gastroenterology

[Kevo]

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what is the scoop on this subspecialty of internal medicine? patient population? procedures done? where is most time spent (hospital, office, etc)? working hours? compensation? anything else you might like to add would nbe appreciated.
thnaks

 

[AJM]

I think Future GI Guy will be the best one to answer your questions. GI is a very procedural field -- they do a lot of upper endoscopies, colonoscopies, sigmoidoscopies, etc. It's largely outpatient-based, but there is a pretty big inpatient component to it as well. Your patient population depends on what you choose to specialize in GI. For example, if you're a liver specialist, you will have a ton of cirrhosis patients, and will probably spend more time in the inpatient setting.

They often work a lot of hours -- especially since the demand for colonoscopies has been greatly increasing. But because they tend to do a lot of procedures, they also get compensated more than many other fields in Internal Medicine.

Now we'll just wait for GI Guy to fill in the details... 🙂

 

[MSU2004]

I'd be interested in hearing how competitive such a fellowship is to get.

Thanks,

MSU2004

 

[Winged Scapula]

I'll move this over to The Rotations and Residency Forum for ya. 😀

 

[doughboy]

I did a month of GI during my rotations and they were long hours. Ton's of scoping, both EGD and Colonoscopies. Then you put in G-tubes, ERCP, pericentesis. A ton of procedures...don't forget the all-powerful rectal exams. They also got a lot of consults on the floor. All the GI bleeders, pancreatitis, cirrhosis, hepatitis. Its like everyone gets a GI consult. Best advice is to do your IM at a hospital with a GI fellowship, tell them you're interested in the field, work your butt off during IM and so when you apply they'll be impressed. I originally wanted to go into GI but I can't stand 4 years of IM. Its way too "academic", too many lectures, discussions on journals, blah blah blah, with very little quick results. You basically treat chronically ill patients who are all old and have a zillion medical conditions that take 20 medications and all you can do is treat their symptoms and send them home until they come again. How depressing. But the subspecialties are nice. Like the above poster said...a ton of procedures means a ton of money.....insurance companies pay a lot for procedures and little for thinking.

 

[AJM]

I agree that many of the subspecialties are much more appealing than general Internal Medicine. But IM residency is only 3 years (not 4), so I decided that I'll be able to "suffer" through a 3 year IM residency to do the subspecialty that I want. 🙂 And the IM residencies aren't *only* general -- you do a bunch of subspecialties in it, so I calculate that on average the total time you spend doing general medicine during that residency is only about a year and a half. 😉

 

[doughboy]

Yeah, you're right, I forgot to think about that. Maybe I'll have to reconsider what I want to do now. But I do love the knife and the OR.

 

[AJM]

Originally posted by doughboy:
•Yeah, you're right, I forgot to think about that. Maybe I'll have to reconsider what I want to do now. But I do love the knife and the OR.•

So what are you planning on going into, doughboy? I'm assuming you're a 4th year, yes? If I had to guess, it sounds like with your interest in GI and procedures but dislike of IM, that you may want to do general surgery?

It's pretty sad that I've had to figure out how much time I would have to spend doing general IM during residency... but I really like some of the subspecialties -- particularly pulmonary/critical care -- great mix of thinking and procedures, but definitely not for everyone. Not as many procedures as in GI, but GI does pretty much stand out as just about the most procedural IM subspecialty, 2nd only to interventional cardiology.

 

[doughboy]

ajm, I did want to go into ENT but it is so competitive and I don't have the energy to commit all my time and ass-kissing to get a spot. I do like GI, thought about cardiology, but I think I'm going to go into OB-GYN. I love the mix of surgery, clinic, and continuum of care. Plus, its a specific focus of area so I can learn it well. I like the "happier" patients too.