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DrShelmonMD
Thanks
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I like both specialities, and I feel that they could compliment one another. Would it be wise or useful for me to become a gastroenterologist AND an endcrinologist(focusing on metabolism and diabetes)? I also would want to do research. I'm not sure if I want to open my own practice yet. I think that I would rather be a part of a hospital full-time. Can you all think of any advantages or disadvantages to this? Any info would be helpful. Thanks
I like both specialities, and I feel that they could compliment one another. Would it be wise or useful for me to become a gastroenterologist AND an endcrinologist(focusing on metabolism and diabetes)? I also would want to do research. I'm not sure if I want to open my own practice yet. I think that I would rather be a part of a hospital full-time. Can you all think of any advantages or disadvantages to this? Any info would be helpful. Thanks
I've thought of doing a double fellowship too (except in ID and heme-onc). Of course, there's more time spent on doing the fellowships as opposed to practicing and earning money. Why are you interested in combining GI and endocrine? GI is highly procedural whereas endocrine is not so much.
If, in the end, you end up wanting to do both, try to match in the most high caliber academic IM residency, then GI, then endocrine.
technically, hemeonc docs are double boarded so that's 3 fellowships.
since GI is so competitive, if OP doesn't match into a competitive IM program, could he could use the endocrine fellowship as a springboard into GI?
If you want to manage both sets of patients, why not skip both fellowships and be a generalist?
I think it would be hard to maintain both knowledge bases in practice.
So hearing someone saying they are interested in both is a bit like listening to an M3 saying, "I am either going to do Pathology or Emergency Medicine" -- it seems to reflect a lack of either self-knowledge or knowledge about the fields at hand.
Hey! Some of us are actually having this internal debate. Maybe I lack a little more than a bit of both?
I like both specialities, and I feel that they could compliment one another. Would it be wise or useful for me to become a gastroenterologist AND an endcrinologist(focusing on metabolism and diabetes)? I also would want to do research. I'm not sure if I want to open my own practice yet. I think that I would rather be a part of a hospital full-time. Can you all think of any advantages or disadvantages to this? Any info would be helpful. Thanks
*Snip*
Path and EM are actually both great fields with relatively high job satisfaction and income for hours worked (path > EM in terms of $). I just think that the student who is torn between them needs to do some soul-searching (preferably with the help of trusted faculty mentors) to answer the question "what I am really looking for in a career?"
Why don't you ask yourself this question after your first set of ABIM in-training exam scores come back after you take this exam your first year of Internal Medicine Residency? Also, be sure that your Internal Medicine Residency Match is high-caliber university too. GI is one of the most competitive IM fellowships out there and community programs are not going to get you into GI. Also, be aware endo is not a "chip shot" either. Before you start looking at practice options, lets see what you bring to the table in terms of where you match and how you do in residency.
Hey! Some of us are actually having this internal debate. Maybe I lack a little more than a bit of both?
Both are concerned with making THE diagnosis . . .
Both are concerned with making THE diagnosis...
I have never met an ER doctor who was concerned with making a diagnosis.
Unless you consider "hyponatremia" and "altered mental status" diagnoses.
So the OP can't consider his career options ahead of time? When IS the precise moment that we students are permitted to consider fellowships of interest? Is it after we match our residency? Is it after we get our scores back on inservice exams? Is it after we get letters of rec? Be precise as I don't want to think about this prematurely!
I mean geez, why shouldn't the OP look ahead? What if he's making his match list and is torn between that high powered academic program and a little more laid back community program. Maybe knowing his fellowship goals ahead of time might help with the decision, eh? Besides that, when did people on SDN decide that it was 'imprudent' or in fact 'wrongheaded' to aim at a goal until AFTER one had already cleared the hurdles to achieving the goal? Are we afraid of failure around here, or is it something else? It reminds me of the threads on pre-allo where the pre-med will mention being interested in ortho, or derm, or whatever, and then immediately all the naysayers will jump on him about not even thinking about that until he gets into med school, aces his classes, and scores a 397 on Step 1. The kid's not going to med school to become a generic fill in the blank doc, he's going with the idea of working as a specific type of doc, just like EVERY ONE OF US DID.
Let people dream. Let them imagine their futures. Quit trying to get in their way. If you think someone's dream is not feasible, mention the pitfalls you see and allow them to consider your comments and, if necessary, adjust their vision. But quit griping at people for looking ahead to a career they think they'll find enjoyable just because YOU think they might now be able to make it.
Sorry I just find it sad how much negativity flies around this place.
Yeah, I have to agree with tired here, in my admittedly limited experience, the ER guys are concerned with making THE dispo, not so much the diagnosis. The question is "Will this person die or irrecoverably lose function within the next hour?", "Is this patient sick enough to be admitted?", and "Which service do we turf this patient to?" Which is fine, because that's their job. Triage, stabilize, and direct the patient to the appropriate care provider. In tired's example the flow goes like this: Patient has AMS -> patient has hyponatremia per chem7, this is the most likely cause of the AMS -> hyponatremia is most likely a result of a process IM docs deal with -> call admitting IM resident.
That's it. And the IM resident is simply hoping the ER doesn't do something silly like try to treat with hot salt before he can get down there and take over care.
However, I think there are certainly some multifaceted individuals out there who would indeed be exceptional in two completely separate fields because they play to different aspects of their personality.
For the record, it is never advantageous to be an endocrinologist.
This reason, for me at least, is at the root of my dilemma. The Dr. Jekyll in me wants to be involved in molecular diagnostics and basic science as it is applied to medical practice, while Mr. Hyde wants to be in the center of the drama, doing procedures and handling emergencies.
Why can't I find a career path that combines all the aspects of everything I like about medicine? The closest I have come thus far is family med. (Unfortunately, the bulk of the "pathology" I experienced on my FM rotation was looking at endless vaginal discharge smears for yeast and clue cells. Not particularly exciting.)
How 'bout derm? As hands on as you want to be, lots of looking at slides and histology. Focus on skin cancer and you'll have plenty of both.
Dude, this kid IS a premed.
I mean, yeah it's true, but at the same time, it's not really fair to blame the EM docs for the fact that the general public uses them for primary care and not for emergencies. If someone wants a fullblown dx workup for a problem that's been going on for weeks --> months --> years and is NOT life threatening, the ED is not the appropriate place to go (hence the "emergency" in "emergency department"). So yes it's unfortunate that other services have to deal with the backlash (not safe to go home --> admit) but it's not totally their fault. Also, if someone came in with AMS, the ED often runs multiple tests at once and diagnoses based on what comes back positive... but they can't exactly sit there are correct the hyponatremia to make sure that's the cause of the AMS when they have a waiting room full of "chest pain" and "abdominal pain" and "vaginal bleeding" and a limited number of beds.
For the record, it is never advantageous to be an endocrinologist.
For the record, it is never advantageous to be an endocrinologist.
I dunno -- the couple I've worked with say they love their job, do a lot of clinical research on a handful of patients who will never be "cured" (steady flow of repeat business), and don't seem to work too hard compared to some of the other medicine subspecialties.
What if your main area of interest is obesity? Endo has diabetes, GI has hepatology and fat storage. Which specialty do you think is more relevant if you want to be an obesity specialist or pursue clinical obesity research?
What if your main area of interest is obesity? Endo has diabetes, GI has hepatology and fat storage. Which specialty do you think is more relevant if you want to be an obesity specialist or pursue clinical obesity research?
Endocrine only.
About 0.01% of GI training would help you above and beyond what you would get out of endo training.