is really worth **** since you've been out of the trenches of real medicine for sometime.

By not being replicated, I mean not able to be replicated by other fields. A Surgery doc can't be an IM doctor. An IM doc can't be a Surgeon. A PM&R doc can't do Anesthesiology, and you can do the entire combinatorix of the possibilities.

Dermatology is not a subspecialty of Internal Medicine and is not thought of as one. The same way Anesthesiology is not a subspecialty of Surgery. So what's your point?

Yes, Derm (as does Rads, Rad Onc, Neuro, Anesthesia, Ophtho, PM&R, etc.) all require an internship year - that can done with a prelim or transitional? Again, what's your point? Are you saying the ones who do transitional years are effectively serving as medical students on the team? Yeah, um no. The only difference btw a Transitional vs. a Prelim is usually the number of electives. The expectations of wards as a prelim and wards as a transitional are exactly the same.

"I've done 10 central lines, have been involved in numerous codes and resuscitations, have intubated half a dozen or so crashing patients etc." --- You're right, no specialty outside of Emergency Medicine does this.

 

[username456789]

Come on guys, this is getting pretty ridiculous. It has devolved into a penis measuring contest. As usual.

 

[DermViser]

EM was created because internists, family docs etc weren't that great at taking care of sick, undifferentiated patients. End of story. That is what we do. No specialty is better at this than ER doctors. From cradle to grave, pregnant or not, we deal with it all. In my short few months as a resident I've done 10 central lines, have been involved in numerous codes and resuscitations, have intubated half a dozen or so crashing patients etc. No specialty trains likes this.

Are you seriously going to make the argument that no other specialty -- IM, Surgery, Psych, Peds, OB-GYN, etc. takes an undifferentiated patient and works them up?

 

[swamprat]

By not being replicated, I mean not able to be replicated by other fields. A Surgery doc can't be an IM doctor. An IM doc can't be a Surgeon. A PM&R doc can't do Anesthesiology, and you can do the entire combinatorix of the possibilities.

Dermatology is not a subspecialty of Internal Medicine and is not thought of as one. The same way Anesthesiology is not a subspecialty of Surgery. So what's your point?

Yes, Derm (as does Rads, Rad Onc, Neuro, Anesthesia, Ophtho, PM&R, etc.) all require an internship year - that can done with a prelim or transitional? Again, what's your point? Are you saying the ones who do transitional years are effectively serving as medical students on the team? Yeah, um no. The only difference btw a Transitional vs. a Prelim is usually the number of electives. The expectations of wards as a prelim and wards as a transitional are exactly the same.

"I've done 10 central lines, have been involved in numerous codes and resuscitations, have intubated half a dozen or so crashing patients etc." --- You're right, no specialty outside of Emergency Medicine does this.

My point? You tell me. Your rebuttal to my argument was something about a tree and the fact that cardiologists and all these other subspecialties go through IM and therefor that makes it ok that every disease managed by an internist can be managed better by the respective specialist? That makes sense...?

 

[DermViser]

My point? You tell me. Your rebuttal to my argument was something about a tree and the fact that cardiologists and all these other subspecialties go through IM and therefor that makes it ok that every disease managed by an internist can be managed better by the respective specialist? That makes sense...?

I didn't say in this thread that every disease managed by an internist can be better managed by a subspecialist.

The reason that a Cards fellow, GI fellow, Heme/Onc fellow, Pulm fellow, have to go through IM first is bc an IM foundation is very necessary. You can't compare the unique and expansive set of knowledge and skills in a Cardiology fellowship, with the amount of knowledge and skills acquired in an Ultrasound "fellowship". You can't do Cards/GI/Heme-Onc/Pulm thru Surgery. It's a whole different tree.

Emergency Medicine is medicine based on a temporal circumstance (an emergency) or physical environment (the emergency room). It's not a unique set of skills and knowledge, in and of itself. If it was, it wouldn't be dependent on nearly every other specialty in the hospital.

Understand now?

 

[Winged Scapula]

Because this thread is no longer on topic and has devolved into bashing each other, I am closing it.