Medical Education

 Posted by on 28 August 2005 at 9:15 pm  Health Care
Aug 282005

In the comments section, Marnie recently asked,

What is Paul’s specialty please? How many years out of school is he? Does he still recommend the business? [I start post-bac pre-med classes in 3 weeks.]

In response to Marnie’s questions:

1) My field is diagnostic radiology, with subspecialty interests in trauma/emergency radiology and orthopedic radiology.

2) My education consisted of 4-years college (i.e., pre-med), 4 years medical school, one year laboratory research at the NIH (National Institutes of Health) in Bethesda MD, 4 years residency in diagnostic radiology, and one year of additional clinical fellowship training in MRI (magnetic resonance imaging) with emphasis in advanced orthopedic radiology.

Since then, I’ve been in practice for 11 years, both as a faculty member at the Washington University School of Medicine in St. Louis (3 years) as well as 8 years of private practice (3 years in San Diego, and 5 years now in Denver.)

3) I still recommend the field provided that one finds the actual science and art of medicine interesting in their own right. In that case, the various b*llsh*t elements related to government regulations are tolerable, at least for the time being.

I personally find the field intellectually fascinating. Plus the technology is advancing at an exciting pace.

During my daily practice, I get to deal with people who are for the most part very rational (at least with respect to work), goal-directed, and efficacious. Most of my day is a constant use of reason (both induction and deduction), applied directly to issues of ultimate value, namely another person’s life. In terms of job satisfaction, it’s hard to beat this combination.

Since a lot of people don’t know exactly what a modern radiologist does, I thought I’d explain in a little bit more detail what I do and what I like about my job.

There’s nothing I enjoy more than solving a diagnostic mystery by taking a set of subtle and apparently disconnected findings from a patient’s x-rays, CAT scans, and MRI’s, and integrating them in order to arrive at a correct diagnosis.

Similarly, I enjoy performing invasive radiology procedures (so-called “interventional radiology”) where I use real-time x-ray imaging to guide a needle to a target within a patient’s body (avoiding all the critical nerves and blood vessels), in order to either perform a biopsy or deliver a dose of medication to exactly the right spot in as pain-free and safe a fashion as humanly possible.

Advances in imaging technology allow radiologists to perform procedures in the x-ray suite that 20 years ago would have required much riskier open surgery. Interventional radiology is like playing a video game, but where the stakes are much higher (as are the rewards).

Colorado is a very outdoors-oriented state, and hence a lot of people enjoy activities like skiing, snowboarding, mountain biking, rock-climing, etc. Hence, if you were to take a bad fall on the ski slopes at Aspen or Vail and hurt your knee, it would be me who would interpret your MRI scan and tell your orthopedic surgeon which structures were torn and which were ok.

Or if you were to get into a bad car accident in the middle of the night and were helicoptered to our Level 1 trauma hospital, it would be me who would read your emergency CAT scans and tell the trauma surgeons which organs were critically injured and needed immediate repair, which were less critically injured (and still needed attention, but not immediately), and which structures were ok.

I think I have one of the coolest jobs in the world. It was a long road to get to the point of being able to practice independently as full-fledged board-certified physician, but it was well worth it in the end.

Medicine is an extremely varied field, and there is a branch of medicine that should suit nearly any personality type. For instance, some people enjoy high-pressure specialities that require quick-decision making skills like trauma surgery, whereas other people like slower paced puzzle-solving fields like pediatric endocrinology. Some people enjoy fields with a lot of patient contact like family practice, others prefer fields with minimal patient contact like pathology. Hence, Marnie, you should be able find a field that suits your interests and temperament.

I wish you much success and happiness in your studies, Marnie. If you have any further questions about medical education, I’d be happy to answer them, either here or via e-mail.

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