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Internal Medicine and IM Subspecialties
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Lifestyle of a GI doc/resident
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<blockquote data-quote="task" data-source="post: 397669" data-attributes="member: 8578"><p>GI has emerged as the most competitive IM subspecialty, a result of high demand, high reimbursement, comparatively better lifestyle than Cards and GI fellowship programs keeping the number of fellowship spots low and stable. There are something close to 800 Cards spots and 250-300 GI spots, so the truth is in the numbers. </p><p></p><p>Lifestyle during fellowship will probably vary from program to program. Most GI procedures are elective, with busy night call dependent on how many bleeders show up in a given night. Remember that 80% of bleeds resolve on their own, so you're definitely not up as much at night as you would be in Cards.</p><p>Otherwise, the bulk of your day while you are at work is busy with consults and endoscopy. </p><p></p><p>Historically, GI has been very protective of its procedures. For example, while there are surgeons who do ERCP, ERCP is a technically demanding procedure that requires a lot of experience, and is not something one can be proficient at just doing it every so often. Complicated biliary cases can take 3-4 hours or longer. For these reasons, there aren't many surgeons who do ERCP. I actually think the # of ERCPs done in the future will decrease, but not to the detriment of GI docs. Instead, the new wonder-technology that is EUS will keep GIs busy. The clinical indications for EUS for both diagnostic and therapeutic purposes is expannding every day. EUS is extremely challenging both from a diagnostic and technical standpoint, and this will remain well within the realm of GI as well. Capsule endoscopy is being pioneered by GIs as well, and from what I've seen they have no plans to relinquish it either.</p><p></p><p>As for screening virtual endoscopy, the general opinion from most GI fellows and faculty I've spoken to is "let the Radiologists have it." From their standpoint, there is such a backlog for screening procedures and they are already so overloaded with endoscopies for biopsy that any efforts to alleviate the screening backlog would be welcome. Frankly speaking, they don't need the screening business. Interesting</p><p></p><p>Lifestyle after fellowship is gonna depend on practice type and size. But like with anything else, I think you can make your lifestyle what you want.</p></blockquote><p></p>
[QUOTE="task, post: 397669, member: 8578"] GI has emerged as the most competitive IM subspecialty, a result of high demand, high reimbursement, comparatively better lifestyle than Cards and GI fellowship programs keeping the number of fellowship spots low and stable. There are something close to 800 Cards spots and 250-300 GI spots, so the truth is in the numbers. Lifestyle during fellowship will probably vary from program to program. Most GI procedures are elective, with busy night call dependent on how many bleeders show up in a given night. Remember that 80% of bleeds resolve on their own, so you're definitely not up as much at night as you would be in Cards. Otherwise, the bulk of your day while you are at work is busy with consults and endoscopy. Historically, GI has been very protective of its procedures. For example, while there are surgeons who do ERCP, ERCP is a technically demanding procedure that requires a lot of experience, and is not something one can be proficient at just doing it every so often. Complicated biliary cases can take 3-4 hours or longer. For these reasons, there aren't many surgeons who do ERCP. I actually think the # of ERCPs done in the future will decrease, but not to the detriment of GI docs. Instead, the new wonder-technology that is EUS will keep GIs busy. The clinical indications for EUS for both diagnostic and therapeutic purposes is expannding every day. EUS is extremely challenging both from a diagnostic and technical standpoint, and this will remain well within the realm of GI as well. Capsule endoscopy is being pioneered by GIs as well, and from what I've seen they have no plans to relinquish it either. As for screening virtual endoscopy, the general opinion from most GI fellows and faculty I've spoken to is "let the Radiologists have it." From their standpoint, there is such a backlog for screening procedures and they are already so overloaded with endoscopies for biopsy that any efforts to alleviate the screening backlog would be welcome. Frankly speaking, they don't need the screening business. Interesting Lifestyle after fellowship is gonna depend on practice type and size. But like with anything else, I think you can make your lifestyle what you want. [/QUOTE]
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