Allergy/ImmunologyAmerican Board of Medical Specialties description: "An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation or malignancies of the immune system. As our understanding of the immune system develops, the scope of this specialty is widening.
Training programs are available at some medical centers to provide individuals with expertise in both allergy/immunology and adult rheumatology, or in both allergy/immunology and pediatric pulmonology. Such individuals are candidates for dual certification.
Training required: Prior certification in Internal Medicine or Pediatrics; two years in allergy/immunology.
Certification in the following subspecialty requires additional training and examination.
Clinical & Laboratory Immunology: A subspecialist who utilizes various laboratory procedures to diagnose and treat disorders characterized by defective responses of the body's immune systems. These results are used for patient management." Reproduced from Which Medical Specialist for You, ABMS. Revised, March 2000.
Other A/I information links and sources
Careers in A/I for Medical Students, an American Academy of Allergy, Asthma & Immunology web page.
Try a PubMed search using these (or your own) search strings:
allergy and immunology career allergy and immunology/trends allergy and immunology/education allergy and immunology/economics.AnesthesiologyAmerican Board of Medical Specialties description: "An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation, an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during, and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute. long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
Training required: Four years.
Certification in one of the following subspecialties requires additional training and examination.
Critical Care Medicine: An anesthesiologist who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff, and other specialists.
Pain Management: An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists." Reprinted from Which Medical Specialist for You, ABMS. Revised, March 2000.
More anesthesiology info ....
"Information about Anesthesia as a Career," the personal thoughts of Dr. John Oyston, staff anesthesiologist at Scarborough Hospital, Ontario, Canada.
American Society of Anesthesiologists web site. See the Society's related links for a long listing of other anesthesiology organizations.
American Academy of Pain Medicine web site.
Society of Critical Care Medicine web site. Start with "Professional Resources" section and then try the "Education" and "Public Affairs" areas.
Try searching PubMed using the terms "medical students specialty anesthesiology." Substituting "career choice" for "specialty" will yield a longer list that includes many of the same articles. Other fruitful search terms:
anesthesiology/trendsanesthesiology/economicsanesthesiology/educationRecent journal articles:
"The selection of a residency program: prospective anesthesiologists compared to others," Anesthesia and Analgesia, Aug. 1993, 313-7. PubMed Abstract: A study was undertaken to investigate factors important to senior medical students, particularly prospective anesthesiology residents, in selecting a residency program. A previously published questionnaire was used to determine whether previous findings could be replicated. One hundred ninety-seven senior medical students rated the importance of 22 items in their selection of a residency program. Factors were ranked nearly identically as in the previous study. Factors rated as most important were "diversity of training experience" as well as "house officer satisfaction," whereas items about treating patients with the acquired immunodeficiency syndrome were rated as least important. There were gender differences that showed women assigned more importance to having a manageable case load, call schedules, and geographic location. Prospective anesthesiology residents perceived "prestige" of the program, and the department as significantly more important than did prospective nonanesthesiology residents. The replication of results with regard to the overall ranking of factors demonstrates the reliability of the results. Resident selection committees need to focus on the issue of quality of training, the impression made by the interviewers, and include satisfied residents as part of the interview process.
"Specialty intentions of 1995 U.S. medical school graduates and patterns of generalist career choice and decision making," Academic Medicine, Dec. 1995, pp 1152-7. PubMed Abstract: The authors report on the specialty intentions that graduating students declared on the 1995 AAMC Medical School Graduation Questionnaire (GQ) and compare the pattern of career choices in 1995 with that in 1992. Family practice was the leading choice of graduates in 1995, followed by internal medicine subspecialties and general internal medicine. These choices represented significant gains over those made in these specialties in 1992 and were at the expense of declines in the interest of 1995 graduates for internal medicine specialties, radiology, anesthesiology, obstetrics-gynecology subspecialties, and some other fields. In 1992, 14.6% of graduating students declared plans to pursue careers in one of the generalist specialties; in 1995, 27.6% declared such plans. In 1992, no school graduated 50% or more students with generalist intentions, and only one school reached 40%; in 1995, five schools graduated more than 50%, and another 15 graduated more than 40% who favored generalist careers. Medical schools with significant GQ response rates (110 out of 125) were aggregated by level of generalist production (top 25%, middle 50%, and bottom 25%) according to the percentages of their 1995 graduates selecting careers in the individual generalist specialties of family practice, general internal medicine, and general pediatrics, and in these generalist specialties in toto. Within these groups, the linking of GQ responses to declarations given by the same students on the Matriculating Student Questionnaire (MSQ) made it possible to determine the extent to which graduates' specialty choices represented early interests that were retained or interests acquired later during medical school.
