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    (Original post by Canterbury bloke)
    Can anyone explain why people go into proctology? Who wants to be a butt doctor, and why?
    Even though this is likely the worst attempt at trolling I've seen in maybe three or four years: proctology isn't a specialty in the UK, it's called gastroenterology, and it's a practical, mix of chronic and acute patients, major organ system, research, etc.
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    (Original post by Boredomstrikes)
    Why are there so few number of people wanting to be a psychiatrist?
    Psychiatry is a very distinct field. I may not know much about it (I'm still pre-clinical so I don't know much about a lot!) but for psychiatrists, the exciting days of being the first doctor on scene in A&E and seeing a patient suffering from a heart attack are long gone. You'd probably need to have a special interest in the field of mental health; illnesses that you can't really diagnose by simply ordering a blood test.
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    (Original post by Beska)
    Even though this is likely the worst attempt at trolling I've seen in maybe three or four years: proctology isn't a specialty in the UK, it's called gastroenterology, and it's a practical, mix of chronic and acute patients, major organ system, research, etc.
    Proctology is colorectal surgery? In a lot of places in the UK it's referred to as coloproctology as well.
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    (Original post by Asklepios)
    Proctology is colorectal surgery? In a lot of places in the UK it's referred to as coloproctology as well.
    Haha yes you are absolutely right, I have no idea why I said all those things. Brainfart. Never heard of coloproctology though!
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    (Original post by Beska)
    Haha yes you are absolutely right, I have no idea why I said all those things. Brainfart. Never heard of coloproctology though!
    I don't think I've heard of it like someone introducing themselves as a coloproctologist. But I'm sure I've seen things like "Chair of Coloproctology" in various places.

    Anyway, I agree with that being the worst attempt at trolling on this forum. Why even bother lol?
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    clinical paediatrics (but not community paediatrics, which was hugely boring).

    and/ or clinical pathology

    ... also, I have enjoyed placements in EM and acute medicine, but have been scared off such possibilities by the current health secretary.
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    (Original post by Boredomstrikes)
    Why are there so few number of people wanting to be a psychiatrist?
    In most of medicine, the way you treat people is by taking a history, performing an examination, ordering some tests, and then you might give them some drugs or refer them for surgery.

    In psychiatry, you pretty much stop at the first one. The efficacy and mechanism of action of most drugs is extremely uncertain. They're a big tool, but extremely difficult and imprecise. There are a few blood tests or scans you may want to do in select patients. Otherwise, your main weapon is your words, and your demeanor. Science does come into it, but in a pretty limited fashion compared to other specialities.

    In short: psychiatry is NOT what most people signed up to med school for!
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    I'm not a medical student yet but I'm very interested in pathology. The study of disease always fascinates me
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    (Original post by Ghotay)
    In most of medicine, the way you treat people is by taking a history, performing an examination, ordering some tests, and then you might give them some drugs or refer them for surgery.

    In psychiatry, you pretty much stop at the first one. The efficacy and mechanism of action of most drugs is extremely uncertain. They're a big tool, but extremely difficult and imprecise. There are a few blood tests or scans you may want to do in select patients. Otherwise, your main weapon is your words, and your demeanor. Science does come into it, but in a pretty limited fashion compared to other specialities.

    In short: psychiatry is NOT what most people signed up to med school for!
    Mental state examination?

    I'd probably agree with the last line of this post but not much else. I think there is a lot of misconception surrounding psychiatry and this might, in some small way, contribute to the undersubscription.

    The efficacy of some drugs may be debatable, but many others have been shown to be effective (e.g. SSRIs for treatment of depression in primary care with NNT of 7-8, Lithium for bipolar = 4). This is similar to any specialty if you look closely enough. Did you have any particular examples in mind?

    The pharmacology of these drugs are also relatively well-defined (apart from Lithium), it is how this relates to the underlying pathophysiology which is uncertain (and an active area of research). As to them being imprecise, I wholeheartedly agree but a great deal of modern medicine is imprecise. Hopefully advances in stratified medicine, nanotechnology and gene technologies can help with this.

