Pathology vs. Infectious Disease vs. Rheumatology

[jewright311md]

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Ok, I am trying to decide which of these i should choose, i know i want to specialize in ID but i dont kno if i should also go in to Pathology or Rheumatology, My main concerns are that all you do as a Pathologist is stay in a lab, and as a Rheumatologist all you do is study joints and bones, and it is to specialized in one feild. I want to sort of be a consultant on all diseases and also help diagnose them, any Advice

 

[jewright311md]

HOW IS A RHEUMATOLOGY SPECIALTY???? And what specialty acts as a consultant to many physician in diagnoses and has a very broad understanding as diseases

 

[Pinkertinkle]

What year are you and what experience do you have with clinical work so far?

 

[jewright311md]

What year are you and what experience do you have with clinical work so far?

1st year

 

[SouthernSurgeon]

I want to sort of be a consultant on all diseases and also help diagnose them, any Advice

Just to be clear, you want to be House?

 

[JeffLebowski]

....what?

 

[SouthernSurgeon]

1st year

Then in all seriousness, settle down and wait. You won't get much experience with Path, ID, or Rheum until your clinical years. Both ID and Rheumatology are fellowships that one completes after and internal medicine residency - so if you really think you are interested in ID/Rheum, gauging your interest in medicine is the first step - which is best done as a 3rd year during your medicine clerkship.

 

[jewright311md]

But which of these serves as more of a consultant

 

[SouthernSurgeon]

But which of these serves as more of a consultant

Rheumatology consults on rheumatology issues; ID consults on ID issues.

 

[jewright311md]

How about pathology

 

[jewright311md]

Im interested in pathology but dont want to sit in a lab all day can someone share the experinces in pathology and also do they act as consultants in diagnosing patients, to the physician

 

[yaah]

I am not sure what you mean by, "Consultant in diagnosing patients." Do you mean do they call us up and say, "we're stumped, can you help us out?" No, that doesn't happen. They send us biopsies and ask us to interpret rare or confusing lab tests though. Most pathologists don't sit in a lab all day, but we do a lot of sitting in offices or multiheaded microscope rooms looking at slides. See the pathology forum - there are some FAQ about what a pathologist actually does. If you have questions go and talk to a pathologist at your med school or ask if you can sit on on signouts for a couple of days, that will give you much more perspective.

 

[jewright311md]

I am not sure what you mean by, "Consultant in diagnosing patients." Do you mean do they call us up and say, "we're stumped, can you help us out?" No, that doesn't happen. They send us biopsies and ask us to interpret rare or confusing lab tests though. Most pathologists don't sit in a lab all day, but we do a lot of sitting in offices or multiheaded microscope rooms looking at slides. See the pathology forum - there are some FAQ about what a pathologist actually does. If you have questions go and talk to a pathologist at your med school or ask if you can sit on on signouts for a couple of days, that will give you much more perspective.

is there any specialty in which "they" call us up and say, "we're stumped, can you help us out?"

 

[SplenoMegastar]

Yes, it's called "Diagnostic Medicine." You can actually telecommute to the fellowship. It's held at 8pm every Tuesday on FOX.

Yeah, I'm a jerk.

 

[yaah]

I just noticed this is a duplicate thread. I am closing this one and moving my original reply to the pathology forum thread.

 

[mjl1717]

How about pathology

The pathologist-He's the doctors doctor but he does everything 24 yours too late!!

You could always do an "Osler" [the full pathology and full internal medicine residency] - a royal academic soldier..

 

[Pinkertinkle]

The reason you call a consult is to get an specialist's opinion, you can't be a specialist in EVERYTHING.

 

[yaah]

HOW is a rheumatology specialty?

A rheumatology specialty is good.

All physicians have a broad understanding of diseases. That is why there are generalists and subspecialists. You can't be a subspecialist in everything. Well, I suppose you could, but you'd 1) never finish training and 2) be spread so thin no one would want your opinion anyway.

 

[SouthernSurgeon]

All right, I've finished dinner so I have a little more time to try and (a) understand your posts and (b) respond to them seriously.

Some points of clarification:
-There is no such thing as specializing in diagnosis. There is no field where (as you asked in the locked thread) someone calls you up when they are stumped and gets you to come in and save the day. A couple of people (me included) have made "House" jokes at you - that is not real medicine.

-You don't really seem to understand what a consult is. When you consult someone, you are asking them to answer a specific question relevant to their field of specialty. For example, if I were a surgeon and had a patient with serious heart disease, I might consult cardiology to get their recommendations on how to effectively manage their heart disease before/during/after surgery. If I were a cardiologist, and one of my patients got a serious or complicated infection, I might consult ID to get their recommendations on what antibiotic to use.

-Even if you go into a "consult heavy" field such as ID, that would not be your whole practice - you would also have your own patient base, clinic duty, inpatient attending service, etc.

-Pathology is a whole different ballgame. It is obviously centered on the understanding of disease, and on making tissue diagnosis, but it more or less doesn't involve direct patient interaction.

 

[DOCTORSAIB]

1st year

You're asking some elementary level questions for a 1st year medical student.

You are in "med school," right?

 

[Doctor4Life1769]

You sure you don't want to sub-specialize in Oncology as well? You'd be outdoing even House himself, who frequently asks Wilson (an oncologist) for advice.

You made my night with all these posts.

