# What Makes Some Doctors Decide to Become Proctologists? **URL:** \ **Category:** In My Humble Opinion\ **Created:** [June 22, 2015, 7:36pm UTC](https://boards.straightdope.com/t/what-makes-some-doctors-decide-to-become-proctologists/723172 "2015-06-22T19:36:32Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![Fotheringay-Phipps](https://avatars.discourse-cdn.com/v4/letter/f/d9b06d/32.png) [@Fotheringay-Phipps](https://boards.straightdope.com/u/Fotheringay-Phipps)\ **Post date:** [June 22, 2015, 7:36pm UTC](https://boards.straightdope.com/t/what-makes-some-doctors-decide-to-become-proctologists/723172/1 "2015-06-22T19:36:32Z")
(I believe they may go by “colorectal” specialists these days, but it’s the same thing.) Now I fully understand that the world needs these types of doctors. No doubt about it. What I’m wondering about is suppose you’re a doctor choosing additional training etc. to become a specialist. The world is open in front of you, and there are numerous specialties that you might go into. What makes you decide “hmm, being a proctologist is the thing for me”? The downsides are the unpleasantness of the body parts and functions (truth is that most doctors deal with a certain amount of unpleasantness, but this seems a lot worse than most), and what has to be a certain amount of squeemishness from people you meet and tell them what you do for a living. Is there less competition for jobs in this area? Higher salaries? Or am I wrong about my premise and people consider being a proctologist just as pleasant as being a orthopedist (for example)? ---
**Author:** ![CinnamonBabka](https://avatars.discourse-cdn.com/v4/letter/c/bbce88/32.png) [@CinnamonBabka](https://boards.straightdope.com/u/CinnamonBabka)\ **Post date:** [June 22, 2015, 7:38pm UTC](https://boards.straightdope.com/t/what-makes-some-doctors-decide-to-become-proctologists/723172/2 "2015-06-22T19:38:01Z")
I’d imagine the stories they hear are too good to pass up. ---
**Author:** ![QuickSilver](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/quicksilver/32/7832_2.png) [@QuickSilver](https://boards.straightdope.com/u/QuickSilver)\ **Post date:** [June 22, 2015, 7:43pm UTC](https://boards.straightdope.com/t/what-makes-some-doctors-decide-to-become-proctologists/723172/3 "2015-06-22T19:43:02Z")
I imagine that any sort of foreign object removal is handled by your run of the mill ER first year intern and not a GI specialist. ---
**Author:** ![Smapti](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/smapti/32/17938_2.png) [@Smapti](https://boards.straightdope.com/u/Smapti)\ **Post date:** [June 22, 2015, 7:49pm UTC](https://boards.straightdope.com/t/what-makes-some-doctors-decide-to-become-proctologists/723172/4 "2015-06-22T19:49:15Z")
_Someone_ has to do the job. If there’s a lack of trained specialists in that field, then going into it would just be a smart financial choice. ---
**Author:** ![Jophiel](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jophiel/32/66_2.png) [@Jophiel](https://boards.straightdope.com/u/Jophiel)\ **Post date:** [June 22, 2015, 7:56pm UTC](https://boards.straightdope.com/t/what-makes-some-doctors-decide-to-become-proctologists/723172/5 "2015-06-22T19:56:49Z")
I’ve never studied medicine but, to me, the digestive tract seems more fascinating than, say, feet do. I’m sure that there’s some passionate specialists out there who’d tell you all about how important the lower intestines are, how they can determine the health of the body, yadda yadda. ---
**Author:** ![peedin](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/peedin/32/14095_2.png) [@peedin](https://boards.straightdope.com/u/peedin)\ **Post date:** [June 22, 2015, 7:58pm UTC](https://boards.straightdope.com/t/what-makes-some-doctors-decide-to-become-proctologists/723172/6 "2015-06-22T19:58:11Z")
They are now called gastroenterologists. This specialty also includes diagnosis and treatment of liver disease, pancreatic issues, etc. It’s much more than bowel movements _cue hysterical laughter_ I’m guessing physicians go into that specialty because it interests them. ---
**Author:** ![Jas09](https://avatars.discourse-cdn.com/v4/letter/j/d07c76/32.png) [@Jas09](https://boards.straightdope.com/u/Jas09)\ **Post date:** [June 22, 2015, 7:58pm UTC](https://boards.straightdope.com/t/what-makes-some-doctors-decide-to-become-proctologists/723172/7 "2015-06-22T19:58:58Z")
It is my understanding that GI docs are up at the very high end of the money/workload spectrum for physicians. It’s almost all scheduled (read: good hours) procedures (read: good money). Basically the only things better-paying are cardiology and orthopedics, both of which are much harder to get residencies and fellowships in (due to the exactly factors you mention). Radiology and anesthesia are the other hot specialties but are ultra-competitive as well. Dermatology too, but I’ve heard that’s actually really, really boring. You can see here for some more details (includes satisfaction numbers as well, where GI is middle-of-the-road): [Latest Medical News, Clinical Trials, Guidelines - Today on Medscape](http://www.medscape.com/features/slideshow/compensation/2014/public/overview#2) ---
