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Anesthesiology vs. Radiology...

Discussion in 'Anesthesiology' started by auburnO5, May 1, 2012.

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  1. auburnO5

    auburnO5

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    If there is already another thread addressing this exact same subject I apologize.

    I am an MS3 right now, and I having a VERY difficult time figuring out what I want to do in life. I know I definitely want a "lifestyle" specialty - if there is such thing in medicine (and I'm most likely not competitive enough for derm). I really enjoy both radiology and anesthesiology. I read both of the residents forums quite frequently. It seems like all of the DR guys are terrified of salary cuts, and then there is the issue of CRNA's for anes.

    I guess my question is, how in the *%$& am I supposed to figure out what I want to do for the rest of my life??? Any general advice? Also, how real is the CRNA threat? Going forward I think I will be happy with a decent salary (I don't really want to dip down into the primary care doc range, but I'm not trying to make ridiculous amounts of money). I really would like a relatively stress free career. :shrug:
  2. IveGotTwins

    IveGotTwins

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    I don't think anyone on here would agree that anesthesiology is a relatively stress free career.
  3. InvisibleSphere

    InvisibleSphere

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    The two fields Are Completely different. The only way you can decide what you like is by doing an elective, and see what you like better. Honestly, I think too many people go into anesthesia because they think its going to be low stress, and later realize it can be very stressful and become very unhappy. I'm sure radiologist, and anesthesiologist, will figure out a way to more money when the cuts come. So be honest with yourself and do what you is most interesting, rewarding etc.. Good luck!
  4. PMPMD

    PMPMD 4G MD

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    yup
  5. auburnO5

    auburnO5

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    I guess I should have been more clear, I really just mean that I don't want to do surgery.
  6. doctor712

    doctor712

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  7. Magnus67

    Magnus67 Lord of Sleepytime

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    Are u serious? :eek:Besides the ability to make a high salary and being viewed as "competitive" How are RADs and Anesthesia at all similair?????

    One of my best friends from medical school is a Rad guy, our typical day is nowhere near being in the same ballpark of being similair. We are both happy in life, but these are completely diffrerent career paths. You should be able to figure this out on your own.:D

    If you are all about a lifestyle, please dont pick anesthesia.
  8. auburnO5

    auburnO5

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    Completely serious. I know the fields are completely different, why can I not like both of them? Where did I ever say they are similar?

    I'm not "all about a lifestyle," I would just prefer to have more of a life than a general surgeon.
  9. Masseter Spasm

    Masseter Spasm

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    There will be no lifestyle specialties in any field of medicine by the time you complete a residency. Do what you truly enjoy doing regardless of current financial incentives.
  10. auburnO5

    auburnO5

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    I'm all for a good dose of realism and cynicism, but the doom and gloom on the site is out of control.
  11. kazuma

    kazuma CA-3

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    It's a dose of reality that you will likely never get from professors or administrators at most money-mill/med schools. They like to tell you that things are going to be just dandy while they line their coffers with infinitely increasing tuition and fees.
  12. gasblaster

    gasblaster ASA Member

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    I think it's completely possible to like both anesthesiology and radiology. Yes they are quite different fields, in terms of content, but people have diverse interests which aren't always mutually exclusive. I have a handful of friends, myself included, who were either deciding between the two (along with others) or switched from one to the other.

    I agree with the above posters that you should definitely do a rotation at the beginning of 4th year in both if possible. That's the only way you will know for certain. Hearing/reading other people's perspective only provides a small insight. No one knows you better than yourself.
  13. pie944

    pie944 ASA Member

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    It sounds simple, but ask yourself what will you be happy doing 5 years from now, 10 years, etc? Most jobs in life are fun at first, but what will keep you happy down the line is a lot harder to figure out.

    In terms of determining what will keep you happy over the years, make an honest list of what you like and what you don't like in medicine(don't get too complicated, keep it simple), physically write it out. I think you will find an honest list gives you an honest answer.

    It isn't easy figuring out what you want to do in medical school, exposure is limited and skewed. For the majority of people there won't be a 'magical' moment that they can attribute their choice to, it's too simplistic... An orthopedic surgeon once stated in front of me when it comes to picking a field that ,"the hardest thing you need to do is separating who you like from what you like." I never forgot that.

