Anesthesiologists, how are you now, in 2015?

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OnePunchBiopsy

OnePunchBiopsy

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There is quite a bit of gloom and doom in this forum about the next "X" years in the future. For all the anesthesiologists here, what is your job like currently?
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Too numerous to mention but here are a few: lousy hours, night call, OB, decreasing compensation.
 
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Awesome! Brilliant! Lots of fun. But I'm in Australia where there are no CRNAs disrespecting attending anesthesiologists or worse, to my knowledge no AMCs buying out private groups across the nation, where the vast majority of surgeons regard anesthesiologists as professional colleagues rather than hired help, where anesthesiologists do their own cases basically 1:1, where lifestyle is far better for the same or similar starting salaries, etc. There are downsides since nothing is perfect, but from my perspective they're far outweighed by the upsides. :)
 
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bashwell said:
Awesome! Brilliant! Lots of fun. But I'm in Australia where there are no CRNAs disrespecting attending anesthesiologists or worse, to my knowledge no AMCs buying out private groups across the nation, where the vast majority of surgeons regard anesthesiologists as professional colleagues rather than hired help, where anesthesiologists do their own cases basically 1:1, where lifestyle is far better for the same or similar starting salaries, etc. There are downsides since nothing is perfect, but from my perspective they're far outweighed by the upsides. :)
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Glad to hear some positivity :). I live in Texas though, but have always wanted to visit the land down under.
 
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junojpeg said:
Glad to hear some positivity :). I live in Texas though, but have always wanted to visit the land down under.
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I've been to Texas a few times i.e. Houston, Dallas-Ft. Worth, San Antonio, Austin, and one or two others, and enjoyed all of them. :)
 
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Hours are up, yet money is down.

Turnover is up.
 
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@bashwell

Off hand do you know if a US trained anesthesiologist has to do a critical care fellowship to practice in Australia. I'm under the impression that anesthesia residency is 5 years in most of the world that it includes critical care and that US docs have to do a fellowship to have their training recognized.

Any truth to this?
 
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NOsaintsfan said:
@bashwell

Off hand do you know if a US trained anesthesiologist has to do a critical care fellowship to practice in Australia. I'm under the impression that anesthesia residency is 5 years in most of the world that it includes critical care and that US docs have to do a fellowship to have their training recognized.

Any truth to this?
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Sorry, I don't know for sure, and things can change with ANZCA which is the Aussie and New Zealand College of Anaesthetists (aka anesthesiologists), but there's a very helpful thread in the Australia forum here on SDN by @C.P. who is an American and did his anesthesiology residency in the U.S. but moved to Australia and now practices here. Hopefully he can answer this question. But if I remember I think he mentioned he didn't do a fellowship in anything. I believe he did have to be observed by ANZCA for a year or so to make sure he had equivalent training but after that year or so (and maybe taking or sitting their exit exams?) he is basically dual boarded to practice in the U.S. and Australia/New Zealand. By the way, during that year of being observed, you're paid essentially as a very senior resident (registrar) which is minimum well over six figures. Cost of living in Australia is generally very high compared to most places in the U.S. though.

Anesthesiology residency in Australia is 5 years though. But prior to residency you have to complete at least two years, one year as an intern and another as an RMO, before you're even allowed to apply for residency. So minimum 7 years from med school graduation to become an anesthesiologist aka anaesthetist in Australia. But you're paid a lot better than US residents during this time like getting overtime pay, etc. Normal full time work week is 38 hrs. Just to give you a rough idea, PGY1 i.e. not an anesthesiology resident/registrar but just a first year intern starting salary differs depending on which state you live in but ranges from around $65k plus overtime to I think I've heard $75 or $80k plus overtime in places like Western Australia.
 
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bashwell said:
Awesome! Brilliant! Lots of fun. But I'm in Australia where there are no CRNAs disrespecting attending anesthesiologists or worse, to my knowledge no AMCs buying out private groups across the nation, where the vast majority of surgeons regard anesthesiologists as professional colleagues rather than hired help, where anesthesiologists do their own cases basically 1:1, where lifestyle is far better for the same or similar starting salaries, etc. There are downsides since nothing is perfect, but from my perspective they're far outweighed by the upsides. :)
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Do you need a superstar pediatric anesthesiologist?
Have sevo, will travel.
 