**Author:** ![RealityChuck](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/realitychuck/32/195_2.png) [@RealityChuck](https://boards.straightdope.com/u/RealityChuck)\ **Post date:** [June 22, 2015, 8:05pm UTC](https://boards.straightdope.com/t/what-makes-some-doctors-decide-to-become-proctologists/723172/8 "2015-06-22T20:05:55Z")
[It’s all explained here.](https://www.youtube.com/watch?v=W2gABYTmXos) ---
**Author:** ![Frazzled](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/frazzled/32/3368_2.png) [@Frazzled](https://boards.straightdope.com/u/Frazzled)\ **Post date:** [June 22, 2015, 8:07pm UTC](https://boards.straightdope.com/t/what-makes-some-doctors-decide-to-become-proctologists/723172/9 "2015-06-22T20:07:04Z")
My brother is a radiologist. If I understood him correctly, the specialty has more say in choosing the doctor than the doctor has in choosing the specialty. Part of medical training includes spending time working within various specialties. If the doctor does well, the school will extend an invitation to work on that specialty. As mentioned above, there’s only so many slots they can fill so the path a doctor follows may not be the path they would choose if they had total freedom. I may have completely misunderstood how the path works though so am looking forward to reading other responses. ---
**Author:** ![Spiderman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/spiderman/32/230_2.png) [@Spiderman](https://boards.straightdope.com/u/Spiderman)\ **Post date:** [June 22, 2015, 8:22pm UTC](https://boards.straightdope.com/t/what-makes-some-doctors-decide-to-become-proctologists/723172/10 "2015-06-22T20:22:46Z")
There was a proctologist & a psychiatrist who opened a practice together… …called it Odds & Ends. d & r ---
**Author:** ![Fotheringay-Phipps](https://avatars.discourse-cdn.com/v4/letter/f/d9b06d/32.png) [@Fotheringay-Phipps](https://boards.straightdope.com/u/Fotheringay-Phipps)\ **Post date:** [June 22, 2015, 8:26pm UTC](https://boards.straightdope.com/t/what-makes-some-doctors-decide-to-become-proctologists/723172/11 "2015-06-22T20:26:24Z")
> [@peedin](#): > > They are now called gastroenterologists. This specialty also includes diagnosis and treatment of liver disease, pancreatic issues, etc. It’s much more than bowel movements _cue hysterical laughter_ I’m guessing physicians go into that specialty because it interests them. Gastroenterologists and colorectal specialists are different specialties. The colorectal specialists are what was commonly known as proctologists. ---
**Author:** ![Habeed](https://avatars.discourse-cdn.com/v4/letter/h/a587f6/32.png) [@Habeed](https://boards.straightdope.com/u/Habeed)\ **Post date:** [June 22, 2015, 8:36pm UTC](https://boards.straightdope.com/t/what-makes-some-doctors-decide-to-become-proctologists/723172/12 "2015-06-22T20:36:44Z")
It’s a set of money/time/lifestyle tradeoffs. Also, the most desirable specialties (the ones that pay the most and involve the doctors having to do the least amount of work/unpleasant work) are ruthlessly sought after. Last I heard, dermatology was the one everyone wanted. Nice, easy office work that pays $300k a year. Surgeons sometimes make only 150k-200k, and they have to work a lot harder and a lot longer hours for their money - they have to be available to do surgeries all hours of the day or night, and it’s a lot longer hours, and it is obviously stressful to have a human being cut open in front you of where a mistake could cost the patient their life. I think office working dermatologists send the patients with the horrible skin cancers that might kill them to other doctors so they don’t actually have to try to chop out the tumors or watch the patients die slowly and horribly from the cancer. Anyways, urology and proctology are specialties, so they make more than primary care (pediatricians/internal medicine/family practice) and have to work less hours. So, plenty of medical students who don’t have the perfect grades for derm choose it so they can go home at night and sleep on top of a big pile of money and perfumed ladies so they don’t think about poop. ---
**Author:** ![billfish678](https://avatars.discourse-cdn.com/v4/letter/b/7bcc69/32.png) [@billfish678](https://boards.straightdope.com/u/billfish678)\ **Post date:** [June 22, 2015, 8:41pm UTC](https://boards.straightdope.com/t/what-makes-some-doctors-decide-to-become-proctologists/723172/13 "2015-06-22T20:41:14Z")
> [@CinnamonBabka](#): > > I’d imagine the stories they hear are too good to pass up. I thought it was the free pasta. ---
