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发信人: myosotis (阿金), 信区: AdvancedEdu
标 题: 98-99 ocupational outlook/Physicians
发信站: BBS 水木清华站 (Mon Apr 6 22:33:44 1998)
Significant points
* Amid reports of an oversupply of physicians, opportunities
will be best in primary care fields of general and family
medicine, internal medicine, and general pediatrics.
* Physicians are much more likely to work as salaried
employees of group medical practices, clinics, or health
care networks than in the past.
* It takes many years of education and training to become a
physician, but earnings are among the highest of any
occupation.
* Nature of the Work
Physicians 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, perform, and interpret
diagnostic tests. They counsel patients on diet, hygiene,
and preventive health care.
There are two types of physicians: The M.D.Doctor of
Medicine and the D.O.Doctor of Osteopathic Medicine. M.D.'s
are also known as allopathic physicians. While 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.
About one third of M.D.'s are primary care physicians. They
practice general and family medicine, general internal
medicine, or general pediatrics and are usually the first
health professionals patients consult. Primary care
physicians tend to see the same patients on a regular basis
for preventive care and to treat a variety of ailments.
General and family practitioners emphasize comprehensive
health care for patients of all ages and for the family as a
group. Those in general internal medicine provide care
mainly for adults who have a wide range of problems
associated with the body's organs. General pediatricians
focus on children's health. When appropriate, primary care
physicians refer patients to specialists, who are experts in
medical fields such as obstetrics and gynecology,
cardiology, psychiatry, or surgery (See table 1). D.O.'s are
more likely to be primary care providers than allopathic
physicians, although they can be found in all specialties.
Table 1. Percent distribution of M.D.'s by specialty, 1995
Percent
Total 100.0
Primary care
General internal medicine 16.0
General and family medicine 10.5
General pediatrics 7.0
Medical specialties
Allergy .5
Cardiovascular diseases 2.6
Dermatology 1.2
Gastroenterology 1.3
Obstetrics and gynecology 5.2
Pediatric cardiology .2
Pulmonary diseases 1.0
Surgical specialties
Colon and rectal surgery .1
General surgery 5.2
Neurological surgery .7
Ophthalmology 2.4
Orthopedic surgery 3.1
Otalaryngology 1.3
Plastic surgery .8
Thoracic surgery .3
Urological surgery 1.4
Other specialties
Aerospace medicine .1
Anesthesiology 4.6
Child psychiatry .8
Diagnostic radiology 2.7
Emergency medicine 2.7
Forensic pathology .1
General preventive medicine .2
Neurology 1.6
Nuclear medicine .2
Occupational medicine .4
Pathology 2.5
Physical medicine and rehabilitation .8
Psychiatry 5.3
Public health .2
Radiology 1.1
Radiation oncology .5
Other specialty 1.0
Unspecified/unknown/inactive 14.4
SOURCE: American Medical Association
* Working Conditions
Many physicians work long, irregular hours. About one-third
of all full-time physicians worked 60 hours or more a week
in 1996. They must travel frequently between office and
hospital to care for their patients. Increasingly,
physicians practice in groups or health care organizations
that provide back-up coverage and allow for more time off.
These physicians work as part of a team that coordinates
care for a population of patients; they are less independent
than solo practitioners of the past. Physicians who are
on-call deal with many patients' concerns over the phone,
and may make emergency visits to hospitals.
* Employment
Physicians (M.D.'s and D.O.'s) held about 560,000 jobs in
1996. About 7 out of 10 were in office-based practice,
including clinics and HMO's; about 2 out of 10 were employed
by hospitals. Others practiced in the Federal Government,
most in Department of Veterans Affairs hospitals and clinics
or in the Public Health Service of the Department of Health
and Human Services.
A growing number of physicians are partners or salaried
employees of group practices. Organized as clinics or as
groups of physicians, medical groups can afford expensive
medical equipment and realize other business advantages.
Also, hospitals are integrating physician practices into
health care networks that provide a continuum of care both
inside and outside of the hospital setting.
The Northeastern and Western States have the highest ratio
of physicians to population; the South Central States, 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 educational
centers.
Osteopathic physicians locate chiefly in States that have
osteopathic schools and hospitals. In 1997, about one-half
of active D.O.'s practiced in six States: Pennsylvania,
Michigan, Ohio, Florida, New Jersey, and Texas.
medical schools offer a combined undergraduate and medical
school program that lasts 6 years instead of 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 also
volunteer at local hospitals or clinics to gain practical
experience in the health professions.
The minimum educational requirement for entry to a medical
or osteopathic school is 3 years of college; most
applicants, however, have at least a bachelor's degree, and
many have advanced degrees. There are 142 medical schools in
the United States125 teach allopathic medicine and award a
Doctor of Medicine (M.D.); 17 teach osteopathic medicine and
award the Doctor of Osteopathy (D.O.). Acceptance to medical
school is very competitive. Applicants must submit
transcripts, scores from the Medical College Admission Test,
and letters of recommendation. Schools also consider
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 illness. During the last 2 years,
students work with patients under the supervision of
experienced physicians in hospitals and clinics to learn
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
residencygraduate 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 before entering a residency which may last
2 to 6 years. Physicians may benefit from residencies in
managed care settings by gaining experience with this
increasingly common type of medical practice.
All States, the District of Columbia, and U.S. territories
license physicians. To be licensed, physicians must graduate
Association of American Medical Colleges.
Table 2. Median net income of M.D.'s after expenses, 1995
All physicians $160,000
Radiology 230,000
Surgery 225,000
Anesthesiology 203,000
Obstetrics/gynecology 200,000
Pathology 185,000
Emergency medicine 170,000
General internal medicine 138,000
Pediatrics 129,000
Psychiatry 124,000
General/Family practice 124,000
SOURCE: American Medical Association
* Related Occupations
Physicians work to prevent, diagnose, and treat diseases,
disorders, and injuries. Professionals in other occupations
that require similar kinds of skill and critical judgment
include acupuncturists, audiologists, chiropractors,
dentists, nurse practitioners, optometrists, physician
assistants, podiatrists, speech pathologists, and
veterinarians.
* Sources of Additional Information
For a list of allopathic medical schools and residency
programs, as well as general information on premedical
education, financial aid, and medicine as a career, contact:
American Medical Association, 515 N. State St., Chicago, IL
60610.
Association of American Medical Colleges, Section for
Student Services, 2450 N St. NW., Washington, DC 20037-1131.
Homepage: http://www.aamc.org
For general information on osteopathic medicine as a career,
contact:
American Osteopathic Association, Department of Public
Relations, 142 East Ontario St., Chicago, IL 60611.
Homepage: http://www.am-osteo-assn.org
American Association of Colleges of Osteopathic Medicine,
5550 Friendship Blvd., Suite 310, Chevy Chase, MD
20815-7321. Homepage: http://www.aacom.org
Information on Federal scholarships and loans is available
from the directors of student financial aid at schools of
allopathic and osteopathic medicine.
Information on licensing is available from State boards of
examiners.
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