Gastroenterology

[hp6527]

Sorry for my curiosity. Is anyone here pursuing to become gastroenterologist ? How is its rotation in medical school ?

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[Winged Scapula]

I'll move this to the Rotations and Residencies Forum for ya.

BTW, I don't think you'll find much info on a medical school Gastro rotation here as it would be a 4th year IM subspecialty rotation, although certainly students doing Core and sub-I IM rotations would have some experience with GE (just not a devoted rotation unless they specifically request it, usually as an elective).

 

[tussy]

I did a rotation in Gastroenterology for my IM selective when I was in third year. I was thinking of going into GI, but have since decided on general surgery.

I absolutely loved my GI rotation. I was on a consult service so there was very little scut to do. Spent my mornings in the endoscopy unit where I actually got my hands on the scope a few times (it's much harder than it looks). Spent the afternoons seeing consults in both the ER and on the wards. I also went to a few special clinics (IBD clinic, hepatology pre-transplant clinic,etc.). My rotation was probably one of my favorites, but that was mostly because I had such a great preceptor.

Any more questions???

 

[hp6527]

Many thanks ! Best regards to both of you.

 

[Jamier2]

Originally posted by tussy:
•Any more questions???•

I have a couple.

1. I hear that Gastro is a field with a good blend of procedure and office visit type activity. How would you describe it? I know you aren't a gastro, but how did it seem to you?

2. If you were to compare this specialty to something like general surgery, how would you rate it? Better or worse? Why?

If you don't have time to go into detail I understand, but gastroenterology is one of my main interests in medicine and I would love to hear more about it.

If you want to you could email me at [email protected]

Thanks for any help.

 

[Stinky T]

I can't say I'm an expert in the field, but I couldn't imagine myself being a GI doc. The lifestyle is great, GI Docs are in demand (they cut down on the number of fellowships), and they get paid very well.

You get to do a lot of procedures and if you learn how to do ERCPs, you can demand roughly 10% more (at least that's what I've been told). However, you do have to do an IM residency (major drawback in my mind) and the GI Fellowship is three years. Also, there's just so many times that I would want to be doing a Sig and a Colonoscopy. No, that's not all they do, but they spend a heckuva lot of time doing those two procedures. I didn't really like that patient population either (Hep, Pancreatitis, IBD, IBS, etc.).

Personally, GenSurg would be much more interesting to me. Unfortunately, I'm not strong enough to be able to handle all that love/abuse from the domineering surgery residents -- especially the ones with pictures of Hugh Grant in their lockers.

 

[tussy]

Hmmm. I'll give this a try.

First of all, since I'm going into gen surg I obviously thought that it was the better choice. GI does have a better lifestyle, but if you're really procedure oriented you'll probably not find that scoping is enough for you. It's also an IM specialty, so you have to be one of those people that like IM. It does have a good variety, and the patients are generally younger than other IM specialties and often are much sicker.

Practices are quite varied depending on where you are. They guys I worked with all had practices based in a teaching hospital. They had a good group of patients that were all quite sick, although I've heard that in other places the GI practice is only made of IBS patients which are not all that interesting. THey also had a lot of sick inpatients (IBD mostly). They spent about a third of their time scoping, a third doing clinics and a third doing inpatient medicine.

However, I'm here in Canada and I understand a few things are quite different between here and the USA, so I'm not sure how well I can answer this question for you.

Try to shadow a GI guy in your area, or do an elective or someting. I did a research project in the GI department the summer after my first year. The guy I worked with let me shadow him 1 day a week as well so it was a great experience.

 

[Winged Scapula]

The responses given by Stinky and tussy are really the reasons I gave for the infamous Surgery interview question, "Why not Gastro or Cardio?" Simply not enough variety in the procedures, and conditions which don't really interest me (IBD). While it was fun "driving" the scope and snipping some samples during the first few colonoscopies, it wasn't really something I could see myself doing for years and years....and years.

 

[Test Boy]

You have to ask yourself, "do I want to be a butt scoper?"

