Physicians work to prevent, diagnose, and treat diseases, disorders, and
injuries. Other health care practitioners who need similar skills and who
exercise critical judgment include chiropractors, dentists, optometrists,
physician assistants, podiatrists, registered nurses, and veterinarians.
Many physicians and surgeons work long, irregular hours; over one-third
of full-time physicians worked 60 or more hours a week in 2004.
Formal education and training requirements are among the most
demanding of any occupation, but earnings are among the highest.
Job opportunities should be very good, particularly in rural and
low- income areas.
New physicians are much less likely to enter solo practice and
more likely to work as salaried employees of group medical practices,
clinics, hospitals, or health networks.
Physicians and surgeons serve a fundamental role in our society and have an
effect upon all our lives. They diagnose illnesses and prescribe and administer
treatment for people suffering from injury or disease. Physicians examine
patients, obtain medical histories, and order, per-form, and interpret
diagnostic tests. They counsel patients on diet, hygiene, and preventive health
care.
There are two types of physicians: M.D.—Doctor of Medicine—and D.O.—Doctor of
Osteopathic Medicine. M.D.s also are known as allopathic physicians. While both
M.D.s and D.O.s may use all accepted methods of treatment, including drugs and
surgery, D.O.s place special emphasis on the body’s musculoskeletal system,
preventive medicine, and holistic patient care. D.O.s are more likely than M.D.s
to be primary care specialists although they can be found in all specialties.
About half of D.O.s practice general or family medicine, general internal
medicine, or general pediatrics.
Physicians work in one or more of several specialties, including, but not
limited to, anesthesiology, family and general medicine, general internal
medicine, general pediatrics, obstetrics and gynecology, psychiatry, and
surgery.
Anesthesiologists. Anesthesiologists focus on the care of
surgical patients and pain relief. Like other physicians, they evaluate and
treat patients and direct the efforts of those on their staffs.
Anesthesiologists confer with other physicians and surgeons about appropriate
treatments
and procedures before, during, and after operations. These critical care
specialists are responsible for maintenance of the patient’s vital life
functions—heart rate, body temperature, blood pressure, breathing— through
continual monitoring and assessment during surgery. They often work outside of
the operating room, providing pain relief in the intensive care unit, during
labor and delivery, and for those who suffer from chronic pain.
Family and general practitioners. Family and general
practitioners are often the first point of contact for people seeking health
care, acting as the traditional family doctor. They assess and treat a wide
range of conditions, ailments, and injuries, from sinus and respiratory
infections to broken bones and scrapes. Family and general practitioners
typically have a patient base of regular, long-term visitors. Patients with more
serious conditions are referred to specialists or other health care facilities
for more intensive care.
General internists. General internists diagnose and provide
nonsurgical treatment for diseases and injuries of internal organ systems. They
provide care mainly for adults who have a wide range of problems associated with
the internal organs, such as the stomach, kidneys, liver, and digestive tract.
Internists use a variety of diagnostic techniques to treat patients through
medication or hospitalization. Like general practitioners, general internists
are commonly looked upon as primary care specialists. They have patients
referred to them by other specialists, in turn referring patients to those and
yet other specialists when more complex care is required.
General pediatricians. Providing care from birth to early
adulthood, pediatricians are concerned with the health of infants, children, and
teenagers. They specialize in the diagnosis and treatment of a variety of
ailments specific to young people and track their patients’ growth to adulthood.
Like most physicians, pediatricians work with different health care workers,
such as nurses and other physicians, to assess and treat children with various
ailments, such as muscular dystrophy. Most of the work of pediatricians,
however, involves treating day-to-day illnesses that are common to
children—minor injuries, infectious diseases, and immunizations—much as a
general practitioner treats adults. Some pediatricians specialize in serious
medical conditions and pediatric surgery, treating autoimmune disorders or
serious chronic ailments.