"Factors affecting the choice of anesthesiology by medical students for specialty training," Journal of Medical Education, Apr. 1984, 323-30. PubMed Abstract: To learn some of the reasons why anesthesiology as a specialty is not preferred by more graduating medical students and to determine the effects of various factors on their specialty choice, the authors studied the number of medical students who chose anesthesiology as a specialty after graduation and the quality of clerkships available in various departments. The study established that medical students do not find anesthesiology as attractive as other specialties and that several factors are related to the students' choice of anesthesiology. Most surprising was the negative effect of the presence of certified registered nurse anesthetists on the operating room floor. These results suggest the need for a thorough study of the use of nurse practitioners, physician's assistants, and nurse-clinicians, at least where teaching of medical students is taking place.
DermatologyAmerican Board of Medical Specialties description: "A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles, and other tumors of the skin, the management of contact dermatitis, and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars, and the skin changes associated with aging.
Training required: Four years.
Certification in one of the following subspecialties requires additional training and examination.
Clinical and Laboratory Dermatological Immunology: A dermatologist who utilizes various specialized laboratory procedures to diagnose disorders characterized by defective responses of the body's immune system. Immunodermatologists also may provide consultation in the management of these disorders and administer specialized forms of therapy for these diseases.
Dermatopathology:A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative, and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings, and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes." Reprinted from Which Medical Specialist for You, ABMS. Revised, March 2000.
More dermatology info ....
Try searching PubMed using the terms "medical students specialty dermatology." Substituting "career choice" for "specialty" will yield a slightly different list. Other fruitful search terms:
dermatology/trendsdermatology/economicsdermatology/educationEmergency MedicineAmerican Board of Medical Specialties description: "An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury:
Training required: Three years.
Certification in one of the following subspecialties requires additional training and examination.
Medical Toxicology: An emergency physician who has special knowledge about the evaluation and management of patients with accidental or purposeful poisoning through exposure to prescription and nonprescription medications, drugs of abuse, household or industrial toxins, and environmental toxins. Areas of medical toxicology include acute pediatric and adult drug ingestion, drug abuse, addiction and withdrawal; chemical poisoning exposure and toxicity; hazardous materials exposure and toxicity; and occupational toxicology.
Pediatric Toxicology:An emergency physician who has special qualifications to manage emergencies in infants and children.
Sports Medicine: An emergency physician with special knowledge in sports medicine is responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention and management of injury and illness. A sports medicine physician has knowledge and experience in the promotion of wellness and the role of exercise in promoting a healthy lifestyle. Knowledge of exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation and epidemiology is essential to the practice of sports medicine." Reprinted from Which Medical Specialist for You, ABMS. Revised, March 2000.
Other emergency medicine information links and sources:
Society for Academic Emergency Medicine's "Emergency Medicine as a Career Choice."
Try searching PubMed using the terms "medical students specialty emergency medicine." Substituting "career choice" for "specialty" will yield a slightly different list. Other fruitful search terms:
emergency medicine/trendsemergency medicine/economicsFamily PracticeAmerican Board of Medical Specialties description: "A family physician is concerned with the total health care of the individual and the family, and is trained to diagnose and treat a wide variety of ailments in patients of all ages. The family physician receives a broad range of training that includes internal medicine, pediatrics, obstetrics and gynecology, psychiatry, and geriatrics. Special emphasis is placed on prevention and the primary care of entire families, utilizing consultations and community resources when appropriate.
Training required: Three years.
Certification in one of the following subspecialties requires additional training and examination.
Geriatric Medicine: A family physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive, and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.
Sports Medicine: A family practice physician who is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice), and the role of exercise in promoting a healthy life style are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as a individual or in team participation." Reprinted from Which Medical Specialist for You, ABMS. Revised, March 2000.
Other family practice information links and sources:
American Academy of Family Physicians web site, including "Family Practice--What You Need to Know," which has video profiles of practicing family physicians.
