Future anesthesia job market ?

[bronx43]

Ortho is just one example. Other examples include ENT, Urology, neurosurgery, Retina, hand surgery, etc. All of which will fare better than anesthesia.

The fact is CMS does not value anesthesia services and the reimbursement from the government reflects it. If you think any new system will alter this situation you are misguided.

Single payer system will straight up eliminate the parity that you speak of. Simply look at every other country in the world. Anesthesia's problem is that the midlevel threat is more real than it is for any other field.

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[BLADEMDA]

Single payer system will straight up eliminate the parity that you speak of. Simply look at every other country in the world. Anesthesia's problem is that the midlevel threat is more real than it is for any other field.

Again, I disagree with you. Anesthesia is very poorly reimbursed in some countries and when you factor in the CRNA issue I expect anesthesiology to be marginalized by a single payer system. CMS will use its current reimbursement levels to decide on "worth" for each Physician. Naturally, Family Doctors will be tweaked upwards while specialists are tweaked downwards. So, where does this leave Anesthesiology? Most likely at current CMS reimbursement levels which would be at the same level as Family practice in a single payer system.

 

[BLADEMDA]

What about for an average student though, those aren't exactly options

Agree. For an average student the options are limited to Family Practice, Pediatrics, IM, IM/Subspecialty, Anesthesiology, General Surgery and perhaps Neurology.
Perhaps, IM with a subspecialty is the best option?

Honestly, Med Students are fantastic at figuring out which specialties they have an excellent probability of matching into. So, make the list and pick one.

 

[sleepallday]

Way to much speculation in this thread. What I see is that anesthesiologists are still some of the higher earners in medicine. You have to remember, most surgeons do not operate everyday. We, on the other hand, are in the OR every single day. We may not make the same case by case as most surgeons, but we more than make up for it on sheer volume of cases. The key is to find a group with a "eat what you kill" model at a busy place.

 

[bronx43]

Again, I disagree with you. Anesthesia is very poorly reimbursed in some countries and when you factor in the CRNA issue I expect anesthesiology to be marginalized by a single payer system. CMS will use its current reimbursement levels to decide on "worth" for each Physician. Naturally, Family Doctors will be tweaked upwards while specialists are tweaked downwards. So, where does this leave Anesthesiology? Most likely at current CMS reimbursement levels which would be at the same level as Family practice in a single payer system.

Actually, in most single payer systems including the UK, pay grades are broken down to GP and medical consultant (specialist). There is small to moderate discrepancy between GP and consultant pay and even smaller variation in pay between various consultants. A neurologist would not make much less than an orthopedic surgeon or ENT. This is the rule, not the exception across the world.
I am not sure how anesthesia is like, so I will refrain from making any assumptions.

 

[bronx43]

Agree. For an average student the options are limited to Family Practice, Pediatrics, IM, IM/Subspecialty, Anesthesiology, General Surgery and perhaps Neurology.
Perhaps, IM with a subspecialty is the best option?

Honestly, Med Students are fantastic at figuring out which specialties they have an excellent probability of matching into. So, make the list and pick one.

Agree. I would go with IM and then specialize if I am an average medical student. You just have to make sure you get into an academic residency if you want to land the competitive specialties. If I was an elite medical student, I would go derm or plastics. In my opinion, I would rather do an IM subspecialty over prematurely aging myself by 5-10 years by suffering through a rough surgical residency and career.

 

[MaximusD]

Agree. I would go with IM and then specialize if I am an average medical student. You just have to make sure you get into an academic residency if you want to land the competitive specialties. If I was an elite medical student, I would go derm or plastics. In my opinion, I would rather do an IM subspecialty over prematurely aging myself by 5-10 years by suffering through a rough surgical residency and career.

OK. Have fun rounding and dealing with dispositions to random SNF's for three years of your existence for the possibility that you *may* get a medical subspecialty...

 

[bronx43]

OK. Have fun rounding and dealing with dispositions to random SNF's for three years of your existence for the possibility that you *may* get a medical subspecialty...

