Mommy...how are doctors made?

Over the last couple years, I've had to explain how doctors are trained to soooooo many people...and I think they still don't get it!!! That seems like a good place to start.

I go to a medical school that is 4 years long, as most are (some students are in 3 year programs...that's just nutbar!) Every med school has slightly different programs, but in mine, the first 2 years are primarily academic. We learn the basics of anatomy, physiology (how the body works normally), pharmacology (how the body handles medications and what meds do to the body), pathology (how disease processes work), genetics, clinical examination techniques (ie. how to examine patients), history taking (ie how to get meaningful information from patients), and have developed a rough strategy for narrowing down a diagnosis. There is a bit of patient contact during the first 2 years...just enough to keep you interested and remind you why the hell you chose to go into medicine! The doubt usually sets in during what I call 'exam season' (December and June).

Our third year consists of rotating through all the major specialties. This is the year I am in. I'm starting in Obstetrics and Gynecology but will eventually rotate through Psychiatry, Orthopedics, Anesthesia, Dermatology, Opthomology, Emergency Medicine, Surgery, Pediatrics, and Internal Medicine (fancy words for 'treating the REALLY sick/complicated people'). There is also an elective where we can do whatever we want. The purpose of this year is to try on all the specialties for size (as a future potential career), expand our medical knowledge, and learn the principles of diagnosis and treatment. This occurs in hospital and clinic settings and is where we learn how to write orders and prescriptions, work in a team with all hospital staff, learn to do procedures (ex. take biopsies, insert IVs, stitch, intubate...the list goes on and on). We also take call, which usually means shifts overnight at the hospital. If you ever see exhausted-looking people wearing short white coats with pockets stuffed to the brim and a stethoscope around our necks walking aimlessly around hospital hallways...that's us. We are officially called 'Clinical Clerks' (don't ask me why) but we call ourselves med school dorks/nerds/geeks.

Our 4th year will consist of 6 electives (whatever we want to do) with a chunk in the middle of the year for more academic work. It's an extension of third year, but with more knowledge and responsibility and with a bit of focus on narrowing down choices for a carreer. During 4th year, we in Canada apply for CaRMS (Canadian Resident Matching Service). After 4 years of medical school we will have an MD degree (and are called doctors), but will still not be able to practice medicine on our own. We still need more training as what are called Residents. The way CaRMS works is we apply for and rank what specialty and what school we want to go to for more training. For example if I wanted to be a Pediatrician, I would apply for the Peds programs at U of T, U of A, U of C, UBC, etc, etc. All the schools then interview suitable students and then rank who they want to train with them. If successful, I would be a Peds Resident. Each specialty has a different amount of residency training: Family Medicine is 2 years, Peds is 4 years, everything else is 5 years.

It takes at least 10 years to train a doctor. 4 years of a bachelors degree, 4 years of medical school, plus residency (anywhere from 2-5 years). And to sub-specialize is even more.

I haven't even mentioned the costs...don't remind me.