HereWeGo21

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Can we put an end to this debate once and for all?

As the stereotype goes, internal medicine, neurology, etc. are the intellectual fields. Surgeons, on the other hand, are regressive manual laborers and little thinking goes on inside their heads.

Of course, surgery is difficult, and so on. So it can't be entirely true. Where does the truth lie? Is it possible that surgery is every bit as intellectual (and then some) but they just don't show it?

Quite a few people have told me something along the lines of "anything besides internal medicine would be a waste of your brain." But then how do you explain that neurosurgery, ENT, etc, have higher board scores? And assuming Step 1 reflects intelligence...something doesn't add up.

Thoughts?
 

Taddy Mason

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There's always IR :D
 
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But then how do you explain that neurosurgery, ENT, etc, have higher board scores?
$$$$$, perceived prestige. Also, IM has a bunch of low-quality community programs that anyone with a pulse can attend. There's no such thing in nsgy or ent. There is an order of magnitude difference in the number of spots.

also, there's a difference between having a brain and using it, not that I think surgeons don't use their brains. Using 50% of 260 brain < using 80% of 240 brain
 

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Can we put an end to this debate once and for all?

As the stereotype goes, internal medicine, neurology, etc. are the intellectual fields. Surgeons, on the other hand, are regressive manual laborers and little thinking goes on inside their heads.

Of course, surgery is difficult, and so on. So it can't be entirely true. Where does the truth lie? Is it possible that surgery is every bit as intellectual (and then some) but they just don't show it?

Quite a few people have told me something along the lines of "anything besides internal medicine would be a waste of your brain." But then how do you explain that neurosurgery, ENT, etc, have higher board scores? And assuming Step 1 reflects intelligence...something doesn't add up.

Thoughts?
A few thoughts. Tl;dr: Medical students gain an appreciation for medical management because they are beaten over the head with it throughout med school. Their exposure to surgery is a painful anatomy course and miserable or useless gen surg rotation.

Surgery is very intellectual, but not always in a way that is obvious to medical students and non-surgeons. Medical students are pounded with the minutiae of internal medicine throughout med school: physiology, pharmacology, huge blocks of inpatient medicine during M3/M4 year (peds, IM, family med, specialty rotations, etc). They get tested on the steps and whys and wherefores of basic inpatient care (rightly so). And they finish intern year with an appreciation for the complexity of quality and thoughtful inpatient care.

But what is the medical student's exposure to surgical science? The basis of surgery is anatomy, and most medical students learn to despise anatomy. It's a massive block of information with little clinical significance for an M1, the learning process is physically nauseating for many students, and when they get to M3 year, the limit of their use of anatomy is often being pimped by a surgeon while they are retracting from low-earth orbit. Then they get to the rotation where they get some exposure to clinical surgery -- their gen surg rotation.

Gen surg rotations tend to fall in one of two extremes: 1. extremely cushy rotations at community hospitals with 7am-5pm hours, no responsibility, and mostly standing around watching disinterested community docs operate, or 2. Hellish death marches with 5am-10pm hours, overnight call, dealing with overworked surgery residents who are as likely to strangle a med student as ignore them. Med students rarely leave these experiences with an appreciation for even the basics of surgery: wound care, perioperative medicine (fluids/ambulation/feeds/vital sign instability). And they definitely don't leave with an appreciation for the actually "intellectual" parts of surgery: deciding when a patient needs to go for surgery, deciding what operation they need, deciding what approach to use, what intraoperative factors to consider, and what postoperative care is necessary. There's a reason that takes 5-7 years of residency to learn: it's really, really complicated and "intellectual".

There's this idea that a lot of non-surgeons have, that being a surgeon = being able to do "procedures" or "operations". That's like saying being an rheumatologist is about being able to choose immune modulators. It's partially because non-surgeons usually have very little idea what goes into peri-operative and intraoperative decision making. And I think it's also partially because medical students' exposure to procedures is very rote. Central line = draping like this, putting the ultrasound there, and then sticking the needle in and doing all the steps in the right order. Suturing = pass the needle like this, make it very even, and then tie the knots like this. Being able to do a procedure is about doing all the steps correctly and in the right order, like a cookbook...not very intellectual.