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bashwell said:
Awesome! Brilliant! Lots of fun. But I'm in Australia where there are no CRNAs disrespecting attending anesthesiologists or worse, to my knowledge no AMCs buying out private groups across the nation, where the vast majority of surgeons regard anesthesiologists as professional colleagues rather than hired help, where anesthesiologists do their own cases basically 1:1. :)
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Granted I've only been working my first big boy job for 3 weeks but I think it's pretty bad ass and I love it. My limited experience is similar to the quote above. Non-opt out state, excellent/fair/well established/collegial 100% physician private group. Our hospitals are awesome. The surgeons are our friends/colleagues and respect our opinions. By far the majority of them are excellent and efficient. The support staff is great and treats us with respect. Excellent outdoor opportunities minutes from my house. I can't complain at all. I'm looking forward to finishing orientation at all the hospitals so I can start taking more calls and paying down my loans.
 
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kazuma said:
Granted I've only been working my first big boy job for 3 weeks but I think it's pretty bad ass and I love it. My limited experience is similar to the quote above. Non-opt out state, excellent/fair/well established/collegial 100% physician private group. Our hospitals are awesome. The surgeons are our friends/colleagues and respect our opinions. By far the majority of them are excellent and efficient. The support staff is great and treats us with respect. Excellent outdoor opportunities minutes from my house. I can't complain at all. I'm looking forward to finishing orientation at all the hospitals so I can start taking more calls and paying down my loans.
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where is this magical place
 
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junojpeg said:
There is quite a bit of gloom and doom in this forum about the next "X" years in the future. For all the anesthesiologists here, what is your job like currently?
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current job is me just living the dream. My only hope is the ride doesn't end til I'm ready to retire.
 
Psai said:
where is this magical place
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When people are young and just out of residency they usually have an overly optimistic outlook on life, they are finally paid a real salary and are allowed to do cases on their own, that explains the transitory happiness that many of them experiences early on, but it usually goes away very quickly.
 
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I'm not so disappointed with my job. I've been here 10yrs
Pluses:
Good pay that seems to be staying steady
Decent hours 30-60/wk depending on call schedule and time of year
Good cases
Good surgeons and staff
Friendly collegial environment
Live in the perfect place (for me) and enough time off to enjoy it.
Number of Vacation weeks are high. Don't ask me how many. I'll just say more than 10
Call from home
All MD GROUP and partners rock it
I even enjoy traumas but that is a personal thing
Pt population is good. Mostly healthy with the intermittent train wreck
Employed so the benefits are good (mal practice covered)

Minuses:
Would like to see bigger cases more frequently
Increasing administrative demands
OB sucks but not particularly bad here, just in general
Call sucks -some nights up all nite and some sleep all nite.
Cost of living a bit high but not San Fran high
Employed which isn't that bad but retirement opportunities to save are different.

I might be able to come up with more pluses and minuses but that's a good start.
 
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As I am applying to anesthesiology residency now and have just finished 3-4 months of anesthesiology rotation, its obvious anesthesiologists are not going anywhere. I can't count how many people wouldn't have lived through surgery if it wasn't for the anesthesiologists fixing a mid levels mistake. Sure there may be some pay cuts and the days of 700+ are over for most all, but anesthesiologists will always be paid on the higher end of all medical professionals. If they aren't well then I hope surgeons don't mind some patients not making it through an elective procedure on a routine basis as everyone boards a flight to Aussie land.
 
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I'm 1 year from partner on a 2 year track. Partners making very good money, not great. But, the lifestyle is pretty good and the environment is the friendliest I've been exposed to at this point. Better than that of med school and residency for sure. Retirement benefits for partners are very good. Some other nice perks as well. Very good relationships with the surgeons in a truly collegial environment. Some big cases, but mostly B&B. Some hearts and lung cases. Lots of vascular but not much open at all. OB is medium busy. Partners are good guys. My buy in is fair and I do not suspect any issues becoming partner. We all do it all, except for a couple that don't do hearts anymore.

