Thinking of switching out of anesthesia for path or family

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Hi all,
I matched last March into a great advanced program in anesthesia, but I'm getting worried now about being an anesthesiologist after 4 years and having invasive procedures thrown at me left and right. I miss my family and didn't match in their state. I'm feeling a little uneasy about my match now as intern year comes close.

My next choice would be path then family/psych. I know those fields are way too different, but I knew I 'd be happy looking at slides all day.

Any advice is greatly appreciated. How do I go about switching if I decided to go down that path? I know this might be pre-residency jitters, but any advice would be great.

Thanks.

Originally Posted by CAthunder

Hi all,
I matched last March into a great advanced program in anesthesia, but I'm getting worried now about being an anesthesiologist after 4 years and having invasive procedures thrown at me left and right. I miss my family and didn't match in their state. I'm feeling a little uneasy about my match now as intern year comes close.

My next choice would be path then family/psych. I know those fields are way too different, but I knew I 'd be happy looking at slides all day.

Any advice is greatly appreciated. How do I go about switching if I decided to go thingdown that path? I know this might be pre-residency jitters, but any advice would be great.

Thanks.

Im not sure I understand why you wanna switch out of anesthesia. "having invasive procedures thrown at you left and right?"??? not sure that is a reasonable reason. If you mentioned no control over anything you do, no control over when you come in and when you leave, practice encroachments by mid levels, marginalisation of anesthesiology by everyone including the ASA, lack of jobs in decent areas, ability to be controlled easily by hospital, and corporate entities, i can go on and on that is a good reason. Invasive procedures is not a reason..

I would not do anesthesia again ..

I agree that I do not completely understand your lack of desire to pursue anesthesiology except for being away from your family for 4 years. You seem to be in a difficult position especially with internship just around the corner.

I am not going to air all of my beliefs and grievances about MY choice in anesthesia as a medical specialty. Anecdotal experience is just that and it is not a blanket you can wrap around all practicing anesthesiologists.

You have put a lot of time and effort into becoming a physician. The sacrifice of being away from your family for 4 years of training could be worse than being close to your family during that time in exchange for a lifetime of professional unhappiness from choosing a different field. Only you know your reasons for choosing anesthesia. If path/family medicine are alternatives that you have equally thought about and considered, then it comes out to what is more important to you. If they are just current available options, I would caution jumping ship into more unknown territory.

Is the field of anesthesia changing at a quick clip? It sure is, but so is the medical field as a whole. Anesthesiologists do need to strengthen our advocacy and get involved in the change. This is not a doomsday scenario that a lot of docs here on SDN claim. It will be for the ones who are unable to adapt to the changing environment, all while the majority of us continue to practice and enjoy caring for our patients.

Originally Posted by CAthunder

Hi all,
I matched last March into a great advanced program in anesthesia, but I'm getting worried now about being an anesthesiologist after 4 years and having invasive procedures thrown at me left and right. I miss my family and didn't match in their state. I'm feeling a little uneasy about my match now as intern year comes close.

My next choice would be path then family/psych. I know those fields are way too different, but I knew I 'd be happy looking at slides all day.

Any advice is greatly appreciated. How do I go about switching if I decided to go down that path? I know this might be pre-residency jitters, but any advice would be great.

Thanks.

Great idea! Quit while your ahead....the jobs are scarce now and it'll be even worse when you're done. I'd go with Path if I were you.

Originally Posted by darby11

Im not sure I understand why you wanna switch out of anesthesia. "having invasive procedures thrown at you left and right?"??? not sure that is a reasonable reason. If you mentioned no control over anything you do, no control over when you come in and when you leave, practice encroachments by mid levels, marginalisation of anesthesiology by everyone including the ASA, lack of jobs in decent areas, ability to be controlled easily by hospital, and corporate entities, i can go on and on that is a good reason. Invasive procedures is not a reason..

I would not do anesthesia again ..

Agree with all of this

Switch to family and be marginalized by nurse practitioners, disrespected by specialists, and make half as much as anesthesiology. Good plan! Switching into dentistry is a better idea than anything you laid out.

Originally Posted by Consigliere

Great idea! Quit while your ahead....the jobs are scarce now and it'll be even worse when you're done. I'd go with Path if I were you.

When I was a med student, I was confused as to what to go into. Before med school, I figured radiology or surgery. Eventually knocked off radiology early on and was set for surgery until I discovered anesthesiology. Never had given it a moment's thought until I shadowed an anesthesiologist and then later did an M3 elective.

