Introduction
An MBBS makes you a doctor, but for those who are not satisfied with the title of a general practitioner, start hunting for a post graduation option. There will be a plethora of options to scare you, but choosing between the two distinct roads will surely simplify your life.So your major decision at the juncture of post MBBS and pre PG is deciding if you wish to be a physician or a surgeon. If you decide to be a physician, then you will have to pursue MD [doctor of medicine] and if you wish to pursue surgery, then you will have to take up MS [Masters of surgery]. Each of these paths further branch out into dozens of options.
There are various factors which are taken into consideration before choosing the branch.Some may have a certain positive or negative perception towards physicians or surgeons, some may pick a path out of interest, some have a parent whose footsteps they need to follow, or some choose it because they don't get the other option at their rank. The two most fundamental specializations in MD and MS are MD internal medicine and MS general surgery.Many doctors aspire to take up surgery because of the prospects and prestige over physicians and their OPD and vice versa. But a warning before you allow any such thoughts to percolate your brain, every doctor is a doctor for a reason and need. Both are irreplaceable, and make belief and glamour are not sound parameters for choosing a career.
This article will give you a peep into both the branches, and will therefore aid in your decision making process.
The qualifying procedure:
After due completion of their MBBS, students can take their entrance exams. Entrance tests are varied and many. The national level exam is the All India Post graduate Entrance exam, At the individual state levels, entrance exams are held for the domicile holders. Besides, central government colleges like AIIMS have their separate entrance, and so do the private colleges and deemed universities.
These entrance exams are highly competitive, and hence acquiring a rank suitable for grabbing a seat in the intended/desired specialization is extremely difficult. Once the results of these entrances are out, there are counseling rounds, through which you can take a suitable, wise decision out of the available options.
Rank Needed:
The rank at which you will get a particular specialization differs from year to year. Since the popularity of a specialization and trends amongst students change, the preference of a particular branch changes too. Generally MD internal medicine is the fourth or fifth most preferred branch, and MS Surgery follows almost immediately.
MS Surgery Course :
MS general surgery is a three year course. There is no diploma available in this field. besides the MS a DNB [Diplomate of National Board], which is also a three year course, is another option. There are separate entrance exams for DNB. During your MS, you will acquire the skill and knowledge for surgery. You will learn about surgeries from head to toe. You will learn how to perform a surgery, how to prevent disasters, and how to foresee the prognosis of the patient. Your MS will be all about surgeries, case presentations, thesis under a guide, and books.
Choosing a College:
Before choosing a college you must keep in mind a few things like
-The patients inflow. The higher it is the higher are the cutting edge opportunities.
-The number of senior consultants. If the place is full of senior surgeons, You can leverage on their experience and skills to perfect the traits required to be a good surgeon. An institution with lesser number of experienced staff might result in a less focused effort and attention required to become a good surgeon.
Preferred colleges are-
Grant medical college [J.J. Hospital, Mumbai]
Seth G.S. Medical College [K. E. M. Hospital, Mumbai
Safdarjung medical College, Delhi
All India Institute of Medical Sciences, Delhi
Post MS options:
A majority of surgeons stop at general surgery. Either because of the fatigue of studying for so many years, or out of monetary, age and rank restrictions. Well for these MS candidates, joining a teaching institute or attachment to a private / government hospital are the options. besides, setting up their private practice is also lucrative. The investment will be significant, since you will need your own operation theatre and ICU set up. This means a lot of initial investment as well as maintenance cost. This cost will be recovered over a period of years as you gradually stabilize in your career.
If someone has the will, passion, determination, and strength to study further, there are multiple MCH options, like cardiac surgery, gastro intestinology, neuro surgery and so on.
If not then you can do a fellowship from India or abroad. Like a fellowship in onco surgery from the TATA memorial cancer hospital in Mumbai, or a fellowship in neuro surgery from Nadiad hospital in Gujarat. Abroad the popular ones are Fellowships of American college of surgeons and fellowship of international college of surgery.
What and How of Surgery:
As the mind set goes, each individual wishes to avoid surgery. Every patient has just one question "do we have an alternative to surgery?" at such a crucial moment, it is the surgeons duty to convince and council the patient that a surgery is the only and an inevitable solution to their ailment.