Rounding's fine. I only deal with SNFs and crappy dispos for 4-5 months a year. And by deal with I mean I have interns and case managers to do the dirty work. Like I said, academic center or bust. If you can't land the subspecialty of your choice coming from a decent academic center, you probably shouldn't be a specialist in the first place.

 

[msmith83]

The thing about IM subspecialties is that in regards to the ones that make great money, as far as I know there's really only two, GI and Cardio both of which are extremely competitive. Not to mention with GI you have to deal with.... what like at least 25% of your patients having purely psychosomatic issues?

 

[deleted171991]

Actually, in most single payer systems including the UK, pay grades are broken down to GP and medical consultant (specialist). There is small to moderate discrepancy between GP and consultant pay and even smaller variation in pay between various consultants. A neurologist would not make much less than an orthopedic surgeon or ENT. This is the rule, not the exception across the world.
I am not sure how anesthesia is like, so I will refrain from making any assumptions.

I would be very careful before making generalizations.

In many European countries, specialists make 30-40-140% more than GPs. Please see chapter 6 here. In single payer systems, usually there is a difference in hourly pay between specialties based on the years of training and the intensity of work.

The "success" of European systems is what leads many of their local talents to either emmigrate to other countries, or not go to medical school at all.

 

[BLADEMDA]

Single payer system will straight up eliminate the parity that you speak of. Simply look at every other country in the world. Anesthesia's problem is that the midlevel threat is more real than it is for any other field.

What does the average Anesthesiologist in Germany earn per year? Hint: Not much

I am not speculating on a single payer system but rather extrapolating current CMS rates to all patients. This would leave Anesthesiology near Family practice in terms of income. Naturally, you are speculating on an entirely new system based on governmental employee model rather than a Canadian style healthcare system.

As for "eat what you kill" that is a fine model but also remember to include payer mix into the equation.

For example, "eat what you kill" at a surgicenter which doesn't accept medicare/Medicaid would result in a far higher income than working TWICE As hard at a job which was 80% CMS.

Anesthesia is NOT valued as a service by the US govt unlike Ortho, Neurosurgery, Retina, Oncology, GI, etc. I fail to see why a newly elected Clinton administration would suddenly value anesthesia services any higher than current CMS rates. On the contrary, the govt. will likely reduce reimbursement even further which means the more CMS you get the more likely your income falls to Family practice levels.

There are reasons the most successful anesthesia groups in the country have sold to AMCs and I'm trying to make some of them clear to you.

 

[step213]

Rounding's fine. I only deal with SNFs and crappy dispos for 4-5 months a year. And by deal with I mean I have interns and case managers to do the dirty work. Like I said, academic center or bust. If you can't land the subspecialty of your choice coming from a decent academic center, you probably shouldn't be a specialist in the first place.

Just sharing the perspective of a student who did some research before deciding to go into anesthesia with plans to do CCM (for honesty i'm actually doing the combined program IM/Anesth but I have no plans to do a med subspecialty), to say why i chose anesth even in these uncertain times.

I hear a lot about doing med -> sub specialty for the "average" medical student. But in terms of career outlook - only GI seems to be a good deal, and the "average" medical student can have a very hard time landing a GI spot as it has very little spots and is the most competitive of the subspec, and if you don't land a spot it means you are stuck in IM.

For students who really fell in love with anesthesia or anesthesia/CCM (myself), even after researching other specialties I still think besides GI, there aren't very much other "great" options. Medicine sub specialties aren't that great anymore. I tried to like derm - absolutely hated it in terms of acuity/clinic/feel its all pattern recognition. Surgical sub specialties - I would rather do 3 years as a med intern then 1 as a surg intern... and even then I would have been miserable in residency and miserable as an attending.

Cardiology? They are even more fearful of their future then people on this board:
http://forums.studentdoctor.net/threads/future-of-cardiology.1059691/
http://forums.studentdoctor.net/threads/save-cardiology-sos-call.1056774/

Heme Onc: want to break 300k? "Yes. Not pleasant but do-able."..."you're going to be seeing 30+ patients a day to pull down that cash"
"I am a third year heme/onc fellow who lives in a major city in the US. It definitely has become more difficult to find a job in hematology/oncology. A lot of practices are not hiring because of the uncertainity of Obama care. Everyone is panicking a little and groups are being bought left and right."
http://forums.studentdoctor.net/threads/hem-onc-lifestyle-salary-satisfaction.800145/

Neph, ID, Rheum, Endo... i don't think i need to explain these.