I love my gig and feel very lucky to be earning what I earn. Yes, we work hard. Yes, there are lots of challenges to our career. But, it's still a very good gig. We are ACT but do our own cases every now and then. I have no plans on losing my skills and have been surprised at how easy it's been in the type of ACT model we have. We'll give breaks, and we also work with resident. Just took a new CA2 into the heart room yesterday. So, we keep up our skills and get that reward of doing as well as teaching.

There's no perfect gig. You can earn a very nice living. Keep your expenses reasonable and live within your means and you can have a very comfortable life with the ability to live well (not extravagant) and save for retirement, as well as having some nice things and going on some nice vacations. Driving a nice car etc......

I'm very happy so far. I think one's attitude is crucial in all of this. Try to keep a positive attitude and do well in your profession.
 
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Just starting 3rd year in PP world and have no complaints. Love my job. Great hours. Great case mix. Some days doing sick hearts and heinous ASA IV cases. Some days doing low stress ortho and OB. ACT model with lots of procedures and great relationship w staff. I'm incredibly happy w my current work/pay/vaca mix and I'm not even a partner yet (one more year). Not all doom and gloom. 95% of time I love my job.
 
Psai said:
where is this magical place
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Looks like a few folks have also found a magical place. I don't think my experience is exceedingly rare. All of my buddies have had similar experiences, except for one who was worked like a dog by an AMC but fortunately he left and found his own magical place. :clap:
 
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How are you guys finding these positions? Is it residency alumni people, through the ASA annual meeting, cold calling..?
 
secants said:
How are you guys finding these positions? Is it residency alumni people, through the ASA annual meeting, cold calling..?
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Alumni/people I trained with. Friends from med school or undergrad are also good resources.
 
Anyone willing to PM me the following: Geographic region, hours/week, type of caseload, annual salary?
 
secants said:
How are you guys finding these positions? Is it residency alumni people, through the ASA annual meeting, cold calling..?
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I swooped in on a hospital that had just let its entire anesthesia dept sort of. They actually gave the hospital an ultimatum which didn't work out for them and they walked. The hospital used locums for about a year before I got there. They were so ready for someone who knew what they were doing to take over that they threw it in my lap. Funny thing is, I had no clue what I was doing. I just knew what I wanted in a group and made it happen. 10+yrs later I'm at 12 anesthesiologist (no nurses) and I have actually hired two members of the old group back. They think it is the best job they have ever had now. Probably due to the fact that they didn't know how good they had it back then. It is much better here now but I can't say they had a bad deal either.
I found out about the opportunity from an attending in residency that knew I wanted to live here and he called and told me of the collapse. I swooped in.
 
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Now for the real trick. How did I manage to keep this good thing going?
I surrounded myself with some very talented and smart individuals.
Everyone has something to offer.
I'm probably the least knowledgeable person in this group when it comes to issues outside of the OR but I do know how to assimilate all the data. I just sit back and tap into everyone's specific talents and knowledge.
 
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I enjoy my gig. Came into a situation somewhat like Noy but a few years into it. We had some turnover but now 5 years in and we are on cruise control. The big thing for me was learning to keep my head down low and collect the dough. You can spend your life being pissed about this or that worrying about what might happen or you can say f uck it and realize there's just shi t you can't control. Ever since I came to that conclusion I have to admit things have only gotten better. I feel like Peter from Office Space . Fact is I make a more money than I can spend - but that's mainly because I live below my means. Have time with my kids and a good marriage. Sure I wish I paid less in taxes and for some reason I loathe OB. Hate everything about it. But can't win them all. Just a little different perspective from the chronic negativity.
 
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I'm very happy with my job. Average pay, low hours, no stress, nice work environment, easy calls though probably more frequent than most would want. OB is sometimes annoying but comes with the job. My colleagues and I get along, we divide the work/schedule evenly, we don't dump on each other or call in sick and ask others to cover for us, and we're all relatively young and flexible despite having kids/family.

