Gonorrhea and Chlamydia are very common sexually transmitted diseases in the United States. In fact, Chlamydia is the most commonly reported notifiable disease in the United States. Most commonly, these disease are spread by unprotected sexual intercourse. So how common are they?
According to the CDC, in 2010 there were a total of 1,307,893 cases of chlamydia reported in the United States. This accounts for 426 cases out of 100,000 population and an increase of 5.1% over the period 1990-2010. Gonorrhea came in as the second most common STD with 334,826 cases in 2012. The rate increased 4.1% since 2011 but decreased 2.9% between 2008-2012. These numbers are staggering!
These numbers may be rising in part due to the fact that we have better screening techniques to detect these diseases. At a doctor's visit, most adolescents and young adults will be recommended to have a screening exam for these diseases as long as they are agreeable to it. There are two types of testing: urine and swab. The urine test is for males and females and results are available within 1 to 2 days. The swab can be used for women when they are already having a PAP smear.
The problem is that those in their teens or twenties are either not seeing a doctor for symptoms, not being screened during routine visits, or are not taking their treatment medication. Treating these two diseases is not especially difficult as we have very effective antibiotics against them. Both the patient and their partner must be treated to prevent spread of the disease between individuals.
I think the battle we are losing is prevention. We are noticing that people are sexually active at a younger age now and with more partners. When we couple that with lack of protection or incorrect use of protection, we are headed for trouble. High schools still offer sex education, but the problem continues to grow. The responsibility is that of parents and the youth themselves. Parents must be ready to have those difficult conversations regularly as their children continue to grow. They should also ask that their children get tested and make it easy for them to do so by allowing them to speak to the doctor privately. Although privacy in STD transmitting is required by law, some parents try to stay in the room with their children when the doctor asks them to leave to discuss personal matters. This makes the child uncomfortable and may lead to the child withholding information.
We may never fully eradicate these two diseases, but we have to recognize their wildfire-like spread. Taking an active role in testing is the only chance we have to make a difference. Until we make screening for STD's as important as screening for cancers, we will continue to lose this uphill battle. Spread the word, not the disease.
Friday, July 25, 2014
Wednesday, July 23, 2014
How do you become a Doctor?
I often get asked by patients, friends, and family members - How do you become a doctor? How long do you have to go to school? I had similar questions before I entered the medical field and thought I would break down the numbers first.
1. 4 years of college. Your major actually does not matter as long as you take prerequisite courses that all medical school hopefuls take (i.e. 1 year of biology, 1 year of chemistry, 1 year of math, etc.)
2. 4 years of medical school. Everybody goes through the same general training where the first 2 years are spent in the classroom and the last 2 years are clinical with patient interaction.
3. Residency training, variable, 3-7 years. Once you finish medical school, you have to complete specific training in a residency program. These include Family Medicine, Internal Medicine, General Surgery, OBGYN, Pediatrics, etc. There are many types of residencies and you have to decide what you want to practice. Hopefully medical school gave you enough of an idea of what you like at this point.
4. Fellowship, optional, 1+ years. This is where you get to further specialize. Lets say you wanted to become a cardiologist. This would require you to first complete a 3 year residency in Internal Medicine, followed by a 3 year fellowship in Cardiology. This can get very confusing to say the least because you can specialize for years and years.
The variables are residency and fellowship, which can add up to up to 10 years. This is why most doctors will never be practicing independently until the age of 28 or 29, and some as late as 34 or 35. There you have it, the basic steps to becoming a doctor.
1. 4 years of college. Your major actually does not matter as long as you take prerequisite courses that all medical school hopefuls take (i.e. 1 year of biology, 1 year of chemistry, 1 year of math, etc.)
2. 4 years of medical school. Everybody goes through the same general training where the first 2 years are spent in the classroom and the last 2 years are clinical with patient interaction.
3. Residency training, variable, 3-7 years. Once you finish medical school, you have to complete specific training in a residency program. These include Family Medicine, Internal Medicine, General Surgery, OBGYN, Pediatrics, etc. There are many types of residencies and you have to decide what you want to practice. Hopefully medical school gave you enough of an idea of what you like at this point.
4. Fellowship, optional, 1+ years. This is where you get to further specialize. Lets say you wanted to become a cardiologist. This would require you to first complete a 3 year residency in Internal Medicine, followed by a 3 year fellowship in Cardiology. This can get very confusing to say the least because you can specialize for years and years.
The variables are residency and fellowship, which can add up to up to 10 years. This is why most doctors will never be practicing independently until the age of 28 or 29, and some as late as 34 or 35. There you have it, the basic steps to becoming a doctor.
How often do you exercise?
Most doctors recommend 30 minutes of moderate exercise 5 times per week. How often do you exercise?
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