    There are the variables that will influence your decision(money, vacation, lifestyle), but the problem is these variables can change. So if you go into anesthesia expecting $600K, but then find out at graduation you will be making $200K, will you still be happy? How much weight did that factor have on influencing your decision?

    That's why I think people should focus on how much they enjoy the day to day moments. Some people absolutely love Dermatology, but you could not pay me any amount of money to make a career out of that. Some people ask why go into Family Medicine if you are going to be underpaid compared to what you put into obtaining that career, well it makes them happy, they enjoy it.

    Just my opinion, hope it helps, you'll work it out.
  14. darby11

    darby11

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    You will never have a "normal life" in hospital based anesthesia. You do not control who, what, or when cases come to the OR and the OR operates 24/7 365. The best you can hope for is shift work or outpt surgery centers. If you want a decent lifestyle, don't go into anesthesia, especially as a doc. CRNAs have the luxury of shift work, most MDs don't
  15. JackShephard MD

    JackShephard MD

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    :confused:
  16. pretenda

    pretenda ASA Member

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    Do you like procedures or do you like analyzing procedures?
  17. EtherBunny

    EtherBunny

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    To the OP:

    Anesthesiology and radiology are very different fields. In order to make an informed decision, you need to do rotations as an M4 in both fields AND you need to spend some time with private practice docs in these specialties. Take a couple days during your vacation to shadow a couple docs in private practice.

    In terms of choosing a specialty based largely on lifestyle preferences, I think that's a mistake. The truth of the matter is that you can determine your lifestyle in just about any medical specialty, provided that you're willing to make the requisite compromises. For instance, even in a notoriously difficult field like neurosurgery, there are positions that allow for a very reasonable lifestyle (40-45 hours/week, limited call responsibilities, etc.). The catch? You don't make as much money, or you don't live in the heart of a major metropolis (Los Angeles, New York City, etc.). Every medical specialty has a wide range of career opportunities from the standpoint of lifestyle.

    Anesthesiology and radiology aren't exceptions to that rule. There are plenty of jobs in both specialties that are very intense--long hours, a lot of call, high stress, etc. There are jobs in both fields that are fairly laid-back, too. They just don't pay as much and the areas are less desirable.

    It's simple: choose a specialty that you genuinely enjoy. The lifestyle issues can be addressed later.
  18. auburnO5

    auburnO5

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    Thanks for your response. This is good advice.

    I have a hard time believing all of this, and I have worked with quite a few anesthesiologists.

    edit: I've only worked with private practice docs, I haven't done my rotation yet
  19. usnavdoc

    usnavdoc Senior Member

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    Rad...then do a fellowship in interventional neuro
  20. auburnO5

    auburnO5

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    Sold
  21. Mman

    Mman Senior Member

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    but it's very good advice. Too many people go into medical school with a glorified idea of how much money they will make and how awesome their lifestyle will be as an attending, etc. It's the wrong attitude and sets them up for disappointment later on.

    Just gotta do something you love and the rest will work itself out. Personally I find my job stressful and tiring and on some days I feel like you couldn't pay me all the money in the world to make me want to deal with some of the things I deal with. But in the end, I love what I do and I'd do the same thing if you only paid me 50K a year (although you better do something about all my loans if that's my salary).
  22. pgg

    pgg Laugh at me, will they? Moderator

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    It isn't just medicine as a whole, or CRNA encroachment, or even those stupid CMS Nazi clipboard zombies screwing with us.* Western civilization is in for a rough couple of decades. ;)





    * I **** you not, the latest CMS stunt here is that ALL electric devices to be plugged into an outlet in the hospital must be individually approved by biomed. Someone just got chastised for plugging in an iPhone charger in the OR. External speakers for MP3 players are still OK for the moment, but only if they're battery powered. Now that is "out of control" ...
  23. MTGas2B

    MTGas2B Sunny and 70

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    That's been a command level issue as long as I've been in SD. Is this out in town or at your regular gig?
  24. pgg

    pgg Laugh at me, will they? Moderator

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    This is the .civ moonlighting place ... no such silliness in the .mil day job.