**Author:** ![CinnamonBabka](https://avatars.discourse-cdn.com/v4/letter/c/bbce88/32.png) [@CinnamonBabka](https://boards.straightdope.com/u/CinnamonBabka)\ **Post date:** [June 22, 2015, 8:48pm UTC](https://boards.straightdope.com/t/what-makes-some-doctors-decide-to-become-proctologists/723172/14 "2015-06-22T20:48:55Z")
> [@billfish678](#): > > I thought it was the free pasta. Million to one shot, doc. ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [June 22, 2015, 9:05pm UTC](https://boards.straightdope.com/t/what-makes-some-doctors-decide-to-become-proctologists/723172/15 "2015-06-22T21:05:35Z")
> [@Habeed](#): > > I think office working dermatologists send the patients with the horrible skin cancers that might kill them to other doctors so they don’t actually have to try to chop out the tumors or watch the patients die slowly and horribly from the cancer. A dermatologist with a patient like this would refer them to oncology and plastic surgery. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [June 22, 2015, 9:21pm UTC](https://boards.straightdope.com/t/what-makes-some-doctors-decide-to-become-proctologists/723172/16 "2015-06-22T21:21:47Z")
> [@Fotheringay-Phipps](#): > > Gastroenterologists and colorectal specialists are different specialties. The colorectal specialists are what was commonly known as proctologists. Maybe you are thinking of colorectal surgeons? That’s, duh, a surgical subspecialty that deals with things like tumor removal and such. Colonoscopies are generally done by the gastroenterologists. Procedures pay well. Parts are parts and these be important parts. Some find they like problems they can get to the bottom of. We all deal with crap anyway, at least these folk have an end in sight … unless they get pooped out. Some people are just anal. Seriously very likely had a good attending on a GI rotation, enjoyed it and was encouraged to pursue it. Good pay, good lifestyle, enough variety to keep it interesting, making enough of a difference to think it matters. ---
**Author:** ![Fotheringay-Phipps](https://avatars.discourse-cdn.com/v4/letter/f/d9b06d/32.png) [@Fotheringay-Phipps](https://boards.straightdope.com/u/Fotheringay-Phipps)\ **Post date:** [June 22, 2015, 9:24pm UTC](https://boards.straightdope.com/t/what-makes-some-doctors-decide-to-become-proctologists/723172/17 "2015-06-22T21:24:30Z")
> [@DSeid](#): > > Maybe you are thinking of colorectal surgeons? That’s, duh, a surgical subspecialty that deals with things like tumor removal and such. Things like fissures, fistulas, strictures, hemmerhoids etc. etc. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [June 22, 2015, 9:30pm UTC](https://boards.straightdope.com/t/what-makes-some-doctors-decide-to-become-proctologists/723172/18 "2015-06-22T21:30:30Z")
> [@Fotheringay-Phipps](#): > > Gastroenterologists and colorectal specialists are different specialties. The colorectal specialists are what was commonly known as proctologists. Most ‘proctologists’ these days are actually colorectal surgeons, a subspecialty of general surgery. A very important specialty as regards treatment of colorectal cancer, Crohn’s disease, anal fistulas, and other common diseases of the very distal GI tract. However, most of those types of surgeons still do general abdominal surgery too. And most general surgeons do basic colorectal surgery too, though may refer more complex cancer resections and reconstructions to the more specifically trained colorectal subspecialist. Gastroenterologists can also diagnose and treat a lot of colorectal disease via the colonoscope, particularly colorectal polyps and internal hemorroids. But any significant tissue removal such as is found in cancers needs a surgeon. So what you’re asking is why do doctors go into general surgery? Well, it’s an interesting place to muck around, you get to make interesting diagnoses, treat and even cure certain diseases, and save lives. And it’s still considered a pretty macho specialty. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [June 22, 2015, 9:32pm UTC](https://boards.straightdope.com/t/what-makes-some-doctors-decide-to-become-proctologists/723172/19 "2015-06-22T21:32:09Z")
> [@Fotheringay-Phipps](#): > > Things like fissures, fistulas, strictures, hemmerhoids etc. etc. As noted, those can be taken care of by some gastroenterologists, and even family medicine physicians such as myself. I don’t treat strictures or fistulas, but do deal with fissures and acutely thrombosed hemorrhoids. Why do I do it? It needs doing. ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [June 22, 2015, 9:34pm UTC](https://boards.straightdope.com/t/what-makes-some-doctors-decide-to-become-proctologists/723172/20 "2015-06-22T21:34:36Z")
> [@Qadgop\_the\_Mercotan](#): > > And it’s still considered a pretty macho specialty. So, how does this explain the increasing percentage of women who go into it? I do know that some surgical fields are VERY territorial (OB/GYN being the first one that comes to mind). [Next page](https://boards.straightdope.com/t/what-makes-some-doctors-decide-to-become-proctologists/723172.md?page=2)