Sure more money, benefits, and vacation would be nice. But I don't live in BFE and won't ever. I don't know what it's like to make $600-750k, so ignorance will have to be bliss.

I don't live to work. Work is a job, like any non-doctor job normal people have. It pays the bills, doesn't define my life or who I am, and lets me live well enough.
 
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Question, has anesthesiology gotten to the point where you basically have to do a fellowship like in radiology and pathology? All specialties for introverts-rads, path, anes seems to be getting hit with horrible job markets.
 
olivarynucleus said:
Question, has anesthesiology gotten to the point where you basically have to do a fellowship like in radiology and pathology? All specialties for introverts-rads, path, anes seems to be getting hit with horrible job markets.
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No you don't need a fellowship.
While it may not be as easy to find a great job as it was 10 years ago, they are still there if you go looking. I see people getting into the tightest markets all the time. Be better than average, work hard so you have good LORs, work your contacts and you should be fine.
If you don't know a single unemployed anesthesiologist and can get another job any time you want (with a clean record), I don't think you can really call the job market horrible.
 
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Honestly the best way to find a job is to be an outstanding resident. Here is the secret. The most important person to impress is not the attending its your upper level resident. When the time comes just look where your upper level residents went and give them a call. If you are real good they will call you when their group has job opening.

BTW my definition of "good" is someone who 1) I'd want to hang out with in the office for the rest of my career. 2) I have no doubt is hard working 3) I trust their clinical judgement and overall life management skills

In last two years in PP I've gotten a number of calls from former lower level residents. My enthusiasm about presenting their cv to the group is 100% dependent on my experience w them when I worked w them in residency.

In summary. Be a normal person and a good resident and you will find a good job.
 
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Stillwater45 said:
Honestly the best way to find a job is to be an outstanding resident. Here is the secret. The most important person to impress is not the attending its your upper level resident. When the time comes just look where your upper level residents went and give them a call. If you are real good they will call you when their group has job opening.

BTW my definition of "good" is someone who 1) I'd want to hang out with in the office for the rest of my career. 2) I have no doubt is hard working 3) I trust their clinical judgement and overall life management skills

In last two years in PP I've gotten a number of calls from former lower level residents. My enthusiasm about presenting their cv to the group is 100% dependent on my experience w them when I worked w them in residency.

In summary. Be a normal person and a good resident and you will find a good job.
Click to expand...

Agree. Would change the last line to maximizing your chances of finding a good job.
 
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Stillwater45 said:
Honestly the best way to find a job is to be an outstanding resident. Here is the secret. The most important person to impress is not the attending its your upper level resident. When the time comes just look where your upper level residents went and give them a call. If you are real good they will call you when their group has job opening.

BTW my definition of "good" is someone who 1) I'd want to hang out with in the office for the rest of my career. 2) I have no doubt is hard working 3) I trust their clinical judgement and overall life management skills

In last two years in PP I've gotten a number of calls from former lower level residents. My enthusiasm about presenting their cv to the group is 100% dependent on my experience w them when I worked w them in residency.

In summary. Be a normal person and a good resident and you will find a good job.
Click to expand...


Can be a lot of racial and sexual bias here, what if you just didn't click with someone?
 
olivarynucleus said:
Can be a lot of racial and sexual bias here, what if you just didn't click with someone?
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If someone didn't get along with you as a resident, it's unlikely they are going to be interested in giving you the keys to their kingdom and make you a partner. There are lots of residents and fellows that want to stay on and work with us, but we don't really want them. Not because they don't have potential or can't do the job, but because they probably wouldn't be good partners for one or more reasons. That's the first question I ask myself at these faculty and fellow recruitment meetings, do I want to work with this person. As long as we have the luxury of many more applicants than openings, we can continue to be very selective.
We have someone now that I hope every day will quit. They are miserable 24/7 and it is a drain to have to deal with them, listen to them in the lounge, etc. They're competent, show up on time, and do what they're asked, so they'll never get fired.
 
