What's the kind of doc who can do everything?

[HK42]

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So maybe I have a fantasy of going to Guatemala and doing as much as I can with little worry about legal restrictions. But I have an in general question:

What kind of doc is the most autonomous and would serve an impoverished third world country best?

I'm guessing it would be important for this doc to know how to use a microscope, so they can look at slides and get an idea if something is one of three possible candidates. But not a pathologist, bc they'd have to talk to people and possible even touch a few.

So would an IM residency set this up with a year of peds? Would a family medicine residency suffice? Would an IM residency with a subspecialization in ID be important?

Thoughts, bc I'm seriously thinking about doing some setting up shop in a third world country type thing, and am trying to gauge what kind of docs are in demand, and could I be real automous and useful? What would make me most useful?

 

[Arsenic]

here's a link to Doctors Without Borders:

http://www.doctorswithoutborders.org/volunteer/field/physicians.cfm

According to that page they are particularly seeking emergency medicine physicians, general practitioners, family practitioners, internists, pediatricians, obstetricians/gynecologists, and infectious-disease specialists.

 

[MattD]

I believe (but look it up to check me) that there are FP or IM residency programs out there with a 'rural' track, where they are trained in basic surgery as well as general medicine. This might be similar to what you're looking for.

 

[ZagDoc]

I believe (but look it up to check me) that there are FP or IM residency programs out there with a 'rural' track, where they are trained in basic surgery as well as general medicine. This might be similar to what you're looking for.

Agreed. GPs and ER docs are probably the closest you get to a jack of all trades. You won't be able to do many things particularly well (thats not meant as a slight since most procedure in medicine are a matter of experience), but you'll be able to do a little bit of pretty much everything.

 

[PeepshowJohnny]

A surgeon who gave a presentation on international medicine said surgery was the best option for someone to be autonomous oversees.

The scenario he outlined made some sense to me. If a medicine or family guy goes over there, they're going to have no surgery experience so they're already limited in what they can do.

The surgeon has the ability to do surgeon (assuming he has the backing of somebody who can do anesthesia). However, he can also practice medicine since a lot of the subtlety it requires over here is gone. For example, over here IM docs are great with subtle pick ups for stuff like thyroid disease, it's hard not to miss somebody with the GIANT THYROID GOITER and figure out what's causing their problem. Treating medicine problems is really different from practicing medicine here, so a surgeon is at less of a disadvantage.

I think he made a good point, but he's also kinda an egotistical loser, so take it for what it is.

 

[deleted77919]

The surgeon has the ability to do surgeon (assuming he has the backing of somebody who can do anesthesia).

Anesthesia? If you're doing it pro-bono just give them a bite stick before you do their appy.

 

[Cirrus83]

FP's are pretty jack of all trades, but I dunno about microscopes...that said, anybody willing to put in the time to learn can learn enough to get by regardless of what specialty they're officially in.

One of my profs does screening colonoscopies and he's FP.

 

[smq123]

I'm guessing it would be important for this doc to know how to use a microscope, so they can look at slides and get an idea if something is one of three possible candidates. But not a pathologist, bc they'd have to talk to people and possible even touch a few.

FP's are pretty jack of all trades, but I dunno about microscopes...that said, anybody willing to put in the time to learn can learn enough to get by regardless of what specialty they're officially in.

In Family Med and OB/gyn, you have to know how to use microscopes in daily practice. (And yes - this means that you will have to know how to use a microscope when you start those particular rotations in 3rd year!) Diagnosing yeast infections, bacterial vaginosis, trichomonas, and testing to see if a pregnant woman's water broke all require a microscope. So it's not just pathology.

What kind of doc is the most autonomous and would serve an impoverished third world country best?

So would an IM residency set this up with a year of peds? Would a family medicine residency suffice? Would an IM residency with a subspecialization in ID be important?

Thoughts, bc I'm seriously thinking about doing some setting up shop in a third world country type thing, and am trying to gauge what kind of docs are in demand, and could I be real automous and useful? What would make me most useful?

IM doesn't routinely include a year of peds. You'd have to do a Med/Peds residency, which is roughly broken up into 2.5 years IM and 1.5 years peds (I think).

Family med would definitely make you quite autonomous and useful - family med includes some peds training, some OB/gyn training, some ER training, and a surgical rotation. It would make you very well rounded.

An IM residency with an ID fellowship may or may not be useful. It also may or may not interest you (which is equally important). IM will not make you as well-rounded as family med, since it does not offer surgical training, peds training, or OB/gyn training at all. But you would have a greater in-depth knowledge of adult medicine.

 

[smq123]

A surgeon who gave a presentation on international medicine said surgery was the best option for someone to be autonomous oversees.

The scenario he outlined made some sense to me. If a medicine or family guy goes over there, they're going to have no surgery experience so they're already limited in what they can do.

The surgeon has the ability to do surgeon (assuming he has the backing of somebody who can do anesthesia). However, he can also practice medicine since a lot of the subtlety it requires over here is gone. For example, over here IM docs are great with subtle pick ups for stuff like thyroid disease, it's hard not to miss somebody with the GIANT THYROID GOITER and figure out what's causing their problem. Treating medicine problems is really different from practicing medicine here, so a surgeon is at less of a disadvantage.

I think he made a good point, but he's also kinda an egotistical loser, so take it for what it is.

He does make a good point...but I would still rather have a family med person overseas rather than a surgeon (if I had to choose one or the other). At least the family med person would have some kind of OB/gyn training - not too sure about surgeons though....

 

[howelljolly]

Family Practice is what you are looking for. It encompasses Pediatrics, Adult/IM, Geriatrics, OB/Gyn, GS (30% of FPs have kept their obstetrics priviledges, some FPs have minor surgical priviledges ), .
The OB/Gyn, and General Surgery rotations within the residency are more involved than in IM residency.
Since FP is "self-limiting" (theoretically, all medicine is) you'll be able to do whatever you are willing to take full legal responsibility for, within your scope of training. This includes clinical lab stuff like looking under a microscope for Candida or Gardnerella.
You can select a Rural Medicne track is some FP residencies, and train to be the proverbial "country doctor".

hope that helps