Friday, April 24, 2015

Physician Specialty and Intelligence

What makes medical students select one specialty career path over another? 

While academics and economists tell us it boils down to lifestyle and income, the Disease Management Care Blog thinks there's more to it. As its medical education progressed, the DMCB noticed that students who enjoyed the company of others pursued careers in primary care, while the not-so-sociably-inclined preferred the company of unconscious patients by entering anesthesia. Those with hand dexterity seemed to gravitate toward surgery and the brainiest, naturally, chose internal medicine.

The classic stereotype has been that students with an athletic background, especially if they had less intellectual "heft," tend to go into that field of applied human carpentry known as orthopedics. But is that true? In a small tongue-in-cheek-study published in the British Medical Journal that was designed to shed more light on the link between native ability and specialty, Dr. Subramanian and colleagues performed intelligence (IQ, as measured by the Mensa test) and strength (by testing grip with a calibrated dynanometer) on 36 orthopedists and compared them to 40 anesthesiologists - who went through the same tests.

The orthopedists beat the anesthesiologists by small and statistically significant amounts in both measures. What's more, the IQ and the grip strength, compared to the normal population, clustered around average.

The authors, who are orthopedists, naturally find the data redeeming and take comfort in their favorable specialty comparison. While the study was performed in England and excluded women (both of which have important and decidedly divergent implications for the IQ measures), the DMCB looks forward to using this study to remind its non-internist colleagues of the existence of published science that confirms their average abilities.

Last but not least, it's important to note that confidence may also play a role in specialty selection.  That's displayed by an old joke of two docs - an internist and an orthopedist - who had never seen wild ducks but decided to go duck hunting anyway.  Spying two of the apparent waterfowl headed their way, they both made successful shots.  Upon retrieving hapless birds, the internist looked at his and remarked that the bill, webbed feet and feathers certainly suggested it was a duck, but that he'd confirm it by comparing it to some pictures when he got home. The orthopedist's conclusion: "I shot it, so it must be a duck."

Image from Wikipedia

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