Anyone?
I know it may LOOk like I’m not doing anything, but at the cellular level, I’m actually quite busy,
Medical training:
4 yr. undergraduate studies, usually culminating with BA/BS.
4 yr. Medical school culminating in MD/DO
1 year Internship (everything supervised/countersigned)
** eligible for license in most states & could practice as GP **
2-6 years Residency = specialty training (progressively less supervision & more supervisory/teaching role with more junior docs)
___2 years Family Practice, Internal Medicine
___6 years Neurosurgery
** eligible for board certification, privileging at hospitals = attending/staff**
Optional: 2-4 years fellowship (subspecialty training)
My path (a little atypical)
3 years Int Med internship/residency
5 years Int Med staff
2 years Endocrinology fellowship
1.5 years Endocrinology staff
For non-military docs, there are huge financial disincentives for interrupting training. For me it was a terrific opportunity to be a more full-time mom, and regain some curiosity.
Hope this answers your ?, without being overload.
Sue from El Paso
Siamese Attack Puppet - Texas
Experience is what you get when you didn’t get what you wanted.
Do nurses often become doctors? I guess what I’m asking is, do nurses and doctors share much early training and could a person work as a nurse while training as a doctor? I know that to become a R.N. requires a lot of education, and that a lot of the work doctors get credit for is actually done by nurses.
Peace,
mangeorge
I only know two things;
I know what I need to know
And
I know what I want to know
Mangeorge, 2000
What Sue said is correct, the term residency comes from the fact that the MD’s typically live in the area they’re training in. Where I work, in a busy ER, we have attending physicians who work for, or are subcontracted to, the hospital, and residents who are training in Fresno through the UCSF program. While thay are MD’s they are in a training setting with progressively more independence. In addition to practicing in the chosen specialty, they attend lectures and do rotations in surgery, internal medicine, cardiology etc.
As far as the second question, I have known nurses to progress to MD, but I wouldn’t call it common. Interestingly, most of the training for RN is not transferable to med school. While in practice it’s solid education and experience, you have to start virtually all over in terms of credits and prerequisites. It’s much more common for RNs to progress to nurse practitioner or physicians assistant because it builds on your established education and experience much better,
Larry
Love Sue’s admission:
What the conventional type of med training seems to do (at least for males), though I think there’s quite a bit of genetics also involved, is to limit one’s curiosity to whether the golf ball will sink in the hole this time.
Ray
“The more the universe seems comprehensible, the more it also seems pointless.” – Steven Weinberg, Physicist
Actually, the term residency comes from the “good old days” when no physician-in-training would ever consider having a personal life, let alone a wife or family. They typically lived on the grounds of the hospital, a big step up from the room in the hospital they would have occupied as an intern.
I agree with what Larry said about few RNs going back to school to become physicians. Most RNs (correct me Holly or Larry if I’m wrong) get a bachelor’s degree in 4 years. 2 years of this is basic science; 2 years of this is clinical work.
While they do have a 4-year degree, they likely would not have taken the same science courses in college that a pre-med undergrad would have. Some med schools have specific course requirements that would not be met by a BS in nursing program; others have more flexible requirements & welcome nurses.
The big obstacle to nurses going to med school is the additional minimum 7 years to be a board certified physician with all the financial ramifications of switching from earner to student, and the fact that some nurses ::donning teflon undies here:: do not have the book smarts/standardized test taking ability to get into med school. I say this with a great deal of trepidation - I don’t want to get into a pissing match over intelligence (which is VERY different from book smarts or MCAT scores). OTOH, if we’re touching on stereotypes, most nurses have it hands downs over most docs in bedside manner/people skills.
::hope it’s safe to come out now::
As Larry mentioned, nurses can do further training (2-3 years, I believe) & become a Nurse Practitioner, Nurse Midwife, or Nurse Anesthetist. These nurses are then licensed in accordance with state laws to see patients independently, but with (mostly nominal) physician supervision & physician backup for patients with unusual or complicated conditions. Physician Assistant training is a little bit different, but some schools have special programs for nurses who wish to become a PA (similar practice situation to NP’s).
To summarize the time from HS to being able to independently see patients:
Physician’s Assisitant - 4-5 years
Nurse Practitioner - 6-7 years
Internal Medicine/Family Practice physician - 11 years.
- Sue
To try to extricate myself from any trouble I may have gotten myself into, let me clarify:
Nurses are not half-way trained doctors. Their profession calls for different skills and aptitudes. They independently assess patients, make nursing diagnoses, and come up with nursing treatment plans. All that and treat me like a goddess because I know how to open a file drawer & pull out the piece of paper I need, and have been known to answer the phone myself when I’ve paged a colleague 
They are my eyes, my ears, and my hands. I couldn’t do what I do without them.