It's certainly a challenging specialty. I know I've caught a lot of flack (sp?) from the medicine folks and other sub-specialties when I eventually realized I wanted to do anesthesiology. I have always loved the OR. I love the different cases, the different patients. Everything is individualized and focused. Acute/intensive care (medicine!). Lots of physiology and pharmacology. Patients' lives are in YOUR hands. You're keeping the patient alive during some of their scariest moments of their lives (i.e. surgery). They are putting their trust in you. This is what made it so cool.

Procedures initially scared me, too, as a med student and even through the initial half of intern year. The latter half of intern year, I stepped up and forced myself to take part in doing procedures on my own patients. Hell, when seniors weren't signed off in medicine/ICU and the attending was super busy, it forced me to just do it. Put in that art line, draw up that ABG. Of course, I was always supervised with central lines. Things certainly have gotten easier (but I wouldn't say I'm an expert quite yet). Hell, I'll even intubate if allowed to and asked by a senior anesthesia resident while in the ICU.

Point being, just because it seems tough (and hell yeah, the thought of it kinda scares me too) shouldn't be the reason why you shy away from the specialty. It should push you to challenge yourself to be up for the task and then some. Be the best possible.

All in all, yeah, I'm scared, but it's a good type of scared, and I'm so ready to start. THIS is what got me through intern year. I can see the light at the end of the tunnel.

Originally Posted by Consigliere

Great idea! Quit while your ahead....the jobs are scarce now and it'll be even worse when you're done. I'd go with Path if I were you.

Path?! You're either joking or a huge troll.

Originally Posted by DannyB

Path?! You're either joking or a huge troll.

You obviously didn't catch the irony.

Originally Posted by Doctor4Life1769

You obviously didn't catch the irony.

I didn't catch it either.

The OP is interested in path and Consigliere hates anesthesia. What did I miss?

I'm still not sure how anyone makes it as far as matching into anesthesia and then decides that they don't want "invasive procedures" thrown at them. Seriously, is there a single residency interviewer here who hasn't heard "working with my hands/procedures" from every applicant ever?

Originally Posted by Doctor4Life1769

You obviously didn't catch the irony.

Well there were three options, he was either joking, trolling, or made one of the dumber comments I've seen on here. I gave him the benefit of the doubt when I guess I shouldn't have. I'm still shocked that someone has their head so far in the sand that they claim scarcity of jobs is a reason to switch from anesthesia to path. I see from his pot history he's very unhappy though

Originally Posted by scudrunner

I didn't catch it either.

The OP is interested in path and Consigliere hates anesthesia. What did I miss?

Path's job market is even worse. Maybe I'm giving Consig too much credit here but we all know how he likes to crap on the job market when it comes to anesthesia.

Originally Posted by Doctor4Life1769

Path's job market is even worse. Maybe I'm giving Consig too much credit here but we all know how he likes to crap on the job market when it comes to anesthesia.

Ah, didn't know that about pathology.

Originally Posted by Doctor4Life1769

When I was a med student, I was confused as to what to go into. Before med school, I figured radiology or surgery. Eventually knocked off radiology early on and was set for surgery until I discovered anesthesiology. Never had given it a moment's thought until I shadowed an anesthesiologist and then later did an M3 elective.

It's certainly a challenging specialty. I know I've caught a lot of flack (sp?) from the medicine folks and other sub-specialties when I eventually realized I wanted to do anesthesiology. I have always loved the OR. I love the different cases, the different patients. Everything is individualized and focused. Acute/intensive care (medicine!). Lots of physiology and pharmacology. Patients' lives are in YOUR hands. You're keeping the patient alive during some of their scariest moments of their lives (i.e. surgery). They are putting their trust in you. This is what made it so cool.

Procedures initially scared me, too, as a med student and even through the initial half of intern year. The latter half of intern year, I stepped up and forced myself to take part in doing procedures on my own patients. Hell, when seniors weren't signed off in medicine/ICU and the attending was super busy, it forced me to just do it. Put in that art line, draw up that ABG. Of course, I was always supervised with central lines. Things certainly have gotten easier (but I wouldn't say I'm an expert quite yet). Hell, I'll even intubate if allowed to and asked by a senior anesthesia resident while in the ICU.

Point being, just because it seems tough (and hell yeah, the thought of it kinda scares me too) shouldn't be the reason why you shy away from the specialty. It should push you to challenge yourself to be up for the task and then some. Be the best possible.

All in all, yeah, I'm scared, but it's a good type of scared, and I'm so ready to start. THIS is what got me through intern year. I can see the light at the end of the tunnel.