But even in the simplest operations, there's a million factors that med students aren't considering. Look at nasal obstruction, one of the most common problems ENTs see. Even if we exclude all the medical causes of nasal obstruction and reduce it to a simple surgical problem, the management is complex. Where's the obstruction? Septum? Internal or external valve? Turbinates? Each one has it's own therapy. Now let's reduce it even further. Just septal obstruction. But how are we doing septoplasty? Is the deflection anterior enough that I need to use an alternate incision or even a rhinoplasty approach? What about extracorporeal septoplasty? What if the deflection involves structural elements that I can't resect? What if I make a perf? How do I approach spurs that impinge sidewall? Etc, etc, etc.
 
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Foot Fetish

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It doesn't.
You seriously think there's no correlation between Step 1 score and IQ ? That's ridiculous. People who score 270+ are, on average, much more intelligent than people who score in the 220's, for example. You basically need to have gifted / possibly genius level IQ to score that high. Someone of average IQ could study USMLE material full time for years and still never crack 250.
 
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Dr. Death

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Can we put an end to this debate once and for all?

As the stereotype goes, internal medicine, neurology, etc. are the intellectual fields. Surgeons, on the other hand, are regressive manual laborers and little thinking goes on inside their heads.

Of course, surgery is difficult, and so on. So it can't be entirely true. Where does the truth lie? Is it possible that surgery is every bit as intellectual (and then some) but they just don't show it?

Quite a few people have told me something along the lines of "anything besides internal medicine would be a waste of your brain." But then how do you explain that neurosurgery, ENT, etc, have higher board scores? And assuming Step 1 reflects intelligence...something doesn't add up.

Thoughts?
Why would you ever think that such a basic, blanket stereotype would be true? Obviously little thinking goes on inside your head.
 
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You seriously think there's no correlation between Step 1 score and IQ ? That's ridiculous. People who score 270+ are, on average, much more intelligent than people who score in the 220's, for example. You basically need to have gifted / possibly genius level IQ to score that high. Someone of average IQ could study USMLE material full time for years and still never crack 250.
It's more of an achievement test than aptitude.
 
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DocWinter

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There is some correlation for sure between step score and IQ, but I know some pretty dense "smart people" with high boards and some sharp average Joes who passed and that's about it. Booksmark and streetsmart rarely meet equally.


If you think surgery is a pit of meatheads who can't or don't want to use their brain you haven't appreciated the talent or mixture of preop, postop, fluid and electrolyte balance, critical care and cormorbid conditions consideration lwhich surgeons deal with daily.

The cutting and sewing is the tip of the iceberg
 

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You seriously think there's no correlation between Step 1 score and IQ ? That's ridiculous. People who score 270+ are, on average, much more intelligent than people who score in the 220's, for example. You basically need to have gifted / possibly genius level IQ to score that high. Someone of average IQ could study USMLE material full time for years and still never crack 250.
I knew and have seen people who were very good at taking tests. Common sense and reasoning... well, not so much. You can learn to take a test, you can't learn to have a good head on your shoulders.
 
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Can we put an end to this debate once and for all?

As the stereotype goes, internal medicine, neurology, etc. are the intellectual fields. Surgeons, on the other hand, are regressive manual laborers and little thinking goes on inside their heads.

Of course, surgery is difficult, and so on. So it can't be entirely true. Where does the truth lie? Is it possible that surgery is every bit as intellectual (and then some) but they just don't show it?

Quite a few people have told me something along the lines of "anything besides internal medicine would be a waste of your brain." But then how do you explain that neurosurgery, ENT, etc, have higher board scores? And assuming Step 1 reflects intelligence...something doesn't add up.

