Currently, I am doing a surgical ICU rotation. I work with very intelligent and capable surgical attendings but I can’t help but feel that there is quite a bit of medical knowledge lacking in them.
To compare a SICU attending vs. a medical critical care attending: to become board certified SICU attending, you complete a one-year fellowship in Trauma/CC. However, for most of that year, many programs train the fellows moreso in trauma than critical care, so they aren’t really doing one FULL year of critical care. So a pulmonary/CC fellow has THREE years of training. Would that not make a medical intensivist WAY more qualified in critical care than a surgical intensivist?
I think surgeons are, in general, more competent to treat a sick patient but how in today’s medicine, most surgical patients are over 80 years old with multiple medical problems, yet my attendings have trouble reading EKG’s, knowing which chronic anti-hypertensives to use, how to treat concurrent heart/renal failure patients, complex medical diseases, etc. We know how to resusticate/pound fluids/when to take patients to the OR, but outside of that, I feel that my surgical attendings are "winging" it when it comes to managing medical patients. Am I missing something?
Is there an ergonomics question in there somewhere? Just to let you know, from personal experience, I have never known a physician that didn’t think that he was smarter than his peers or mentors in some way or another. It takes a lot of guts to take over reponsibility for the life of another being. If you all weren’t so cocky, there would be a lot less idiots around to respond to posts like this. Speaking for the rest of us, I hope you are better educated than your mentors. Keep up the hard work!
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