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Title: Probably very straight forward
Description: Diagnostics


Armchair Elvis - February 2, 2006 07:52 AM (GMT)
In the episode Occam's Razor, House utters this little gem of snarkdom...

QUOTE
This ray of sunshine is Dr. Lisa Cuddy.  Dr. Cuddy runs this whole hospital so, unfortunately, she’s much too busy to deal with you.  I am a BORED certified diagnostician with a double specialty of infectious disease and nephrology.  I’m also the only doctor currently employed at this clinic who is here against his will.  That is true, isn’t it? But not to worry, because for most of you this job could be done by a monkey with a bottle of Motrin.  Speaking of which, if you’re particularly annoying, you may see me reach for this.  This is Vicodin.  It’s mine.  You can’t have any.  And no, I do not have a pain management problem, I have a pain problem.  But who knows?  Maybe I’m wrong.  Maybe I’m too stoned to tell.  So, who wants me? And who would rather wait for one of the other two doctors? Okay, well, I’ll be in Exam Room 1 if you change your mind.


There is obviously such thing as a Board Certified Diagnostician (House seems to not balk at adding puns to his list of snarky jokes), but my question is, what exactly do they do?
Is a certified diagnostician just a doctor like a GP? Or a physician? Someone specialised in a certain field?
This is probably something very basic either in the medical profession or in the US, so excuse me for potentially stating the obvious.

Auditrix - February 2, 2006 01:39 PM (GMT)
Diagnostics, as a formal specialty, is made-up. There is no board certification for being a "diagnostician."

All physicians diagnose, of course, and when you're talking very specifically about the art of diagnosis, that's when you'll hear terms like "diagnostics" and "the diagnostician." I could see courses in medical school titled "diagnostics" (to go with things like "pharmacology", "gross anatomy", and "The Art of Breaking Bad News.")

But as its own specialty? Nope.

runawayhouse - February 2, 2006 08:51 PM (GMT)
I think in layterms it's the specialty of I'mSmarterThanYou. :P

Armchair Elvis - February 3, 2006 11:44 AM (GMT)
:D Runawayhouse!

Thanks for your post, Aud. (and your medical knowledge).
To clarify a misunderstanding, in Australia we call a 'normal' (for lack of a better word) doctor a GP or General Practitioner. Basically the dude that you rock up to if you have a cold, or need a doctor's certificate because you threw up on the first day of your exams. In America this is known as a physician, which is where my misunderstanding arose.
In Australia a physician is a specialist in internal medicine, in other words someone who has become a doctor and specialised in this field. In Britain this strand of medicine is known as general medicine or general (internal) medicine.
I wanted to know if House was a Physician, in the antipodean sense of the word. You probably all know this, but I'll continue anyway. Yes, he is.

QUOTE
Internists can choose to focus their practice on general internal medicine, or may take additional training to "subspecialize" in one of 13 areas of internal medicine, generally organized by organ system. Cardiologists, for example, are doctors of internal medicine who subspecialize in diseases of the heart. The training an internist receives to subspecialize in a particular medical area is both broad and deep. Subspecialty training (often called a "fellowship") usually requires an additional one to three years beyond the standard three year general internal medicine residency. (Residencies come after a student has graduated from medical school.)

In the United States, there are two organizations responsible for certification of subspecialists within the field, the American Board of Internal Medicine, and the American Osteopathic Board of Internal Medicine. The following are the subspecialties recognized by the American Board of Internal Medicine[1].
Cardiology
Endocrinology
Gastroenterology
Hematology
Infectious disease
Medical oncology
Nephrology
Pulmonology
Rheumatology


Docs in America have to do three years of undergraduate study at uni before they start med. Whoa! I see what you meant in your blog about starting them young in Australia, Aud. (Love it). Most Unis that I can think of off the top of my head in Australia will start medicine basically straight out of high school. However, the University Of Sydney, Australia's oldest University, stipulates that you must do an undergraduate degree before starting medicine.
There's no Board Certification for Diagnostics as such, I mean, not one that I can find - so although diagnostics does not seem to be a certifiable branch of medicine you could stretch to believe that there is some kind of certifying board, because you can find a certifying board for just about everything else on the internet. So, it's make believe with a solid foundation of fact, I just needed to clarify a few things.
Cheers. Enjoy the read.

Auditrix - February 3, 2006 02:13 PM (GMT)
ha! I was just being flippant about starting 'em young in Australia.

In the US, the use of the word "physician" isn't as precise; surgeons sometimes get called "physicians."

QUOTE
Docs in America have to do three years of undergraduate study at uni before they start med. Whoa!


Actually, it's usually four, though a few grinds and wunderkinder might be able to complete four years of coursework in three years.

So after university, then it's four years of medical school and then a residency. The residency lasts from three to five years depending on if you've chosen to go into medicine or surgery. After that you can either go into general practice or specialize further by completing a fellowship, which lasts two to three years.

Foreman lays it all out in Detox:

QUOTE
Four years of college, four at med school, two years of residency, another four of sub-specialty training, and where do I end up?


although I would quibble that he would more likely have three years of residency and another three of subspecialty training -- in his case, neurology. But the math comes out the same: he's still talking instead of digging. :)

Armchair Elvis - February 4, 2006 04:38 AM (GMT)
Thanks Auditrix. :)
I guess if I ever have a question about the hierachy of Doctors in America, I'll send it to you...
Actually, I'll probably post it there and then answer the question myself. Oh well. B)




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