Thoughts?
I don't think surgeons are dumb or are wasting their brain/intelligence. While I can't understand why anyone does it, I am really glad someone does. My first surgery attending know more medicine than any IM doc I have met and was truly a genius. I think general surgery might be one of the most challenging specialties due to the amount of medicine you also have to know. That would not be a waste of your brain.

This year I discovered that I have a very strong visceral reaction to being asked to do any task with my hands. Suturing, playing an IV, placing a foley, even taking out drains. I don't find it "gross", but I get really anxious about hurting the patient, doing damage, or just doing something irreversible and wrong. Even with practice these feelings haven't gone away. I thought I wanted to do a surgical sub but have been forced to do some honest introspection and reevaluate my identity and future goals.

Because of this I am leaning very much towards an IM subspecialty or neurology despite a Step 1 score that would get me an interview for any competitive surgical subspecialty anywhere. I have had reservations based simply on income/lifestyle. I know that is not a popular thing to admit, but neurology and IM docs work hard (call for neurology can be very bad and they work more in residency than any non-surgical specialty) and have stress (stroke codes for example) with relatively poor compensation. What is driving the divide in board scores isn't intelligence. Its compensation. Its not that smart people go into ENT or ortho for an intellectual challenge. Its because they want to maximize their earning potential if they are smart enough to do so. I know because I feel that pull to capitalize on my score. There is also the confounding issue that people who come into school thinking they want ortho will work a lot harder on Step 1 than someone who is smarter but just wants to do anesthesia or EM. The difference in board score is thus just some sweat, blood, and tears. The test is beatable and doesn't take a genius to score well on it.
 

Foot Fetish

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I did that and I'm not a genius. I got like a 30 on my MCAT and struggled with math as a child and through undergrad. The pattern recognition and memorization of medicine and Step 1 suits my specific skill set (photographic memory and algorithmic thinking process). That's all.


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Photographic memory is a type of genius in my opinion.
 

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You seriously think there's no correlation between Step 1 score and IQ ? That's ridiculous. People who score 270+ are, on average, much more intelligent than people who score in the 220's, for example. You basically need to have gifted / possibly genius level IQ to score that high. Someone of average IQ could study USMLE material full time for years and still never crack 250.
Where would we be without first year med students to tell us what it takes to do well on step 1?
 

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I don't think surgeons are dumb or are wasting their brain/intelligence. While I can't understand why anyone does it, I am really glad someone does. My first surgery attending know more medicine than any IM doc I have met and was truly a genius. I think general surgery might be one of the most challenging specialties due to the amount of medicine you also have to know. That would not be a waste of your brain.

This year I discovered that I have a very strong visceral reaction to being asked to do any task with my hands. Suturing, playing an IV, placing a foley, even taking out drains. I don't find it "gross", but I get really anxious about hurting the patient, doing damage, or just doing something irreversible and wrong. Even with practice these feelings haven't gone away. I thought I wanted to do a surgical sub but have been forced to do some honest introspection and reevaluate my identity and future goals.

Because of this I am leaning very much towards an IM subspecialty or neurology despite a Step 1 score that would get me an interview for any competitive surgical subspecialty anywhere. I have had reservations based simply on income/lifestyle. I know that is not a popular thing to admit, but neurology and IM docs work hard (call for neurology can be very bad and they work more in residency than any non-surgical specialty) and have stress (stroke codes for example) with relatively poor compensation. What is driving the divide in board scores isn't intelligence. Its compensation. Its not that smart people go into ENT or ortho for an intellectual challenge. Its because they want to maximize their earning potential if they are smart enough to do so. I know because I feel that pull to capitalize on my score. There is also the confounding issue that people who come into school thinking they want ortho will work a lot harder on Step 1 than someone who is smarter but just wants to do anesthesia or EM. The difference in board score is thus just some sweat, blood, and tears. The test is beatable and doesn't take a genius to score well on it.
don't worry. plenty of medical specialties offer very high compensation. think about heme/onc and cardiology.
 