To see a more extensive and current list of articles on this topic, do a search in PubMed using the terms "medical students specialty family practice." Substituting "career choice" for "specialty" will yield a slightly different hit list. Also, try:
family practice/trendsfamily practice/economicsfamily practice/education"Prime Time," The New Physician, April 2000, pp 10-17. Summary: A week in the life of Dr. Michele A. Romano, who has a solo family practice in northern Virginia.
GeriatricsAlso see Family Practice and Internal Medicine sections.
Other geriatrics information links and sources:
To see a more extensive and current list of articles on this topic, search in PubMed using the term strings:
medical students career choice geriatricsgeriatrics/trendsgeriatrics/economicsgeriatrics/education."Help wanted: geriatricians," The New Physician, Jan.-Feb 2001, pp 32-42. Summary: Needs of a growing elderly population in the United States require more geriatricians, experts say. The American Geriatrics Society says only 8,000 geriatricians currently practice, but the aging population could support 16,000 more. One reason for the small number of practioners is the median income of geriatricians: about $141,500, lowest of medical specialties, reports the Medical Group Management Association. Low Medicare reimbursement rates also deter potential geriatricians, although one expert says that these rates are looking more attractive as managed care pushes reimbursement rates down for other populations. Experts say geriatrics knowledge is important to each specialty but medical schools generally fall short in providing it.
Links
Internal MedicineAmerican Board of Medical Specialties description: "A personal physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults, and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections, and diseases affecting the heart, blood, kidneys, joints, and digestive, respiratory and vascular systems. They are also trained in the essential of primary care internal medicine which incorporates an understanding of disease prevention, wellness, substance abuse, mental health, and effective treatment of common problems of the eyes, ears, skin, nervous system, and reproductive organs.
Training required: Three years.
Certification in one of the following subspecialties requires additional training and examination.
Adolescent medicine: An internist who specializes in adolescent medicine is a multi-disciplinary health care specialist trained in the unique physical, psychological, and social characteristics of adolescents, their health care problems and needs.
Cardiovascular Disease: An internist who specializes in diseases of the heart, lungs, and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythmns.
Clinical Cardiac Electrophysiology: A field of special interest within the subspecialty of cardiovascular disease which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them.
Clinical and Laboratory Immunology: An internist who uses laboratory tests and complex procedures to diagnose and treat disorders characterized by defective responses of the body's immune system.
Critical Care Medicine: An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff, and other specialties.
Endocrinology, Diabetes and Metabolism: An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, pituitary diseases, and menstrual and sexual problems.
Gastroenterology: An internist who specializes in diagnosis and treatment of diseases of the digestive organs, including the stomach, bowels, liver, and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer, and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to see internal organs.
Geriatric Medicine: An internist with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive, and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.
Hematology: An internist with additional training who specializes in diseases of the blood, spleen, and lymph glands. This specialist treats conditions such as anemia, clotting disorders, sickle cell disease, hemophilia, leukemia, and lymphoma.
Infectious Disease: An internist who deals with infectious diseases of all types and in all organs. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and conditions associated with travel.
Interventional Cardiology: An area of medicine within the subspecialty of cardiology which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and technical procedures and medications to treat abnormalities that impair the function of the heart.
Medical Oncology: An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers chemotherapy for malignancy, as well as consulting with surgeons and radiotherapists on other treatments for cancer.
Nephrology: An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Pulmonary Disease: An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational diseases, bronchitis, sleep disorders, emphysema, and other complex disorders of the lungs.
Rheumatology: An internist who treats diseases of joints, muscle, bones, and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries, and 'collagen' diseases.
Sports Medicine: An internist trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice), and the role of exercise in promoting a healthy life style are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as a individual or in team participation." Reprinted from Which Medical Specialist for You, ABMS. Revised, March 2000.
Other internal medicine information links and sources:
American College of Physicians-American Society of Internal Medicine (ACP-ASIM) Internal Medicine Careers page.