Obstetricians and gynecologists. Obstetricians and
gynecologists (ob/gyns) are specialists whose focus is women’s health. They are
responsible for general medical care for women, but also provide care related to
pregnancy and the reproductive system. Like general practitioners, ob/gyns are
concerned with the prevention, diagnosis, and treatment of general health
problems, but they focus on ailments specific to the female anatomy, such as
breast and cervical cancer, urinary tract and pelvic disorders, and hormonal
disorders. Ob/gyns also specialize in childbirth, treating and counseling women
throughout their pregnancy, from giving prenatal diagnoses to delivery and
postpartum care. Ob/gyns track the health of, and treat, both mother and fetus
as the pregnancy progresses.
Psychiatrists. Psychiatrists are the primary caregivers in the
area of mental health. They assess and treat mental illnesses through a
combination of psychotherapy, psychoanalysis, hospitalization, and medication.
Psychotherapy involves regular discussions with patients about their problems;
the psychiatrist helps them find solutions through changes in their behavioral
patterns, the exploration of their past experiences, and group and family
therapy sessions. Psychoanalysis involves long-term psychotherapy and counseling
for patients. In many cases, medications are administered to correct chemical
imbalances that may be causing emotional problems. Psychiatrists may also
administer electroconvulsive therapy to those of their patients who do not
respond to, or who cannot take, medications.
Surgeons. Surgeons are physicians who specialize in the
treatment of injury, disease, and deformity through operations. Using a variety
of instruments, and with patients under general or local anesthesia, a surgeon
corrects physical deformities, repairs bone and tissue after injuries, or
performs preventive surgeries on patients with debilitating diseases or
disorders. Although a large number perform general surgery, many surgeons choose
to specialize in a specific area. One of the most prevalent specialties is
orthopedic surgery: the treatment of the musculoskeletal system. Others include
neurological surgery (treatment of the brain and nervous system), cardiovascular
surgery, otolaryngology (treatment of the ear, nose, and throat), and plastic or
reconstructive surgery. Like primary care and other specialist physicians,
surgeons also examine patients, perform and interpret diagnostic tests, and
counsel patients on preventive health care.
A number of other medical specialists, including allergists, cardiologists,
dermatologists, emergency physicians, gastroenterologists, ophthalmologists,
pathologists, and radiologists, also work in clinics, hospitals, and private
offices.
Many physicians—primarily general and family practitioners, general internists,
pediatricians, ob/gyns, and psychiatrists—work in small private offices or
clinics, often assisted by a small staff of nurses and other administrative
personnel. Increasingly, physicians are practicing in groups or health care
organizations that provide backup coverage and allow for more time off. These
physicians often work as part of a team coordinating care for a population of
patients; they are less independent than solo practitioners of the past.
Surgeons and anesthesiologists typically work in well-lighted, sterile
environments while performing surgery and often stand for long periods. Most
work in hospitals or in surgical outpatient centers. Many physicians and
surgeons work long, irregular hours. Over one-third of full-time physicians and
surgeons worked 60 hours or more a week in 2004. Only 8 percent of all
physicians and surgeons worked part-time, compared with 16 percent for all
occupations. Physicians and surgeons must travel frequently between office and
hospital to care for their patients. Those who are on call deal with many
patients’ concerns over the phone and may make emergency visits to hospitals or
nursing homes.
Physicians and surgeons held about 567,000 jobs in 2004; approximately 1 out
of 7 was self-employed and not incorporated. About 60 percent of salaried
physicians and surgeons were in office of physicians, and 16 percent were
employed by private hospitals. Others practiced in federal, state, and local
governments, including hospitals, colleges, universities, and professional
schools; private colleges, universities, and professional schools; and
outpatient care centers.
According to the American Medical Association (AMA), in 2003 about 2 out 5
physicians in patient care were in primary care, but not in a subspecialty of
primary care.
A growing number of physicians are partners or salaried employees of group
practices. Organized as clinics or as associations of physicians, medical groups
can afford expensive medical equipment and realize other business advantages.
According to the AMA, the New England and Middle Atlantic states have the
highest ratio of physicians to population; the South Central and Mountain states
have the lowest. D.O.s are more likely than M.D.s to practice in small cities
and towns and in rural areas. M.D.s tend to locate in urban areas, close to
hospital and education centers.
