Other careers in medicine

For those of you out there who are unsure what career path they want to follow may I suggest exploring the following career fields and seeing if they appeal to you.

• Podiatry- this a a growing field that allows more flexibility than I originally thought, most work regular office hours with very little (if any) emergencies. They can go into surgery (orthopedics) or generalize and do a little of everything. They earn on par with many physicians.
• Nursing- this is a HUGE field with jobs available practically everywhere. There are several different types of nurses specializing in many different areas. I once met a nurse practitioner who billed as a specialist (more than her general practice physician bass) for her additional training in women's health. Many go into nursing for the flexible schedules, others like it because increased patient contact, (go to an ER and you'll see what I'm talking about, they are the marine corps of the medical field) I have also been impressed by the growing number of men entering this field. While volunteering at Castle Hospital I met a male nurse who was among the first in the Iron Man 2 years in a row, and you would be crazy to challenge his masculinity. I think the stereotype of the 'murse' is going away because the increase in popularity and need for male nurses.
• Physicians Assistant- PA's do everything a doctor does like perform procedures and sign prescriptions the only difference I can see as of yet is they have to work under a physician (who doesn't necessarily have to be on site) PA's make decent money while not worrying about malpractice a win-win if you ask me.
• Medical Anthropologist- these people help the world at on the macro scale. Many of which have MD or PhD's. They look to environmental and societal causes for disease and treatment. These are the people who work with governments and charity organizations. Read the book "Mountains Beyond Mountains" to see what I'm talking about.
• Physical Therapist- most now have a PhD. This is a hands on job with lots of patient interaction. PT's work a lot with Dr.'s and Athletic Trainers. PT's can specialize in working with amputees, the elderly, athletes, or everyday people. Physical therapy combines aspects of new technologies and exercise and flexibility in order to get the job done.

Different types of Nurses

I'm sorry I haven't really educated myself into the world of nursing but I have had exposure to different types during my shadowing and volunteering at Castle Hospital. Nurses enjoy a lot of flexibility. Nurses are needed everywhere and with the right credentials can live anywhere. When I had my baby there were several nurses borrowed from other areas of the country meaning Kapi'olani Medical Center paid for nurses from places like Utah and Louisiana to live and work in Hawaii on a short term contract after which they can return home to their same job. At Castle medial center I became friends with a few of the nurses who are extremely happy with their jobs. They can take vacations whenever they can work as much as they want they can make their own schedules in many cases and they enjoy full benefits, no malpractice insurance, and more exposure to patients than most doctors. If you want to speak to an expert in the field of nursing track down Dr. Goodwill who was a prophesor at a nursing school. Think nursing isn't manly enough think again the military's called coremen and medics who go into combat often times go into nursing when they complete their service obligation with little additional training. So if you're interested in nursing I suggest you look into all the different programs out there and find the one that is right for you. Also nursing can be a great backup plan to medical school.

Certified Nurse Assistant (CNA)

Certified nurse assistants are also known as nurses' aides, patient care technicians, home health aides or home health assistants (HHAs). CNAs provide patients with assistance in their daily living tasks, working under the supervision of a registered nurse. They can be found in hospitals, as well as in different types of nursing homes, adult living facilities, and even in private homes. Their close interaction with patients, often for hours each day, puts them in a position to observe their patients' health status and inform their reporting nurse of any changes. (click for more info.)

Registered Nurse (RN)

Registered nurses comprise the largest occupation in health care, and the most flexible type of nursing career. They perform a variety of duties including providing treatments, educating patients and their families about various medical conditions, and providing advice and emotional support to patients and family members. RNs may choose to specialize in areas of health care relating to a particular condition, an area of the body, a certain type of patient (for example, children), or an area of the hospital (such as the ER). RNs may also provide direction for licensed practical nurses and nurse assistants. (Click for more info.)