Ray, I would ask that in the future you post your doctor-bashing rants in the Pit, and your pointless observations in MPSIMS. It’s really getting old here and adds nothing.
I am making a sincere effort to answer other poster’s questions, including yours, in case you haven’t noticed. Your medical conspiracy schtick and non-stop sniping at professionals are getting old.
::sigh::
Answer to mangeorge’s first question:
Yes. My mother did. She received her RN in 1981. She worked as a nurse for awhile, and returned to school to complete prereq’a for medschool in 1982. This took one and a half years, and she entered medschool in 1984. Received her MD in 1988. At the age of 39.
Her best friend from nursing school is interviewing for residencies for this fall.
That’s really cool, Melatonin. I have a feeling that her experiences as a nurse just might serve her well in her new job.
And thanks, Majormd, for your informative responses.
Nano, you’re a bad boy. Gross generalities are naughty.
Peace,
mangeorge
Well, my mom didn’t really have much experience working as a nurse. Less than a year.
She got knocked up with my sister ASAP after going to work in nursing. It didn’t take her very long to figure out that:
a)Nursing is a totally thankless job, and
b)An utterly inadequate means of satisfying a life long dream to become an MD.
Well , I don’t find nursing to be a totally thankless job, you just have to find the thanks yourself. One of the Tshirts I’ve seen refers to a profession measured not in years, but in moments, which I think is true, you find the gratification in seeing the results of your work, not what people say about it.
Recently I had the opportunity to place a 17 day old into it’s mothers arms and tell her that her baby was well enough to leave the ICU and she could start breast feeding again. The way she looked at her child is beyond my ability to discribe, and all the thanks I need, especially since, at this juncture, it is unlikely that I will have any kids of my own.
Aw shit, now I’m getting all misty,
oh and BTW Nanobyte,
perhaps it’s because I work in Peds ICU and ER, but the MDs I know are all overworked and under-appreciated; are you sure that your bad experiences with healthcare professionals don’t begin with your own attitude? Just a thought
Funny you should mention this. Not only is it off-topic, it is factually incorrect. I’ve recently taken up golf, and I can tell you that doctors are the worst golfers on the course. Why? Because as Ivick correctly points out, they have no time to practice. From the first day of med school until well into a doctor’s career, their lives are characterized by lack of sleep, constant activity and stress. It goes well beyond the 18+ hour shifts regularly expected of first-year residents (a pace which so tires new doctors that NY State is considering a legislative solution to get them a few more hours of off time to decrease errors). Even after establishing a practice, doctors spend untold hours seeing patients and even more hours dealing with the paperwork. (You think you hate your HMO? Ask your doctor about them, then stand back.)
IMHO, the sacrifices one has to make in order to practice medicine are too high for the fair-to-middling compensation they get, especially now that society seems to have decided that they ought not be treated with the social standing they deserve. To become a physician nowadays, one really has to love medicine and people. (Perhaps my high esteem for medical professionals, whether of the MD or RN variety, is influenced by the fact that I like neither medicine nor people.)
Oh. And as a golfer, I can tell you that the answer is no. The ball will not sink in the hole this time.
Livin’ on Tums, vitamin E and Rogaine
In further defense of MD’s. . .
My mother completed her residency in 1992, but it took her several years to establish a practice. I think, at this point in time, she may finally actually be turning a profit, but she has had to move camp and set up in three different states in order to get to that point.
Trying simultaneously to establish a business, pay for a home, take care of payroll for all your staff and pay off 100,000 dollars in loans (while being constantly paged to come to the hospital to deliver babies at 4am) isn’t the cake-walk it’s cracked up to be.
Even more fun for a single mom.
I’m not saying doc’s aren’t a little- materialistic. But if you look at what they have to do to get that money, it’s borderline excusable.
I wouldn’t however say that American docs deserve MORE money.
Pay us teachers a living wage first, then we’ll get down to the financing of Dr. MD’s next Lexus.
Somewhat different question, but:
Should I have any reservations about getting routine medical care from a nurse practitioner instead of an MD?
I recently moved to a new area and chose a medical office (within a nearby hospital) that has 10 doctors and 2 nurse practitioners. I went there this week with a throat infection and got an immediate appt. with one of the latter. She was very nice and I’m going back to her next week for a routine physical.