 

[tussy]

I happen to like scoping. However, most of the general surgeons I've met also do colonoscopies (along with all the other cool procedures).

 

[Jamier2]

Thanks for the advice and the opinions. I didn't realize the procedures were so limited, and I am afraid I would become bored quickly, at least with that aspect of it.

I have found Gastro and Urology interesting because although I really think I'd love surgery, I don't think I want to miss that much time with my family. How would you guys compare the lifestyles of a surgeon (general, for the sake of discussion) and a GI or Urologist? Luckily I have about 3 to 4 years to decide.

 

[Winged Scapula]

Originally posted by Jamier2:
•I have found Gastro and Urology interesting because although I really think I'd love surgery, I don't think I want to miss that much time with my family. How would you guys compare the lifestyles of a surgeon (general, for the sake of discussion) and a GI or Urologist? Luckily I have about 3 to 4 years to decide. •

You may not realize it Jamie, but Urology is a surgical specialty, not a medical one. There are some Urological emergencies but when I rotated through the Urology service it was TURP (trans-urethral resection of the prostate) after TURP after TURP, with some bladder CAs & general cystoscopies thrown in for good measure. I did more prostate exams in one day on that service than I did in the remaining 1.5 years of medical school. Mostly elderly male patients because of the prevalance of BPH, but some females as well, with bladder, lower GU problems. Supposed to be one of the "lifestyle" specialties, which is why it remains one of the most competitive surgical residencies around. Certainly somone contemplating Urology can give a more detailed answer.

Gastro as we've said above may entail a less rigorous (as far as time, call schedule, etc.) residency than a surgical field, but it HIGHLY depends on where you are doing your training. A community surgery program may be less of a pain than a high-volume IM/Gastro service at a major university center.

The same is true for the work schedule after completion of residency. It depends on where you want to be working. In general, non-trauma fields like Gastro and Urology have less frequent call and are less likely to be called in when on call. Working at an HMO or non-academic center without teaching and frequentc all responsibilities found in academic centers, will make your life easier.

 

[Jamier2]

Let me rephrase my question, and get more opinions.

My dream job as a physician:

T1. Love interacting with patients, preferrably long enough to see if what I was able to do was of any help.
T1. I am very interested in doing something which entails a lot of procedures.
3. When I go home at night I don't want to be a stranger. I want to have at least the flexability to allot my family some time. I know the demands on your time fluctuate, but I would prefer to be able to be reasonably sure that I actually will be there when I tell young Richard (Assuming my next child is a boy) that I'll be at his ball game next Saturday.

I do realize that sometimes this will not be possible, but I don't want to miss too many things with my family.

What type of specialty would you suggest? I have always wanted surgery, but not bad enough to abandon my family. (except during residency, I know that is unavoidable)

Also, thanks for the info Kimberli. I did not realize that urology was a surgical sub-specialty.

 

[Winged Scapula]

Jamie...

Plastic and Reconstructive Surgery is your game, my friend! Lots of procedures, many of the patients are long-term (ie, repeat aesthetic patients, trauma, burn, skin CA, congenital, etc.) and the lifestyle, for a surgical specialty is much more benign than other surgical specialties.

Derm would also be a good choice, although the potential for procedures in the OR is pretty darn low, mostly office type of stuff.

ENT also has a great lifestyle, as does Urology (which is not a surgical SUB-specialty, but is considered one of the Core Surgical Specialties, along with General, Ortho, Neuro, ENT - ie, each having their own residency [not following after a Gen Surg residency]).

Things you wanna stay away from: Trauma/Crit Care, Neuro (lots of middle of the nights), Transplant (ditto and LONG operations), Vascular (same, lots of emergencies), just off the top of my head.

Hope this helps. Seriously consider Plastics - its a great field, with so much diversity in patients and work and if you aren't working in academics, your after-hours work will be seriously limited (making your family happy)>

 

[Jamier2]

I had never even thought of plastics before. Interesting, and it sounds like a pretty good fit. As far as derm goes, I guess me and everybody else wants that one.

I don't expect to work in an academic setting at all, but who knows where I'll end up.