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sloop

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Where would we be without first year med students to tell us what it takes to do well on step 1?
Fair enough about people who haven't taken the test commenting on it. However, I've taken this test and done well on it and I think a person with average intelligence (i.e. IQ 100) would be hard-pressed to even get into med school and pass the classes, let alone score well on the standardized board exams against their substantially smarter peers. It's not impossible, but relatively few people of truly average intelligence probably make it to med school to begin with. Of these, a disproportionate number likely fail out. Of the remaining, it seems that it would be difficult to score above average on step 1 with reasoning aptitudes that are below average for your peer group. I recognize that it is not strictly a reasoning test, but I think reasoning ability factors in enough that if you're far enough below the average intelligence of the test-takers, the compensation required to do well in spite of this would become an almost insurmountable obstacle.

I think that a lot of people in med school get into a bubble and their perception of "smart" changes. It can be easy to forget what average intelligence really looks like.
 
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Fair enough about people who haven't taken the test commenting on it. However, I've taken this test and done well on it and I think a person with average intelligence (i.e. IQ 100) would be hard-pressed to even get into med school and pass the classes, let alone score well on the standardized board exams against their substantially smarter peers. It's not impossible, but relatively few people of truly average intelligence probably make it to med school to begin with. Of these, a disproportionate number likely fail out. Of the remaining, it seems that it would be difficult to score above average on step 1 with reasoning aptitudes that are below average for your peer group. I recognize that it is not strictly a reasoning test, but I think reasoning ability factors in enough that if you're far enough below the average intelligence of the test-takers, the compensation required to do well in spite of this would become an almost insurmountable obstacle.

I think that a lot of people in med school get into a bubble and their perception of "smart" changes. It can be easy to forget what average intelligence really looks like.
education =/= intelligence necessarily though, right?
 

sloop

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education =/= intelligence necessarily though, right?
Education and intelligence covary better than intelligence and just about anything else.

Particularly if you're talking about a degree for which people have been sequentially selected based on multiple levels of standardized testing and years of academic achievement, yeah I think education and intelligence are going to be pretty linked.

I'm a 4th year medical student, so I've interacted with plenty of med students and a lot of "average" people. I honestly can't think of a med student I've met who I think probably has an IQ below 110.
 

eteshoe

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Not really - though it's a useful skill in certain careers
And completely useless in others. I could do a really long and multi step physics/calculus problem on a practice set and then on the exam not be able to do a problem that was similar. I could have written that old problem down perfectly from memory probably but couldn't apply or understand what I was doing enough to solve something slightly different.

So it's probably good I wasn't an engineer. Nobody in that field would call me a genius if I had tried to do it.


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HereWeGo21

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And completely useless in others. I could do a really long and multi step physics/calculus problem on a practice set and then on the exam not be able to do a problem that was similar. I could have written that old problem down perfectly from memory probably but couldn't apply or understand what I was doing enough to solve something slightly different.

So it's probably good I wasn't an engineer. Nobody in that field would call me a genius if I had tried to do it.


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Yo, just saying:

http://www.scientificamerican.com/article/i-developed-what-appears-to-be-a-ph/

"The intuitive notion of a “photographic” memory is that it is just like a photograph: you can retrieve it from your memory at will and examine it in detail, zooming in on different parts. But a true photographic memory in this sense has never been proved to exist."
 
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You seriously think there's no correlation between Step 1 score and IQ ? That's ridiculous. People who score 270+ are, on average, much more intelligent than people who score in the 220's, for example. You basically need to have gifted / possibly genius level IQ to score that high. Someone of average IQ could study USMLE material full time for years and still never crack 250.
Real cases:
24-28 MCAT'ers with 227-252 Step 1 (n =6). I know a 29 MCAT dude with a 265 Step 1.
30-40 MCAT'ers with 222-265 (n=4).