To see a more extensive and current list of articles on this topic, search in PubMed using the term strings:
medical students career choice internal medicine
internal medicine/trends
internal medicine/economics
internal medicine/education
Recent articles
"The effect of medical education on primary care orientation: results of two national surveys of students' and residents' perspectives," Academic Medicine, Apr. 2001, pp 355-65. PubMed Abstract: To examine changes among a nationally representative sample of students and residents in their orientations toward primary care as reflected in their attitudes toward the psychosocial and technical aspects of medicine and their perceptions of the academic environment for primary care. METHOD: Confidential telephone interviews of stratified national probability samples of first- and fourth-year medical students and residents were conducted in 1994 and 1997. The 1997 survey included 219 students and 241 residents who had also been interviewed in 1994. Participants were asked about their attitudes toward addressing psychosocial issues in medicine and their perceptions of faculty and peer attitudes toward primary care. Responses were compared over time and across groups. RESULTS: Between the first and fourth years of medical school, there was a decline over time in students' reported orientations to socioemotional aspects of patient care (61.6% versus 42.7%, p =.001) and their perceptions that working with psychosocial issues of patients made primary care more attractive (56.3% versus 43.5%, p =.01). This pattern continued for 1997 residents (PGY-3), who were even less likely to say that addressing psychosocial issues made primary care more attractive (26.9%). For fourth-year students in 1994 who became PGY-3 residents in 1997, there was an increased perception that non-primary-care house officers and specialty faculty had positive attitudes toward primary care (20.8% versus 33.0%, p =.005; 28.3% versus 45.7%, p <.0001; respectively). CONCLUSIONS: Between 1994 and 1997 students and residents perceived a positive shift in the attitudes of peers and faculty toward primary care. During the course of their education and training, however, the students experienced an erosion of their orientations to primary care as they progressed through medical school into residency.
"Specialty choices of students who actually have choices: the influence of excellent clinical teachers," Academic Medicine, Mar. 2000, pp 278-82.
PURPOSE: To determine the influence of the quality of attending physicians and residents on the specialty choices of excellent medical students, who actually have a broad choice of specialties. METHOD: In 1993-94 and 1994-95, 169 third-year students at the University of Kentucky College of Medicine were randomly assigned to two one-month rotations on general medicine inpatient wards. At the end of each rotation, the students confidentially evaluated the attending physician and the supervising resident (different for each rotation) with whom they had worked. Data were collected for 62 attending physicians and 89 residents. The authors analyzed the influences of the "best" and "worst" clinical instructors (those rated in the top and the bottom 20% by all students with whom they had worked over the two years) on "excellent" medical students (the 52 students whose USMLE I scores were in the top 30% of their class). RESULTS: Using regression approaches from the general linear model, the authors found that independent predictors of internal medicine residency choice for excellent medical students were exposure to highly rated internal medicine attendings (p = .02) and residents (p = .03). Nine of 29 (30%) of the excellent students who worked with a "best" medicine clinical instructor chose an internal medicine residency, while none of the 23 excellent medical students who did not work with a "best" medicine clinical instructor did so. The authors found no correlation in students' ratings of their pairs of attendings and residents, suggesting that rater bias did not explain the results. CONCLUSION: Better medical students who work with the best internal medicine attending physicians and residents in their internal medicine clerkship are more likely to choose an internal medicine residency.
"Motivation underlying career choice for internal medicine and surgery," Social Science and Medicine, Dec. 1997, pp 1705-13. PubMed Abstract: Self-determination theory (Deci and Ryan, 1985) was used to predict medical students' career choices for internal medicine or surgery based on their experiences of the autonomy support provided by the instructors in the two corresponding third-year clerkships. Fourth-year medical students (n = 210) at three medical schools completed questionnaires that assessed (1) retrospective prior likelihood (as of the end of second year) of their going into internal medicine and surgery, (2) their perceived competence with respect to these two medical specialties, (3) their interest in the problems treated in each specialty, (4) the autonomy support of the instructors on the two corresponding rotations, (5) the current likelihood (late in the fourth year) of going into each of the two specialties, and (6) their actual residency choices. For a subset (n = 64), actual prior likelihoods of going into the two careers had also been assessed at the end of their second year. Structural equation modeling confirmed, as hypothesized, (a) that perceived autonomy support of the corresponding clerkship would predict students' choices of internal medicine or surgery, even after the effects of retrospective (and actual) prior likelihood had been removed, and (b) that this relationship between perceived autonomy support and career choice was mediated by perceived competence and interest. The present study suggests that students' experiences on clerkships do affect the likelihood that they will select particular specialties, and that students' interest in the areas are good indicators of the selections they will make.