Originally Posted by CAthunder

I'm getting worried now about being an anesthesiologist. I miss my family and didn't match in their state. I'm feeling a little uneasy about my match now as intern year comes close.
I'd be happy looking at slides all day.
How do I go about switching if I decided to go down that path?

Like Doctor4Life1769 said, it gets better. And as Frank Herbert wrote "fear is the mind-killer."

I disagree with scrapping your plans because 4 years seems really painful and long, as your career will likely span 20-30 years after residency. Now if you'll be happy doing family/path and won't be happy doing anesthesia, then it's an easy decision, regardless of the time you'd lose.

From most of the folks I've talked to who've switched specialties, it takes a lot of conversations with people at your residency program and at the one you'd like to end up in. They tell me it helped to have support from medical school advisers. I think stating that you've realized you can't be apart from your family for four years is something most people would appreciate and understand.

<br />
<br />
Path's job market is even worse. Maybe I'm giving Consig too much credit here but we all know how he likes to crap on the job market when it comes to anesthesia.

For the life of me, I cannot understand why he just doesn't quit and get another job. He must be extremely geographically limited, or actually in possession of a good job. Residents and fellows, still wet behind the ears, get fair offers in desirable locations every year. I see it with my own eyes. Every year.
He could also mix it up and do a fellowship in something and reinvent himself in a new career. If I was that miserable, I'd have left long ago.

Cheers!

Originally Posted by Doctor4Life1769

When I was a med student, I was confused as to what to go into. Before med school, I figured radiology or surgery. Eventually knocked off radiology early on and was set for surgery until I discovered anesthesiology. Never had given it a moment's thought until I shadowed an anesthesiologist and then later did an M3 elective.

It's certainly a challenging specialty. I know I've caught a lot of flack (sp?) from the medicine folks and other sub-specialties when I eventually realized I wanted to do anesthesiology. I have always loved the OR. I love the different cases, the different patients. Everything is individualized and focused. Acute/intensive care (medicine!). Lots of physiology and pharmacology. Patients' lives are in YOUR hands. You're keeping the patient alive during some of their scariest moments of their lives (i.e. surgery). They are putting their trust in you. This is what made it so cool.

Procedures initially scared me, too, as a med student and even through the initial half of intern year. The latter half of intern year, I stepped up and forced myself to take part in doing procedures on my own patients. Hell, when seniors weren't signed off in medicine/ICU and the attending was super busy, it forced me to just do it. Put in that art line, draw up that ABG. Of course, I was always supervised with central lines. Things certainly have gotten easier (but I wouldn't say I'm an expert quite yet). Hell, I'll even intubate if allowed to and asked by a senior anesthesia resident while in the ICU.

Point being, just because it seems tough (and hell yeah, the thought of it kinda scares me too) shouldn't be the reason why you shy away from the specialty. It should push you to challenge yourself to be up for the task and then some. Be the best possible.

All in all, yeah, I'm scared, but it's a good type of scared, and I'm so ready to start. THIS is what got me through intern year. I can see the light at the end of the tunnel.

Doctor4Life and Orin,

Thanks so much for the advice. I guess I'm getting pre-residency jitters. I always hear how I won't have a life anymore during intern year and the thought of having so many invasive procedures on top of that overwhelmed me even more. After reading your posts, I feel alot better knowing that it will get better (hopefully) and that perhaps being scared should fuel me to work to my top potential.

Thanks again. Any further advice is greatly appreciated. PM my anytime.

Just to clarify, you do the invasive procedures on patients, not yourself.

Originally Posted by CAthunder

Doctor4Life and Orin,

Thanks so much for the advice. I guess I'm getting pre-residency jitters. I always hear how I won't have a life anymore during intern year and the thought of having so many invasive procedures on top of that overwhelmed me even more. After reading your posts, I feel alot better knowing that it will get better (hopefully) and that perhaps being scared should fuel me to work to my top potential.

Thanks again. Any further advice is greatly appreciated. PM my anytime.

Most people view the invasive procedures as the good part and sitting charting vitals as tedious.

Originally Posted by CAthunder

Doctor4Life and Orin,

Thanks so much for the advice. I guess I'm getting pre-residency jitters. I always hear how I won't have a life anymore during intern year and the thought of having so many invasive procedures on top of that overwhelmed me even more. After reading your posts, I feel alot better knowing that it will get better (hopefully) and that perhaps being scared should fuel me to work to my top potential.

Thanks again. Any further advice is greatly appreciated. PM my anytime.

I'm curious, when you refer to "invasive procedures" are you talking about A) your own 'invasive procedures' such as aspirating something, placing an IV, central line, arterial line, or intubating a patient, or B) your responsibility to anesthetize patients for any surgery that crosses the OR desk?