I don't think you need to be a genius to get a high USMLE score, but you must work hard at a minumum. There probably is some intelligence factor since I don't understand why some people with better grades/work ethic scored significantly less than others with worse grades and less effort. I recall reading posts here by a 38+ scorer who scored mid 230's with reasonable effort, but yet a dude with a 25 MCAT in my class got a 246, nearly what I scored even though my MCAT was >90th percentile. I just don't think we truly understand intelligence, its domains, and what it predicts.
 

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There is some correlation for sure between step score and IQ, but I know some pretty dense "smart people" with high boards and some sharp average Joes who passed and that's about it. Booksmark and streetsmart rarely meet equally.


If you think surgery is a pit of meatheads who can't or don't want to use their brain you haven't appreciated the talent or mixture of preop, postop, fluid and electrolyte balance, critical care and cormorbid conditions consideration lwhich surgeons deal with daily.

The cutting and sewing is the tip of the iceberg
And that's why we all still consider ortho a bunch of meatheads...
 

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Can we put an end to this debate once and for all?

As the stereotype goes, internal medicine, neurology, etc. are the intellectual fields. Surgeons, on the other hand, are regressive manual laborers and little thinking goes on inside their heads.

Of course, surgery is difficult, and so on. So it can't be entirely true. Where does the truth lie? Is it possible that surgery is every bit as intellectual (and then some) but they just don't show it?

Quite a few people have told me something along the lines of "anything besides internal medicine would be a waste of your brain." But then how do you explain that neurosurgery, ENT, etc, have higher board scores? And assuming Step 1 reflects intelligence...something doesn't add up.

Thoughts?
Surgery requires a lot of intellect, but its related to surgery rather than medicine. You need to be smart to do both fields, but with surgery you just don't have the time to be an expert in the medicine as well.
 

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When talking about IQ, it seems that its use in debate and calculations are incomplete. IQ is age-dependent. By definition, the 30-year old with IQ 100 will be "smarter" than the 25-year old with 100 IQ. It is a comparison to the average person of your age and general area of residence (EU and USA are scaled differently, as are other regions).
 

sloop

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When talking about IQ, it seems that its use in debate and calculations are incomplete. IQ is age-dependent. By definition, the 30-year old with IQ 100 will be "smarter" than the 25-year old with 100 IQ. It is a comparison to the average person of your age and general area of residence (EU and USA are scaled differently, as are other regions).
This is not really accurate. IQ can change over one's life but usually the change is not huge and one's IQ at age X usually correlates highly with their IQ at age Y. The entire concept of the "quotient" in IQ was that of intellectual age per chronological age. Psychometric tests for specific age populations (I.e. The WISC) are normed against the age range for which they have been validated.

The reality is that IQ does attempt to account for age (that is, an attempt is made to make it age-independent). Whether it happens to actually do so is a different question that is kind of outside the scope of this discussion. If you're trying to say that an older person with the same IQ has a higher intellectual age, fine, but I don't really know why this is material. People don't typically conceptualize intelligence as a person's raw intellectual capabilities without consideration to the context of what is expected of that individual's cohort. People don't say an average person is smart because they have more raw intellect than a gifted 3-year-old.
 
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By definition, the 30-year old with IQ 100 will be "smarter" than the 25-year old with 100 IQ.
Not really, actually. As you age, your mental speed (generically) drops. So depending on what you mean by "smarter" the inverse is likely to be true. A 30-year-old would presumably have more knowledge to draw upon, and perhaps be more efficient. But in terms of raw processing power, the 25-year-old would likely have the advantage.
 

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Not really, actually. As you age, your mental speed (generically) drops. So depending on what you mean by "smarter" the inverse is likely to be true. A 30-year-old would presumably have more knowledge to draw upon, and perhaps be more efficient. But in terms of raw processing power, the 25-year-old would likely have the advantage.
Raw processing power = G, not IQ
 

darknecrosforte

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This is not really accurate. IQ can change over one's life but usually the change is not huge and one's IQ at age X usually correlates highly with their IQ at age Y. The entire concept of the "quotient" in IQ was that of intellectual age per chronological age. Psychometric tests for specific age populations (I.e. The WISC) are normed against the age range for which they have been validated.