Medical GeneticsAmerican Board of Medical Specialties description: "A specialist trained in diagnostic and therapeutic procedures for patients with genetically linked diseases. This specialist uses modern cytogenic, radiologic, and biochemical testing to assist in specialized genetic counseling, implements needed therapeutic interventions, and provides prevention through prenatal diagnosis. A medical geneticist plans and coordinates large-scale screening programs for inborn errors of metabolism, hemoglobinopathies, chromosome abnormalities, and neural tube defects.
Training required: Two or four years.
The Board issues multiple general certificates in the following areas of genetics:
Clinical Biochemical Genetics: A clinical biochemical geneticist demonstrates competence in performing and interpreting biochemical analyses relevant to the diagnosis and management of human genetic diseases, and is a consultant regarding laboratory diagnosis of a broad range of inherited disorders.
Clinical Cytogenetics: A clinical cytogeneticist demonstrates competence in providing laboratory diagnostic and clinical interpretive services dealing with cellular components, particularly chromosomes, associated with heredity.
Clinical Genetics (M.D.): A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management, and counseling services for genetic disorders.
Clinical Molecular Genetics: A clinical molecular geneticist demonstrates competence in performing and interpreting molecular analyses relevant to the diagnosis and management of human genetic diseases, and is a consultant regarding laboratory diagnosis of a broad range of inherited disorders.
Ph.D. Medical Genetics: A medical geneticist works in association with a medical specialist, is affiliated with a clinical genetics program, and serves as a consultant to medical and dental specialists.
Certification in the following subspecialty requires one year additional training and examination:
Molecular Genetic Pathology: A molecular genetic pathologist is expert in the principles, theory, and technologies of molecular biology and molecular genetics. This expertise is used to make or confirm diagnoses of Mendelian genetic disorders, of human development, infectious diseases and malignancies, and to assess the natural history of those disorders. A molecular genetic pathologist provides information about gene structure, function, and alteration and applies laboratory techniques for diagnosis, treatment, and prognosis for individuals with related disorders." Reprinted from Which Medical Specialist for You, ABMS. Revised, March 2000.
More info....
Careers in the Genetics Field, by the Federation of American Societies for Experimental Biology.
To see a more extensive and current list of articles on this topic, do a search in PubMed using the terms
Neurology/Child NeurologyAmerican Board of Medical Specialties description: "A neurologist specializes in the diagnosis and treatment of all types of disease or impaired function of the brain, spinal cord, peripheral nerves, muscles, and autonomic nervous system, as well as the blood vessels that relate to those structures. A child neurologist has special skills in the diagnosis and management of neurologic disorders of the neonatal period, infancy, early childhood and adolescence.
Training required: Four years.
Certification in one of the following subspecialties requires additional training and examination.
Clinical Neurophysiology: A neurologist who specializes in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using a combination of clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS), among others.
Neurodevelopmental Disabilities: A pediatrician or neurologist who specializes in the diagnosis and management of chronic conditions that affect the developing and mature nervous system, such as cerebral palsy, mental retardation, and chronic behavioral syndromes, or neurologic conditions.
Pain Management: A neurologist or child neurologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings." Reprinted from Which Medical Specialist for You, ABMS. Revised, March 2000.
Other neurology/child neurology information links and sources:
American Academy of Neurology has a Medical Student Information section. Look under "Education and CME" in the site index.
To see an extensive and current list of articles on this topic, do a search in PubMed using the terms "medical students specialty neurology." Substituting "career choice" for "specialty" will yield a slightly longer list, including many of the same articles.
"Controllable lifestyle: a new factor in career choice by medical students,"
Academic Medicine, Oct. 1989, pp 606-609. PubMed abstract: To determine whether control of work hours (controllable lifestyle) was becoming an increasingly important factor in choices of specialties by medical students, data from three medical schools over the past ten, ten, and six years, respectively, were reviewed for the types of specialty training entered by students in the top 15% of their classes. Since students in the upper 15% of the class are likely to obtain the specialties of their choice, any change in the pattern of their specialty preferences probably reflects a general trend. Specialties that feature a controllable lifestyle (CL) were defined as anesthesiology, dermatology, emergency medicine, neurology, ophthalmology, otolaryngology, pathology, psychiatry, and radiology. Non-CL specialties were surgery, medicine, family practice, pediatrics, and obstetrics-gynecology. The results showed that the percentages of students entering CL specialties increased significantly at all three schools, the percentages of students entering non-CL specialties decreased significantly at all three schools, and there was no significant change in the percentage of students entering surgical specialties.
