Different Kinds of Doctors
Doctors, also called physicians, have an effect on everyone’s life. They treat people when they are sick or hurt. They give advice to patients to help keep them from getting sick. They bandage knees, prescribe medicine, sew up cuts, and operate on bones. They bring new babies into the world and comfort older people who are sick or dying. Some doctors see all kinds of patients, and other doctors only see patients with a particular illness or injury. There are even doctors who never see patients at all. In the United States alone, there are over a half-million doctors. They all do different things, and they are all important in their own way.
Family Practice Doctors
Most people have a family doctor. This is the person who sees and treats all members of the family. These doctors are usually called family practice or primary care doctors. They are trained to provide medical care to everyone from pregnant mothers to babies and adults. If their patients need further treatment, or need more specialized care, family practice doctors may refer them to a specialist.
Some family practice doctors work in large or medium-sized cities, where there are a number of hospitals and many physicians. Others, like Dr. Larry Curtis, are “country” or “rural doctors,” who may be the only physician to serve an entire county of people. Country doctors work in small, rural towns such as Driggs, Idaho, where Dr. Curtis has his medical practice. He says that he enjoys being a country doctor because he feels at home in a small town and thinks of his patients as his friends. Also, he must deal with a wide variety of medical needs, as he explains: “At fall harvest, an injured farmer might not want to travel [to a distant town] for treatment. He might ask, ‘Sew me up quick, doc, so I can get back to work.’”1
Many doctors have regular office hours and see most of their patients during the daytime. This is not the case, however, with emergency room (ER) doctors. ER doctors see patients at all hours of the day and night. Over 100 million people visit emergency rooms each year, for all kinds of reasons. ER doctors see patients for everything from broken bones to breathing problems, from food poisoning to pneumonia. In fact, there is no other type of doctor who sees such a variety of medical problems as an ER doctor.
Some hospitals have different types of emergency rooms—for instance, those that fly. The MCG Health System in Augusta, Georgia, has a large emergency room on the ground and a smaller one in the air. The hospital owns a specially equipped helicopter that serves as a flying emergency room. It resembles a miniature hospital ER, and it is staffed with an ER doctor and two other emergency medical professionals. When every second counts because a patient is seriously ill or injured, the three jump in with the pilot and take off in the “flying ER.”
Doctors who perform operations are called surgeons. Years ago almost all surgery was performed by general surgeons. As medicine became more advanced, surgery became more specialized. Today general surgeons perform many types of common surgeries such as removal of tonsils, appendix, or breast lumps and repairing hernias. However, there are also specialist surgeons who operate only on particular areas of the body.
Plastic surgeons repair body parts that are abnormal in some way, from injury, disease, or birth defects. They also perform “cosmetic” surgery on patients, which is surgery that improves a patient’s appearance. Several other types of surgeons include orthopedic surgeons, who operate on bones, joints, muscles, nerves, and tendons; neurosurgeons (brain surgeons) who operate on the brain and surrounding nerves; and pediatric surgeons, who perform surgery on children, from newborn babies to teenagers.
Some pediatric surgeons specialize in children’s heart conditions, and are called pediatric heart surgeons. Dr. Tom Karl, of UCSF Children’s Hospital in San Francisco, is a well-known pediatric heart surgeon. During the summer of 2002, Dr. Karl traveled to Nicaragua with a team of health care professionals. While he was there, he and his team performed surgery on twenty children who were born with heart defects.
Many Different Specialties
Like Dr. Karl, many physicians specialize in treating one particular age group. Pediatricians, for example, work exclusively with babies, children, and teenagers. Internal medicine doctors, often called internists, focus on medicine for adults.
Just as some doctors specialize in a certain age group, others specialize in a particular area of medicine. Obstetricians, usually called OB/GYNs, are specialists in women’s health. These are the doctors who take care of pregnant mothers, and who often deliver their babies. Otolaryngolists are doctors who specialize in problems with the ear, nose, and throat. Dermatologists diagnose and treat diseases of the skin, hair, and nails. Allergists specialize in treating allergies, as well as immune system disorders such as asthma, hay fever, and breathing problems. Ophthalmologists diagnose and treat eye diseases, and they perform eye surgery to correct vision problems. Hematologists specialize in diseases of the blood, such as sickle cell anemia and leukemia. Oncologists specialize in diagnosing and treating cancer. Anesthesiologists give anesthesia to patients having surgery so the patients do not feel pain during the operation.