The reality is that IQ does attempt to account for age (that is, an attempt is made to make it age-independent). Whether it happens to actually do so is a different question that is kind of outside the scope of this discussion. If you're trying to say that an older person with the same IQ has a higher intellectual age, fine, but I don't really know why this is material. People don't typically conceptualize intelligence as a person's raw intellectual capabilities without consideration to the context of what is expected of that individual's cohort. People don't say an average person is smart because they have more raw intellect than a gifted 3-year-old.
We're talking about IQ in relation to Step performance and somewhat in relation to the original post topic of people underestimating the intellectual demands of surgery. With IQ being equal, an older person would likely have an advantage over the younger one, whether it be a larger general knowledge base to draw from (seen in a lot of non-trads) or having more experience in relevant areas (test taking skills, coping mechanisms, etc.). It can be generalized that anyone successfully learning medicine (or physics/engineering/"insert specialty") in the US is branching into intellectual areas that make it difficult to match them to the corresponding "intellectual age". A 60-year old with a 180 IQ has the intellectual age of 108. They probably had to extrapolate that intellectual age, unless they're testing people in retirement homes or in hospice care. This is all just beating off into a sock, since a "high IQ individual" could negate any advantage gained during an exam via anxiety, poor sleep, studying ineffectively, etc.

Additionally, "raw ability" has its own psychometric metric g, which gets erroneously conflated with IQ, but has more application to what we're attempting to discuss. Surgery probably takes more general intelligence because it adds on kinesthetic competence/adaptability and typically more time pressure to tax the brain further. If we want to "end the debate", we would need to collect all 7 dragon balls and wish for all humans to "git gud" and stop getting rekt. And everyone knows that pathology is the most intellectual *PEW PEW
 

IsleyOfTheNorth

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Raw processing power = G, not IQ
"In any collection of test items that make up an IQ test, the score that best measures g is the composite score that has the highest correlations with all the item scores."
 

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And that's why we all still consider ortho a bunch of meatheads...
Orthopods are the smartest because they convinced everyone that they're stupid meatheads who can't manage anything other than fractures so they get to operate on fractures all day and drop patients off with medicine for basically everything that no one wants to do which is basically all the medical issues, organ problems, and electrolyte abnormalities, and social work.
 

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Orthopods are the smartest because they convinced everyone that they're stupid meatheads who can't manage anything other than fractures so they get to operate on fractures all day and drop patients off with medicine for basically everything that no one wants to do which is basically all the medical issues, organ problems, and electrolyte abnormalities, and social work.
This.
Actual conversation I overheard while on ortho rotation way back in medical school

Ortho:hey we need you to admit this guy, he's got a tibial fracture and his blood sugars are really high
IM: well is he diabetic? did you put him on a sliding scale?
O: Yeah maybe, his sugars are just really high. what sliding scale?
IM: an insulin sliding scale. Is he on insulin
O: I don't know, they're really high. How do you do a sliding scale?
IM: its a standard order set.
O: really? I've never done that before. can you put that in your admit orders?
IM: Well yeah, but...
O: thanks, that really helps

walks away. Playing stupid isnt the same as being stupid.
 

sloop

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We're talking about IQ in relation to Step performance and somewhat in relation to the original post topic of people underestimating the intellectual demands of surgery. With IQ being equal, an older person would likely have an advantage over the younger one, whether it be a larger general knowledge base to draw from (seen in a lot of non-trads) or having more experience in relevant areas (test taking skills, coping mechanisms, etc.). It can be generalized that anyone successfully learning medicine (or physics/engineering/"insert specialty") in the US is branching into intellectual areas that make it difficult to match them to the corresponding "intellectual age". A 60-year old with a 180 IQ has the intellectual age of 108. They probably had to extrapolate that intellectual age, unless they're testing people in retirement homes or in hospice care. This is all just beating off into a sock, since a "high IQ individual" could negate any advantage gained during an exam via anxiety, poor sleep, studying ineffectively, etc.