EM? This was my prior career - used to be an ER nurse then did some mid level management for a couple of years at a 45+ bed ED. They have as bad or worst danger of mid levels and with the enlargment of class size I predict in about 10 years their job market will be saturated. The only reason they have a good job market now is because of the relatively new board cert. There was an article from awhile ago about an EM department that kicked out their physicians and had just NP's running it the department.... and as stated before i don't really love clinic, and EM is ... well 80% urgent care clinic.

Neurology? Nope

Peds? definitely not same for FM.

Rads? I tried to like this specialty as well as I think I would enjoy IR, but the job market for rads is horrible with reimbursement declining. I also found that after reading 2-3 studies i started feeling sleepy in the reading room...http://forums.studentdoctor.net/threads/job-market.924768/

So that brought me back to Anesth which is what i actually fell in love with in the first place. I understand these are uncertain times, but it seems the same for all the specialties I would truly consider. Edit: I'm not going to lie, I REALLY wish I had a surgical mindset or at least could tolerate it better- then I would have went into ortho or uro.

 

[BLADEMDA]

Just sharing the perspective of a student who did some research before deciding to go into anesthesia with plans to do CCM (for honesty i'm actually doing the combined program IM/Anesth but I have no plans to do a med subspecialty), to say why i chose anesth even in these uncertain times.

I hear a lot about doing med -> sub specialty for the "average" medical student. But in terms of career outlook - only GI seems to be a good deal, and the "average" medical student can have a very hard time landing a GI spot as it has very little spots and is the most competitive of the subspec, and if you don't land a spot it means you are stuck in IM.

For students who really fell in love with anesthesia or anesthesia/CCM (myself), even after researching other specialties I still think besides GI, there aren't very much other "great" options. Medicine sub specialties aren't that great anymore. I tried to like derm - absolutely hated it in terms of acuity/clinic/feel its all pattern recognition. Surgical sub specialties - I would rather do 3 years as a med intern then 1 as a surg intern... and even then I would have been miserable in residency and miserable as an attending.

Cardiology? They are even more fearful of their future then people on this board:
http://forums.studentdoctor.net/threads/future-of-cardiology.1059691/
http://forums.studentdoctor.net/threads/save-cardiology-sos-call.1056774/

Heme Onc: want to break 300k? "Yes. Not pleasant but do-able."..."you're going to be seeing 30+ patients a day to pull down that cash"
"I am a third year heme/onc fellow who lives in a major city in the US. It definitely has become more difficult to find a job in hematology/oncology. A lot of practices are not hiring because of the uncertainity of Obama care. Everyone is panicking a little and groups are being bought left and right."
http://forums.studentdoctor.net/threads/hem-onc-lifestyle-salary-satisfaction.800145/

Neph, ID, Rheum, Endo... i don't think i need to explain these.

EM? This was my prior career - used to be an ER nurse then did some mid level management for a couple of years at a 45+ bed ED. They have as bad or worst danger of mid levels and with the enlargment of class size I predict in about 10 years their job market will be saturated. The only reason they have a good job market now is because of the relatively new board cert. There was an article from awhile ago about an EM department that kicked out their physicians and had just NP's running it the department.... and as stated before i don't really love clinic, and EM is ... well 80% urgent care clinic.

Neurology? Nope

Peds? definitely not same for FM.

Rads? I tried to like this specialty as well as I think I would enjoy IR, but the job market for rads is horrible with reimbursement declining. I also found that after reading 2-3 studies i started feeling sleepy in the reading room...http://forums.studentdoctor.net/threads/job-market.924768/

So that brought me back to Anesth which is what i actually fell in love with in the first place. I understand these are uncertain times, but it seems the same for all the specialties I would truly consider. Edit: I'm not going to lie, I REALLY wish I had a surgical mindset or at least could tolerate it better- then I would have went into ortho or uro.

