Intro to Becoming a Physician

Small group of U.S. allopathic medical students going over human anatomy.

Allopathic doctors (MDs) and osteopathic doctors (DOs) require more education and training and work longer hours than the majority of other healthcare professionals. They are also the most highly paid. Beyond these generalizations, several other factors should be considered if you’re planning to pursue this career path. For information on the physician assistant (PA) profession, check out this page.

Characteristics

Men and women who want to be doctors must have a desire to serve patients, be self-motivated, and be able to survive both day-to-day pressures and long hours of study. Some medical residents (med school graduates) can be on call 24 hours a day during work weeks of up to 80 hours.



Physicians also must be willing to study throughout their career to keep up with medical advances. They should have a good bedside manner, emotional stability, and the ability to make the right decisions in emergencies.

The Ideal Physician: Top 15 Personality Traits

  1. Unquestionable integrity; highly principled
  2. Forthright
  3. Naturally energetic and enthusiastic
  4. Genuinely concerned about the problems of others
  5. Orderly, logical mind; mentally efficient
  6. Understanding
  7. Motivated by idealism, compassion, and service
  8. Confidence-inspiring
  9. Calm in critical and stormy situations
  10. Able and willing to learn from others
  11. Conscientious
  12. Wise, thoughtful, able to get to the heart of a problem
  13. Observant
  14. Adaptable, able to adjust to new knowledge and changing conditions
  15. Considerate, courteous, and tactful

Preparation

When you hear someone say, “you have to go to school for over 10 years to become a doctor”, they’re usually referring to having to complete the following:

  • 4 years of undergraduate (earning bachelor’s degree)
  • 4 years of medical school (earning MD or DO degree)
  • 3 years of residency (earning license to practice)

Now, there are exceptions to the time it takes.

Some undergrad and med programs offer accelerated pathways, thereby enabling you to pursue residency sooner. On the other hand, there are combined MD/PhD programs that have the potential to put off your starting residency beyond 4 years of med school or extend your residency period.

Residency Lengths

When it comes to residency, that 3-year length only pertains to a few areas of medical training. Depending on what type of doctor you want to be, your residency training can be 7+ years.

Types of residencies and fellowships, including length of time, can be viewed here.

Early 20th Century Medical Education Reform

Abraham Flexner (1866-1959), an internationally-renown education advocate, was largely instrumental in North American medical education reform, including the standardization of criteria for entrance into and graduation from medical school. He published what was known as the Flexner Report in 1910 which outlined why reform was necessary and the changes that needed to be made.

Up until this time it was relatively easy to get admitted and graduate – so as long you had the desire. Academic prerequisites were very minimal and in some cases non-existent. This led to, what would be viewed today as, a high percentage of very underqualified doctors practicing medicine.

In essence, Flexner’s reform called for physicians to be better trained and more qualified. This basically meant less med students would be going in and graduate doctors coming out, despite the looming concern of an already nationwide physician shortage at the time. It was a double-edged sword.

By 1935 the number of U.S. med schools, and subsequently graduates, had been significantly reduced (by over 50 percent) as a result of compliance with Flexner’s recommendations.

The reform he set into motion also led to the wide-scale adoption of med school prerequisites still in place today, including 2 semesters worth of coursework in biology, general chemistry, organic chemistry and physics, as well as a standardized entrance exam (Medical College Admissions Test or MCAT).

Despite noble efforts towards increasing physician quality, you should also know Flexner’s report also contained negative, ignorant and highly discriminatory ideals relating to physician diversity.

Roles

Both medical doctors (MDs) and doctors of osteopathic medicine (DOs) treat disease and injury, but DOs consider all body systems as interrelated and dependent upon one another for good health. They put particular emphasis on the musculoskeletal system: bones, muscles, ligaments, and nerves.



In addition to all of the medication and surgical remedies used by MDs, DOs offer osteopathic manipulative treatments as well for some kinds of back pain, neck pain, headaches, and other medical conditions.

Approximately 60 percent of all DOs are primary care physicians (PCPs) who, unlike specialists, see the same patients on a relatively regular basis for a variety of ailments and preventive treatments.

The number of MDs that practice primary care is much lower, at around 34 percent. However, these figures are projected to decrease further.

