GI or cardiology?

[FourthTime]

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I know it's early to start thinking about it (I won't be an MS1 until this fall), but I can't help it. I'm so excited to get started that I've been looking through all the specialties and wanted some advice. I'm looking for something procedural that also has a great deal of patient contact. OB/GYN sounds perfect, but I want a life outside of medicine too. So, I'm looking at GI and cardiology fellowships for internists. What's the scoop? What kinds of patients do these people see (ie. age)? Are these doctors happy? What about lifestyle? Any info. is much appreciated. Thanks! 🙂

 

[tussy]

When I started med1 I was similar to you. I decided I wanted to do GI medicine. Now 4 years later I've decided on Gen Sx, but I've seen enough of the GI department to give you a little info. GI is an internal medicine subspecialty. To be a gastroenterologist you have to do 3 years of IM and then a 3 year GI fellowship. The type of patients seen by GI include: irritable bowel syndrome, inflammatory bowel disease, peptic ulcer disease, dyspepsia, all sorts of constipation and diarrhea and bellyaching, liver disease, etc. As for procedures, gastroenterologists do upper and lower endoscopy and some do ERCP (endoscopic retrograde cholangiopancreatography), and some do liver biopsies. That's about it for procedures though.

I don't know much about Cardiology - sorry.

I didn't find that GI had enough procedures for me. If you really like procedures you might be better in a surgical discipline (including obs/gyne, gen surg, urology, ENT, etc.).

Just keep an open mind in med school and try to expose yourself to all areas you think you might potentially be interested in. ANd, you do still have a few years to decide, but it is good to think about it early.

Good luck.

 

[FourthTime]

Thanks Tussy, but what about lifestyle. Subconsciously, I think I'm kind of drawn to surgery (esp. ob/gyn). However, I want to be a father/husband too. Is this possible? Did this play a role in your decision? Any subspecialties better than others re: lifestyle? Any info is helpful. Thanks and good luck.

 

[UHS03]

I am quite familiar with cardiology. There are not nearly as many procedures as was noted for GI above. Mainly angiography and interventional stuff if you do the fellowship AFTER your cardiology fellowship. The cardiology patient population is mainly older people who are quite sick...that is something to think about. Many people do not want to deal with such a high percentage of very sick people who are not likely to get much better. All the cardiologists I know work very long hours (interventional is even worse...you get to come in every time someone has an MI to see if they need CABG or can be treated with a stent.) You can also learn to read cardiac US and nuclear studies if so inclined. I love the fact that there are a myriad of non-invasive tests that can be done to evaluate your patients. I find it very fun to see a patient where you have no clue what's going on and then look at the US, stress testing, nuclear studies, etc. to put the pieces together. I also like the fact that you have to be well-versed in internal medicine to understand cardiology, but in general I like that about all IM sub-specialties. I think they are all well-rounded doctors because of their training. It's one of my favorite fields.

Also, I know many cardiologists who have a good family life...although the interventional guys (like I said before) are busier. If you want to get real specialized, you can even become an electrocardiologist by doing a fellowship after cardiology. I also think that in the future we will see a fellowship for cardiologists who want to specialize in CHF.

 

[Chucky Painkomo]

Hi 4th time,

I'm starting in fall too and do a little brainstorming about what specialty I'd see myself doing so you're not alone. I think Tussy covered GI, so I'll take a stab at Cards.

Cards does have plenty of procedures if you go the interventional/invasive route, but you will do alot of the same ones (stent placement, angioplasty, etc.) over and over. It's very very delicate work so it requires quite a bit of manual dexterity. Try to check it out in the Cath Lab at your local hospital. I've noticed that docs are far more willing to let you see procedures now that you are in the "club" rather than a "dreamer pre-med." Cardiology is cool stuff...if you think the hours are worth it. These guys are the hardest working type of physician at my county hospital. It seems they never leave and always come back soon if they do. Their CHF patients aren't all that stable. GI is a much more lifestyle friendly specialty from what I've seen, although many consider it boring (and sometimes rather stinky!!!). Well, good luck from a fellow Texan!

 

[KCOM2005]

Electrocardiology in my opinion is incredible, the docs I know seem to love it. There are some downfalls, lots of training, mainly older population (in general, there are a fair number of younger patients then general cardiology), etc. You do a lot of puzzle solving with this specialty, it is for the electronically minded.

One downfall of cardiology is that you often see patients that have abused there bodies and over a lifetime and that is why they are there. You get a lot of frequent flyers who refuse to change their lifestyle (smoking and eating habits, etc.) In general, it seems to be a fairly clearcut and clean medicine. Often the solutions are very tangible. And, for the most part, patients recover quickly and feel a whole lot better; they're walking out the door 5 days after open-heart.

 

[Mango]

Hey 4thTime, don't rule out Ob/Gyn too quickly. These days there are many Ob practices that share the work load and call schedule. This makes their lives a lot more free than it was in the past. To be sure, they still have hectic lives, but if it's the specialty that you find yourself loving the most, you should try and make it work. Good luck!