Additionally, "raw ability" has its own psychometric metric g, which gets erroneously conflated with IQ, but has more application to what we're attempting to discuss. Surgery probably takes more general intelligence because it adds on kinesthetic competence/adaptability and typically more time pressure to tax the brain further. If we want to "end the debate", we would need to collect all 7 dragon balls and wish for all humans to "git gud" and stop getting rekt. And everyone knows that pathology is the most intellectual *PEW PEW
No, really IQ is more relevant to whether someone would do better on boards than raw intellectual age. Who cares if a 90 year old has a higher intellectual age. 90 year olds do not routinely take the test. Besides, part of why IQ is important is that it measures how efficient one is at learning and reasoning rather than just how good they are. A 24 year old with an IQ of 130 has been 1.3 times as intellectually efficient as the 50 year old with an IQ of 100.

Also, what the hell is it with people wanting to label everything intelligence? "Emotional intelligence" "kinesthetic competence=intelligence." Our society is becoming too egalitarian-spirited for its own good. These are all great traits but they are not intelligence. Though impressive, the fact that a tennis player can hit a fast ball reliably does not make him intelligent. Everything is "a form of intelligence" these days because nobody wants to leave anyone out and make them feel bad.
 

darknecrosforte

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Though impressive, the fact that a tennis player can hit a fast ball reliably does not make him intelligent. Everything is "a form of intelligence" these days because nobody wants to leave anyone out and make them feel bad.
Not an equivalent comparison. It would be "how fast or adept is this person at visuospatial learning?", not "how much experience does this person have?" It has nothing to do with participation trophies.
 

TedStark

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No, really IQ is more relevant to whether someone would do better on boards than raw intellectual age. Who cares if a 90 year old has a higher intellectual age. 90 year olds do not routinely take the test. Besides, part of why IQ is important is that it measures how efficient one is at learning and reasoning rather than just how good they are. A 24 year old with an IQ of 130 has been 1.3 times as intellectually efficient as the 50 year old with an IQ of 100.

Also, what the hell is it with people wanting to label everything intelligence? "Emotional intelligence" "kinesthetic competence=intelligence." Our society is becoming too egalitarian-spirited for its own good. These are all great traits but they are not intelligence. Though impressive, the fact that a tennis player can hit a fast ball reliably does not make him intelligent. Everything is "a form of intelligence" these days because nobody wants to leave anyone out and make them feel bad.
Everyone's wife is beautiful and all kids are above average.
 

Phloston

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Can we put an end to this debate once and for all?

As the stereotype goes, internal medicine, neurology, etc. are the intellectual fields. Surgeons, on the other hand, are regressive manual laborers and little thinking goes on inside their heads.

Of course, surgery is difficult, and so on. So it can't be entirely true. Where does the truth lie? Is it possible that surgery is every bit as intellectual (and then some) but they just don't show it?

Quite a few people have told me something along the lines of "anything besides internal medicine would be a waste of your brain." But then how do you explain that neurosurgery, ENT, etc, have higher board scores? And assuming Step 1 reflects intelligence...something doesn't add up.

Thoughts?
People with high board scores choose surgical specialties because they pay more and/or are more prestigious. It's called the thinking of a person who's young who doesn't know better, and is normal. And lots of these surgeons should have been physicians. You can identify these types because they're the ones who pimp their residents/med students on MOAs of antibiotics or physiological mechanisms. Then they're burned out by 50 and are looking for fulfillment in a new career.

So you get thinkers (physicians) in surgery a lot of the time. People are smart (and stupid) in any field so that's not worth debating.

(And just throwing in my personal n=1, I had 260s on steps1/2CK and was looking into paeds/FM by the end of med school, before I ditched residency and moved to Japan)
 

Chromium Surfer

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People with high board scores choose surgical specialties because they pay more and/or are more prestigious. It's called the thinking of a person who's young who doesn't know better, and is normal. And lots of these surgeons should have been physicians. You can identify these types because they're the ones who pimp their residents/med students on MOAs of antibiotics or physiological mechanisms. Then they're burned out by 50 and are looking for fulfillment in a new career.