    I never dreamed I'd see the day when a civilian hospital went more bonkers over clipboardy nursey garbage than the military, but they have totally gone insane with the recent CMS visit and citations. It's one thing after another ... from forced glove changes between leaving the OR and arriving in PACU, to mandatory long sleeves during sterile procedures to prevent "skin squames" from falling on the patient, to 30+ minute room turnovers because the cleaners have to let the surfaces "sit wet" for 10 or 15 minutes (don't recall exactly), to fresh masks every time you walk into a room, to busybodies picking through sharps containers to see if there are drops of glycopyrrolate left in the mostly-empty 2 mL vials, on and on and on.

    When the revolution comes, anyone associated with CMS ought to be the first against the wall. They are very bad people.
  25. PMPMD

    PMPMD 4G MD

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    :eek::confused: At least that situation allows for some natural selection to occur.
  26. MrBurns10

    MrBurns10 Excellent, Smithers Moderator Emeritus

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    You're going to get a lot of good advice on anesthesiology on here, so I'll pitch in from the radiology side of things (I'm a resident).

    I can honestly say radiology is far more difficult than I ever thought it would be. The sheer amount of knowledge that one has to learn is ridiculous, and it's rarely as simple as identifying a fracture or some gigantic mass. It's a humbling experience for sure but is also incredibly rewarding. You're the consult for the entire hospital. 99.9% of patients that walk/are wheeled through the hospital doors gets some sort of imaging study, and you can make the diagnosis or at least narrow the differential on the vast majority of them. Yeah, it's fun to make fun of "clinical correlation is recommended" (my husband, an anesthesia resident, and I do it all the time), but in reality it's much, much more than that. Now with that comes the bad...almost every patient gets an imaging study. The list of studies to get through on a daily basis (not to mention on call when you're really responsible for the entire hospital) can be overwhelming at times. The phone can ring off the hook to the point you feel like throwing it out the window...if only there were windows in the reading room. But it comes with the territory, and you gotta take the good with the bad.

    And if you enjoy doing procedures, at my institution radiologists do almost every single biopsy in the hospital. IR, MSK, neuro, body, peds, breast...there's a dedicated person in each section doing procedures daily. Is it as procedural as anesthesiology? Of course not (unless you do IR). But radiology is really what you want to make of it, and if image-guided procedures are your thing, there's plenty of room for that. And if you don't like procedures and just want to sit in a dark room all day, you totally can, too. (Side note: that is also kind of a misconception. People call and stop by the reading room all the time for help...you're not only wanted, you're needed.)

    As for reimbursement cuts, yep, they're coming. But they're coming for everyone (except maybe primary care). But imaging volume will always be high, and the technology is only growing. And being on the cutting edge is pretty freakin' cool.

    Both radiology and anesthesiology are great fields, and you can't go wrong choosing either, provided you enjoy whichever one you pick. Just do a rotation in each and see what you think. Just know that radiology as a medical student is like watching paint dry...you really have to enjoy the idea of radiology and picture yourself as the person reading the study.

    Best of luck!
  27. AndyRSC

    AndyRSC

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    Thank you for the excellent post, MrBurns. It was quite informative, and your outlook is admirable.
  28. seinfeld

    seinfeld ASA Member

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    Let me get a bit Yoda here for a second.

    The path to the dark side (an unhappy life) is creating expectations that can never be fulfilled. Money, Time, Fulfillment etc

    Find your core values, focus on them, and then be prepared to be flexible, you'll never be 100% satisfied no matter what career/job you choose but if most days you are excited to wake up a go to work you have found a life worth living

    The other day I did one of those Renal Cell Cancer cases where we did a nephrectomy, IVC thrombectomy, R atrial thrombectomy with CPB. I spent 8 hours doing a constant/massive resuscitation (me alone no CRNA or residents), reviewing TEE images. I was looking forward to the case for over a week. I went home afterword exhausted, but I still called into the ICU 2 times that night before i went to bed to see how he was doing and to provide more guidance to my NP/PAs in the ICU. Sure i would have loved to be home with my kids by 3pm but i never get that level of fulfillment when i do the outpt surgery centers and i am home by 3pm
    Last edited: May 5, 2012
  29. Mman

    Mman Senior Member

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    Fun case. There is a definitely a quiet sense of satisfaction when a potential disaster of a case comes off smoothly and your plan works to perfection.
  30. IJL

    IJL

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    I'm stuck with the same conundrum as you, OP
  31. BigMAC3

    BigMAC3

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    Have you rotated through both rads and anesthesia? I didn't find them to be at all similar.