Public Health Nurse (PHN)

Public health nurses are RNs with specialized training in community health. In addition to providing the standard RN functions within their hospital or care facility, PHNs frequently travel to patients' homes, schools or community centers, where they work with families and individuals to find viable, accessible solutions to community health concerns. They work with local resources, articulating community health concerns to local health planners and policy makers, and assist members of the community to voice their own problems and concerns. (Click for more info.)

Licensed Practical Nurse (LPN)

Licensed practical nurses work in all areas of health care, and have more training than CNAs, but less than RNs. LPNs provide basic bedside care such as taking vital signs, preparing and giving injections, applying dressings and ice packs, and monitoring the patient's overall condition. LPNs also observe and report adverse reactions to medications or treatments, sometimes performing routine laboratory tests. They also help patients with daily activities such as bathing, dressing, and personal hygiene, and some LPNs help deliver and care for infants. Licensed practical nurses may work in hospitals, nursing facilities or physicians' clinics, and experienced LPNs may supervise nursing assistants and aides. (Click for more info.)

Nurse Practitioner

A nurse practitioner is an RN who has completed additional courses and specialized training in order to function as a doctor. There are a few different types of nurse practitioner, and any of them can work with or without the supervision of a physician. They take on additional duties in the diagnosis and treatment of patients, and in many states they may write prescriptions. At the advanced level, nurse practitioners provide basic primary health care, diagnosing and treating illnesses and injuries as a doctor would. Nurse practitioners can also prescribe medications, but certification and licensing requirements vary by state. (Click for more info.)

Nurse Midwife

A nurse midwife is an RN who has completed additional specialized education in nurse midwifery. Nurse midwives practice the obstetrical and gynecological care of pregnant women, including prenatal care, delivery, and infant care after birth. Many work with the same women from puberty until menopause. Nurse midwives often pursue certification through the American College of Nurse Midwives to become certified nurse midwives. (Click for more info.)

Certified Registered Nurse Anesthetist (CRNA)

A certified registered nurse anesthetist is an RN with specialized training in anesthetics. CRNAs work closely with other health care professionals such as surgeons, dentists, podiatrists, and anesthesiologists. A CRNA takes care of a patient's anesthesia needs before, during and after surgery and other procedures. They have two to three years of formal education beyond a bachelor of science degree in nursing, and have received certification from the Council of Certification of Nurse Anesthetists. (Click for more info.)

Home Health Nurse (HHN)

Home health nurses are RNs who provide periodic services to patients at home. They may travel to a patient's home from their hospital of employment, or they may work for a home health care facility or outpatient center. Their job is to care for patients who cannot leave home, and instruct patients' families on healthy living. Home health nurses care for a broad range of patients, including those recovering from illnesses, accidents and childbirth. They must be able to work independently, and may supervise home health aides and other nurses. (Click for more info.)

Occupational Health Nurse

Occupational health nurses provide for and deliver health and safety programs and services to workers, worker populations and community groups. Depending on the employer, an occupational health nurse may provide emergency care, prepare accident reports, and arrange for further care if necessary. They also offer health counseling, assist with health examinations and inoculations, and assess work environments to identify potential health or safety problems. (Click for more info.)

Licensed Vocational Nurse (LVN)

Licensed vocational nurses have the same job functions as licensed practical nurses (see LPN above). LVN is the designation in southern states, while LPN is prevalent throughout the rest of the country. LVNs provide basic bedside care, some clinical services, and family health planning to their patients. They work under the supervision of a physician or registered nurse, and may supervise certified nurse assistants or other LVNs. (Click for more info.)