With less than 25 percent of new physicians going into primary care, the shortage of PCPs will continue into the forseeable future.

Primary Care vs. Specialization

There are, in general, five types of primary care physician: Family Practitioner, Internist, Gynecologist/Obstetrician, Geriatrician and Pediatrician. When appropriate, these primarys refer their patients to specialists, such as cardiologists, orthopedists, and dermatologists. However, this isn’t to say PCPs aren’t specialists in their own right.

In medicine, the term ‘specialist’ can be a bit of a misnomer to those outside the industry. Reason being, primary care physicians are actually considered specialists in their respective fields and can become board certified in their field of primary care if they so choose.

These primary fields of medicine are recognized as specialties by the American Board of Medical Specialties:

  • Family Medicine (6 subspecialties)
  • Internal Medicine (20 subspecialties)
  • Obstetrics and Gynecology (6 subspecialties)
  • Pediatrics (20 subspecialties)
  • Geriatrics (a subspecialty of both Family and Internal Medicine)

Furthermore, there are subspecialties within these general specialty fields a primary care physician can choose to become certified in, creating the potential to step out of the primary care spectrum altogether to pursue a role as a dedicated subspecialist.

For example, a general internist can earn subspecialty certification in transplant hepatology, then choose to only work with patients in that particular population.

Post Early-mid 20th Century War and Specialized Medicine

Before World War II, most doctors in the United States were GPs or family practitioners. Dealing with heart problems as readily as broken bones, they delivered babies and treated cancer patients with equal facility. But WWII (1939-1945) and the Korean War (1950-1953) changed the medical profession profoundly, most dramatically of all in emergency medicine.

The staggering number and variety of battlefield injuries forced doctors to exercise unprecedented creativity. The resulting innovations, discoveries and inventions inevitably found their way home, leading to civilian applications that forever changed the way medicine is practiced. These events also helped spur the need for producing physicians specially trained in particular branches of medicine, as opposed to being generalists.

Subsequently, the need for specialists led, in part, to the phasing out of general practitioning in the United States, with GPs at the time being encouraged to go into specialties/subspecialties and future doctors subsequently having to choose at minimum a 3-year general specialty residency.

The GP to Family Practitioner Transition

Since the family doctor had always been (and still is) the closest thing to a generalist, in 1969 ‘family medicine’ became officially recognized as a specialty requiring a 3-year residency to more comprehensively meet the primary medicine needs of the population. (Prior to 1970 only a 1-year post graduate internship was required to become a family practitioner or GP).

In the fall of 1971, the American Academy of General Practice changed its title to the American Academy of Family Physicians (AAFP), as we know it today, to reflect the GP to FP transition. GPs at the time were even exempt from having to complete the newly established 3-year residency requirement in family medicine if they chose to practice as an FP.

Having basically been set to phase out in the 1970s, it’s important to note the generalist role is still alive and well in some regions and organizations, including the U.S. Navy, where “first-line” physicians are known as General Medical Officers (GMOs). Also, it’s still common nowadays for patients to refer to primary care physicians (usually their family doctor, internist or geriatrician) as GPs. The other PCP roles, ob/gyn and pediatrician, tend to be referred to by their correct title.

Types of Physicians (more profiles coming soon)

Some physicians prefer private practice. Others teach in medical schools or teaching hospitals, work only in research, or are salaried employees of hospitals, health maintenance organizations, or other businesses. Workplace type distribution is largely dependent upon medical specialty and varies widely among specialties.



Below are basic descriptions of the physician specialty fields:

Dermatologist

Dermatologists treat diseases and problems of the human skin, hair, and nails. Their patients may be troubled with something as common as warts or acne, or as serious as skin cancer. Dermatologists treat boils, abscesses, skin injuries, or infections. They remove lesions, cysts, birthmarks, and other growths. They also treat scars and perform hair transplants.

Family Physician

Family physicians are concerned with the total healthcare of the individual and the family. They’re capable of doing a lot more than most people would expect, including performing basic surgeries, caring for the seriously ill in hospital critical care units, handling major trauma cases, staffing a hospital, and delivering babies, including performing cesarean sections.

Given their residency training in multiple niches of essential health care, some end up developing an area of special expertise, such as sports medicine, geriatrics, preventive care, women’s health, adolescent health, or even research.

