Trauma Surgery

In a previous post I mentioned the opportunity I had last summer to shadow an emergency physician for several days. As with most things in life, one thing led to another and I was subsequently invited to shadow a trauma surgeon the following week.

(Of course, they eventually figured out that I’m an idiot and consequently, I can never again set foot inside that hospital, but that’s a story for another day.)

Before they wised up and threw me out, here’s what I learned…

The best thing about trauma surgery is the variety. One time you’re doing abdominal surgery the next you may be performing cardiac or thoracic. There is no routine. You’re not performing the same surgery over and over again day after day.



Trauma surgery is where the action is. It is the exciting, fast paced emergency situations that you’ve come to expect on shows like ER or MASH. The injured patient is brought in to the trauma center and you usually don’t know what operation is required until you open him up and can see the full extent of the injuries.

The trauma surgeon has to be able to think on his or her feet and make quick decisions. There is no time to research a procedure prior to the operation. You have to be Mr. Fix-it, Johnny on the spot and a jack-of-all-trades. (I’ve run out of clichés.)

I was very impressed with the overall abilities of the trauma surgeon I had the privilege of shadowing. I’m not afraid to admit it was a bit intimidating. I came away with a better appreciation for emergency medicine overall and for the incredible skills of the surgeons.

You can’t help but ask yourself, “Will I be able to operate at that level of competence?”

Patience, Grasshopper.

The Big Fat Question of Money

In my post on Monday, I opened up the can of worms that everybody seems to be uncomfortable with. (Some more so than others.) That is, how much you can earn as a physician?

As I alluded to in that previous post, I personally don’t have a problem with the typical earning levels that doctors enjoy. And it’s not because I hope to be a doctor one day. I felt that way long before I decided to pursue a career in medicine.

In fact, for the record, I don’t have a problem with any person earning what they’re worth. You have to get paid. It’s a fact of life. You have to eat and food costs money. You have to think about what you can provide for your family.

There is nothing noble about working for peanuts.

What I do have a problem with are the people who get paid for doing nothing. And I don’t just mean people on welfare. I’m actually referring to people with do-nothing jobs, some of whom I’ve worked for in the past. But I digress…

So just how much do the various specialties make on average? Well, it just so happens the Bureau of Labor Statistics was kind enough to compile some data on that for us.

Table 2. Median compensation for physicians, 2005

Specialty	One year	Two years
Anesthesiology	$259,948	$321,686
Surgery: General	228,839	282,504
Obstetrics/gynecology: General	203,270	247,348
Psychiatry: General	173,922	180,000
Internal medicine: General	141,912	166,420
Pediatrics: General	132,953	161,331
Family practice (w/o obstetrics)	137,119	156,010
Source: Medical Group Management Association, Physician Compensation and Production Report, 2005.

The above chart isn’t going to make your mind up for you, but it should help you in evaluating which areas to consider. I know I found it interesting and I’ll probably opt for one of the specialties in the lower income brackets. It won’t be because I wouldn’t like to earn the big bucks.

No one goes into any career or business with the attitude; I want to make as little money as possible. Let’s face it, there has to be easier ways to make money than spending 11 years of your life slogging through the medical education process.

If money is your only motivation, you would be wise to forget about medicine and instead consider becoming an investment banker or a stock broker or any of a dozen other professions that don’t require you to sacrifice a major portion of this short life we’re given just to get your foot in the door.


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Reference: Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2008-09 Edition, Physicians and Surgeons. http://www.bls.gov/oco/ocos074.htm

New Pocketscope

Just picked up my second otoscope / opthalmoscope kit today for the physical exam course. I’ve had to borrow one for the last couple of days since mine just up and walked off.

I’d bought one from an upperclassman last semester for $130 but it mysteriously disappeared last week somewhere between class and home. I think someone stole it while I was at the library, but I can’t be sure. I may have just gone off and left it somewhere. Not that I normally do that sort of thing.

I’m usually very careful with expensive stuff like tools and equipment. This time I just wasn’t paying attention.

Anyway, I was able to pick up a second Welch Allyn from a friend of my roommate for $150. It’s in better shape than my first one, but I could almost buy a new kit for what I’ve spent so far.

This one is not leaving my sight. I may chain it to my wrist.

Choosing a Specialty

On Friday I wrote about emergency medicine, which today has me thinking I should say something more about choosing a specialty. Not that I’m an expert on the subject, mind you. I’m simply expressing my own thoughts on the matter.

In my humble opinion, choosing a specialty is a lot like choosing to go to med school in the first place. It really boils down to two basic things:

1) What do you want to be doing day in and day out for the next 30 odd years?
2) What level of income are you going to be comfortable with?

