Specialty War!!!!!

Started by molarseeker
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EM, Ortho or Psych

In before the disgruntled come in to rain on everyone's parade and siht on any answer other than "herp I won't know til 3rd and 4th year derp"

:laugh:
 
PMR leading to Interventional pain ( as per now)...other areas of interest include gas, radonc., neurology, and omg who knows by the time I actually get to ms3
 
Amazingmuzmo said:
Radiology, anesthesiology, ophthalmology, dermatology. If you're not banking 300k+ a year, you're a failure.
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To bank 300k you need to gross well over 500k. Not happening for most rads.

Sent from my SGH-T999 using SDN Mobile
 
Fivo said:
EM, Ortho or Psych

In before the disgruntled come in to rain on everyone's parade and siht on any answer other than "herp I won't know til 3rd and 4th year derp"

:laugh:
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you arent doing yourself a favour here with psych and ortho😆😆
 
Can anyone tell me why the personally think that EM docs aren't trained enough to handle chronic conditions like a FM? Thanks
 
macho07 said:
Can anyone tell me why the personally think that EM docs aren't trained enough to handle chronic conditions like a FM? Thanks
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I think it's because EM doesn't allow for continuity of care. Family doctors care for the same patients again and again over a span of years or even decades, so they become particularly good at managing chronic conditions. EM is pretty much the acute, treat 'em and street 'em, type of care. I'm sure that there are frequent flyers in ER's and maybe the EM docs will see those patients again and again, but the degree to which they manage chronic conditions over time doesn't compare to FM.
 
punkedoutriffs said:
I think it's because EM doesn't allow for continuity of care. Family doctors care for the same patients again and again over a span of years or even decades, so they become particularly good at managing chronic conditions. EM is pretty much the acute, treat 'em and street 'em, type of care. I'm sure that there are frequent flyers in ER's and maybe the EM docs will see those patients again and again, but the degree to which they manage chronic conditions over time doesn't compare to FM.
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So, I'm asking more along the lines of what exactly makes their education different because your answer makes it seem as if the experience is what shapes how the physicians will interact with their patients versus their education (i.e. if an EM doc goes and starts treating patients in the way a FM doc would, after a certain amount of years would they treat equally? Obviously apart from the nuances that come from individuality)
 
macho07 said:
So, I'm asking more along the lines of what exactly makes their education different because your answer makes it seem as if the experience is what shapes how the physicians will interact with their patients versus their education (i.e. if an EM doc goes and starts treating patients in the way a FM doc would, after a certain amount of years would they treat equally? Obviously apart from the nuances that come from individuality)
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Well, different practice models necessitate differences in education. So, the answer is yes.
 
I'm surprised that some med student hasn't come by to rip this to shreds. The vast majority of y'all will change your minds at some point during med school, especially when you're knee-deep in that specialty during ward rotations. I certainly have some specialties in mind that I'd prefer over others, but I'm not going to go into the clinical years with a pre-set bias.
 
Praefectus said:
I'm surprised that some med student hasn't come by to rip this to shreds. The vast majority of y'all will change your minds at some point during med school, especially when you're knee-deep in that specialty during ward rotations. I certainly have some specialties in mind that I'd prefer over others, but I'm not going to go into the clinical years with a pre-set bias.
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Watch out, we got a badass over here. Are you always this serious in real life? If you have some specialties you prefer, why not list them? You act as if everyone on here listed the specialty that they'd die for...
 
Praefectus said:
I'm surprised that some med student hasn't come by to rip this to shreds. The vast majority of y'all will change your minds at some point during med school, especially when you're knee-deep in that specialty during ward rotations. I certainly have some specialties in mind that I'd prefer over others, but I'm not going to go into the clinical years with a pre-set bias.
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The point is to list one you prefer. Not to set your life career today.
 
Fivo said:
Watch out, we got a badass over here. Are you always this serious in real life? If you have some specialties you prefer, why not list them? You act as if everyone on here listed the specialty that they'd die for...
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👍
 
macho07 said:
So, I'm asking more along the lines of what exactly makes their education different because your answer makes it seem as if the experience is what shapes how the physicians will interact with their patients versus their education (i.e. if an EM doc goes and starts treating patients in the way a FM doc would, after a certain amount of years would they treat equally? Obviously apart from the nuances that come from individuality)
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EM spends most of their time in the ED or ICU during training with very little time (if any) doing floor work, surgery or outpatient visits (with the exception of FAST track type stuff).

IM spends most of their time doing a combination of floor work and specialties (nephrology, pulmonology, etc) with some outpatient work.

FM splits their time a little more evenly between floor work, outpatient, peds, ob/gyn, and maybe specialties (not sure about that one).

There is def a lot of crossover and, in fact, a lot of FM docs work in the ED, but they were mostly grandfathered in.

Also, it wouldn't make sense for a med student to bash a premed for changing their mind on specialty...that would be the pot calling the kettle black.
 
Praefectus said:
I'm surprised that some med student hasn't come by to rip this to shreds. The vast majority of y'all will change your minds at some point during med school, especially when you're knee-deep in that specialty during ward rotations. I certainly have some specialties in mind that I'd prefer over others, but I'm not going to go into the clinical years with a pre-set bias.
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:laugh:

Oh I was lurking.