    As to your main weapon being your words, CBT has a NNT of 3-4. I'd be happy to hear about another intervention as efficacious as that with a similar adverse effect profile.
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    (Original post by evil_abed)
    Mental state examination?

    I'd probably agree with the last line of this post but not much else. I think there is a lot of misconception surrounding psychiatry and this might, in some small way, contribute to the undersubscription.

    The efficacy of some drugs may be debatable, but many others have been shown to be effective (e.g. SSRIs for treatment of depression in primary care with NNT of 7-8, Lithium for bipolar = 4). This is similar to any specialty if you look closely enough. Did you have any particular examples in mind?

    The pharmacology of these drugs are also relatively well-defined (apart from Lithium), it is how this relates to the underlying pathophysiology which is uncertain (and an active area of research). As to them being imprecise, I wholeheartedly agree but a great deal of modern medicine is imprecise. Hopefully advances in stratified medicine, nanotechnology and gene technologies can help with this.

    As to your main weapon being your words, CBT has a NNT of 3-4. I'd be happy to hear about another intervention as efficacious as that with a similar adverse effect profile.
    I think you've misunderstood me slightly. I actually love psychiatry, it's something I'm fascinated by. But the question was 'why don't more people want to be psychiatrists', and the fact is that rightly or wrongly a lot of doctors DO feel this way about psychiatry. A mental state examination isn't hands-on with signs that you're looking for. CBT is highly efficacious and I wish it was more widely available. But the fact remains that a lot of doctors HATE having to rely on their words. They want to use technology and surgery, not just 'talk to people about their problems'.
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    (Original post by Ghotay)
    I think you've misunderstood me slightly. I actually love psychiatry, it's something I'm fascinated by. But the question was 'why don't more people want to be psychiatrists', and the fact is that rightly or wrongly a lot of doctors DO feel this way about psychiatry. A mental state examination isn't hands-on with signs that you're looking for. CBT is highly efficacious and I wish it was more widely available. But the fact remains that a lot of doctors HATE having to rely on their words. They want to use technology and surgery, not just 'talk to people about their problems'.
    OK, it wasn't clear from your post whether you supported the view, but either way, my aim was simply to correct the inaccuracies of your post and prevent their perpetuation.

    I suppose your statement about the MSE is again what most medical students would say? If so, you're probably right, but it is a flawed and narrow definition of what an examination is.
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    Neonatologist or obstetrician.

    Its funny how I was never interested in this field before med school, I even disliked pediatrics and anything children-related...but then we started embryology and it is the most interesting thing ever for me
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    (Original post by Nottie)
    Neonatologist or obstetrician.

    Its funny how I was never interested in this field before med school, I even disliked pediatrics and anything children-related...but then we started embryology and it is the most interesting thing ever for me
    I'm actually amazed.How can one understand and enjoy embryology. My 3D imagination probably needs some brushing over.
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    (Original post by frogs r everywhere)
    Psychiatry is a very distinct field. I may not know much about it (I'm still pre-clinical so I don't know much about a lot!) but for psychiatrists, the exciting days of being the first doctor on scene in A&E and seeing a patient suffering from a heart attack are long gone. You'd probably need to have a special interest in the field of mental health; illnesses that you can't really diagnose by simply ordering a blood test.
    The "exciting" days? I know you probably didn't mean it like that, but it does sound kind of callous to suggest that we derive excitement (in the regular sense of the word) from seeing cardiac arrests!

    Anyway, there are more than enough opportunities for high-octane stuff in psychiatry if that's your bag.. as anyone who has ever tried to talk down a floridly psychotic patient, or resuscitated a patient with anorexia who's gone into arrest will attest. And to be fair, most medical illnesses can't be diagnosed with a blood test alone, anyway.