Not all doctors are involved in patient care. Instead, some perform functions that support the work of other physicians. One example is a radiologist, who studies and analyzes pictures taken of the inside of a patient’s body. Radiology is an extremely important field, and it has been around for only about a century. Before that, doctors could only examine the outside of a patient’s body, or examine the internal organs in surgery. Today, sophisticated diagnostic tests such as ultrasounds, X rays, CAT scans, and magnetic resonance imaging (MRI) allow radiologists to find internal problems before they become life threatening.
Another type of behind-the-scenes doctor is the pathologist. Pathologists are often called the “doctor’s doctor,” because they serve as scientific consultants to other physicians. They work in laboratories inside hospitals or at other locations. When doctors order diagnostic tests for their patients—such as blood samples or biopsies—it is the pathologist who analyzes and interprets those tests. Some pathologists specialize in performing examinations, or autopsies, on people who have died. These doctors are called forensic pathologists, and their work helps to determine the cause of death.
Epidemiologists are doctors whose work revolves around medical research. Often called “disease detectives,” these doctors study diseases so they can figure out the cause. Epidemiologists also develop vaccines that prevent disease, as well as medicine to treat it. The work they do is extremely valuable—because of medical research, diseases such as smallpox, diphtheria, polio, and many others can now be prevented with vaccines. In the future, disease detectives may develop vaccines or cures for such serious diseases as cancer and Acquired Immune Deficiency Syndrome (AIDS). Someday they may even be able to cure the common cold—although that disease has continued to stump researchers for decades.
Doctors may work in hospitals or they may work in laboratories. Some analyze blood samples, and others deliver babies. Some doctors work with eight-year-olds, and others work with eighty-year-olds. No matter where they practice or what type of medicine they specialize in, doctors are important. Because of the work they do, people all over the world are able to live longer, healthier lives.
1 Quoted in Lelia Gray, “Town & Country,” University of Washington, September 1998. www.washington.edu.
What It Takes to Be a Doctor
People often know at a young age that they want to become doctors. Perhaps they are naturally good at math and science. Maybe they have a desire to help people and to make a difference in people’s lives. Or, they may just want a job that is full of challenges. These are all very good reasons to consider a medical career. However, anyone who wants to become a doctor must understand how much work it takes to achieve that goal.
The road to becoming a doctor is a long and difficult one. In fact, doctors go through more education and training than almost any other type of professional. At the very minimum, it takes eleven years to become a doctor, and longer for highly specialized medical fields. Still, most doctors love their work and believe it was well worth the years of effort.
The First Four Years
Aspiring doctors spend the first four years of college earning their bachelor’s degrees. Many students major in what is known as “premed,” which has a curriculum that is heavy in science and math. Premed students study such things as physics, chemistry, and biology, and take other advanced mathematics and science courses. During this time students often volunteer or work part-time in hospitals, clinics, or doctor’s offices, so they can gain knowledge and experience.
When premed students are in their third or fourth year of college, they apply to medical school. There are nearly 150 medical schools in the United States, and acceptance to these schools is highly competitive. Students must achieve a high score on an examination called the Medical College Admission Test (MCAT). They must complete an essay to explain why they want to be a doctor. Many schools require letters of recommendation. Also, the grades the students have earned in college are an extremely important consideration. Medical students almost always have grade point averages of 3.5 or higher.
Once students are admitted into medical school, they spend the first two years on what is often called “heavy book learning.” They attend classes in anatomy, biochemistry, and physiology. They study pathology, medical ethics, and laws that govern medicine. They learn about the human body and how it works. They learn about disease and how the human immune system fights disease. They also study pharmacology, which is the science of medications.
During the second year, students begin to learn about basic medical tasks. This includes learning how to examine patients, how to take medical histories, and how to diagnosis certain illnesses.