The best post by a student I have read in months. I'm glad to see you did the legwork before picking a specialty. You seem to be well grounded and realistic in your expectations. As I have posted many times before the glass is still half full and maybe 3/4 full for someone willing to do IM/Anesthesia/CCM then land a solid academic gig.

I think in these uncertain times that an average med student willing to do extra time as a Resident/Fellow will have a huge advantage over those seeking the quick road to success.

IM/Anesthesia/CCM= 6 years

 

[aneftp]

What??? Au contraire, mon ami.

AFAIK, the first Obamacare-type healthcare reform was Hillary's pet project during the Clinton administration. It was nicknamed "Hillarycare".

In theory working single payer is better than working for AMC.

We all seen the how this all plays.

American public wants to keep their private system access but pay govt insurance rates. Something has got to give.

Again, I disagree with you. Anesthesia is very poorly reimbursed in some countries and when you factor in the CRNA issue I expect anesthesiology to be marginalized by a single payer system. CMS will use its current reimbursement levels to decide on "worth" for each Physician. Naturally, Family Doctors will be tweaked upwards while specialists are tweaked downwards. So, where does this leave Anesthesiology? Most likely at current CMS reimbursement levels which would be at the same level as Family practice in a single payer system.

People will just work less. Work 4-5 days a week. No incentive to take call or extremely very little call.

Just look at the VA system has example 101 with single payer.

I am fine making $200k and working 40 hours a week and not giving a crap about fast turnover time and canceling cases left and right.

Welcome to being a govt worker.

 

[msmith83]

What is the benefit of doing a IM w/ Anesthesia? Just curious as I am interested in both

 

[step213]

What is the benefit of doing a IM w/ Anesthesia? Just curious as I am interested in both

I liked it for the ccm aspect but in general it just gives a lot of options for only 1 year extra of training - that and some of the older academic intensivist that i am in awe of ie anesthesia chair of MGH, anesthesia chair of Stanford and more are also double boarded. People who I talked to who were double boarded before I decided to do it have said their IM background gives a more rounded perspective to their practice of medicine in the specialty of anesthesia and CCM.

Benefits off the top of my head:
1. the most obvious one is CCM (a UCSD combined resident who was switched in also said CT as well? never thought of that before tho). You can easily sell yourself across the spectrum of CCM from the surgical to the medical side.
2. upper hand in academic medicine jobs. (also an interest of mine).
3. directing perioperative care/management of the surgical patient (IE the whole surgical home push by the ASA), director of a preoperative testing clinic.
4. administrative roles (one foot on the wards, one foot in the OR).
5. more job options in PP: pulm groups who run an ICU won't be as hesitant at hiring you as an intensivist as they understand your IM training.
6. expanding scope of care in a pain practice (not my cup of tea but for some it might be).
7. option to do an IM fellowship if for some scenario down the road it is worth it/useful.

There are more but in general for the right applicant I have been led to believe that it is a great way to be part of a "niche" that is relatively small but can be desirable and applicable in a variety of clinical settings.

 

[msmith83]

I liked it for the ccm aspect but in general it just gives a lot of options for only 1 year extra of training - that and some of the older academic intensivist that i am in awe of ie anesthesia chair of MGH, anesthesia chair of Stanford and more are also double boarded. People who I talked to who were double boarded before I decided to do it have said their IM background gives a more rounded perspective to their practice of medicine in the specialty of anesthesia and CCM.

Benefits off the top of my head:
1. the most obvious one is CCM (a UCSD combined resident who was switched in also said CT as well? never thought of that before tho). You can easily sell yourself across the spectrum of CCM from the surgical to the medical side.
2. upper hand in academic medicine jobs. (also an interest of mine).
3. directing perioperative care/management of the surgical patient (IE the whole surgical home push by the ASA), director of a preoperative testing clinic.
4. administrative roles (one foot on the wards, one foot in the OR).
5. more job options in PP: pulm groups who run an ICU won't be as hesitant at hiring you as an intensivist as they understand your IM training.
6. expanding scope of care in a pain practice (not my cup of tea but for some it might be).
7. option to do an IM fellowship if for some scenario down the road it is worth it/useful.