    To the person who asked the question about the lack of trainees: to my mind, there are a few reasons med students shy away from psychiatry. First, as others have said, it's a very communication skills-heavy specialty, which doesn't suit everyone. Second, it's seen as less prestigious than some other specialties and (sadly) that matters to some people. Third, mental health services are chronically under-funded, so when med students go on their psychiatry placements they often see stressed-out staff and departments in need of a lot more money. It's little wonder that they're then put off the idea of making a career out of it.

    In answer to the OP's question: if it wasn't already evident, I'm planning to be a psychiatrist - preferably CAMHS (children and adolescents). I find most mental health conditions pretty interesting, I would count communication as one of my strengths, and after 6 compulsory weeks in liaison psych, a further optional 6 weeks in CAMHS and 3 weeks doing general psych in India, I've still not been put off, which is as good an argument for me as any. I also have 3 weeks doing forensic psychiatry in a secure hospital lined up in the new year before I graduate, so I guess we'll see if that changes my mind. I don't expect it to, though.
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    (Original post by Nottie)
    Neonatologist or obstetrician.

    Its funny how I was never interested in this field before med school, I even disliked pediatrics and anything children-related...but then we started embryology and it is the most interesting thing ever for me
    Neonatology is a subspecialty of paediatrics. You'd have to train in general paediatrics first. It is a fascinating area of medicine, however, despite one of my consultants describing it as "flogging a dead horse".

    As for obstetrics; almost all obstetricians are gynaecologists as well, so if vaginas aren't your bag, I'm not sure how interested you'd be in it.
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    (Original post by navarre)
    ...despite one of my consultants describing it as "flogging a dead horse".
    What did he mean exactly?

    The broader point, as I'm sure Nottie is aware, is that being interested in the science and liking a career's day-to-day activities are very different. Neonatology is usually very practical, interesting and well staffed and I used to be really interested in it (to the extent that I did the MRCPCH), but the constant stabbing (LPs and IV access) of screaming babies, often needing to be done over and over again day after day, really, really grated on me until I couldn't take it any more. And its such a big part of the job even as a consultant.
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    (Original post by nexttime)
    What did he mean exactly?

    The broader point, as I'm sure Nottie is aware, is that being interested in the science and liking a career's day-to-day activities are very different. Neonatology is usually very practical, interesting and well staffed and I used to be really interested in it (to the extent that I did the MRCPCH), but the constant stabbing (LPs and IV access) of screaming babies, often needing to be done over and over again day after day, really, really grated on me until I couldn't take it any more. And its such a big part of the job even as a consultant.
    I think he meant that neonatology is hopeless a lot of the time. Which, of course, is wrong; our technology and methods are so good now, we have babies born at 24 weeks making it.

    And I totally agree with your second point. I am personally fascinated by the brain, but the practicalities of neurology, and the hopelessness of many neurological conditions, puts me off it as a specialty.
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    Ophthalmology+surgery seems interesting to me, if I get in...
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    Would love to be a GP, or an anaesthetist:/ if I get in aswell


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    (Original post by navarre)
    Neonatology is a subspecialty of paediatrics. You'd have to train in general paediatrics first. It is a fascinating area of medicine, however, despite one of my consultants describing it as "flogging a dead horse".

    As for obstetrics; almost all obstetricians are gynaecologists as well, so if vaginas aren't your bag, I'm not sure how interested you'd be in it.
    yeah I am aware of that. I don't really like "talking children" but probably wouldn't mind it that much.
    As to obstetrics, the fact that you have to do gynaecology as well (at least accoridng to RCOG webste) and can't really do "just obstetrics" is putting me off a lot. Its the baby bit that I am interested in atm, not the women health.

    (Original post by frogs r everywhere)
    I'm actually amazed.How can one understand and enjoy embryology. My 3D imagination probably needs some brushing over.
    I find it hard to understand it and often spend hours on just 1 picture trying to understand from which angle the embryo looks this way, but I enjoy it a lot so don't really mind. Most of my medic friends share my interest so I was amazed when few weeks ago I spoke to a girl who said she hates embryology...I just sort of assumed vast majority of people enjoy it :P
 
 
 
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