There are approximately 125 areas of general practice, specialties, and subspecialties for physicians. Physicians are trained to diagnose and treat diseases. Medicine and surgery are the two main categories from which the other specialties branch.
Most physicians practice allopathic medicine, in which the remedies they prescribe produce effects that are different from those that cause the disease. Others practice homeopathy, wherein the physician treats a patient's disease by administering small doses of drugs that, if given in large doses to a healthy person, would cause symptoms of the disease.
Duties/Activities/Scope of Practice
Physicians are the diagnosticians and the coordinators of care. They are the detectives who seek out answers to the mysteries of illness and injury. They collect data from physical examinations, lab tests, and other diagnostics to determine the nature and extent of the illness or injury. Once they have determined a diagnosis, they direct the treatment or refer the patient to another physician for more specialized diagnosis and treatment.
In medicine, there are generalists, also known as the GP (general practitioner). Family practice and internal medicine are also fairly general. There are also specialists who concentrate on certain aspects of health care, such as pediatricians, cardiologists, urologists, and obstetricians and gynecologists.
Surgeons are classified as generalists or specialists as well. There are general surgeons and there are specialists, such as vascular surgeons, orthopedic surgeons, and oncology surgeons. Some cross over from medicine to surgery in specialized areas such as orthopedics, gynecology, and urology.
Education and Training
A bachelor's degree is the primary prerequisite for attending medical school. Most students intending to become physicians major in biology or chemistry. In addition, medical schools require that the BS degree include one year of English, math (algebra or higher), physics, and biology, and two years of chemistry, including both inorganic and organic. Candidates for medical school must also pass the MCAT (Medical College Admissions Test.) Medical school consists of another four years of study.
Getting into medical school is a highly competitive process. Grades from the pre-med program (BS degree), MCAT scores, letters of recommendation, and participation in extracurricular activities are all taken into consideration. In-person interviews are usually conducted with the admissions committee. There are 126 allopathic medical schools in the United States.
The first two years of medical school are spent studying anatomy and physiology, pharmacology, pathology, microbiology, medical ethics and laws governing medicine, psychology, and biochemistry. These are classroom and laboratory courses.
After that, students begin rotations through each of the major clinical areas, including internal medicine, obstetrics and gynecology, pediatrics, surgery, and psychiatry. They will also be exposed to specialty areas, and during their fourth year will be encouraged to take electives in these areas. These are clinical, hands-on courses taught in hospitals and clinics associated with the medical school under the direct supervision of physicians.
After graduation, medical students become interns. Internship lasts one year. After that, another one to seven years of residency training in the specialty of choice is required. This is paid, on-the-job experience.
Physicians have to pass a minimum of three board examinations in order to practice medicine. The first one is given at the end of the first two years of classroom and lab study. The second is given after the third year of medical school, and the third is given at the end of the first year of postgraduate study (internship). After successfully passing all three, they are given the title M.D., and they begin their residency training.
To be board certified as a specialist, physicians have to satisfy residency training requirements and pass another examination given by the specialty board. Board certification in subspecialties requires even longer residency and more examinations.
Each state and the District of Columbia license physicians separately. Each state administers its own licensing exam. Some states allow for reciprocity without another exam, but there may be some limitations.
Graduates of foreign medical schools can be licensed in the United States after completing a residency requirement and passing an examination. Some Americans attend medical schools outside of the United States because of the stiff competition for admission to U.S. schools.
Work Settings and Salaries
The nature of the specialty will define where the physician will work. In general, physicians work in offices or clinics, in hospitals, or in both. Surgeons, for example will spend more of their time in hospitals either performing surgery or visiting patients, and less time in an office examining patients pre- and post-op. Family practice M.D.s and pediatricians will spend more time in offices or clinics. In some instances, physicians will form practices with several physicians, and one will cover all hospital visits, while the others see patients in the office only.
Physicians and surgeons work long and irregular hours. According to the U.S. Department of Labor's Bureau of Labor Statistics, in 2004, almost one-third of physicians worked 60 or more hours each week. In addition to scheduled appointments and procedures, there is always the unexpected in almost every practice. After hours, physicians are on call for patients, other physicians needing consultations, and hospitals in need of orders for patients or patient consultations.
The high costs of health care continue to affect the structure of private practices. Where doctors once hung a shingle on their own front porch and saw patients in their own homes, today most combine their practice with several doctors to share costs of capital and medical equipment, staff, and office space. They also share their practice and cover each other's time off so that they can spend quality time with their own families, and relax and replenish themselves as needed.
What are the most important qualities that a physician should have?
Physicians need to be self-motivated, and they need to be able to withstand the pressures of working long hours. They have to have stamina, and physical and emotional stability. Precision, an eye for detail, and accuracy are all vital characteristics as well.
One in seven physicians in 2004 was self-employed and not incorporated, according to the U.S. Department of Labor. Of the 567,000 physicians working in 2004, about half worked for office-based practices, a quarter were employed by hospitals, and the rest worked for federal, state, and local governments in clinics and educational services.
Physicians make some of the highest salaries of any occupation. Their education costs and the costs of maintaining a practice with state-of-the-art equipment are also very high. Salaries typically range from $150,000 to $320,000 per year depending upon the area of practice. Family practice and pediatricians typically earn less than more specialized M.D.s.
Career Potential and Additional Information
The U.S. Department of Labor predicts that employment for physicians and surgeons will continue to grow at an average pace through 2014. As with all health care fields, the aging population will increase demands for continued and improved health care.
Some of the factors that will heavily influence physicians, however, include the increasing costs for health care and health care coverage. In order to contain costs, insurance companies and consumers have pushed for lower-cost options for many services in health care, such as employing the services of physician assistants, nurse practitioners, and nurse anesthetists.
Technology and advancements in areas such as telemedicine and the use of electronic medical records will also impact physician practices. In many ways these advances will improve productivity and reduce costs as well as improve patients' access to care.
Shortages of physicians in rural and low-income areas continue and will give rise to even more creative recruitment and retention methods. These areas will provide opportunities for many years to come, especially to new physicians.
Technology advancements along with pharmacologic changes, which happen at a frantic pace, will continue to give rise to the need to continue education. Health care is a lifelong learning experience. Those who keep up and are flexible will adapt well to changes in the field and find new opportunities.
For a list of medical schools and residency programs, as well as information about financial aid and careers in medicine, contact the Association of American Medical Colleges.
For information on physicians, contact the American Medical Association.
For licensing information, contact your State Board of Medical Examiners. You should be able to link to this from your state's official Web site.