Internal medicine doctors are dorks, emergency medicine physicians are cowboys, and dermatologists care about nothing more than money. What’s the truth about doctor stereotypes, and what is more fiction than fact? Let’s find out.
You voted for it, and here it is. Welcome to part 2 of the doctor stereotypes. In part one, we covered surgical specialties such as plastics, neurosurgery, orthopedic surgery, urology, OB/GYN, and general surgery. Now it’s time to dive into the non-surgical specialties.
Internal medicine is the default – what most people think about when they think “doctor”. This is the specialty you go into for one of three reasons. Either (1) you love the idea of being a hospitalist or primary care doctor, (2) you plan on specializing after residency in fellowship such as cardiology or gastroenterology, or (3) you didn’t fall in love with any other specialty, so you this becomes the default.
The stereotype of internal medicine, amongst medical students and physicians, is that they love thinking and talking more than they love doing. It’s often affectionately called “mental masturbation”. The reason this stereotype exists is that on inpatient medicine, teams spend several hours, sometimes up to half a day, rounding on patients and discussing the minor nuances of which antibiotic to prescribe or the minutiae of an obscure disease. Surgeon personalities, such as yours truly, are often less enthusiastic about spending such a long time rounding and prefer to be getting their hands dirty.
But as with most stereotypes, that isn’t fully accurate. Within internal medicine, there are two main ways of practicing: inpatient and outpatient. Inpatient medicine is where you take care of patients who are inpatient, meaning they are staying in the hospital. On average, these patients are sicker and more complex from a medical management perspective. With outpatient medicine, you are seeing patients in the clinic. When you think of going to the doctor, this is generally what you think of. You have an appointment, go to the clinic, wait an excessively long time, and then see your physician for 15 minutes to discuss your concerns.
In contrast to internal medicine, which is primarily focused on adult patients, family medicine is focused less on a specific patient population, like adults for internal medicine, or children for pediatrics, or women for gynecology, and is instead focused on the social unit of the family.
The differences and similarities between family medicine and internal medicine are often confusing. Both residencies are generally 3 years. However, internal medicine has much more inpatient and ICU, or intensive care unit, training. Internal medicine also has significant training in internal medicine subspecialties, like endocrinology, rheumatology, infectious diseases, cardiology, and the like. While outpatient clinic medicine is included, it’s less heavily emphasized.
With family medicine, outpatient medicine is the primary focus, although they do receive a bit of gynecology, surgery, musculoskeletal, and other specialty training. In short, family medicine places an emphasis on outpatient medicine, continuity of care, health maintenance, and disease prevention. Internal medicine, given its deeper adult medicine training, is often better suited for managing adult patients with complex medical histories.
The stereotype of family medicine is that you generally go into the specialty if you’re not a particularly strong student. Compared to other specialties, it’s less competitive, the average board scores are low, and the pay is towards the bottom of the stack. That being said, I know several brilliant medical students that went into family medicine because they’re passionate about the field, not because they couldn’t do something else. And plus, a low or high board score is not necessarily predictive of whether or not you’ll be a good physician.
These next few specialties have something that most others don’t – a more balanced lifestyle. Anesthesiologists get a bad rap for being lazy, and it’s not hard to see why. During surgeries or other operations, anesthesiologists are busy at work at the beginning of the procedure, at the end of the procedure, and at moments in the middle of the procedure. However, compared to surgeons who are constantly “on”, there is a lot more down time. During cases in the operating room, I’ve seen anesthesiologists browsing Reddit on more than one occasion, or checking email, or watching videos.
Anesthesiologists often joke about the blood-brain barrier, and they aren’t referring to the semipermeable border separating circulating blood from the central nervous system within the human body. They’re talkinng about the drapes in the operating room that separate the surgeons, the blood, from the anesthesiologists, the brains.
Being an anesthesiologist is harder than it looks. When things are calm and steady, all is well. But when a patient is unstable and rapidly decompensating, you won’t be envious of their position. It’s not surprising that given the stress of their job and access to drugs, they have some of the highest rates of substance abuse.
All in all, it’s a great specialty. Your hours are more flexible compared to other specialties, pay is relatively good, it’s less competitive to match into, and you still get to work with your hands doing procedures. That being said, there are two deal breakers – ego and operating. If putting aside your ego is tough, it may be hard being second in command in the operating room, or being yelled at by a cranky surgeon who, quite frankly, has no business to be yelling at you. And if you love the art, challenge, and excitement of operating, it’s tough to forever be on the other side of the curtain, too brainy to get your hands dirty.
If you like computers more than you like people, then radiology may be the right field for you. Radiologists spend the entire day in dark reading rooms looking over radiographs, MRI’s and other imaging . Some say radiologists are vampires, but others claim to have spotted a lone radiologist walking outside the hospital in the daylight. Sounds like Bigfoot if you ask me.
If you don’t like patients and computers aren’t your jam, then consider pathology. Pathologists are stereotyped as lacking social skills, highly introverted, and not keen on interacting with those pesky homo sapiens.
While pathologists generally don’t have patient interaction or continuity, they are regularly working with physicians of other specialties, just as radiologists do. For that reason, you wouldn’t get very far in pathology, or any specialty for that matter, if you couldn’t work with other people as part of a team.
If you love money but don’t like working too hard, dermatology is the field for you. Just know that there are many other people like you, and for that reason it’s incredibly challenging to match into derm.
General Medical Officer
If you want to call yourself a surgeon without actually doing any surgery, join the military and become a General Medical Officer, or GMO for short.
A GMO is essentially a primary care doctor plus. They are colloquially referred to as “surgeons”, such as flight surgeons, dive surgeons, etc. However, they are NOT surgeons. After completing their intern year, GMOs are assigned to different units, where they undergo additional training to best support their team. For example, Navy Flight doctors would go to flight school where they will learn not only about the physiology involved in flying fighter jets and helicopters, but they themselves will also learn to fly.
What other specialties do you want me to cover? Let me know with a comment down below!