Please continue.

:corny:
 
Fivo said:
Watch out, we got a badass over here. Are you always this serious in real life? If you have some specialties you prefer, why not list them? You act as if everyone on here listed the specialty that they'd die for...
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Sorry about the pessimism, I've had a bit of a rough morning. I like all surgs (except colorectal), anesthesiology, neuro, and cards. However, I could see myself doing practically any specialty other than OB/GYN, psych, and colorectal.

The reason why I don't like people who are dead-set on one thing is that it limits your opportunities. For example, I didn't really like physics coming in to college and pushed taking it until Jr. year. My dislike of this subject came from my jackass high school physics teacher, who made it a chore. However, I thoroughly enjoyed taking it in college (I guess it made more sense conceptually after taking Calc) and now I kind of regret not majoring in it.

For the record, the only time I'm serious is when I'm on SDN. Even then, I still post some smartass comments. 😉
 
Disclaimer: I've never sat in on a surgery!!

Either way, I just respect these guys so much. There is no way I could ever just stand up and concentrate like the way they do for hours on end. The money sounds awesome and the fact that you have that interaction with the patients is amazing but from my understanding their lifestyle sucks. Nevertheless, it seems as if this specialty can only be for a certain type of person. Someone who unlike me has a great back and can deal with the physical demands of this job.
 
I really like surgery...most specifically ortho or pediatrics but who knows. I wouldn't mind doing anesthesiologist either.

Overall just getting I med school would make me extremely happy!! 😀
 
Anesthesia, IM --> Cardiology, Diagnostic Radiology

I hear that rads is on the decline, and that CRNA's are taking over the anesthesia. Guess that leaves cardiology. Meh.
 
molarseeker said:
How's the anesthesia lifestyle?
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I know and have befriended an Anes. Who went to sgu for med school. He works 2 weeks on call, 2 weeks off. It's here in Louisiana so I think he's probably raking in money... Probably not as much as 5-10 years ago
 
molarseeker said:
How's the anesthesia lifestyle?
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Cruise over to the anesthesiology part of the board.

The anesthesiologists there are always talking about lifestyle and hours, etc.

From what I've gathered, their days start early, really early, and then end anywhere from 3-6pm.

They usually work >50 hours a week, sometimes with call on top of that.

In other words, it's not very befitting of its ROAD designation, but sometimes there are jobs that are better in that respect than others.
 
mtremblay said:
I really like surgery...most specifically ortho or pediatrics but who knows. I wouldn't mind doing anesthesiologist either.

Overall just getting I med school would make me extremely happy!! 😀
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You don't want to do peds surg. 4 yrs med school, 5 yr gen surg residency, 2 yr research (unwritten requirement for fellowship), 2 yr fellowship (which is really hard to get without knowing someone), then taking call every 4th night if you live in a big city and get a great set up for the rest of your life. I talked to a ped surg that was the only one in a state for a few years - I.e. he was on call 24/7. He is now "lucky" enough to be one of 2 or 3 in his current area so he "only" takes q2 or q3 call..
 
vasca said:
Curiously Mexico with it's dire specialist doctor shortage usually employs very large numbers of FM doctors to be ER doctors which are in less dire shortage than ER docs (the number of FP residency programs is almost 3 times the amount of ER programs just to give you a small idea). If you are a patient and show up in a rural community hospital ER room, chances are you are more likely to be treated by a FP doc than an ER doc.

The quality of care between specialists will probably not vary too much because in Mexico it's very common for FP residents to rotate at least 33% of their residency in the ER and are trained alongside ER residents, but the capacity to perform invasive procedures is more program specific and the kind pf patient population the hospital usually gets. The urgency of specialist doctors in Mexico is so bad that hospitals in rural areas usually employ large numbers of GP doctors who do short certification programs to learn about basic ER medicine and mostly learn-on-the-job with senior ER and FP docs teaching them how to perform invasive procedures. Many of them over time become just as good as ER docs but sadly don't have the specialist license.

If the GP doc is unionized, they can request to be granted a permit for a residency slot being paid their normal salary (which is usually at least twice the salary of a normal resident), but the number of available slots for ER medicine for these workers as such are so few, most of them opt for Family Medicine since the license is still just as good for general ER medicine anyways. Family Medicine residency is also very attractive because the first year or two the unionized worker enjoys a cushy 40 hour a week schedule and can comfortably moonlight depending on the program. In the final year they work at the hospital full time as any resident but with more hierarchy power. The option is great if you are a mom with kids and want to become a specialist without working 100 hours a week for 4 years.

I am however somewhat hesitant towards Integrative medicine specialists which is a specialty that does not exist in the US. Basically it's a watered down FM specialty that only lasts two years where the specialist is only able to treat outpatient diabetics and hypertensive patients and nothing else. They rotate in IM floors in hospitals but are only trained to treat patients with the 2 aforementioned diseases and thus are not as well rounded as their IM peers. A lot of people find the specialty attractive because it's so short but the job market is very poor and usually end up working as GP doctors.

Don't be too keen on choosing a specialty as a pre-med, 90% of the time you will probably end up choosing something completely different.
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There is an EM shortage in the states too (it's a new specialty). A lot of EDs in the states are not exclusively staffed by EM trained physicians.
 
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