smartest doc's

Discussion in 'Clinical Rotations' started by goodkid, Apr 5, 2002.

  1. goodkid

    goodkid New Member

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    Just curious, what docs do you guys feel are the smartest? I'll go first:

    nephrologists, old school profs of int med and general surgery, and pathologists
     
  2. Whisker Barrel Cortex

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    I'd agree with nephrologists and pathologists. I would add some radiologists to that list, especially the pediatric and neuroradiologists I have met.
     
  3. Acinetobacter

    Acinetobacter Junior Member
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    I second the nephrology and would add critical care physicians to that list.
     
  4. ApacheIndian

    ApacheIndian philomath
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    Every Neurologist I've ever encountered is a genius... and I'm not just talking about medicine either. I have an uncle Neurologist who's a multi-millionaire b/c of his shrewd business/investment sense. And, there's always Dr. Malik Hassan... X-Neurolgist turned HMO kingpin... one of the wealthiest docs in the nation.
     
  5. neutropeniaboy

    neutropeniaboy Blasted ENT Attending
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by goodkid:
    <strong>Just curious, what docs do you guys feel are the smartest? I'll go first:

    nephrologists, old school profs of int med and general surgery, and pathologists</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I think old school anybodies are the smartest docs around. It seems as though they had to rely on a little thing called "the physical exam" to make all their diagnoses. No fancy imaging. No fancy blood tests. Sure, a lot of patients died or never got better, but they knew how to spot them and learned through trial and error epidemiology.

    On a related note, I think the state of medicine today is screwing newer physicians, especially training physicians. They're more likely to say "Where's the head CT?" than they are to say "What's the patient's compaint and physical exam show?" And for better or worse, the Federal government is creating lackluster physicians with its rules and regulations concerning care. If a resident can never stand on his own and go out on a limb, make mistakes, and be accountable for them, he's never going to learn medicine like his mentors did.
     
  6. Ralph Wiggum

    Ralph Wiggum Member
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    I would have to vote for the infectious disease docs.
     
  7. Stormreaver

    Stormreaver The Blade of Tyshalle
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by neutropeniaboy:
    <strong>I think old school anybodies are the smartest docs around. It seems as though they had to rely on a little thing called "the physical exam" to make all their diagnoses. No fancy imaging. No fancy blood tests. Sure, a lot of patients died or never got better, but they knew how to spot them and learned through trial and error epidemiology.

    On a related note, I think the state of medicine today is screwing newer physicians, especially training physicians. They're more likely to say "Where's the head CT?" than they are to say "What's the patient's compaint and physical exam show?"</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Having studied in a third world country, that was exactly what we were taught--the H&P was used to guide the tests, which were ordered specifically to confirm clinical suspicion. We had some pretty canny diagnosticians on our faculty--some of the things our Chief of Medicine could do were downright amazing.

    Oh--and although the Chief of med was a cardiologist, I'd still agree with the nephro comments.
     
  8. rad

    rad Member
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    smartest doctors are the ones who realized by late third year of medical school that primary care is something to avoid like the plague.
     
  9. To play devil's advocate, while it is true that the older docs could come up with an impressive differential diagnosis and narrow it down through a long, belabored culling of physical diagnosis signs and symptoms, many of them are behind the times on evidence-based medicine, and they're still practicing a very paternalistic doctor-knows-best kind of medicine. In short, a lot of guys form their opinions immediately and just refuse to entertain any other possibilites, and a lot of the time, they're either slightly off or just dead wrong. While the balkanization of clinical responsibilities today does make for a more limited clinician sphere of influence, it also adds a greater number of opinions and ideas to the mix, and entertaining more possibilities and using more modalities by probability alone increases the chance of correct diagnosis and most appropriate treatment plan. Just because they're old doesn't ALWAYS make them great. There is no substitute for experience, it's true, but there's also something to be said for the vigor of youth.
     