Nuclear MedicineAmerican Board of Medical Specialties description: "A nuclear medicine specialist employs the properties of radioactive atoms and molecules in the diagnosis and treatment of disease, and in research. Radiation detection and imaging instrument systems are used to detect disease as it changes the function and metabolism of normal cells, tissues, and organs. A wide variety of diseases can be found in this way, usually before the structure of the organ involved by the disease can be seen to be abnormal by any other techniques. Early detection of coronary artery disease (including acute heart attack); early cancer detection and evaluation of the effect of tumor treatment; diagnosis of infection and inflammation anywhere in the body; and early detection of blood clot in the lungs are all possible with these techniques. Unique forms of radioactive molecules can attack and kill cancer cells (e.g., lymphoma, thyroid cancer) or can relieve the severe pain of cancer that has spread to the bone.
The nuclear medicine specialist has special knowledge in the biologic effects of radiation exposure, the fundamentals of the physical sciences and the principles and operation of radiation detection and imaging instrumentation systems.
Training required: Three years." Reprinted from Which Medical Specialist for You, ABMS. Revised, March 2000.
Other nuclear medicine information links and sources:
Obstetrics/GynecologyAmerican Board of Medical Specialties description: "A obstetrician/gynecologist possesses special knowledge, skills, and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians, and as a primary physician for women.
Training required: Four years plus two years in clinical practice before certification is complete.
Certification in one of the following subspecialties requires additional training and examination.
Critical Care Medicine: An obstetrician/gynecologist who specializes in critical care medicine diagnoses, treats and supports female patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff, and other specialists.
Gynecologic Oncology: An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications.
Maternal-Fetal Medicine: An obstetrician/gynecologist who cares for, or provides consultation on, patients with complications of pregnancy This specialist has advanced knowledge of the obstetrical, medical, and surgical complications of pregnancy, and their effect on both the mother and the fetus. He/she also possesses expertise in the most current diagnostic and treatment modalities used in the care of patients with complicated pregnancies.
Reproductive Endocrinology: An obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility." Reprinted from Which Medical Specialist for You, ABMS. Revised, March 2000.
Other obstetrics and gynecology information links and sources:
A Career in Obstetrics & Gynecology, revised Dec. 1998, by the Association of Professors of Gynecology and Obstetrics and the Council on Residency Education in Obstetrics and Gynecology (CREOG) Joint APGP-CREOG Committee on Career Counseling.
To see an extensive and current list of articles on this topic, do a search in PubMed using the terms "medical students specialty obstetrics/gynecology." Substituting "career choice" for "specialty" will yield a slightly different list, including many of the same articles.
"Considering obstetrics and gynecology as a specialty: current attractors and detractors," Obstetrics and Gynecology," Aug. 1991, pp 308-312. PubMed abstract:
We surveyed senior students at 11 medical schools to identify the criteria they used in considering obstetrics and gynecology (OBG) as a career. Nearly half (49.6%) of the students responded. Their demographic characteristics compared well with national figures. Regression analyses identified 15 significant predictors of specialty choice among the 445 students who ranked OBG as one of their top four choices. More women than men chose OBG. Students attracted to the specialty liked contact with (mostly healthy) patients. They expressed strong beliefs on reproductive issues and perceived a need for more obstetrician-gynecologists. They associated their interests in operative procedures with certain risks and responsibilities. Physicians in OBG modestly affected their decision. Students who chose a different specialty wanted more variety in disease and patient mix. They wanted a more controllable life-style, particularly in residency training. They felt that the insurance costs and the risk of lawsuit detracted from OBG. These findings offer a stimulus for discussion between students and their advisors. Students need sufficient exposure to the specialty to help them assess the value they place on these specialty characteristics.
OphthalmologyAmerican Board of Medical Specialties description: "An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor, and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Training required: Four years." Reprinted from Which Medical Specialist for You, ABMS. Revised, March 2000.
Other ophthalmology information and links:
OtolaryngologyAmerican Board of Medical Specialties description: "An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck.
An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of ears, nose, sinuses, throat, respiratory systems, face, jaws, and other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery, and the treatment of disorders of hearing and voice are fundamental areas of expertise.
Training required: Five years.
Certification in one of the following subspecialties requires additional training and examination.