Now I’m sure there are those who will immediately object and say that I’m over simplifying things, or worse, that money shouldn’t be a factor. They will be quick to point out a dozen other factors you should also consider such as what sort of personality traits you possess and so on and so forth.

But the truth is, if you really examine those other factors they are merely subsets of the two I listed. Your personality traits, for example, are simply characteristics that go into determining what you will be happy doing for the rest of your working life.

Are you an outgoing person who likes dealing one on one with people? Or are you the studious type who would rather bury yourself in the lab doing research? Ultimately, you’re going to be drawn towards the things you like to do.

And then there is the “hot button” question over compensation. That’s right, I’m talking about all that dirty old money, wampum, bread, moulah, greenbacks, coin, jack… whatever you want to call it.

Bring up the subject of doctors and money and somebody is bound to get upset. Don’t ask me why. As far as I’m concerned, it’s just part of the job description. It is nothing more than statistical data to be used in figuring the cost / benefit ratio. Getting emotional about it won’t change which direction the sun comes up every morning.

Earning potential is a factor that comes into play when choosing any career path. Medicine is no different. How much of an influence it has on your decision is entirely a matter of personal choice.

For that reason, I refuse to enter into discussions with my fellow students (or anyone else for that matter) over the question of how much doctors should earn. If your motivation for entering the medical profession is purely altruistic, fine. If not, that’s fine too. Won’t make you a better doctor one way or the other in my opinion.

I’m not about to waste my time arguing about it.

Are You The Next Dr. Carter?

Like a lot of medical students I first became interested in pursuing medicine as a result of watching shows like ER on television. So naturally, my first choice as a specialty all through pre-med was emergency medicine. I was just sure I was destined to be the next Doctor Carter.

Of course, it doesn’t take long before you realize that the ED is nothing like on TV, but the initial interest is sparked and so it is only natural for ER addicted med students like myself to consider that specialty.

Rest assured, I have not settled on a specialty yet. That would be foolish this early in my education, but here are some of the facts (or Pros and Cons as I like to call them) about emergency medicine that I’ve gathered so far. (This list is not all-inclusive and what I list as Pros and Cons may be just the opposite for someone else.)

The Pros:

1) Emergency medicine is practical and fast paced
2) You get to save lives for real, day in and day out
3) You spend more time treating patients rather than writing notes
4) The work hours are fairly decent (at least, I thought so)
5) You see a wide variety of patients
6) You don’t have to worry about getting paid

The Cons:

1) You don’t get to develop long-term doctor-patient relationships

2) You have to deal with more trauma cases (gore) than the average doctor. This may seem cool at first, but trust me, seeing a 3-year old involved in a serious accident will break your heart. It doesn’t seem cool after that. Yes, there is the satisfaction that goes along with being able to help put that child back together, but it is still tough to deal with

3) EP’s (Emergency Physicians) don’t get paid as much as some other specialties

I could probably list more, but these are the ones that stand out to me.

If any of this appeals to you, do whatever you can to get the opportunity to shadow an emergency physician for a few days. I have and it was a worthwhile experience even if I do eventually decide to go in a different direction. As I said earlier, I haven’t completely decided on a specialty yet, but emergency medicine is definitely at the top of my list.

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Photo Courtesy of NBC

The New Blog

I’m not sure exactly what direction this blog will go. For now I’m just going to write whatever is on my mind at the moment and not worry about developing a theme.

I will probably write a little about medical school, my pre-med experience, the application process, and the decision-making process I went through (and still sometimes question) in deciding to go into this profession. But I doubt that this will strictly be a medical school blog.

In case you haven’t already picked up on the vibe, I want to try and work humor into the mix as much as possible. For me blogging is mainly an outlet for letting off steam.

I am still playing with Blogger trying to figure everything out, so posts may be spotty for a while. But please keep coming back and checking out what’s new. Any comments or advice is always welcome.

Thanks for stopping by,

Neumed

Turning to Stone

Once when I was younger, a friend and I were headed down to our favorite fishing spot when we came across this woman bathing naked in the stream. All of a sudden my friend takes off running like his pants were on fire.

Thinking we were about to get caught, I took off after him.

When I finally caught up to him, panting and all out of breath I asked, "Why'd you run away?"

"Are you kidding?" he exclaimed, "My mom told me if I ever saw a naked lady I would turn to stone. I felt something getting hard, so I ran."

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Neumed (sometimes also known as, Jim Anderson) is not yet a medical professional. He is but a lowly medical student, so please don’t ask him for advice. Instead, see your doctor.

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