Formal education and training requirements for physicians are among the most
demanding of any occupation—4 years of under-graduate school, 4 years of medical
school, and 3 to 8 years of internship and residency, depending on the specialty
selected. A few medical schools offer combined undergraduate and medical school
programs that last 6 rather than the customary 8 years.
Premedical students must complete undergraduate work in physics, biology,
mathematics, English, and inorganic and organic chemistry. Students also take
courses in the humanities and the social sciences. Some students volunteer at
local hospitals or clinics to gain practical experience in the health
professions.
The minimum educational requirement for entry into a medical school is 3
years of college; most applicants, however, have at least a bachelor’s degree,
and many have advanced degrees. There are 146 medical schools in the United
States—126 teach allopathic medicine and award a Doctor of Medicine (M.D.)
degree; 20 teach osteopathic medicine and award the Doctor of Osteopathic
Medicine (D.O.) degree. Acceptance to medical school is highly competitive.
Applicants must submit transcripts, scores from the Medical College Admission
Test, and letters of recommendation. Schools also consider an applicant’s
character, personality, leadership qualities, and participation in
extracurricular activities. Most schools require an interview with members of
the admissions committee.
Students spend most of the first 2 years of medical school in laboratories and
classrooms, taking courses such as anatomy, biochemistry, physiology,
pharmacology, psychology, microbiology, pathology, medical ethics, and laws
governing medicine. They also learn to take medical histories, examine patients,
and diagnose illnesses. During their last 2 years, students work with patients
under the supervision of experienced physicians in hospitals and clinics,
learning acute, chronic, preventive, and rehabilitative care. Through rotations
in internal medicine, family practice, obstetrics and gynecology, pediatrics,
psychiatry, and surgery, they gain experience in the diagnosis and treatment of
illness.
Following medical school, almost all M.D.s enter a residency graduate medical
education in a specialty that takes the form of paid on-the-job training,
usually in a hospital. Most D.O.s serve a 12-month rotating internship after
graduation and before entering a residency, which may last 2 to 6 years.
All states, the District of Columbia, and U.S. territories license
physicians. To be licensed, physicians must graduate from an accredited medical
school, pass a licensing examination, and complete 1 to 7 years of graduate
medical education. Although physicians licensed in one state usually can get a
license to practice in another without further examination, some states limit
reciprocity. Graduates of foreign medical schools generally can qualify for
licensure after passing an examination and completing a U.S. residency.
M.D.s and D.O.s seeking board certification in a specialty may spend up to 7
years in residency training, depending on the specialty. A final examination
immediately after residency or after 1 or 2 years of practice also is necessary
for certification by a member board of the American Board of Medical Specialists
(ABMS) or the American Osteopathic Association (AOA). The ABMS represents 24
specialty boards, ranging from allergy and immunology to urology. The AOA has
approved 18 specialty boards, ranging from anesthesiology to surgery. For
certification in a subspecialty, physicians usually need another 1 to 2 years of
residency.
A physician’s training is costly. According to the Association of American
Medical Colleges, in 2004 more than 80 percent of medical school graduates were
in debt for educational expenses.
People who wish to become physicians must have a desire to serve patients, be
self-motivated, and be able to survive the pressures and long hours of medical
education and practice. Physicians also must have a good bedside manner,
emotional stability, and the ability to make de-cisions in emergencies.
Prospective physicians must be willing to study throughout their career in order
to keep up with medical advances.
Employment of physicians and surgeons is projected to grow faster than
average for all occupations through the year 2014 due to continued expansion of
health care industries. The growing and aging population will drive overall
growth in the demand for physician services, as consumers continue to demand
high levels of care using the latest technologies, diagnostic tests, and
therapies. In addition to employment growth, job openings will result from the
need to replace physicians and surgeons who retire over the 2004-14 period.
Demand for physicians’ services is highly sensitive to changes in consumer
preferences, health care reimbursement policies, and legislation. For example,
if changes to health coverage result in consumers facing higher out-of-pocket
costs, they may demand fewer physician services. Demand for physician services
may also be tempered by patients relying more on other health care
providers—such as physician assistants, nurse practitioners, optometrists, and
nurse anesthetists—for some health care services. In addition, new technologies
will increase physician productivity. Telemedicine will allow physicians to
treat patients or consult with other providers remotely. Increasing use of
electronic medical records, test and prescription orders, billing, and
scheduling will also improve physician productivity.