IlDestriero said:
If someone didn't get along with you as a resident, it's unlikely they are going to be interested in giving you the keys to their kingdom and make you a partner. There are lots of residents and fellows that want to stay on and work with us, but we don't really want them. Not because they don't have potential or can't do the job, but because they probably wouldn't be good partners for one or more reasons. That's the first question I ask myself at these faculty and fellow recruitment meetings, do I want to work with this person. As long as we have the luxury of many more applicants than openings, we can continue to be very selective.
We have someone now that I hope every day will quit. They are miserable 24/7 and it is a drain to have to deal with them, listen to them in the lounge, etc. They're competent, show up on time, and do what they're asked, so they'll never get fired.
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Shouldn't that be all that matters? I feel like after residency, so much of your employment potential depends on how well you fit into the old white guys club, and that can be hard for minorities to do.
 
olivarynucleus said:
Shouldn't that be all that matters? I feel like after residency, so much of your employment potential depends on how well you fit into the old white guys club, and that can be hard for minorities to do.
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Yes, it does matter, it matters a lot. This has nothing to do with being in the old white guys club. There's more to any job than just showing up to work and being competent. Take the appliance guy that came over this week. My wife thought he was an absolute creep and didn't want him coming back especially when I'm not home. He gave me kind of an Asperger vibe. The warranty company called and asked my wife some questions and they also asked how the appliance guy was. She told them he was a creep and she felt uncomfortable with him in the home and wondered if they could send someone else out when the parts come in. As it turns out, they agreed that he's a creep and they've tried to talk to him about it, but he's one of the guys in town and one of the only ones who knows how to fix some of our appliances besides a supervisor. Unlike anesthesiology, there's apparently not a glut of appliance repair people out there so he's coming back in a few weeks to finish the repairs. You can't get away with that in our field. If your're not personable and get along well with the group (which despite your feelings, is usually made up of all types of races, ages, and sexes including my group) then you're not going to get a job in the first place or you'll eventually leave or be asked to leave. Groups need someone who shares the same values and represent the group well when working with patients, surgeons, support staff and administration. Everyone needs to be on the same page.
 
Stillwater45 said:
Honestly the best way to find a job is to be an outstanding resident. Here is the secret. The most important person to impress is not the attending its your upper level resident. When the time comes just look where your upper level residents went and give them a call. If you are real good they will call you when their group has job opening.

BTW my definition of "good" is someone who 1) I'd want to hang out with in the office for the rest of my career. 2) I have no doubt is hard working 3) I trust their clinical judgement and overall life management skills

In last two years in PP I've gotten a number of calls from former lower level residents. My enthusiasm about presenting their cv to the group is 100% dependent on my experience w them when I worked w them in residency.

In summary. Be a normal person and a good resident and you will find a good job.
Click to expand...

Exactly. That's actually how I got my job. Unfortunately, many residents (at least at my program) didn't get this.
 
olivarynucleus said:
Shouldn't that be all that matters? I feel like after residency, so much of your employment potential depends on how well you fit into the old white guys club, and that can be hard for minorities to do.
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No. That's the purpose of the interview, and it definitely goes both ways.
If you come off as arrogant, entitled, weird, etc. why would I want you as my partner, or even as a fellow for a year? There are a lot of odd people out there in medicine. If there are closet racists voting down minorities or women, citing minor issues as deciding factors, etc. I'm not sure you can do much about that. We have a pretty fair system for employment and fellowship selection. But ultimately the leadership makes the final ranking based on our recommendations.
One exception would be for research people, we seem more tolerant of quirkiness if your research potential is high.
 
kazuma said:
Granted I've only been working my first big boy job for 3 weeks but I think it's pretty bad ass and I love it. My limited experience is similar to the quote above. Non-opt out state, excellent/fair/well established/collegial 100% physician private group. Our hospitals are awesome. The surgeons are our friends/colleagues and respect our opinions. By far the majority of them are excellent and efficient. The support staff is great and treats us with respect. Excellent outdoor opportunities minutes from my house. I can't complain at all. I'm looking forward to finishing orientation at all the hospitals so I can start taking more calls and paying down my loans.
Click to expand...

Sounds like a great gig...! :rolleyes:
 
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