How Becoming A Doctor Works'

1
How Becoming A Doctor Works.

• An inside look at obtaining a Medical Degree and
  becoming a practicing physician.

2
To Be or Not To Be a Doctor?

• Three cornerstones of a successful career in
  medicine
• 1. A love for learning in general.
• 2. A true intellectual curiosity about medicine
  in particular.
• 3. A strong desire to help others.

3
PROS (As Reported by the Pros Themselves!)

• Medicine is a career filled with choices.
• You can do research in whatever specialty you
  choose, with the potential to make a real
  breakthrough in preventing or treating illness.
• Medicine is a career that is honorable and is
  held in high esteem.
• Job security with excellent salaries.

4
CONS

• Lots of education (costing lots of money)
  required.
• Long periods of unpaid internships.
• Large amount of money spent on insurance and
  malpractice.
• Long hours, being on call etc.

5
What kind of education do you need?

• It all starts in High School!!
• Get a good general education. (S.A.T. Test
  prep.)
• Take 4 years of science in high school, including
  biology, physics and chemistry, plus 4 years of
  math (including calculus).

6
COLLEGE

• There are no required majors for acceptance into
  medical school.
• The most common major is Biology!
• When choosing a college, remember that there is
  no perfect college. There is only what is right
  for you. (quality of faculty, facilities,
  advisors percent of pre-meds accepted to medical
  school.)

7
Requirements for Medical School

• Here are the required courses for most medical
  schools
• 1 year of Biology with lab
• 1 year of Inorganic Chemistry with lab
• 1 year of Organic Chemistry with lab
• 1 year of English
• Many schools require 1 year of calculus
• Some medical schools request a course in
  Biochemistry

8
MCAT (Medical College Admissions Test)

• The M.C.A.T. (Medical College Admission Test) is
  an all-day, standardized, multiple-choice test
  administered by the American Association of
  Medical Colleges (A.A.M.C.)
• The M.C.A.T. is given twice per year (April and
  August) and in 1999 cost 165.

9
The MCAT has 4 sections

• 1. Biological Sciences (Biology and Organic
  Chemistry - 77 questions)
• 2. Physical Sciences (Physics and Inorganic
  Chemistry - 77 questions)
• 3. Verbal Reasoning (65 questions)
• 4. Essay Writing (2 essays).

10
Applying to Medical School

• In 1998 there were 41,000 applicants for 16,170
  spots in traditional medical schools.
• There were 9,500 applicants for 2,500 spots in
  Osteopathic schools.
• The process generally involves a formal interview.

11
Medical School

• In 1998 there were 69,340 medical students in
  U.S. medical schools (57 males, 43 female).
• Medical school is very difficult
• If you can retain the information presented to
  you, not just memorize and forget, you will be
  highly successful.
• Most of the day is filled with lectures, labs and
  small group activities.
• The problem is not the difficulty of the subject
  material -- it is the volume.

12
The Good News...

• Over 95 of the students entering medical schools
  do end up earning their M.D. degree.
• By the time you get here, most medical schools
  consider you among the elite so no further
  weeding out is required!

13
Medical School Curriculum

• Generally the first two years are
  classroom-based, with patient contact beginning
  in the second year.
• The third and fourth years consist of rotations
  through the different major specialties of
  medicine.

14
1st Year Medical School Coursework

• Anatomy
• Physiology
• Histology
• Biochemistry
• Embryology
• Pathology
• Neuroanatomy
• Pharmacology

15
So what about your Grades?

• Many medical schools use a pass/fail system
  instead of the traditional letter system.
• This system tends to reduce competitiveness
  (quite high in medical students). It also
  encourages learning for learning's sake.

16
The Boards

• At the end of 2nd year all medical students take
  the first part of the United States Medical
  Licensing Examination (USMLE-1), administered by
  the National Board of Medical Examiners (NBME).

17
The Match

• In your 4th year of medical school you must
  decide which field of medicine (specialty) to
  practice. Each medical field requires a residency
  (a training period -- sort of an apprenticeship)
  of 3 or more years.
• Every graduating medical student finds out the
  results on the same day in mid-March on "Match
  day".

18
Specialties

• Anesthesiology - 4 years
• Dermatology - 4 years
• Emergency Medicine - 3-4 years
• General Surgery - 5 years
• Internal Medicine - 3 years
• Neurology - 4 years
• Obstetrics and Gynecology - 4 years
• Pathology - 4 years
• Pediatrics - 3 years

19
Internship, Residency and Fellowship

• Residency is a 3 year training program in a
  medical specialty.
• The first year of training after medical school
  is called internship.
• The training that is done after a residency (in a
  subspecialty) is usually called a fellowship.
• During your residency you will learn medicine by
  caring for patients with a variety of diseases.

20
Making the Rounds

• "Rounds" mean you walk around to each patient to
  discuss his or her care. Suggestions on further
  diagnostic tests and treatments are the usual
  topics of discussion.
• At the end of the day you "sign out" to the team
  that is "on call" that night.
• At home it is important to continue to read about
  medicine, especially at this point in your
  career. However, fatigue plays a big role and you
  often need recovery sleep from your night on
  call.

21
On Call

• Being on call while in residency means that you
  stay in the hospital over night and care for the
  patients on your team and the other teams, and
  care for the new admissions.
• This means you will be working up to 30-36 hours
  with little or no sleep. This is done every 2nd,
  3rd, or 4th night depending on the institution
  and specialty you are in.
• This is a long-standing tradition in medicine.
• The argument goes that the more experience you
  have treating patients and their diseases the
  better you will be as a physician.
• Also, someone needs to care for patients after
  hours.

22
The Lowly Intern

• An intern is at the bottom of the food chain at a
  teaching hospital. Any unpleasant, menial task
  (called "scut" work) is the intern's job.
• Another medical tradition during internship is
  the phenomenon of "see one, do one, teach one".
• At this point you are finally being paid for your
  services. The mean salary for a first year
  resident in 1998-99 was 34,104. For each
  additional year of residency the mean salary
  increase was 1,451.

23
Medical License

• After completing a residency or fellowship, you
  must obtain a medical license so that you can
  practice medicine.
• Each state has its own individual rules.
• You need to have passed one of several exams to
  prove that you are competent (such as the USMLE).
  
• Letters of reference are usually required.
• A check of your malpractice history will also be
  obtained.

24
Board Certification

• Becoming a board certified physician in a
  specialty involves the completion of a residency
  in a given specialty
• You must then complete a comprehensive exam
  (often a written and oral exam).
• Many boards require recertification every 7-10
  years.

25
The Real World

• Join a group practice or start your own private
  practice.
• Join a clinic.
• Join an H.M.O. Some physicians are hospital
  based (emergency physicians, radiologists,
  pathologists, anesthesiologists) but can be part
  of a private practice or an employee.