Ob/Gyn

Gynecologists and obstetricians are concerned with the health of a woman’s reproductive system. Gynecologists specialize in treating diseases and disorders of non-pregnant women; obstetricians provide medical care before, during, and after childbirth. Some physicians handle both specialties.

Internist

Internists diagnose and treat diseases and injuries of human internal organ systems. They employ diagnostic images and tests, using medical instruments and equipment. They also commonly prescribe medication and recommend dietary and physical activity programs, as diagnosed.

Neurologist

Neurologists, often called brain specialists, diagnose and treat functional or organic disorders of the nervous system, which includes the brain, spinal cord, and nerves. They use an electroencephalograph (EEG) to measure brain waves and thus diagnose and evaluate head trauma, strokes, infectious diseases, epilepsy, brain tumors, and other problems.

Otolarnygologist

Otolaryngologists are ear, nose, and throat specialists. They treat patients with hearing loss or speech loss from disease or injury, prescribe medications, and may perform surgery. Commonly referred to as ENTs (ear, nose and throat doctors), a physician my decide to specialize in only one type of disorder: ear (otologist), nose (rhinologist), or throat (laryngologist).

Pathologist

Pathologists study the nature, cause, progression, and effects of diseases. They perform tests on body tissues, fluids, secretions, and other specimens to see if a disease is present and to determine its stage. They perform autopsies to find out why a person died and to study the effects of medical treatment. Pathologists often specialize in areas such as clinical chemistry, microbiology, or blood banking. They may supervise the pathology department of a medical school, hospital, clinic, medical examiner’s office, or research institution.

Pediatrician

Pediatricians specialize in the development and care of children, and the diagnosis and treatment of childhood diseases. They are concerned with behavioral and social problems, as well as specific medical aspects of child health.

Physiatrist

Physiatrists specialize in the use of physical devices and exercise to rehabilitate patients. They determine the kind of therapy needed; prescribe exercises or treatments using heat, cold, light, and other processes; in addition to instructing the physical therapists who administer these treatments. They may also recommend occupational therapy for patients who must remain hospitalized for long periods of time or for those who must change or adapt their work because of a disability.

Proctologist

Proctologists treat diseases and disorders of the anus, rectum, and colon. They may prescribe medication and recommend changes in the patient’s dietary and lifestyle habits or may perform surgery to remove or repair the affected organ or tissues.

Urologist

Urologists treat disorders of the urinary system of both men and women, and of the reproductive organs of men. They may prescribe medicines for simple ailments, such as a bladder infection, or perform surgery fro more complicated conditions, such as kidney stones or an enlarged prostate gland.

Outlook

In 1992, approximately half a million physicians were at work in this country, two thirds of them in office-based settings such as clinics and HMOs. In 2014, there were 633,480 physicians employed in the United States. From 2012 through the year 2022, employment of physicians is expected to grow by 18 percent, which is faster than the average for all occupations.

Demand for primary care physicians (especially family practitioners), as well as geriatric and preventive care specialists are among the roles with highest demand. In general, job prospects nationwide are more competitive in the Northeast and the West, where the ratio of physicians to the general population in urban areas is highest, and more favorable in the Southwest and Mountain regions, where the ratio of physicians to general population is much lower.

A shortage of doctors also exists in many rural and low-income regions throughout the entire country. Some MDs and DOs find these areas unattractive because of lower earning potential and isolation from from family, friends and medical colleagues; many also prefer the stimulation and faster pace of a metropolitan environment.

Others, however, find the rewards and challenges of working with the medically underserved both personally and professionally fulfilling.

Many new physicians avoid solo practice and take salaried jobs in group medical practices, clinics, hospitals and HMOs because of the regular hours and the opportunity to consult with peers. Others go for salaried positions because they can’t afford the high medical malpractice insurance and/or the cost of setting up a private practice while they pay off student loans.

Earnings

According to the Bureau of Labor Statistics, the average income for all U.S. physicians (including surgeons) was approximately $194,990 in 2014. Of course, earnings can vary widely according to physician specialty, number of years in practice, geographic region, hours worked, skill and professional reputation.

View starting salaries for physicians (1st year after residency or fellowship) categorized alphabetically by specialty field.

Further Reading