General Question

Jeruba's avatar

From a med student's point of view, which doctors are the lightweights?

Asked by Jeruba (53100points) March 13th, 2009

It has to be the case that some fields of medicine are regarded as much heavier than others. I would guess that brain surgery is right up there. Other guesses: heart surgery, lung cancer surgery, surgery on newborns. How about diagnosing mystery symptoms as House does? I likewise suppose that some fields are regarded as less challenging: dermatology? allergies? anesthesia?

Here’s my question. If I were an average medical student, hearing the specialties that my colleagues were choosing and heading for, seeing which the most brilliant and ambitious students chose, which are the fields that would make me think “lightweight”? Which of my doctors are lowest in the status hierarchy, not because of their reputations but just on account of their fields?

Yes, I know all medical professionals are deserving of respect. That is not what I’m asking. I just want to know: if peers look up to their colleagues in the toughest fields, who’s down there looking up the most?

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23 Answers

Allie's avatar

Chiropractors? Or so I’ve heard… What kind of school do they go to? Is this even a med profession? I don’t know.
Note: I am not a med student, but felt like answering anyway.

casheroo's avatar

I’m not a med student, but I feel like answering too.

My guess is (and this is just a shot in the dark) Podiatry. Unless they do surgery, what else do they really do? I don’t even know. I’ve never seen a foot doctor.

Mr_M's avatar

From a hospital administrator’s point of view, the ladies above got it right. Chiropractors, then Podiatrists. But dentists are the lowest.

casheroo's avatar

I don’t understand why dentists would be so low. I think a lot goes into being a good dentist.

Mr_M's avatar

Because sometimes students who can’t get into Medical School go to Dental School instead. Sometimes they make sure they do well in Dental School so that they can try to transfer over to a Med School.

But, understand, no one thumbs their nose at ANY medical specialty. They’re all respected (and rightfully so) and require years of training. The general public is not even aware of all the specialties there are.

Even Veterinarians (who are not doctors), in fact, have to do extremely well in school since the competition for Veterinary School seats (of which there aren’t a hell of a lot) is fierce.

cwilbur's avatar

A friend of mine who’s now a surgical resident says that pediatricians are held in pretty low regard too—it seems that most pediatric work is fairly routine. He was considering it for a while because he likes kids (and he has the people skills to deal with sick kids and helicopter parents) but he ultimately settled on trauma surgery for the challenge.

wundayatta's avatar

The lower prestige jobs also tend to have the most stable jobs. Dermatologists, Pediatricians, Chiropractors, Podiatrists, and even Internists these days, can work a fixed schedule. They don’t have to show up for emergencies. The hospitals take care of that. People, more often women, tend to go into these fields because it leaves them more able to have a family as well as practice medicine.

ON the other end of things, besides cardiology surgeons and brain surgeons, you might include oncology surgeons and transplant surgeons.

I think that anesthesiology is also a pretty well respected field. Maybe not at the top, but also not at the bottom.

Mr_M's avatar

Surgeons would probably be the highest.

Jeruba's avatar

Where does “family practice” fall in the scale of things?

shilolo's avatar

First, neither podiatrists nor chiropracters go to medical school. They have their own schools, and so, I think can be excluded from this discussion. If you are asking about intellectual lightweights, then I can give you my opinion. It used to be (a generation ago) that the smartest students went into Internal Medicine (adult medicine-primary care). Now, the students with the best grades (and all students for that matter) are leaving internal medicine-primary care in droves to go into more lucrative specialties (mostly surgical). These include dermatology, urology, radiology, plastic surgery, opthalmology, and otolaryngology (ENT medicine). Both general surgery and internal medicine have suffered at the hands of these specialties.

It is my impression however, that often, once the residency takes over, that these same specialists become relatively dumbed down, because they focus on one very specific area. I always find it odd to have discussions about infections with various specialists who had to be at the top of their class to get into residency in the first place and to discover that they are clueless. Case in point are orthopedic surgeons. A common infection that they see are bone infections (osteomyelitis) or infections of artificial materials (think artificial hips or knees). Yet, nearly every time this happens, they act shocked at the recommendations I make for management, as if each time is the first time this has happened. My own opinion is that they like to dumb themselves down to then make the other doctors (namely, internists) shoulder the burden of actual medical care, and they get to focus on surgery only.