    Do you enjoy anatomy and visual problems or physiology/pharm? Do you want pt contact or only work with other physicians? Are you ok with taking call on nights and weekends? Do you like clinching the diagnosis or would you rather manage acute issues?

    Anesthesia is more stressful than many specialties, and is a demanding job with call responsibilities. While the hours are better than surgery -- if you're choosing anesthesiology based primarily on lifestyle, I think you'd be disappointed.
  32. KLPM

    KLPM

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    I would say become a neurosurgeon.
  33. yesno

    yesno

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    I am going to start ms3 soon.. And I can choose to do rads or anesthesia as ms3 electives. But so far to answer your questions:
    Definitely physio/pharm>>>> anatomy. I tend to get A's in preclinical subjects but anatomy is my toughest subject and I do not understand why some pulmonologist who ordered chest ct would not be able to interpret it as well as a radiologist, especially if I were the radiologist.. What does a radiologist find except for "incidental findings" unrelated to the patient presentation? Definitely prefer physicians>>>patients. I am terrible in medically stressful situations. Like if someone starts screaming at me and showing weakness, I just want to get away and it will really show... I am not a sissy physically. But I could certainly see myself doing step1-type written questions while sitting at my desk, if that was what radiologist was about.
  34. Mman

    Mman Senior Member

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    I doubt the Radiologist is wondering why they get to bill for something that the pulmonologist is also going to look at themselves. Every unnecessary CXR that gets ordered is a little cash register going off in their office.

    And I'm pretty sure the reason the radiologist is reading it is that they are more experienced at doing so and are far better at noting incidental findings unrelated to the primary cause of the study being ordered. For example, when I get a CXR after putting an IJ line in somebody, I'm probably as good (or nearly so) as the radiologist at looking for a pneumothorax and seeing if the line position is correct. But I'd probably miss 95% of the incidental nodules and things they would also pick up on. The are really good at what they do.
  35. Noegrus

    Noegrus

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    I am curious that if the radiologist is looking for something very specific, then how many incidentalomas are they actually finding and how many do they miss because they are not looking for them? The gorilla in CT scan study was fairly interesting...
    http://www.bbc.co.uk/news/health-21466529
  36. yesno

    yesno

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    So how is this considered cerebral/making a diagnosis? If all you look for is some nodule or other anatomic findings, then what is the point in reading all those books on pathophysiology? And if I have lower aptitude in anatomy, I don't know that I'll be better at differentiating those nodules than any other doctor, even if I do have more experience. But I do like the idea of sitting in front of my desk.. I really like written problems of the form "what do you expect to see on ct if you have such and such PE and history and lab values?" I know that if you are good at your nerve blocks or whatever, then you are not expendable. But I don't know if reading those anatomy books would secure me a stable job in radiology. But at the same time I doubt I would be any good at anesthesia either. I wonder if it's possible to do anesthesia without having to talk to the families of critically ill patients.
  37. yesno

    yesno

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    I find it difficult to believe that someone who is not color-blind would seriously miss that. I think it is much harder to see the heart borders and pulm arteries on a normal chest xray. But in any case, I would find radiology much more interesting if with that CT scan you got a full history and lab values and were asked to explain the cause of those abnormalities beyond what the referring dr might know.
  38. DrBowtie

    DrBowtie Responsible?!?! PGY3 Moderator Emeritus

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    Spotting an abnormality on imaging is only half the job. Knowing pathology extremely well, combined with patient info and specific radiology findings to create a clinically relevant DDx is the cerebral nature of the field.

