MICU

So today I met with Dr. Thomas Kalb, a Pulmonology/Critical Care physician who works at Mount Sinai's Medical ICU. I didn't get a chance to shadow him because he had some family matters to take care of, it was great to get a chance to talk to him for a while. He was a really nice guy to talk to, and was really interested in hearing about what I want to do and telling me about pulmonology. He thought my decision to do the MPH before medical school was a great idea, and it would be very beneficial during the learning process in medical school. He also really supported my interests in global health, and gave me some advice as far as what I can do with that. He said that in general, critical care is a technology-dependant field, and is really not relevant to situations in the developing world. If I wanted to have skills that could be used in other parts of the world, I should either look into general surgery or ID. Those are the two fields, he said, that have the most in common with global health work. Not to say that pulmonology is not important, but there is only a limited amount of work that I would be able to accomplish with it. I thought that what he said held a lot of truth-- and I think this is where my interest in global health comes into conflict with my desire to be grounded in one place and be financially stable. I genuinely think that is is possible to do both, but I'm not sure if I have found out the right way to do that yet. Still Dr. Kalb was extremely nice to me, and offered me a chance to round with him after his teaching duties are over for the year, some time in early June. I'm not sure how I'll feel by that point, but I think I'll take him up on that offer.

After thinking about what he had to say, I don't think I would count pulmonology out, but it certainly has moved a little further down my list. Walking through the ward on my way out made me realize that all the patients in the MICU are generally elderly, and are all attached to a machine of some sort. It was remarkably quiet on the floor, and there was just this sense of keeping people alive using machines.

The Belize experience has made me think a little more about ER, because that seems to be a field that be highly involved with global health (at leave three or four of the physicians coming with us are ER docs), has reasonable hours and lifestyle (on a shift, so no phone calls in the middle of the night), is compensated quite well (avg. is $200,000) and has only a 3 year residency that isn't horribly competitive (according to this website, it's middle of the pack: a relative competativeness rating of 0.84, as opposed to derm which is 1.26 and medicine which is 0.53). I'm going to try to shadow an ER doc at Elmhurst sometime in the near future, as soon as I get a hold of him.