Opportunities for individuals interested in becoming physicians and surgeons are
expected to be very good. Reports of shortages in some specialties or geographic
areas should attract new entrants, encouraging schools to expand programs and
hospitals to expand available residency slots. However, because physician
training is so lengthy, employment change happens gradually. In the short term,
to meet increased demand, experienced physicians may work longer hours, delay
retirement, or take measures to increase productivity, such as using more
support staff to provide services. Opportunities should be particularly good in
rural and low-income areas, because some physicians find these areas
unattractive due to less control over work hours, isolation from medical
colleagues, or other reasons.
Unlike their predecessors, newly trained physicians face radically different
choices of where and how to practice. New physicians are much less likely to
enter solo practice and more likely to take salaried jobs in group medical
practices, clinics, and health networks.
Earnings of physicians and surgeons are among the highest of any occupation.
According to the Medical Group Management Association’s Physician Compensation
and Production Survey, median total compensation for physicians in 2004 varied
by specialty. Total compensation for physicians reflects the amount reported as
direct compensation for tax purposes, plus all voluntary salary reductions.
Salary, bonus and/or incentive payments, research stipends, honoraria, and
distribution of profits were included in total compensation.
Self-employed physicians—those who own or are part owners of their medical
practice—generally have higher median incomes than salaried physicians. Earnings
vary according to number of years in practice, geographic region, hours worked,
and skill, personality, and professional reputation. Self-employed physicians
and surgeons must provide for their own health insurance and retirement.
Median total compensation for physicians with over one year of practice in the
following specialties: Anesthesiology, $321,686; Surgery: General, $282,504;
Obstetrics/gynecology, $247,348; Psychiatry, $180,000; Internal medicine,
$166,420; Pediatrics, $161,331; and Family practice, $156,010.
Additional Physician and Surgeon career and job resources are presented in the paperback
version of
Health Care Job Explosion! 4th edition by Dennis V. Damp for this
occupational group. Resources include Job Ads, Job Hotlines, Job Fairs,
Placement services, Associations, Books, Directories and Internet (Web) Sites.
Your local library may have this book in their reference section or you can
purchase a copy for $19.95 plus shipping with all major credit cards from our
toll free service at 1-800-782-7424 (Orders Only). Also available at all major
bookstores. Also explore jobs at VA hospitals and other
federal government employment options.
American Academy of Family Physicians (AAFP) - 11400 Tomahawk Creek Parkway,
Leawood, KS 66211; 800/274-2237. (http://www.aafp.org,
fp@aafp.org) Information on residencies for medical school students considering
this career and job ads posted by state. AAFP placement service is free for
members.
American Medical Association (AMA) - 515 N. State St., Chicago, IL 60610;
800/621-8335. (http://www.ama-assn.org)
The AMA web site has extensive information on the process involved in becoming a
physician, including planning and financing. Sponsors FREIDA the Fellowship and
Residency Electronic Interactive Database containing over 7,800 graduate medical
education programs accredited by the Accreditation Council for Graduate Medical
Education, as well as over 200 combined specialty programs.
Get Into Medical School : A Strategic Approach - by Maria Lofftus and Thomas
C. Taylor, Kaplan Pub. 2003, ISBN: 0743240960 “As a pre-med student, you'll be
working for at least two years without guarantee of a spot in medical school. It
means publicly stating that you want something that in 2002 only 52 percent of
those applying got - a position in medical school.”
National Medical Association (NMA) - 1012 10th St. NW, Washington DC 20001;
202/347-1895, (http://www.nmanet.org,
Publicaffairs@NMAnet.org) The NMA focuses primarily on health issues related to
African Americans and medically under-served populations. Career opportunities
tab of web site has placement service. Programs include breast-feeding,
HIV/AIDS, asthma, traffic safety and tobacco control.
Resume Writing Service - Professionally package your health care resume
for entry level, standard, and executive positions.
Health Care Jobs, Physician and Surgeon Careers
& Jobs, Medical Jobs