    You really need to do a rotation in both fields to decide. Its clear your idea of radiology and anesthesia is rather theoretical as well as rudimentary.
  39. MrBurns10

    MrBurns10 Excellent, Smithers Moderator Emeritus

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    Unfortunately, these are all common misconceptions about radiology, ones you really can only dispel by doing a rotation. If you like anatomy, imaging, and the diagnostic/detective process, definitely do an elective in radiology. If you only like the idea of sitting at your desk, sipping your coffee while working under stress-free conditions, radiology should not be on your list. (I'm not sure what would be...preventive care maybe?) Radiology call is easily the most stress I've had in the hospital. I remember my very first night of late body CT call I misinterpreted a duodenal perforation. Nothing bad happened in this particular case overnight but it was a terrible feeling the next morning knowing I ****ed up. When you're reading 30-70 CTs in a given night shift, sometimes with the trauma residents sitting behind you waiting for your call, and knowing that on each study you could miss something that should send (or at least encourage the surgical team to take) the patient to the OR...well, it's scary.

    Anyway, I'm not trying to compare rads to anesthesia because they're very different fields with very different forms of stress. I just wanted to point out a few (common) misconceptions about radiology. Keep an open mind during your 3rd year and hopefully you'll come across a field you can be really passionate about.

    Good luck!
  40. yesno

    yesno

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    THank you! I will try to take electives in these 2 disciplines next year.
  41. nycitygas

    nycitygas

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    Anesthesia Job market >> Radiology job market

    Something to keep in mind
    Last edited: Mar 19, 2013
  42. Mman

    Mman Senior Member

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    While anesthesiology gets encroached on by CRNAs trying to elbow us out of a job through legislation, diagnostic radiology gets encroached on by docs in India and other poorer countries via teleradiology.

    Interventional radiology seems fairly resistant, but that's also a fairly long and intensive training period.
  43. DrBowtie

    DrBowtie Responsible?!?! PGY3 Moderator Emeritus

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    Glad the outsourcing fear mongering is being perpetuated to medical students by other fields.

    Secondly IR is the same length as diagnostic with expected 1yr fellowship.
  44. Mman

    Mman Senior Member

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    "Fear mongering"? One of the hospitals that I cover outsources their radiology reads. I'm sorry you aren't yet in the real world to see that there are lots of things happening there that you don't see in academia. I also am friends with another radiologist that does his own teleradiology from home. He essentially contracts himself out on a locums basis to provide coverage for short periods of time and never leaves his house.
  45. DrBowtie

    DrBowtie Responsible?!?! PGY3 Moderator Emeritus

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    I doubt they are outsourced to India since they wouldn't get reimbursed by Medicare.

    Domestic Teleradiology exists and has been a threat, but seems to be declining in popularity.

    The biggest threat to Radiology is domestic overproduction of radiologists.
  46. MrBurns10

    MrBurns10 Excellent, Smithers Moderator Emeritus

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    Like most fields, radiology has its share of issues, declining reimbursements and increasing volume being two of the biggest. Domestic teleradiology is another because it commodifies (not sure if that's actually a word but I'll go with it) radiology. But teleradiology by docs in India is not one of them...not until Medicare reimburses for final reads in foreign countries, which I don't see ever happening.

    Also, the job market is cyclical. Trying to predict how the market will be 7-8 years after one makes the decision to go into a particular field is pointless...basing one's specialty choice on such a hypothetical even moreso.
  47. Silent Cool

    Silent Cool Member

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    Well this has been fun. Now, would someone please get to the meat of the matter and just tell me: which field is BETTER.

    Thanks in advance. :laugh:
  48. yappy

    yappy

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    I think the point is that no one can predict the future; or pick, for a diverse readership, which field is better.
    Make a decision and roll with it.
  49. BLADEMDA

    BLADEMDA SDN Gold Donor Gold Donor

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    They both suck. Anesthesiology has major issues going forward as does Radiology.
    Interventional Radiology is probably the best Choice among the lot but Pain Management doesn't look too bad either.

    Critical Care Anesthesiologists will be needed in larger numbers down the road so if you can stomach the job then you won't go hungry.

    Diagnostic Rads? General Anesthesiology? That's like asking whether you want death by hanging or a firing squad. I'd avoid either of them.
  50. Physio Doc 2 Be

    Physio Doc 2 Be Supratentorial problems

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    Sep 4, 2007
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    2,408
    Location:
    TDC
    Status:
    Resident [Any Field]
    Physician SDN 5+ Year Member
    Stomach the job? I'll be beating down the door to get in. I find this very reassuring.

    Question for you Blade (or anyone for that matter), what do you think of the trauma fellowship offered at UW?

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