Otology/Neurotology: An otolaryngologist who treats diseases of the ear and temporal bone, including disorders of hearing and balance. The additional training in otology and neurotology emphasizes the study of embryology, anatomy, physiology, epidemiology, pathophysiology, pathology, genetics, immunology, microbiology, and the etiology of diseases of the ear and temporal bone.
Pediatric Otolaryngology: A pediatric otolaryngologist has special expertise in the management of infants and children with disorders that include congenital and acquired conditions involving the aerodigestive tract, nose and paranasal sinuses, the ear, and other areas of the head and neck. The pediatric otolaryngologist has special skills in the diagnosis, treatment, and management of childhood disorders of voice, speech, language, and hearing.
Plastic Surgery within the Head and Neck: An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery.
The field is diverse and involves a wide range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgery are practiced, there are many additional procedures which interface with them." Reprinted from Which Medical Specialist for You, ABMS. Revised, March 2000.
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To see an extensive and current list of articles on this topic, do a search in PubMed using the terms "medical students specialty otolaryngology."
"The otolaryngologist as a role model," Ann Otol Rhino Laryngol, Nov. 1999, pp 1042-1045. PubMed Abstract: Throughout our daily interactions with medical students and residents, each of us, whether we like it or not, functions as a role model. Since role modeling is primarily a passive function - teaching by example - we may not be acutely aware of this role and its importance. In what respect is the concept of the role model important to otolaryngology-head and neck surgery? In addition to the function of specific training - teaching the trade - most of the literature on role modeling cites 2 major areas of significance: 1) influencing medical students' career choices and 2) facilitating socialization into the world of medicine with the establishment of an appropriate professional identity. This brief article reviews some of the current literature, catalogs those attributes that have beekn identified as those of excellent role models, and offers some thoughts as to what our specialty might consider in response to the challenges to medical education in the changing health care environment.
"The interface of academic and community practice in medical and graduate medical education," Archives of Otolaryngology--Head and Neck Surgery, Oct. 1996, pp 1041-1044. PubMed abstract: Historically, the interaction between academic departments of otolaryngology-head and neck surgery and the community practice of the specialty has been erratic, anecdotal, and often strained. A general sense of autonomy and isolationism that has characterized many university programs coupled with a paranoia on the part of many practitioners with respect to concerns about protecting their patient base have led to an uneasy relationship. Difficulties with managed care now threaten this relationship even more. It is clearly time to seek a solution that can enhance the educational opportunities for medical students and residents.
"Controllable lifestyle: a new factor in career choice by medical students,"
Academic Medicine, Oct. 1989, pp 606-609. PubMed abstract: To determine whether control of work hours (controllable lifestyle) was becoming an increasingly important factor in choices of specialties by medical students, data from three medical schools over the past ten, ten, and six years, respectively, were reviewed for the types of specialty training entered by students in the top 15% of their classes. Since students in the upper 15% of the class are likely to obtain the specialties of their choice, any change in the pattern of their specialty preferences probably reflects a general trend. Specialties that feature a controllable lifestyle (CL) were defined as anesthesiology, dermatology, emergency medicine, neurology, ophthalmology, otolaryngology, pathology, psychiatry, and radiology. Non-CL specialties were surgery, medicine, family practice, pediatrics, and obstetrics-gynecology. The results showed that the percentages of students entering CL specialties increased significantly at all three schools, the percentages of students entering non-CL specialties decreased significantly at all three schools, and there was no significant change in the percentage of students entering surgical specialties.
"The use of Part I National Board scores in the selection of residents in ophthalmology and otolaryngology," JAMA, Jan. 8, 1988, pp 240-242. PubMed abstract: A survey of ophthalmology and otolaryngology residency program directors was conducted to determine the extent to which National Board of Medical Examiners (NBME) Part I scores are used in selection of residents in these highly competitive specialty fields. Results from 218 completed questionnaires representing nearly 90% of all US ophthalmology and otolaryngology/head and neck surgery programs were analyzed. More than three fourths indicated that Part I NBME scores were used in selecting residents; more than half of the programs used these scores as a means to determine whom to interview. The direct use of NBME scores in the residency application process is widespread; however, such use of NBME scores is not consistent with the purposes of the National Board. The preeminent role of the faculty in the evaluation of medical students and in the assessment of their clinical competence needs emphasis.