 

[DocPsychosis]

I don't know if English is not your first language or if you're just a subliterate American but your questions make no sense, especially for someone claiming to be in med school.

 

[Forthegood]

Agreed. It is frustrating. Also, all of these threads should be combined into one, that states simply "I need a doctor to diagnose either myself or a loved one and I don't know who to go to", at which point, a moderator should step in and close the threads.

 

[TMP-SMX]

I'm still scratching my head. As any sub-specialist in IM, you still have to know internal medicine and all of the organ systems as they interact. Rheumatologists know quite a bit about immunology as does an ID sub-specialist. Are you assuming that every physician has to refer to an allergist/immunologist for anything having to do with the immune system? The ultimate generalists are in primary care, but you can't know everything as your pay isn't going to go up for knowing a little bit about everything and each fellowship you do cuts your time opportunities for a decent income. Sure you could practice general internal medicine and do every fellowship out there but you would soon notice that being a consulted physician doesn't make you money and nobody refers to you as they probably have more experience treating whatever condition they need a referral for.

 

[Isoprop]

-There is no such thing as specializing in diagnosis.

no department of diagnostic medicine? i'm shocked.

i think house is supposedly boarded in ID and rheum.

 

[146233]

i think house is supposedly boarded in ID and rheum.

ID and nephrology; it makes him an expert in everything.

 

[Forthegood]

I don't know if House knows everything, but he sure does have a sweet office. Where do you sign up to get an office like that?

 

[cfdavid]

Just to be clear, you want to be House?

No, for him to be House, he'd need to add interventional cardiology, neurosurgery, general surgery, IR, and perhaps neurology.....LOL

 

[Re3iRtH]

No, for him to be House, he'd need to add interventional cardiology, neurosurgery, general surgery, IR, and perhaps neurology.....LOL

I always wonder when I see certain things on House,
Do internal medicine/fellows do things like perform catheterizations,
read complex brain MRIs, sleep medicine, throracotomy, etc.?
If they do then I think I will give IM a serious consideration!!

 

[TMP-SMX]

I always wonder when I see certain things on House,
Do internal medicine/fellows do things like perform catheterizations,
read complex brain MRIs, sleep medicine, throracotomy, etc.?
If they do then I think I will give IM a serious consideration!!

Catheterizations? Interventional Cardiology fellows
MRIs well not so much
Sleep Medicine? Yeah Sleep Medicine fellows
Thoracotomy? I can't say I've seen them doing this on House but this is a serious surgical procedure.

Thing is with House none of them are any of these except Chase who is a surgeon.

 

[mercaptovizadeh]

In my impression, the subspecialties with the broadest range of extremely-complicated-to-diagnose diseases/zebras are ID, rheumatology, and hematology/oncology. However, we can't be house and we must pick one field. If you really want to do ID and rheum, I suppose that's possible (JHU and UCSF supposedly have great fellowships in both, so you might be able to dovetail them somehow), but you would probably have to justify it somehow - e.g. you are interested in the possible role of infectious agents in the pathogenesis of autoimmune diseases such as RA and SLE, or you are interested in managing infections in patients with suppressed immune systems (although you could just consult for that).

 

[Mr hawkings]

I always wonder when I see certain things on House,
Do internal medicine/fellows do things like perform catheterizations,
read complex brain MRIs, sleep medicine, throracotomy, etc.?
If they do then I think I will give IM a serious consideration!!

Dont forget, they also run all the lab tests themselves in their own dedicated lab.

 

[146233]

Thoracotomy? I can't say I've seen them doing this on House but this is a serious surgical procedure.

ED docs will do these under the right circumstances.

Thing is with House none of them are any of these except Chase who is a surgeon.

*bzzt* Since the beginning of the show, Chase was an intensivist. His appearance seemingly credentialed as an attending surgeon this season is .. magic?

 

[Re3iRtH]

ED docs will do these under the right circumstances.



*bzzt* Since the beginning of the show, Chase was an intensivist. His appearance seemingly credentialed as an attending surgeon this season is .. magic?

Intensivist? Same thing as Critical Care, right?

 

[Orthodoc40]

Intensivist? Same thing as Critical Care, right?

Yes.


This thread is really entertaining. More than House.

 

[TMP-SMX]

ED docs will do these under the right circumstances.

I know. The fellows are not ED specialists except Cameron (magic) and of course Taub is actually a plastic surgeon turned IM fellow? Makes a lot of sense.

*bzzt* Since the beginning of the show, Chase was an intensivist. His appearance seemingly credentialed as an attending surgeon this season is .. magic?

Lol you are correct. I was talking about currently. It's all "magic".

 

[umean2tellme]

While we're on the subject of House, is it routine for neurologists to perform surgical procedures like brain biopsies? I don't think but just wanted to ask.

 

[yaah]

No it is not.

 

[PeepshowJohnny]

ED docs will do these under the right circumstances.



*bzzt* Since the beginning of the show, Chase was an intensivist. His appearance seemingly credentialed as an attending surgeon this season is .. magic?

And don't get me started on the time he was moonlighting in the NICU...

I mean, I get as annoyed as anyone when pediatricians recite their "kids aren't little adults"...but come on!

 

[Forthegood]

I can't believe neurologists don't do neurosurgeons jobs. ****, this changes everything.

I want to be a radiologist who occasionally does heart surgeries and total knee replacements. At least that avenue is still open...