Doctors can pursue many career paths, including private practice, university-hospital work, or a job with a health maintenance organization. The first lets you be your own boss. The second offers you the opportunity to divide your work between treatment, research and instruction, in varying proportions. The third means you work for a large corporation, which provides you with patients and handles most of the administrative and business tasks that physicians in private practice have to handle on their own. Doctors can also work in inner-city clinics or in rural areas, where shortages of doctors exist. Doctors can be general practitioners or they can specialize in internal medicine, cardiology, endocrinology, neurology, oncology, sports medicine, or one of the many other specialties. Medicine is a very rewarding profession, but it is hard work. Doctors are often exhilarated when they know they have helped someone get well and devastated when they lose a patient. It is a job that can prey upon you physically and mentally. Since the average patient is not a doctor, physicians must not only be able to communicate difficult, often painful information to those in their care, but also they must learn how to interpret their patients’ needs. They must relate to their patients as people and not reduce them to just the illness that needs to be treated. One element of this is collaborating with their patients to determine the best course of treatment for them as individuals. This requires patience, empathy, and compassion. “Compassion,” said one doctor, “is absolutely necessary.”
Paying Your Dues
In college, enroll in a premed program. Volunteer to work at your local hospital or with the emergency medical services. During your last year of college, apply for medical school and take the MCAT. The four-year program at medical school encompasses clinical work and book learning, with two years in the classroom and two in the clinical setting. Some of the usual courses are pathology, pharmacology, neuroanatomy, biochemistry, physiology, histology (the anatomy of tissues), and gross anatomy (cadaver class). Clinical study takes place at local hospitals or medical practices. Students are expected to offer diagnoses and suggest courses of treatment in real-life situations, although an MD/instructor makes the final decisions. In standard programs, students enter clinical clerkships in their third year and, in their fourth year, they can choose among various elective subspecialties. Students also spend the fourth year applying for internships. After four years, students sit for the USMLE (the medical boards), and those who pass receive their medical degrees. A three-year internship and residency are next, although many specialties require a longer training commitment. A medical education is never truly complete. New challenges and breakthroughs change the medical landscape at an alarming clip. Nevertheless, those initial years of med school have an enormous impact. One doctor we spoke to could name instructors who still influenced his work, more than thirty years after he earned his degree.
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