Doctor in Podiatric Medicine (PDM)

A Doctor in Podiatric Medicine (DPM) is to the foot and ankle as a dentist is to the mouth.  DPM's undergo extensive training prevent, diagnose, and treat foot diseases.  DPM's often times are the first to detect serious illnesses that are manifest first through the foot that otherwise would have gone on undetected such as arthritis, diabetes, heart disease as well as some kidney problems.  DPM's typically work in private practices but they often times work in orthopedic groups, hospitals, and rehabilitation centers, etc.  There are very few podiatric emergencies, which means that PDM's typically work office hours and have the flexibility to create their own schedule working as much or as little as they see fit.  Finding employment as a podiatrist is expected to grow 10-20% over the next decade as the elderly population have more wear and tear on ther feet and ankles as well as the rest of the population staying physically active.   Podiatry offers areas of specialization such as podiatric surgery, podopediatrics, podogeriatrics, with subspciaties in sports or specific injuries of the foot and ankle.  DPM's like MD's and DO's are required to take the MCAT for intrance into one of the 8 American Podiatric schools.  DPM schools aren't as competitive as MD or DO schools. DPM school is 4 years followed by a 2-3 year residency.   

The Average yearly salary for a Doctor of Podiatric Medicine is $135,000 with significantly less of that going to mal practice insurance premiums.

Make your break fun and productive!!!

With the Christmas break coming up and for many of us a 6+ hour flight each way I thought it would be nice to share the idea recreational reading (if focused) might help plant the seeds of thought and help formulate informed opinions that you will be expected to have when you are writing personal essays or being interviewed. A good GPA and test score are only part of what is necessary to get into the programs you are aspiring to; experience, personal statements and interviews are equally regarded and in most instances can mitigate a below average GPA or Test score. Not only will reading make you informed and prepared for discussion on a number of different topics, you will be able to cite examples which shape your opinions, and most importantly you will be influenced as to what you are going into and why. Interviewers and admissions people can tell when you are sincere and knowledgeable and can tell when you aren't. In fact I think they can see through your soul so please give them something good to look at, for your own sake. This break I encourage all of you to find at least one book that focuses on an area in which you are interested in and read or listen to it. I personally prefer audio books which I listen to instead of music when I'm driving in the car, working alone, or walking around campus and here are some of the books I've read in the past year (there are more below this post). For example if you plan on going into cardiology and you get asked in your interview "what area of medicine do you want to go into?", you will be able to prove that this aspiration isn't a pipe dream but something you actually know quite a bit about. If you have read King of Hearts: the True Story of the Maverick who Pioneered Open Heart Surgery, you will have an in depth understanding of the major advances and the obstacles overcome in the field of open heart surgery, you will have a small glimpse into the life of a cardiac surgeon and you will know the Who, What, When, Where, and Whys of different treatments for heart disease.
If you plan on going into Public Health or doing service in poor under served areas of the World it would be prudent to read Mountains Beyond Mountains: The Quest of Paul Farmer to Cure the World. Paul Farmer was a poor boy living with a big family on a bus and later in a boat ran ashore who was self taught earning a scholarship to first Duke than Harvard Medical School where he bought his text books and left to Haiti where he served the people there only coming back to Boston for exams and to raise money and acquire supplies for the people of Haiti. Paul Farmer is the founder of Partners in Health who have worked very hard to irradiate multi drug resistant strain Tuberculosis in Haiti, Peru, Russia, and other countries. Upon reading this book you will see some of things that are required in this type of service along with the problems and barriers you will encounter along with the example of someone who was able to successfully overcome these obstacles.
In the books Better: A Surgeons Notes on Performance as well as Complications: A Surgeons Notes on an Imperfect Science you gain a better understanding of the problems medicine encounters: learning/practicing, malpractice, career burnout, ethical issues, diagnosis, treatment, etc. These two books will give you a broad look into the world of medicine and inspire the reader to think of the limitations of this science which in many ways is an art.
Outliers: the Story of Success tells the reader what makes some people excel while others struggle. If anything you will be inspired and seek perfection after reading this book. On Call in Hell is a great book for anyone considering entering the military in a medical profession, you see first hand the account of a D.O. who served in the Navy as a field surgeon in Fallujah and the tolls that his experiences had on his life, both good and bad.
and there are more posted below if you are looking for something I recommend them all but don't limit yourself to my selections ask around look at reviews and pick something you think is interesting and if there are no books about the medical field you don't find interesting perhaps medicine isn't your thing and you should focus on another area where you are interested.