There are more but in general for the right applicant I have been led to believe that it is a great way to be part of a "niche" that is relatively small but can be desirable and applicable in a variety of clinical settings.

Thanks for the input, thats something I might end up considering. Although if I did it I would most likely be doing the residencies individually as there appears to be only 4 programs in the country with a combined program.

I think it would be a pretty cool gig to do a general IM practice along with pain management, though that would be 7 years total

 

[BLADEMDA]

Thanks for the input, thats something I might end up considering. Although if I did it I would most likely be doing the residencies individually as there appears to be only 4 programs in the country with a combined program.

I think it would be a pretty cool gig to do a general IM practice along with pain management, though that would be 7 years total

Combined IM/Anesthesia saves you a full year. With that year you can do Pain or CCM. For those who don't want IM/Anesthesia take a look at Anesthesia/CCM/Cardiac.

Too bad our specialty doesn't offer Anesthesia/CCM/Cards for a total of 7 years. That would be quite a powerful combo in clinical practice. Anyway, Step213 did the home work before picking a specialty and that makes his/her decision an informed one.

 

[aneftp]

What does the average Anesthesiologist in Germany earn per year? Hint: Not much

I am not speculating on a single payer system but rather extrapolating current CMS rates to all patients. This would leave Anesthesiology near Family practice in terms of income. Naturally, you are speculating on an entirely new system based on governmental employee model rather than a Canadian style healthcare system.

As for "eat what you kill" that is a fine model but also remember to include payer mix into the equation.

For example, "eat what you kill" at a surgicenter which doesn't accept medicare/Medicaid would result in a far higher income than working TWICE As hard at a job which was 80% CMS.

Anesthesia is NOT valued as a service by the US govt unlike Ortho, Neurosurgery, Retina, Oncology, GI, etc. I fail to see why a newly elected Clinton administration would suddenly value anesthesia services any higher than current CMS rates. On the contrary, the govt. will likely reduce reimbursement even further which means the more CMS you get the more likely your income falls to Family practice levels.

There are reasons the most successful anesthesia groups in the country have sold to AMCs and I'm trying to make some of them clear to you.

U mean the JLR partners taking a 2.6 million buyout per partner that's really an advanced payment? $600k to remain in the "new group" run by investors?

 

[secants]

Combined IM/Anesthesia saves you a full year. With that year you can do Pain or CCM. For those who don't want IM/Anesthesia take a look at Anesthesia/CCM/Cardiac.

Too bad our specialty doesn't offer Anesthesia/CCM/Cards for a total of 7 years. That would be quite a powerful combo in clinical practice. Anyway, Step213 did the home work before picking a specialty and that makes his/her decision an informed one.

What about Anesthesia/CCM/Pain? I feel pain and CCM go hand in hand and allows you to essentially have your choice of practice in either OR, office or ICU.

 

[Yo GabbaPentin]

What I have never understood is why the private insurers don't follow Medicare reimbursement rates. The second they decide to do that or even go Medicare plus 10%(as they do for a lot of specialties), then the anesthesia party is officially over. Then the CRNAs will start being paid as RNs and docs will be paid like current CRNAs.

But if anesthesia is what you like, then who the f$&k cares? Yeah it does suck not to be able to retire at 50-55, be such is life. It beats looking at moles all day or rounding or jamming scopes up a$$es.

 

[msmith83]

So from what I gather from this thread, being an average student (or slightly above) from a financial/economic sense it would be best to either go into IM-GI, or Anesthesia-CCM/Pain?

 

[IanMcGalt]

So from what I gather from this thread, being an average student (or slightly above) from a financial/economic sense it would be best to either go into IM-GI, or Anesthesia-CCM/Pain?

Most medical subspecialties pay better than anesthesia for new grads. The willingness of other anesthesiologists to take half your income and the impossibility of starting your own practice makes new grad anesthesia far, far worse than it is for current 'partners'.
Don't look at averages or billing, they won't apply to you.

 

[msmith83]

According to the AAMC, most IM specialists salaries at best are at the low end of a starting anesthesia salary. I know a lot of these figures aren't accurate but its really the only thing I have to go by

 

[Stank811]

Most medical subspecialties pay better than anesthesia for new grads. The willingness of other anesthesiologists to take half your income and the impossibility of starting your own practice makes new grad anesthesia far, far worse than it is for current 'partners'.
Don't look at averages or billing, they won't apply to you.