So in short, your job will be to diagnose the need for surgery, convince the patient to undergo the surgical procedure, and perform the operation.
There are two broad categories in which the surgeries can be divided
1. The routine surgeries: in this case the patient is suffering from some disorder which is damaging him physically, mentally, or socially. The way out of his predicament is surgery. In the routine surgeries, you as a doctor can give the patients time to get prepared for the procedure. The most common example of this surgery is hernia for which the surgeons perform mesh plasty.
2. the emergency surgeries: these are surgeries which have to be done asap since they are life saving procedures. No time lag is permissible. A classic example of this surgery is laprotomy and craniatomy.
Now along with excellent counselling skills, you will need a bag full of auto- replenishable patience, and also a tinge of assertiveness to your words. Besides you should have a good, trained, and stable operating hand. This should be topped with abundance of stamina so that you can perform longer surgeries with ease.
As you know a surgeons's life is full of cutting and operations. . Emergency cases will regularly knock on your door and some may warn you that the glory of being a surgeon will come at a cost of self sacrifice. There is certainly a percentage of truth in these words. Your life will be well peppered with night calls and emergency cases.
Lastly you must remember that your surgery lasts till you last. This means you cant delegate your work, because your surgical skill cannot be transferred, and you will no more be valued if any impairment grips your hand.
MD Internal Medicine Course:
The MD internal medicine is a degree course of three years duration. there is no diploma offered in this field of specialisation. the Diplomate of National board is available and is for three years. [for the DNB a separate entrance has to be taken].
During these gruelling three years of training, you will learn in depth about medicine from books and from practical interaction with the patience. At the end of the course, which will be densely sprayed with case presentations, you will complete a thesis under a guide.
Choosing a College
Out of the few things to consider before choosing a college the most important one is the patient drain. You also have to consider the hospital facilities, and the faculty or professional help.
The following are some of the preferred colleges:
All India Institute of Medical Sciences, Delhi
Seth G. S. medical college [K. E. M. hospital], Mumbai
J J medical college of Ahmedabad and Pune.
Madras medical College, Chennai
Post MD options
Five and a half years of MBBS topped with three years of specialisation, generally saps people of their patience, strength and determination to study further. If you are someone who has made up his mind and cannot be deterred, then you have a wide spread of DM degrees to choose from. Only a minority of around 25 % of students take up this option. You could do a DM neurology, cardiology, gastro intestinology, or nephrology. The DM will be of another three years.
There are a multitude of fellowships available as well, like Cardiology, rheumatology, diabetology, gastro intestinology etc. there are more fellowship options abroad.
Besides joining a government or private hospital or becoming a part of the teaching institute and tutoring new minds, a MD internal medicine can set up his own practice.
Private practice is very much monetarily viable since you just need the clinic space. If you are good and skilled, you have a great future ahead.
What and How of Internal Medicine
You will have patience ranging from teenagers to senior citizens. You should have the skill and the natural disposition which invokes trust in the patience.
Even if you possess the experience and skill but lack the ability to build a rapport with your patient, or the ability to make him comfortable, your career will be greatly hampered. You have to give time and lend your ear as a part of your diagnosis.
As an Md medicine, the diseases which will knock at your clinic range from the regular typhoid, hepatitis, diabetes hyper tension, infectious diseases, Accidents and trauma.
Looking at the patients and the diseases you will deal with, it is easy for a lay man to confuse you with a general practitioner. The main and the most significant difference that will be is that the general practitioner gives a diagnosis, but you will give a differential diagnosis. [differential diagnosis means that when certain set of symptoms could be a due to a number of diseases, the MD finds out which disease is causing those symptoms.]
The patient will become the center of your universe. This means that you will have to heavily sacrifice your personal life. There will surely be cases which will drag you out of bed in the dead of night, or compel you to abandon a film half way.
Conclusion:
Every coin has two sides, doesn't it? Hence the pros and cons of every branch are laid out for you, and the decision is for you to make, whether this is who you want to be!
Garima is a free lancer with Gyan Central. she is someone who dares to dream, and performs to progress.