Good Reads for over the break!!

ComplicationsIn gripping accounts of true cases, surgeon Atul Gawande explores the power and the limits of medicine, offering an unflinching view from the scalpel’s edge. Complications lays bare a science not in its idealized form but as it actually is—uncertain, perplexing, and profoundly human.

Mountains Beyond Mountains

Mountains Beyond Mountains takes us from Harvard to Haiti, Peru, Cuba, and Russia as Farmer changes minds and practices through his dedication to the philosophy that "the only real nation is humanity" - a philosophy that is embodied in the small public charity he founded, Partners In Health. He enlists the help of the GatesFoundation, George Soros, the U.N.’s World Health Organization, and others in his quest to cure the world. At the heart of this book is the example of a life based on hope, and on an understanding of the truth of the Haitian proverb “Beyond mountains there are mountains”: as you solve one problem, another problem presents itself, and so you go on and try to solve that one too.

King of Hearts: The True Story of the Maverick Who Pioneered Open Heart Surgery

Few of the great stories of medicine are as palpably dramatic as the advent of open heart surgery, yet until now, no journalist has ever brought to life all of the thrilling specifics of this triumph. G. Wayne Miller tells the story of Dr. C. Walton Lillehei, who, along with colleagues at University Hospital in Minneapolis and a small band of pioneers elsewhere, accomplished what many experts considered to be an impossible feat: he opened the heart, repaired fatal defects, and made the miraculous routine.

Better: A Surgeon's Notes on Performance

Gawande gives us an inside look at his own life as a practicing surgeon, offering a searingly honest firsthand account of work in a field where mistakes are both unavoidable and unthinkable. At once unflinching and compassionate, Better is an exhilarating journey narrated by arguably the best nonfiction doctor-writer around. Gawande's investigation into medical professionals and how they progress from merely good to great provides rare insight into the elements of success, illuminating every area of human endeavor

On Call in Hell: A Doctor's Iraq War Story

Blood-and-guts accounts of Fallujah are not in short supply, but Jadick—a career Marine officer and brigade surgeon who took a demotion to battalion surgeon to volunteer for service in Iraq in 2004—tells the story through the eyes of a doctor. Unlike colleagues who remained in battalion aid stations behind the lines, Jadick and his medics accompanied their unit in makeshift ambulances as it battled through the streets. This was not bravado, he writes, but a calculated strategy to reach, stabilize and rush wounded troops to hospitals more quickly. He makes his case many times over, with dramatic accounts of catastrophically injured men from his unit and others who would not have survived a journey to the aid station. This remarkable man's story is well worth telling, although his writer should have discouraged him from frequent pauses for memorial essays on every soldier who died, and to remind readers of the Marines' bravery, of the dedication of the medics, and how much he loves his wife, the Marines and America. Readers who can skim past these segments will find the book a memorable experience.

How Doctors Think

Jerome Groopman pinpoints the forces and thought processes behind the decisions doctors make. He explores why doctors err and shows when and how they can, with our help, avoid snap judgments, embrace uncertainty, communicate effectively, and deploy other skills that can have a profound impact on our health.

Outliers: The Story of Success In this stunning new book, Malcolm Gladwell takes us on an intellectual journey through the world of "outliers"--the best and the brightest, the most famous and the most successful. He asks the question: what makes high-achievers different? His answer is that we pay too much attention to what successful people are like, and too little attention to where they are from: that is, their culture, their family, their generation, and the idiosyncratic experiences of their upbringing. Along the way he explains the secrets of software billionaires, what it takes to be a great soccer player, why Asians are good at math, and what made the Beatles the greatest rock band. Brilliant and entertaining, OUTLIERS is a landmark work that will simultaneously delight and illuminate.

Blink: The Power of Thinking without Thinking

In this best-seller, a staff writer for The New Yorker weighs the factors that determine good decision-making. Drawing on recent cognitive research, Gladwell concludes that those who quickly filter out extraneous information generally make better decisions than those who discount their first impressions.