Not in my part of the country. I love how everyone on this forum thinks that the same tactics do not occur in all other specialities when it comes to buy in and less partnership opportunities….it is occurring in every specialty of medicine.

 

[Dwindlin]

Combined IM/Anesthesia saves you a full year. With that year you can do Pain or CCM. For those who don't want IM/Anesthesia take a look at Anesthesia/CCM/Cardiac.

Too bad our specialty doesn't offer Anesthesia/CCM/Cards for a total of 7 years. That would be quite a powerful combo in clinical practice. Anyway, Step213 did the home work before picking a specialty and that makes his/her decision an informed one.

What do you mean by this? Because if you mean Cardiac Anesthesia then that particular combo would only be 6 years to begin with.

I wish Anesthesia/IM would have been an option when I applied mainly for access to IM CCM fellowships.

 

[Ezekiel2517]

What about Anesthesia/CCM/Pain? I feel pain and CCM go hand in hand and allows you to essentially have your choice of practice in either OR, office or ICU.

They don't go hand in hand, CCM hates pain and vice versa.

To those going into these Anesthesia/IM/CCM/OB-GYN/Psychiatry/... tracks, just be mindful that when it's all said and done, you're actually gonna have to find a job that can accommodate all your training. It will be especially tough in PP where most gigs are straight up GA. I know a couple doods who are quadruple boarded and they're both not using at least 2 of them. Every extra year you spend training is a year you could have been making bank

 

[Stank811]

What do you mean by this? Because if you mean Cardiac Anesthesia then that particular combo would only be 6 years to begin with.

I wish Anesthesia/IM would have been an option when I applied mainly for access to IM CCM fellowships.

Why would you want access to IM CCM fellowships….there are a ton of great anesthesiology CCM fellowships. I do not think plum vs anesthesiology vs ER vs surgery route is going to be a big barrier to practice in the future. I talked to multiple all pulmonary groups when looking for jobs and they were all willing to consider bringing in a anesthesiology CC physician to the group. The hardest part is trying to work out the details in regards to being part of two PP groups….anesthesiology and Pulm/CC. Since both groups have different benefits, partnership tracks, billing, etc it takes time to work out the details.

 

[Dwindlin]

Why would you want access to IM CCM fellowships….there are a ton of great anesthesiology CCM fellowships. I do not think plum vs anesthesiology vs ER vs surgery route is going to be a big barrier to practice in the future. I talked to multiple all pulmonary groups when looking for jobs and they were all willing to consider bringing in a anesthesiology CC physician to the group. The hardest part is trying to work out the details in regards to being part of two PP groups….anesthesiology and Pulm/CC. Since both groups have different benefits, partnership tracks, billing, etc it takes time to work out the details.

I like the two year model as it opens options up for dedicated rotations "outside" the ICU (imaging and bronchs for example). They also tend to allow more freedom in which ICUs you rotate through (not just surgically based), now I understand there are great Anesthesia/CCM programs out there, but I am fairly limited geographically and the ones in my area do not seem to offer the things I have listed, which is a bummer, but obviously won't stop me from going forward.

Plus, like someone else mentioned, while not impossible to find PP work as a Anesthesia/CCM it is MUCH easier with a medicine back ground.

 

[IkeBoy18]

Im guessing the IM/anes combined programs are super competitive

 

[Dwindlin]

Im guessing the IM/anes combined programs are super competitive

There is only like 4-5 spots in the country. So I would say yes.


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[IkeBoy18]

There is only like 4-5 spots in the country. So I would say yes.


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Ah ok.. Dont even know why I asked, IM was the lowest point of my entire life. lol

 

[Dwindlin]

Ah ok.. Dont even know why I asked, IM was the lowest point of my entire life. lol

Don't get me wrong I could NEVER be a Hospitalist. I have all the respect in the world for those guys/gals because man their job is rough. I could force my way through the IM aspect but it would never be more than a means to an end.