Learning on the Job
The third year of medical school is when students do their clinical rotations, which means they work with doctors and other health care professionals. They observe and assist internists, surgeons, and pediatricians, as well as radiologists, neurologists, family practice doctors, and ER doctors. This gives students an opportunity to experience a wide variety of medical specialties. It also allows them to work with many different patients. As they gain knowledge about the different areas of medicine, most students make decisions about which field they like best.
Pediatrician Heather Burrows says that the clinical rotations are a wonderful chance for students to find out what being a doctor is really like. One of her most memorable experiences happened during her third year of medical school, when she was doing a rotation in OB/GYN. It was the middle of the night, and a woman was about to have a baby. Dr. Burrows describes the situation: “I was going to assist with the birth, and I was exhausted from working so many hours. All I wanted was for her to hurry up and get it over with so I could go to sleep. But then the baby was born… and it was the most amazing thing I’ve ever seen. All of a sudden, I was wide awake. I was so excited to be a part of this experience, helping to make this miracle happen.”2
Choosing a Specialty
Students continue their rotations during their fourth year of medical school, but they begin to take on more responsibility. Also, this is when they decide on their specialty. By their fourth year, they have had a chance to explore many different areas of medicine. They have seen real-life doctors in action, and they have worked alongside them. So the next step is to choose the medical field they want to pursue and graduate from medical school. Finally, they are officially doctors.
By the time students graduate, they have completed eight years of formal schooling. However, their education is far from finished. Their next step is the residency, which is usually performed in a hospital under the direction of experienced physicians. A residency is an intense, hands-on medical training period that lasts for a minimum of three years. Some take much longer. For instance, residencies in anesthesiology and obstetrics take four years. An orthopedic surgery residency takes five years, and a plastic surgery residency takes six years. During this training period, residents are paid a salary for their work.
New doctors who are interested in a highly specialized field, such as neurosurgery, must perform residencies that last for six years or more. One example of this type of residency program is at Harborview Medical Center in Seattle. Dr. Richard Winn is the chief of neurosurgery, and he supervises the program. Each year, more than three hundred doctors apply—and only two are accepted. Plus, not only is the program hard to get into, it takes eight years to complete. A sign on Dr. Winn’s office wall explains why his program is so difficult and why it takes such a long time. It reads, “If the training is tough, the war will be easy.” Harborview’s neurosurgical residency program has been called the best in the country.
Once doctors have completed their residencies, their formal medical training is finally complete. However, before they can practice medicine, they must get a license from the state in which they plan to work. When they are licensed, doctors may set up their own private practice or join a practice with other physicians. Or, they may go to work for hospitals, health departments, laboratories, or other medical organizations.
What Makes a Good Doctor
Doctors work hard—very hard. Anyone who has put in the time and effort it takes to earn a medical degree is well aware of that. However, there are also other qualities that doctors need. First, they need to care about people. This applies to all doctors, even those who specialize in research or radiology. They may not work directly with patients, but their work still revolves around helping people. Doctors also need to be excellent thinkers. They must be able to examine a sick patient and figure out what is wrong. Then, they must be able to decide the best way to treat the patient’s illness or injury.
A Special Kind of Person
Dr. Dana Gossett is an OB/GYN who became a doctor for several reasons. She wanted to help people and to have a positive impact on their lives. But she also loves the science that is involved in medicine. She enjoys knowing how the body works and why disease happens. Dr. Gossett shares her thoughts about some qualities that doctors need: “Attention to detail is critical—little things can mean life or death in medicine. The physician MUST be able to listen—the patient frequently can tell you exactly what’s wrong, if you can listen. And the physician must be [understanding]. If you can’t place yourself in your patient’s shoes and understand how scared/happy/painful/etc. their situation is, you will not be able to help them as much, and they will not trust you as much.”3
It takes a special kind of person to be a doctor, and it is not the right career for everyone. However, for people with the right personal qualities—as well as the willingness to complete years of medical education and training—becoming a doctor is the best possible choice they could make.
2 Dr. Heather Burrows, interview with author, September 26, 2002.
3 Quoted in Students Science Enrichment Program (SSEP), “Dr. Dana Gossett.” http://ssep.bwfund.org.