Stiff: The Curious Lives of Human Cadavers

For 2,000 years, cadavers---some willingly, some unwittingly---have been involved in science's boldest strides and weirdest undertakings. In this fascinating, ennobling account, Mary Roach visits the good deeds of cadavers over the centuries and, in so doing, tells the engrossing story of our bodies when we are no longer with them.

Careers in Medicine part1 Physical therapy & Anesthegiology

Not to burst anyone's bubble but chances are many of us will not end up working in the professions we've dreamed about for years, and that isn't necessarily a bad thing either.

There are lot of factors why people desire a certain career: economic incentives, reputation, freedom, expression, admiration, and personal experience. Chances are though most of us aren't going to become orthopedic surgeons pulling down $600K a year, just getting into medical school could be one factor, the residency program is VERY competitive among other things. You'll be OK though if you're prepared. If you get into medical school you'll probably find another specialty that fits your intended lifestyle (there are probably careers that would give you greater job satisfaction). If you have a hard time getting into medical school you might find out you really like research and may ultimately decide to go that rout, you may go into nursing a find fulfillment there.

The other day I talked to a RN who planned on becoming a PA. He went to Pacific Lutheran University in Washington where the PA program suffered and died while he attended school there. After graduating with a bachelors in Biology he contemplated medical school and applied and while he was waiting he found a 3 month EMT certification program, he loved his job and was offered a position with the hospital where they paid for him to to become an RN and he's been there for 15 years. He told me he was glad he was working where he was it fit his life style, he leaves work at work, no malpractice insurance, good benefits, works as little or as much as he wants, he has a lot more patient contact then the doctors do and that is what brings him satisfaction with his job.

I'm not telling you to go into nursing (unless that's what you want to do) but be flexible and open minded, he could have reapplied and probably gotten in (he only applied to University of Washington, and University of Hawaii) but he found something that fit the lifestyle he wanted and that he truly loved doing. With that said consider the following careers.

Physical Therapy:Aspiring PTs have the option to go for a bachelors or doctorate program (however the number of masters programs is shrinking). The prerequisites are similar to medical school but differ with each school and you would take the GRE. Like medical school getting into PT school is competitive.

People who go into physical therapy can specialize and switch specialties in mid career if they want to. Many work in hospitals or make home visits but the majority work in clinics which provides the opportunity to run and manage your own business. You don't have to ever be "on call" and malpractice insurance is nothing in comparison to what and M.D. has to pay.

Depending on where you live the average yearly salary is roughly $60K-70K but it is possible to make much more since a large portion of PTs only work part time.

PT's can focus on rehabilitation for specific injuries, geriatrics, pediatrics, and injury prevention.

Careers similar to physical therapy include: athletic training, occupational therapy, and personal training.

Anesthesiology:

Anesthesiologist go to medical school and then take an additional 4 years of residency training followed by 1-4 more years of internship. Anesthesiologists determine whether someone is fit for anesthesia and then monitors them so the surgeon can focus solely on the operation. Anesthesiologists also have the choice to become pain specialists which is a rapidly growing and much needed field. Anesthesiologist typically have extraordinary math and memorization skills. They preform complex calculations on the fly to adjust drug dosages/rates and they must know how and when to safely use the millions of drugs at their disposal.

Anesthesiologists don't have much continuation of same patient contact they typically meet with the patient before the operation and are with them as they come out of anesthesia, most of their time is spent with the patient unconscious. The anesthesiologist must identify and treat conditions such as high blood pressure in as little as a few heart beats to prevent serious damage.

Anesthesiologists don't have to build up their practices since they are usually employed by hospitals and surgery centers and that also means that they don't have to take work home with them (unless they're on call).

Anesthesiologists average between $400K-600K a year but their malpractice insurance is among the highest. Recently there has been a trend in hospitals hiring nurse anesthetists making finding a job more difficult.

Similar careers: Nurse anesthetist, pharmacist