Training Time!
Subspecialties and Scope
Money Matters
Procedures
Misc Med Careers
100
Official education to become a Medical Doctor (either MD or DO) typically lasting 4 years and comprised of 2 years of “Didactics” (classical classroom education) and 2 years of “Clinical Rotations” (hands on learning)
What is Medical school?
I went to the University of Washington Medical school. Most people end up at in-state institutions because of preferential in-state admission rules and cost, but out of state and private options are also common
100
In this role Family Medicine Physicians take care of newly delivered babies in the hospital, providing emergent stabilizing care when needed (Line placement, Intubation, and critical medical care) and routine cares until discharge from the hospital.
What is Newborn care?
- This is most commonly a role in Rural Hospitals where there is no NICU or separate pediatrics service. Babies that need a higher level of care can be sent by ambulance or helicopter to the closest NICU
- This is a central part of my job in addition to clinic.
100
The average cost of Medical school in the United states (for in-state, public schools)
What is $268,000 to $297,000?
- Out of state tuition is much more expensive, and private medical schools average almost twice that
- My schooling cost ~$260,000
100
Major surgery for delivering a child transabdominally when vaginal delivery isn’t viable. One of the only surgeries performed where speed is a major component. Most family medicine physicians need a fellowship in order to routinely perform this procedure
What is Caesarean Section?
100
These medical professions complete 3-4 years of schooling in order to help coach people through labor, triage sick pregnant patients, and help deliver babies. They can complete additional years of training to deliver babies themselves
What is an OB labor nurse?
Can train to be a nurse midwife and manage less complicated pregnancies, vaginal deliveries, and assist with C-sections
200
A 3-Phase series of Exams that must be passed in order to become a certified Physician, each exam taking 8-16 hours
What is Medical Boards (or Step Exams)?
- Step 1- end of first 2 years (didactics) of medical school. Formerly the most important determination of your competitiveness for specialty application. Recently moved to pass-fail
- Step 2- Completed half-way through clinical rotations, usually year 3 of medical school. Has become more important after step 1 moved to pass-fail
- Step 3- Completed after your first year of specialty training, different test for each specialty. Family Medicine’s is a two day series of exams.
200
Medical care focused on quality of life rather than “cure” or extending life length for patients with terminal diseases or limited life expectancy.
What is Palliative care/Hospice?
- Can be a part of any medical practice, or a specialty after fellowship training
- Palliative care physicians can consult in the hospital, run an outpatient clinic, work at a Nursing Home, or provide in-home care
200
The average cost to apply to medical school (not counting testing fees, travel costs, etc)
What is $3000 to $5000?
- At $100-$200 per application, and a recommended 15-25+ applications it adds up fast!
- I took out a loan to apply to 24 different programs and cover associated travel costs
200
A procedure in which a skin sample is removed to diagnose un underlying skin condition or cancer
What is a skin biopsy?
200
This job requires 2-3 years of school beyond undergraduate training and involves working with patients though specialized exercise, stretching, strength training, and massage to build strength and heal from musculoskeletal injuries
What is a Physical Therapist?
300
The post-Med school training lasting anywhere from 3-8 years in which newly graduated doctors train and practice in their specialty of choice. Doctors in this phase of training work up to 80-90 hour weeks and are paid less per hour than almost any other hospital employee.
What is Residency?
Family Medicine residencies are typically 3-4 years in length
300
After completing an additional year of training, these Family Medicine Doctors care specifically for athletes and those with joint and muscle injuries, often providing ultrasound-guided joint injections, rehabilitation programs, and sometimes even traveling with sports teams to provide medical care
What is Sports Medicine?
300
The average annual income for a family medicine resident in the United States
What is $60,000 to $75,000?
- Residents typically start on the lower end of this range and earn an additional $5000 or so per year
- My intern year I made somewhere between $14 and $19 an hour based on my average working hours (For comparison, Washington State minimum wage is $17.13/hr)
300
A common treatment for Arthritis that targets a single joint and decreases inflammation and pain. A temporary measure that typically provides 3-6 months of relief
What are Joint injections?
I perform shoulder, knee, and trigger finger injections commonly in clinic. These can be performed either with ultrasound or without.
300
The person that supports a Physician or Advanced Practioner in clinic. Their job includes rooming patients, taking vital signs, giving injections, completing basic exams, and acting as a liaison between the Doctor/Practioner and patients, insurance, and pharmacies.
What is a Medical assistant?
Training requires an AA, +/- 6 mo to 1 year certification program
400
An algorithm-based system based on the same math used in many dating websites that pairs newly graduated doctors with a specialty training program
What is The Match?
- About as dystopian as it sounds
- Applicants will rank their preferred programs, and programs will rank their chosen applicants, and based on these rankings the algorithm will assign you a program. You can decline your assignment, but if you do your only other option is to try to match again the next year
- Your competitiveness in the match can often limit your options for medical specialty
- If you are unable to match, you cannot practice Medicine in the United States, even if you graduated Medical school
400
These Physicians work only in the Inpatient, or hospital, setting and take over care of patients from the Emergency Medical Physician until they are ready for discharge. They are the head of the patient’s team and often coordinate with multiple specialists to get patients the care they need.
What is a Hospitalist?
400
Average income for Family Medicine Physician in the United States
What is $300,000?
- Clinic only jobs tend to make less, while jobs that include hospital work and call tend to pay higher
- Many employers use what’s called “RVU based compensation” which creates pressure for physicians to see more patients in a shorter period of time in order to maintain income
400
A type of contraception that can be placed once and left for several years- including IUD’s and Nexplanon- that are highly effective in preventing pregnancy and reversible, but do not protect against STD’s
What are LARCs (Long Acting Reversible Contraceptives)?
400
A Physician specialty that is similar to Family Medicine, without the care of children or pregnant patients. Most Doctors in this specialty become general hospitalists or primary care physicians, but it is often a path to further specialization (GI, rheumatology, critical care, cardiology, oncology, sleep medicine, etc)
What is Internal Medicine?
500
An additional training program lasting typically 1-2 years in which licensed physicians can further specialize/subspecialize in addition to their basic medical training.
What is A Fellowship?
- Common examples of family medicine fellowships are discussed in the “Subspecialty and Scope” category
- You can complete a fellowship at any time after residency training, but most physicians opt to go directly from residency to fellowship if interested
500
Can be practiced by Family Medicine Physicians with or without a fellowship and focuses on providing medical treatment for substance use disorders. A relatively new field with a fellowship here in Madison.
What is Addiction Medicine?
- This is part of my practice as well, specifically providing treatment for Opioid and Alcohol use disorders, and is one of my favorite groups of patient to work with.
500
Average number of years it takes to pay off student loans for Family Medicine doctors in the US.
What is 10 years?
Can pay off more quickly if you are aggressive in paying off your loans right out of medical school (7-10 years) slower if income driven repayment plan (~20-25 years)
500
Most Family Med Doctor’s least favorite procedure! A classic method of torture that acts as definitive treatment for Onychomycosis and Onychocryptosis
What is Toenail Removal?
500
A job developed in the 1960’s to address a Physician shortage and initially tailored to ex-military who had experience working as medics. People in this role can hold many jobs that Doctors do, in some states needing direct Physician oversight, but in Wisconsin are able to practice under their own license.
What is a Physician’s assistant?
- Nurse practioners have a very similar role, both are known as “Advanced Practioners” or “Midlevels”
- PA’s complete 3-4 years of schooling after undergrad and then go straight to practice
- NP’s complete additional 2-4 years after getting a Bachelors in Nursing
- Neither require residency