  10. ortho2003

    ortho2003 Senior Member
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    I have to go with infectious disease, or nephrology.
     
  11. Ferris

    Ferris Member
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    This is probably the dumbest discussion I have ever read.
     
  12. bigfrank

    bigfrank SDN Donor
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    If we're speaking statistically, and using the USMLE as a guide, then the smartest docs are without question Dermatologists.

    Now, I obviously don't think that the USMLE is a valid form of measuring intelligence, but it is something to think about.

    And, since the statistically most intelligent doctors go into what many consider to be the least challenging field of medicine (intellectually, socially, family-time, etc.), this is an interesting paradox.
     
  13. UAB

    UAB Member
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    I think is different be the smartest and be the doctor with biggest knowledge, both are different things.
    The smartest doctors are dermatologists because it?s the most competitive specialty not only for scores also for their curriculum.
    The doctors with biggest knowledge can be nephrologists, cardiologists, .... it?s hard to say.
     
  14. droliver

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    JGDLB,

    the artifically low #'s of training spots for derm is what skews the USMLE average. No one will argue with a straight face that they really think dermatologist are the brightest & best physicians.
     
  15. Goofy

    Goofy Senior Member
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    I think we should stop this pissing contest of a thread over who is the smartest doc. We are all very bright and resourceful, otherwise we wouldn't have made it this far.

    I think it is downright laughable to attribute the greatest smarts to dermatologists because of specialty competitiveness. As someone who has done exceedingly well on two steps of the USMLE, I can easily tell you the exam hardly tests smarts. Worse, it says even less about clinical acumen, a much better meter of medical success in my opinion. The USMLE, and much of medical school is merely a memory test. There is very little in medicine that is challenging to understand. If you can remember it, you can treat it. It takes hours and hours to study only because of the sheer volume of information. Anyone who thinks a top USMLE score equals a ticket to the smartest doc club is sadly mistaken.

    There are many here who have done exceptionally well on the boards, yet clinical success has been marginal at best. Fortunately this is something very easy to hide as a third year by merely showing up early and staying late.

    That isn't to say that dermatologists aren't bright, they are. But so is the overwhelming majority of students who enter this profession. Perhaps students entering this field are the most cunning, but smartest, HAH!
     
  16. rad

    rad Member
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    step 3 tests your clinical decision making ability. If anything this should be the best guage of who the "smartest". There are 9 cases on the test in addition to about 500 mcq where you enter orders and manage the patient in multiple patient care settings.
     
  17. Goofy

    Goofy Senior Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by rad:
    <strong>step 3 tests your clinical decision making ability. If anything this should be the best guage of who the "smartest". There are 9 cases on the test in addition to about 500 mcq where you enter orders and manage the patient in multiple patient care settings.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Rad,

    While I agree with you in principle, I haven't taken the test so I cant say for sure. Your thoughts are very well taken.

    I will say that I am very suspicious of any standardized exam predicting 'smarts'. That is not what they are designed to do, at least in regard to all of the standardized exams I have taken up until this point in my life. Most required so basal level of knowledge, but beyond that, enough studying will usually produce a fine score.

    I would argue further, that academic cunning can often produce excellent results. When confronted with the dizzying array of shelf exams and USMLE I had to confront, I pursued a different approach to exam success. I opted to use the most efficient tools for exam success. For the USMLE, it meant memorizing every single one of their Q-Bank questions. While I didn't feel particularly gifted, I did have a great handle on medical trivia. Both step one and two turned out to be very manageable, and at times I felt as if I had seen many of the same questions before. Each of the shelf exams also had their best question/answer book.

    Most of medical school and step one/two, represent intricate testing of one's ability to remember. Being able to remember is merely one aspect of being a good physician. A much larger part of clinical success is being able to function in this rigorous and fast paced environment. Additionally one must be able to get this knowledge from the head to the fingertips. This is no small feat, and the best physicians are quite often the worst test takers.