Dr_C's avatar

@shilolo saved me from typing my fingers off. Nailed it.
The exodus within the medical community towards more refined (read specific and or focused) specialties makes these practitioners neglect general medicine, general care and overall their patients… their only focus is on what’s on the operating table in front of them. once The patients leaves the OR.. it’s the internists problem.

Having said that… i’m still applying for a surgical residence… i’m focusing on reconstructive surgery… i made a commitment to a very special little girl… she needs her smile back.

shilolo's avatar

@daloon Let’s be honest here. You don’t have to be Einstein to be any kind of surgeon. Yes, it helps to be smart, but, being skilled with the scalpel is equally (if not more) important. Some people may hold up surgeons at the top of the pecking order, but that is mainly because they think the skill set required to be a surgeon is the most complex (and they cut people open, for Pete’s sake). But, my experience is that the most brilliant doctors are the ones that do mainly detective (diagnostic) work such as rheumatologists, endocrinologists, neurologists, and yes, infectious disease docs.

In the hospital, whenever there is a mystery/difficult case, you’re much more likely to see one of those specialists (the diagnosticians, like the TV Dr. House) solve the case than, say, a cardiothoracic surgeon.

Jeruba's avatar

@shilolo, House was in my question details. So there are real people like House? Well, not like House. But people really attack cases that way? House is realistic in that regard? Those sound like they would have to be the alpha docs, then.

shilolo's avatar

@Jeruba. Yes, there are real doctors like House, only, minus the attitude, unethical behavior and inappropriate style (treating his hunches, one at a time). Next time you’re in the hospital, ask around for who is the go to doctor for mystery cases.

Mr_M's avatar

Last but not least (but not far from it), Psychiatrists. Low on the administrative “power pecking order”.

Jeruba's avatar

Really, @Mr_M? Are you being facetious, or are they really looked down upon? I am asking, remember, for a rough ranking from the point of view of other medical practitioners.

Mr_M's avatar

I’m not comfortable saying “looked down upon”. I’d rather say just “not looked up to”. And my answer is from a hospital administrator’s point of view. In the entire scheme of things they’re not as powerful as doctors from other specialties. Why? I have some theories but only theories.

I recently tried to find an outpatient Psychiatrist for someone. The Psychiatrist had to take this person’s insurance. Most of the Psychiatrists listed (99%) were from other countries!

Jeruba's avatar

Your comments are enlightening, @Mr_M. But do you know the doctors’ point of view and whether it is the same as your own?

Mr_M's avatar

I don’t DARE speak for the docs! But with Psychiatrists, I think we share the same opinion.

FrancisRude's avatar

They are all equally good in my opinion.

Snoopy's avatar

It is really odd that there is any pecking order. There is a need for all the specialties that have been mentioned at very specific times. Their narrow focus of expertise is much appreciated if you are the beneficiary. They tend to know “a lot about a little”

Internists or family medicine docs have their place as well and are very much a key piece in the medical team. They tend to know “a little about a lot”...these are broad generalizations and aren’t meant to imply that internists/family docs know less…They simply need to have an understanding of a much wider selection of topics and may not know them as in depth as their counterparts who have specialized in that area.

e.g. A family medicine or internist is well qualified to manage a diabetic patient….just as an endocrinologist.

No speciality should be held in higher regard than the other…..just as some nurses should not be automatically held in lower regard than doctors.

Professionals should be evaluated and considered individually based on their own merits, not on their profession alone.

The other interesting piece that often comes in to play (not yet mentioned) in how the rankings fall in to place is income, pure and simple. Surgeons and specialists tend to make more money so there is a false association/attachment of reverence based, oftentimes, soley on income.

BCarlyle's avatar

I can provide a bit of perspecitve as a current medical students. The fields that some of my peers “look down on” are generally the primary care specialties (family practice, pediatrics etc). I don’t think this has anything to do with the intellectual capacity required to do the job. Rather, these opinions reflect the relative financial renumeration provided by different specialties and the “quality of life” that they may provide. They also greatly reflect the difficulty of getting a residency. Each year there are many more slots for primary care residencies than graduating MDs. Many of the primary care slots are now filled by foreign graduates. I have been told, that 30 years ago the most competitive slots were the primary care fields and these fields were the most respected.

Zen's avatar

Went to see a Proctologist recently (see my question on hemmies). When he looked into my rectum, I had this type of question in mind.

But he laughs all the way to the bank, and makes my monthly salary in about two hours.

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