Thursday, March 5, 2009

Surgery vs medicine, my thoughts on specialty

One of the purposes of the third year of med school is to pick your specialty. The first thing you need to decide is surgery or medicine. Then you could narrow it down after that. Surgery includes anesthesiology and all the specialties of orthopedic, ear-nose-throat, opthalmology, etc. Medicine includes pediatrics, dermatology, psychiatry, etc.

After my 2 weeks in the operating room, I have solidified my rank list of specialties a bit. This was also strengthened by that fact that EVERYONE at the CDC is either a pediatrician or internist.

Summary of my current thoughts on specialty

#1: Pediatrics
Good: I really enjoy kids, they are just cute. And they are not as difficult to deal with as I thought, like hating the doctor and crying every time you enter the room. There are very few people that are faking an illness and less psychiatric components to deal with compared to adults. Even if the parents are crazy and annoying, your patients are the kids, and you are trying to care for them. They tend to come into the hospital really sick and leave quite healthy in a short amount of time. Parents in my experience were very nice and treated the doctors with respect.

Bad: Not as wide variety of illnesses. We study adult medicine for the most part for all of medical school and very little pediatrics. Parents can be terrible, but I haven't run into it or noticed it as much as I expected it. You can't talk to the patients a lot or get the full story from them.

#2: Internal Medicine
Good: An infinite amount of interesting illnesses. They generally generate the most research and have the most money for research. There are more residencies out in medicine. You can talk to the patients, and many are so nice and it's just a pleasure to help them get better, forming a bond of sorts.

Bad: There are lots of psychosocial issues such as homeless people that need a place to sleep, a lot of psychiatric patients including TONS that have headaches/stomach pain due to stress/depression that often never gets solved. Patients are often in the hospital for problems that never get better or are there for weeks because they need nursing home placement.
I'm not very good with elderly patients, I think. I don't enjoy demented patients. They can't tell me what's wrong and are often angry with the doctor for trying to help. I'm not saying they are wrong or bad, but other doctors i know enjoy the humor of the situation, when I just don't.

#3: Emergency Medicine
Good: Emergency medicine sounds really exciting. One of my favorite parts of medicine is hearing the initial story and trying to figure what's wrong so you can solve it. This mainly happens in the ER. You get to talk to patients and form a bond. You also get to do many procedures, like mini-surgeries, so it's a good mix. You can work as little or as much as you want because it is shift work.

Bad:Same as medicine as for the most part. You don't see the same patients twice, except homeless people in the area, etc. I'm not sure if I care about this or not.

Emergency vs infectious disease. These are the 2 specialties I'm interested in. Maybe cardiology too. If I do adults, I have to pick emergency or not while in medical school. If I pick pediatrics, then I have another 3 years or so to decide. At the CDC, there are very few ER docs, but it is a newer specialty.

1 comment:

Chris and Corie said...

Hey! I found this very interesting! My doctor, as well as Emily's pediatrician are double board certified in Peds and Internal Med (your top two!)

My college roomie plans to do emergency medicine.

Good luck choosing!