my future?
So i was reading The Differential and Ben was talking about some online tests you could do to help ascertain your interest in a specialty. I took it honestly and answered all 130 questions of the Medical Specialty Aptitude Test developed by several doctors from U of Virginia. i found that it kinda matches what i’m gunning for:
1 general surgery 46
2 plastic surgery 46
3 obstetrics/gynecology 46
4 nuclear med 45
5 orthopaedic surgery 45
6 thoracic surgery 45
7 infectious disease 44
8 colon & rectal surgery 44
9 anesthesiology 44
10 otolaryngology 44
Not so sure about the nuclear med one, but gen surg and colorectal surg are certainly the big ones i’m interested in. I might want to delve into plastics because of the reconstructive capabilities and treating burn victims can be challenging. With thoracic surgery, i reckon with transplants and CABG-es, they do still have a role in cardiological intervention. I’m not sure how it goes, but upper GI surgeons do have some grounding in this aspect, just not in the cardio side of things. For example, in an Ivor-Lewis oesophagectomy, after the stomach is mobilised from its vascular supply and reconstructed into a tube, the second part of the operation will be the oesophagectomy part, taking out the part of the oseophagus which is diseased. Usually it has a tumour causing dysphagia symptoms. They happen commonly in the upper and lower thirds. Take that out, anastomose it with the new reconstructed stomach. All this has to be down in the thoracic cavity, after one lung has been deflated to allow more access.
Orthopaedic surg seemed really cool for me in the beginning but as i rotated, it became a turn off for me because outpatient clinics are incredibly boring. “See you in 6 weeks for the next appointment and we’ll take an XR of your limb and see how it’s going.” Even the orthopaedic registrar agreed that it does get boring.
Ben was also right in saying
“But there’s no substitute for rotating on those services. Hearing about the field from others, shadowing, getting involved in interest groups, etc. are all somewhat helpful, but they can give you a very different picture of the field than your rotations”
Good luck in finding your specialty.
Very lofty goals, indeed. First you have to finish your internship and the last I heard, you intl students along with feepaying locals are not guaranteed training positions in Oz.
Ever considered General Practice? If not, why not?
Yeah. That’s what they say on the website, but the fact remains that Australia is in need of doctors. Seniors have mentioned no one has been turned away an intern job as of now. This might change when the influx of doctors come from new medical schools set up (to address this shortage) in a couple of years time (2011 onwards), e.g. Deakin, Monash Graduate Campus at Gippsland, etc.
General Practice is interesting but being a generalist isn’t much of a interest to me. While some say General Surgery is the GP of Surgery, but it involves a lot of technical skill which draws me to it. Also, many general surgeons sub-specialise in upper GI or colorectal or liver or breast, etc… So the options are limitless.
I’m vocal about this issue as few undergraduate students are aware of how severely under-resourced specialist training is. 2013 anticipates 3400 graduates into a system which currently trains 1600 interns a year. Our post graduate training system is becoming so saturated that to differentiate between CSP, DFEE and International graduates is redundant. Everyone’s in the same boat. There are already stories of CSP PGY-2 students having to repeat their intern year(s) whilst waiting for registrar positions to open up within their chosen specialty.
In any case, the new Expanded Specialist Training Program (ESTP) isn’t enough to address SET defecits. It might relieve some of the strain on the less competitive training programs but it’s more of a kick in the teeth for wannabe surgeons who don’t like delivering babies or dealing with outpatients. Personally, the only plausible solution I imagine is increased funding of public hospital training programs and putting a cork on the sudden MBBS trend that universities are following. (Besides, MBBS has always been about quantity control. /snarky remark about private universities and DFEE)
There was an excellent article regarding all of this in the 14th March issue of Australian Doctor. If you’re interested, I’d be happy to post you a copy.
sure. please do. i’d like to read that. i had a long around here but can’t find anything you are talking about here.
The father of one of my students happens to be a GP and is kind enough to give me his issues whenever I go over to teach. (Ahh, multiple benefits, how it makes the world spin on its axis.)
The newspaper is mostly geared towards GPs, thus the article had a slant towards the implications of their mentoring of PGY-2. Nonetheless, it’s an eye opener and I refer it to anyone who expresses concern for this issue. There was a recent e-publication on AMSA which also touched on the issue.
http://www.australiandoctor.com.au/news/a1/0c0548a1.asp
Enjoy.
Definitely some very lofty goals indeed. However, there with dedication and a lot of hard work, I’m sure you’ll get there.
looks like a future surgeon to me:)
my fav is paeds…just love it!!
im yet to rotate thr paeds. next yr (2009) i will know!!