    If one is interested in how 'smart' they really are, I would recommend an IQ test. While this exam too has it's limitations, it is perhaps the best method to evaluate intellectual ability.

    I have to say that I really dread these kinds of exams, because they foster a kind of studying that, in my opinion, is inefficient in producing clinically knowledgeable providers. The newly imposed recertification requirements are an absolutely outrageous way to legally steal from fully trained and licensed health care providers. In short, IT SUCKS.

    I envision a future where we are taught and tested in a clinically relevant way. Alas, the arab-israeli conflict is likely to be solved before that vision is realized.
     
  18. Whisker Barrel Cortex

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    I thought that Step II was actually a very good test of clinical acumen. The vignettes presented offered you a choice of diagnostic, treatment, most likely diagnosis, etc. The thinking process in these cases was very similar, in my opinion to those in clinical medicine.

    My opinion above is not about IQ, but more about the intellectual challenge of these fields, how much they need to know (rads and path) and how difficult the things they need to know are (nephrology). Everyone graduating medical school is obviously highly intelligent, how much of that they use in residency and practice varies greatly.
     
  19. Goofy

    Goofy Senior Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Whisker Barrel Cortex:
    <strong>I thought that Step II was actually a very good test of clinical acumen. The vignettes presented offered you a choice of diagnostic, treatment, most likely diagnosis, etc. The thinking process in these cases was very similar, in my opinion to those in clinical medicine.

    My opinion above is not about IQ, but more about the intellectual challenge of these fields, how much they need to know (rads and path) and how difficult the things they need to know are (nephrology). Everyone graduating medical school is obviously highly intelligent, how much of that they use in residency and practice varies greatly.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Hi Whisker,

    I think you make an excellent point about the challenges that different fields offer. I would certainly agree that nephrology is one of the most cognitive of disciplines. Neurology is right up there in my opinion.

    I would still debate you on the relavency of step II to clincical acumen. I found that while the question stems did attempt to imperonate relevant clinical scenarios, most were nitpicky and all too often just plain wrong. Additionally, having an answer staring you right in the face is very different from having to conjure up a diagnosis/treatment strategy at 2AM for a complicated medical patient. Worse, these exams insist we know detailed and largely irrelevant information about disciplines most of us are not entering. Again, I didn't use any special text for the boards, just hundreds of Q/A. My scores before were below average, and in the top percents of the population after. Am I a clinical wizard because I have achieved this kind of success? Hell no, thats what the wards are for. The USMLE only proved I know how to play a particular game. I would be very scared for patient's treated by physicians who called upon their USMLE knowledge pool, even step II, to render care. The results would be disastrous. I maintain that the first two steps are merely memory exams that are designed to look like actual clinical situations, but in large part don't.

    Your mileage may vary
     
  20. wake up sir your surgery is over

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    smartest Docs: in no particular order, nephrology, hem/onc, pediatric cardiology, pulmonary/ critical care, radiation oncology.

    To all those who knock primary care:
    1. for god's sake, do not lump pediatrics in with FP and general IM.
    2. Don't forget about those IM and peds people who could be your cardiologist or your kid's neonatologist g-d forbid.
     
  21. wake up sir your surgery is over

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    oh yeah, haven't met a dumb neurosurgeon lately either, have you?
     
  22. phllystyl

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    I definitly find this thread to be most appalling. Check it.. 99.9999% of us got into medical school. Therefore, the majority of us are all very intelligent people, who all want to do different specialties that appeal to us for different reasons.

    The proverbial cockfight is over. Get over it.
     
  23. gherelin

    gherelin Member
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    I agree this is about the most ignorant thread I've seen on here. I don't even know why I'm responding, except maybe so that some innocent bystanders will realize not all docs have such a narrow view of medicine and healing and humanity, and of course, intelligence. Sometimes when I see these types of discussions, I think the mandatory pre-med curriculum should be something in the humanities rather than the standard one. <img border="0" alt="[Pissy]" title="" src="graemlins/pissy.gif" />
     

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