I’ve always been fascinated by biology and medicine. I don’t want to go to medical school though. If I put enough time into it, is it possible to teach myself enough about medicine to, say, offer a consult or diagnose somebody? If I read enough books and studied enough journals, could I pass as the doctor when we all get stranded on the tropical island?
Obviously, study is no substitute for practice. So what aspects of medicine could I teach myself? Surgery is right out. Pharmacology, I could probably handle.
So what’s my upper limit? How skilled could I get?
Well, you’re not going to get a license without going through proper medical skill, so you won’t be able to practice as a profession, full stop. I’m not sure if that’s what you were thinking or not.
My guess would be that diagnosis and prescribing is 100% textbook and acquired experience (meaning "oh, in x years of practice I can safely discount the odds that you have very rare and foreign disease x and be confident that you probably have the more common disease whose symptoms are the same). Obviously though you can’t actually diagnose as it would require a medical license to do so
Treatment is probably the exact opposite. You need to probably stitch someone up in order to know how to do it.
I don’t have much doubt that an intelligent person who put in the requisite amount of study could be an adequate professional in most fields of endeavor. Attendance at a tertiary institution is vastly overrated in terms of the knowledge people gain from it.
Plenty of non trained people are able to pass themselves off as professionals in real life, I’m sure on the net it is happening thousands of times a day.
(Sometimes even a well-trained doctor is a practical ass because their only skillset is book learning.)
There is an element of being a physician that requires bedside mentoring, real patients, and judgment based on direct experience. A book cannot teach that, and I am not referring only to procedures.
It may be true that universities are over-rated, but the apprenticeship model that makes a good physician is not.
Given that the OP is talking about being stranded on a desert island, I don’t think he’s concerned with certification, licensing, or other appurtenances of civilization for purposes of this question.
That is part of it; focusing on zebras–or even unicorns–when whatcha got is a pony.
When you are on the desert island, the difference would become apparent when you have an atypical appendicitis and you wonder if one of the appendices epiploicae has torsed. Among a million other things, one difference between practical medicine and House (although I have not personally watched House) is that in real life it’s a lot more common to have unusual presentations of common things rather than common presentations of unusual things or unusual presentations of uncommon things.
It’s really judgment, and history-taking and the like, though, which cannot easily be learned from a book. The difficult part of medicine is not making the occasional insightful and obscure diagnosis, even though that’s the fun part.
I had also wondered the same thing about pharmacy - I already have several years of experience, and am good at teaching myself things, (and a total badass at standardized tests), but apparently they won’t grant a pharmacist license without a degree from a pharmacy school, no matter how well you score on any tests :smack:
So could I come up with some novel research idea from being self-taught? Or would I be so far behind the schooled professionals that I’d be useless?
And it’s not really important what I have or where I am. I’m interested in what I’d be capable of doing, not whether I actually went out and did it. Assume, though, that I’m not abducting strangers from the street to practice on. I have to get all my experience from books and House episodes (in other words, what I do now).
Why not become a Nurse or a PA then? Or a Nurse Practitioner if you want to work in the health care industry w/o doing the medical school route.
PAs finish their “scholastic” training in 2 years, and being their rotations in their 3rd year. They get to focus on all the procedural stuff and less emphasis on physiology and the “why” more than the “how to fix it” aspects.
Or you can do the EMT Route. An EMT-B is not that hard- I got my certificate with 6 months of “training” where it was basically a single textbook that I just made sure I read, and around 10-15 hours of practical usage of instruments and practicing scenarios. I’m sure you could just use a book and ignore the practical portions, though as an EMT-B you have a minimal skill set. If you go for another year of training (or 6 mo), you can do the EMT-I where you can give medications and such under a doctor’s orders (at least for my State).
But if you want the whole shebang- you could do w/in 2 years the training to become a Paramedic. That’d probably give you the best access to training, tools and equipment/common medications.
But the person’s value in medicine really lies in the PRACTICAL aspects- a Paramedic is usually vastly more experienced than an EMTB not because of his booksmart training, but because they’ve been running out on the service for hundreds of hours, while I as an EMT-B was out in an ER clinic for around 12 hours.
So for that Desert Island scenario- I think if you had the paramedic Training, that’d be good enough to deal with managing most small problems and a good all around practical training (obviously you wouldn’t be able to manage massive trauma or emergencies that’d require surgery or medical imaging tests or diagnostics, but you’d be training in the ABC’s- Airway management, Blood supply perfusion, and Circulation- so you could at least stabilize your patients and hope for help to arrive.
And I suppose if you had a few medical textbooks around, and you knew them quite well- you could start to improve your diagnostic skills as well- but again the key is getting the experience. You wouldn’t get to See ANY PATIENTS (and nor should you) if you were on your own and self teaching…
So it’s one thing to actually say you could diagnose a case of BPH based on what you read in the book and it’s another thing to actually go out there and start trying to feel up real prostates.
In the Navy, I was once sewn up (4 stitches) by a hospital corpsman who admitted that he’d never actually done it live before. He’d trained and practiced by sewing orange peels.
Medical education (actually all education) is not just about learning facts and skills, it is about inducing you into a social role. I do not just mean that society will not recognize you as being a proper doctor until you have been through the process (though that is part of it). The education is also designed to change you, your personality and your value system, in various subtle and not so subtle ways.
So, you could know as much more about medicine than a regular doctor does, you could have all the skills of diagnosis and treatment, you might even have a better record of curing people than most doctors, but you would still not be a doctor.
Learning things like paramedic grade skills and stuff are a good start, alot of what you will need is understanding the interrelationships of various body systems and the effects that injury and illness have on them.
Paramedic training will start you down the path for diagnostics, but even emt-p level stuff is very limited vs. the full spectrum of diagnostic criteria that an MD is considering.
Also remember even doctors subspecialize into hundreds of categories. A GP can never hope to be equipped to diagnose and treat everything out there.