FYI:
For anyone who might be interested, Reuters put out an article today (or at least I saw it today, and I think it’s recent), about the changing way medical students are picking their specialites. It mentions that more and more med students are picking their specialties based on lifestyle rather than money or prestige-- and that family practice, surgery, and OB/GYN are likely to suffer, due to the long hours/on-call time required.
Also, I heard a brief radio advertisement for a new show called “Resident Life” on TLC starting tomorrow (Monday), at 9 PM, about what residency is like. Too bad I won’t be able to watch it, what with having to study in the hopes of one day BEING a resident 
I can tape though.
Epidoc
Hi there,
General Surgery saw a great surge this past year. There were many fewer open slots with most of them being preliminary. My program was swamped with applicants. The average USMLE Step I score of our interns is 240 and most are AOA. While UVA is a good program, we are not Harvard or Hopkins. I was very happy that all of our slots filled with ease.
General Surgery is a brutal lifestyle but it is the most fun that one can have in medicine. I love operating so much that I can’t wait to get to the hospital. I can’t imagine doing anything else even for lifestyle. When you love surgery, you really LOVE surgery. I look at my fellow residents in EM and IM and I actually feel sorry for them. When a great trauma flies in, I am the one that gets to take the patient to the OR and then take care of them in the Trauma ICU. It is a total blast.
I am most happy when I am operating and I can’t imagine any lifestyle that would be preferable to being a surgeon. This residency is extreme even with the 80-hour work rule but I guess I love living on the extreme. If I am not being challenged mentally and physically, medicine is not worth it for me. When I am not operating, I am studying in preparation to operate. There is always something happening.
When I look back on the past year, I can remember being very nervous when an artery would begin to pump after I had cut. Now I just keep moving and anticipate the next task. I have learned to take each move as it comes and totally concentrate. It’s a great lifestyle and I would have been totally bored in Anesthesia. Still I can see why Dave loves what he does too. People are just different and I applaud the differences.
One of the great advantages of being older is that you know yourself well. I am not defined by medicine and medicine is not defined by me. I previewed some of the “Resident Life” tapes. This will be a decent show but realize that it was done before hours were limited. There is liberal editing for the sake of television. As I have said in other threads, this residency thing is changing from day to day. Also keep in mind that residency is not practice. I look at my attendings and see a bunch of great guys who have wonderful lifestyles and a good family life who like me, love surgery.
Natalie
The primary care specialties - internal medicine, peds, family practice - have taken a big hit in recent years and it’s not lifestyle but workstyle that is the issue. Insurance companies have shifted so much of their surveillance and regulation burden to the docs in their plans that more and more time is being wasted on paperwork and phone calls for insurance purposes. This has nothing to do with practicing medicine; it’s almost entirely about saving the insurance company money which doesn’t make the physician any money and tends to screw her patients besides.
The “referral-based” specialties don’t have to worry about this. The first time a patient calls the office of a neurologist, for example, the office staff asks, “Do you have a referral?” One staffer will spend a few minutes making sure the person can pay before they show up.
But that person - let’s say this is ME for example - has to go to her primary care doc to get that referral. In my case, I need to be seen by a neurologist once a year. In order to do that, I have to see my family medicine doc even though I don’t have any NEED to - or the insurance won’t cover my neurologist visit. The Rx from my neurologist wouldn’t be covered if it were prescribed by my family doc. (I can’t pay this out of pocket, it’s $1000/month!) So essentially to save me, and my insurance company, a bunch of money, I have to tie up the resources of my family doc and her office staff. It’s an idiotic system.
When I write all this out I do wonder why the hell I want to go into family practice? I continue to operate on the optimistic faith that something, somehow, has to change.
DARN! TLC OR MNF??? What’s a girl to do?
MNF. hands down!
Mom2doc:
Absolutely MNF!!! (if I had time to watch either this week-- next week though…)
Epidoc
I am hooked on all those medical shows on TLC, Discovery Health, and the Health Network. By far my favorite is Trauma Life in the ER and then Doctor’s Diaries. The thing is they don’t really censor much. If bad language is used they will beep that butt hey show bleeding bodies and open wounds.
I can’t wait to see some of it for real. Hopefully I will be doing some shadowing very soon. A friend is hooking me up. She works in Labor and Delivery and she is going to clear it with the MD’s so I can “scrub in” and watch a C- Section. Maybe if I am lucky I will even get to see a normal vaginal delivery.
I am also looking into all the hospitals here about doing some volunteering. I just need to get off my lazy backside and get doing it. 
Cathy
Hey Mary,
Thanks for that accurate description of many of my so called days in the life of family practice. And, there are other similarly negative non medical aspects as well… how about the report cards I used to get from the insurance companies on how well I was utilizing pharmacy benefits for my patients! I always put in considerable thought into what was best for my patients rather than for the insurance companies bottom line - and yes, generic, older meds were often fine, too, at times. It is an idiotic system. Mary, please let me know when it gets better so I can come back.
the only reason Nat wrote what she did was to try and get me all jazzed up for surgery…I can see it now. She is pulling the trigger on me…enticing me like Medusa and all that…oh man I better be on the look out…