Whose invasive procedures are you worried about, yours, or the surgeon's?

Invasive procedures are usually one of the major draws to either of these fields, so I'm confused as to why you chose anesthesiology.

Regarding the jitters, learn to accept that feeling of unease because it will be there until you reach competence at the majority of tasks an anesthesiologist is responsible for. Just like everything else up to this point, you will learn how to do it in a *mostly* structured environment where it is safe for you and the patient, and you will eventually have the confidence and desire to do it on your own.

And if you don't, you'll wash out!

Originally Posted by CAthunder

Hi all,
I matched last March into a great advanced program in anesthesia, but I'm getting worried now about being an anesthesiologist after 4 years and having invasive procedures thrown at me left and right. I miss my family and didn't match in their state. I'm feeling a little uneasy about my match now as intern year comes close.

My next choice would be path then family/psych. I know those fields are way too different, but I knew I 'd be happy looking at slides all day.

Any advice is greatly appreciated. How do I go about switching if I decided to go down that path? I know this might be pre-residency jitters, but any advice would be great.

Thanks.

The fact that you have some apprehension about the invasive nature of the procedures that are performed in Anesthesia may actually be a healthy thing- perhaps it reveals your understanding of and full appreciation for the risks you (we) subject patients to everytime we place an arterial line, an epidural or deliver an induction dose of our typical agents. That IMHO is a healthy fear and already sets you apart from many cowboyish non-MD anesthesia providers who are ill equipped to manage true crises.

Anesthesia is a great, technically and intellectually fulfilling field and I am priviledged to practice/train within it daily (I'm a jr resident).

Unfortunately, it seems your mind is already made up about not pursuing it.

If you are set on Path, you may still have a chance via Resident Swap or Freida to transmit your application to programs with PGY1 openings.

Bear in mind, though, you are cutting it close as July 1 is quickly approaching.
Best of luck in the process of switching.
This is a difficult spot for anyone to be in.

Oh and don't forget to call your anesthesia residency program director to let him/her know of your decision early.

Originally Posted by doctor4life1769

when i was a med student, i was confused as to what to go into. Before med school, i figured radiology or surgery. Eventually knocked off radiology early on and was set for surgery until i discovered anesthesiology. Never had given it a moment's thought until i shadowed an anesthesiologist and then later did an m3 elective.

It's certainly a challenging specialty. I know i've caught a lot of flack (sp?) from the medicine folks and other sub-specialties when i eventually realized i wanted to do anesthesiology. I have always loved the or. I love the different cases, the different patients. Everything is individualized and focused. Acute/intensive care (medicine!). Lots of physiology and pharmacology. Patients' lives are in your hands. You're keeping the patient alive during some of their scariest moments of their lives (i.e. Surgery). They are putting their trust in you. This is what made it so cool.

Procedures initially scared me, too, as a med student and even through the initial half of intern year. The latter half of intern year, i stepped up and forced myself to take part in doing procedures on my own patients. Hell, when seniors weren't signed off in medicine/icu and the attending was super busy, it forced me to just do it. Put in that art line, draw up that abg. Of course, i was always supervised with central lines. Things certainly have gotten easier (but i wouldn't say i'm an expert quite yet). Hell, i'll even intubate if allowed to and asked by a senior anesthesia resident while in the icu.

Point being, just because it seems tough (and hell yeah, the thought of it kinda scares me too) shouldn't be the reason why you shy away from the specialty. It should push you to challenge yourself to be up for the task and then some. Be the best possible.

All in all, yeah, i'm scared, but it's a good type of scared, and i'm so ready to start. This is what got me through intern year. I can see the light at the end of the tunnel.

+1

As a CA-0 about 36 hrs or so away from finishing PGY-1 in general surgery I have to say that the procedures are somewhat like therapy or maybe like bloodletting.

The incessant pages, checking on NG tube outputs, trauma trash, sacral decubitus, diabetic feet etc. all seem to concentrate the black bile in my body. And as we all know from our humors course in medical school, an excess of black bile can cause depression, sleeplessness and irritability.

So when I do get to poke someone with something sharp whether the area be sufficiently anesthetized or not, it becomes a relief (for me). In some way, their blood loss releases the built up black bile in my system.

Without the scary invasive procedures I think I would schrivel up into a mess of black goo. Almost exactly like I did at one point during my internal medicine rotations in medical school.

Take heart soon to be intern. In short order you will take pleasure in the invasive to relieve the pain of the mundane and soul-sucking.