So you get thinkers (physicians) in surgery a lot of the time. People are smart (and stupid) in any field so that's not worth debating.

(And just throwing in my personal n=1, I had 260s on steps1/2CK and was looking into paeds/FM by the end of med school, before I ditched residency and moved to Japan)
What are you doing now?
 

Milotic

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And that's why we all still consider ortho a bunch of meatheads...
They are meatheads because they aren't really the type who study long hours to get 250+ on step 1. They are the type who spend most days working out, going on hiking trips on weekends, sitting down here and there blast through the material spending half as much time as the rest of the class and killing it with a 250+ on Steps. These students tend to also be the type that "wonders why their classmates have to study all the time". It's an interesting specimen of human.
 

Señor S

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They are meatheads because they aren't really the type who study long hours to get 250+ on step 1. They are the type who spend most days working out, going on hiking trips on weekends, sitting down here and there blast through the material spending half as much time as the rest of the class and killing it with a 250+ on Steps. These students tend to also be the type that "wonders why their classmates have to study all the time". It's an interesting specimen of human.
No. Just no.
 

sloop

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Please tell me more about how everyone who got a 250 on their step 1 worked their *** for it.
Not sure whose side of this argument this works for, but I got >250 on Step 1 and, while I kept a pretty regular and efficient schedule for 6 wks, I also had time to kick back every night after studying, took 1 day every week completely off, plus a spontaneous half-day or two and the day before my exam. I used this time to really explore the city my med school is in and go to fun and interesting places. Honestly it wasn't that bad, just had a decent plan.

Step 2 was also >250 and significantly better than my step 1 but was a different experience which sucked far more. I was exhausted from a very intense rotation and started studying the day after my shelf for about 2 wks. I had absolutely no study plan and was using multiple study sources, all of which sucked (except uworld, I guess). I woke up at like 11-11:30am every day because of sheer exhaustion and I was super inefficient, burned out and spent like half the time procrastinating. I took no days off and the experience really blew. I had an awful feeling going into that exam.

So I guess I worked pretty hard for both tests but not in the ways I anticipated. The first was a lot of work at sticking to a plan and being efficient to make room for unwinding. The second was hard work to not sleep every day away, stay awake and fed, and make it to the finish line with an empty tank of gas and two flat tires.
 
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Snoopy2006

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I've always found this entire idea stupid. But maybe that's because I began my surgical rotation in the SICU, where I got to see surgeons make tough medical decisions every single morning. The level of thought they put into their decisions - and the physiology behind their decisions - blew me away.

Stop the infighting. Each field has its own degree of badassery and requires a ton of expertise.
 

Stagg737

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I'm a 4th year medical student, so I've interacted with plenty of med students and a lot of "average" people. I honestly can't think of a med student I've met who I think probably has an IQ below 110.
Sadly, I've met more than I'd like to admit who I'd put money on having an IQ below that (thankfully not at my school). I've also met one or two that make me wonder how they dress themselves in the morning, let alone how they actually managed to get into medical school.

Yo, just saying:

http://www.scientificamerican.com/article/i-developed-what-appears-to-be-a-ph/

"The intuitive notion of a “photographic” memory is that it is just like a photograph: you can retrieve it from your memory at will and examine it in detail, zooming in on different parts. But a true photographic memory in this sense has never been proved to exist."
Maybe not proven, but there are people with memories good enough we can basically call it photographic. Like this person:

Orthopods are the smartest because they convinced everyone that they're stupid meatheads who can't manage anything other than fractures so they get to operate on fractures all day and drop patients off with medicine for basically everything that no one wants to do which is basically all the medical issues, organ problems, and electrolyte abnormalities, and social work.
You forgot the part about them also being in the top earning specialty. I wouldn't mind 500k/year to be the "There is a fracture, I need to fix it" guy.