However, I don’t know much about it. Is she as qualified? Will I be disadvantaged if I develop a patient/doctor relationship with her instead of a full MD and then have a condition she can’t diagnose? What are the pros and cons?
In my experience, having an NP as your primary caregiver sucks. This is primarily because they have to get a doc to sign off on every scrip they give, and thus prefer to sugggest OTC and witch doctor cures.
I would strongly disagree with melatonin, the amount of supervision that an NP requires can vary but is often quite nominal as they are working with established treatments and protocols. Yes, if you go in for an exotic or vague problem you will need a referal the same as if to took it to general practice MD (one of my critirea for a good GP is their willingess to punt), and yes, if your NP or PA offers to take out your appendix you should decline, but I’ve had only good experience with them as mid-level providers, and never had a delay for them to get clearance,
Larry
Here’s my spin on NPs & PAs:
For the vast majority of problems in the vast majority of patients, they can provide excellent medical care.
Here are some of the differences I have noted: (these are generalizations - ymmv)
- They tend to make paitients feel more comfortable asking questions. Better communications results in, if not better health care, better satisfaction with health care.
- They tend to do a better job making sure that all the preventive health care measures/screenings are up-to-date, or at least offered to patients (Not everyone wants a flexible sigmoidoscopy as a 50th birthday present).
- They do a better job working within practice guidelines.
Got heartburn a few times a week? Here are likely outcomes based upon which kind of provider you see:
NP - recommend avoidance of late night eating, certain foods, alcohol, smoking, Motrin & aspirin, tight constrictive clothing, and other lifestyle changes, with antacids used for occasional symptoms, return in 4 weeks to reassess.
FP or internist - do a blood test for an infection with Helicobacter pylori, give you a handout about the above, prescribe mild acid-blocking meds (Zantac, Tagamet, Pepcid) to be taken intermittantly, see you back in 3 months.
Gastroenterologist - will likely assume that you have tried the above measures, arrange for an upper endoscopy (scope down the throat to examine the lining of your esophagus, stomach, & upper intestines), and prescribe strong acid-blocking meds (Prilosec, lansoprazole) or anti-reflux meds (Propulsid), see you back in 6 months.
For intermittant heartburn, the most cost-effective management is as described for the NP. But docs create/perpetuate the notion that every ailment warrants a prescription to cure it. - If they can easily ask their doc for assistance when needed, they do so. It all boils down to whether the doc supervising NPs & PAs is overbooked himself, or if s/he allots a reasonable amount of flexibilty in his schedule to assist with those cases which are beyond the NPs abilities/scope of practice.
For my own well-woman care, I see an NP at my hospital. I have never waited more than 10 minutes past my appointment time & have never felt rushed during a visit with her. I can, of course, walk in & chat with any of the OB-GYN physician staff if I have concerns, but so far, have felt no need to.
How happy people are with NPs & PAs as their pricary care provider, depends more on the individual practitioner & how easily s/he can get physician-level backup than on the fact that the provider is an NP or a PA.
Sue from El Paso
Siamese Attack Puppet - Texas
Experience is what you get when you didn’t get what you wanted.
My mother was a Special Ed teacher, then Admin for over 20 years. Her teenage Dream? To be a Nurse. She QUIT her career, and started over from scratch. She was at the top of her class. She was also at least 20 years older than almost all of the students.
Two car accidents in two years stopped her from being a shift nurse on a Surg Floor. Back injuries…and so, she is a Hospice Nurse. Perfectly tuned to the rigors of THAT job, she touches lives in vital ways every day.
You wanna be an MD? Fine, go. But, tread with care when slamming Nurses. I have a lot of respect for what Majormd has said here. It’s as in any other profession. She cannot do her job without the incredibly dedicated and skilled nurses with whom she works. It’s not Second Class Medicine, it’s a Vital Role in the Picture.
One of my best friends is a NICU nurse. ( Neonatal ICU). She, and her co-horts, make decisions that are life and death, many times the Dr’s are there to nod their heads, and sign off on the delicate moves already in progress. Respect, ok?..respect.
Frankly, since I adore EMS work, and will work on my EMT this year ( god willing ), if I thought I had the chops, I’d quit the movie biz and go to nursing school… But, I’m no great student.
Cartooniverse
If you want to kiss the sky, you’d better learn how to kneel.
Cartooniverse is right in every way. Just the sheer amount of on call hours most nurses have to put up with (according to my experiences) is enough to drive many normal people crazy.
Some of the posts in this thread are making me wary of my chosen career path of medical doctor… Well…almost.