But again, moot as that ship has sailed. I know I probably seem whiney, but I am actually supremely happy with where I matched last year and cannot wait to get started July.

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[AngryBird69]

What scares me the most about this field is the quality of applicants that are allowed into the specialty. DOs, IMGs, caribs MDs, US MDs in the lower quartiles of their class -they're all fair game to anesthesiology. Derm ortho, uro and radonc will use your app as toilet paper if you fall into any of those categories.

These "sellouts" we talk about on this forum that lead this specialty into its present and future state? I am willing to bet the majority of them fall within those types of applicants mentioned above based on conversations I've had on the interview trail.

"Meh I'll take 250K working at a surgicenter and call it a day" - carib student on an interview day where I was the only us allo among 9 interviewees.

 

[digitox]

What scares me the most about this field is the quality of applicants that are allowed into the specialty. DOs, IMGs, caribs MDs, US MDs in the lower quartiles of their class -they're all fair game to anesthesiology. Derm ortho, uro and radonc will use your app as toilet paper if you fall into any of those categories.

These "sellouts" we talk about on this forum that lead this specialty into its present and future state? I am willing to bet the majority of them fall within those types of applicants mentioned above based on conversations I've had on the interview trail.

"Meh I'll take 250K working at a surgicenter and call it a day" - carib student on an interview day where I was the only us allo among 9 interviewees.

Why didnt you do one of those specialties? I don't think this field needs more self righteous di**s like you.

 

[Per4mer8]

What scares me the most about this field is the quality of applicants that are allowed into the specialty. DOs, IMGs, caribs MDs, US MDs in the lower quartiles of their class -they're all fair game to anesthesiology. Derm ortho, uro and radonc will use your app as toilet paper if you fall into any of those categories.

These "sellouts" we talk about on this forum that lead this specialty into its present and future state? I am willing to bet the majority of them fall within those types of applicants mentioned above based on conversations I've had on the interview trail.

"Meh I'll take 250K working at a surgicenter and call it a day" - carib student on an interview day where I was the only us allo among 9 interviewees.

If you were the only US allo on that interview day at that program you better look at yourself in the mirror bub. It's probably your sub par boards or douchebag attitude that came across in your letters that put you there.

Unreal. You probably shoulda been a surgeon.

 

[scudrunner]

What scares me the most about this field is the quality of applicants that are allowed into the specialty. DOs, IMGs, caribs MDs, US MDs in the lower quartiles of their class -they're all fair game to anesthesiology. Derm ortho, uro and radonc will use your app as toilet paper if you fall into any of those categories.

These "sellouts" we talk about on this forum that lead this specialty into its present and future state? I am willing to bet the majority of them fall within those types of applicants mentioned above based on conversations I've had on the interview trail.

"Meh I'll take 250K working at a surgicenter and call it a day" - carib student on an interview day where I was the only us allo among 9 interviewees.

Are you drunk? What a foolish assertion.

 

[AngryBird69]

I apologize for the inflammatory nature of my post as I know it couldn't have been interpreted otherwise. It wasn't my objective to insult. Nonetheless I think our "farm system" is killing us.

 

[chudat]

I apologize for the inflammatory nature of my post as I know it couldn't have been interpreted otherwise. It wasn't my objective to insult. Nonetheless I think our "farm system" is killing us.

I may get flamed by the responses, but I'm siding with you on this. I do think, however, most DOs, IMGs, and even less qualified AMGs applying for anesthesia have decent credentials.

The comment about ' "Meh I'll take 250K working at a surgicenter and call it a day ' also doesn't sit well with me.

 

[Baller MD]

I may get flamed by the responses, but I'm siding with you on this. I do think, however, most DOs, IMGs, and even less qualified AMGs applying for anesthesia have decent credentials.

The comment about ' "Meh I'll take 250K working at a surgicenter and call it a day ' also doesn't sit well with me.

+1.

 

[BLADEMDA]

I may get flamed by the responses, but I'm siding with you on this. I do think, however, most DOs, IMGs, and even less qualified AMGs applying for anesthesia have decent credentials.

The comment about ' "Meh I'll take 250K working at a surgicenter and call it a day ' also doesn't sit well with me.

The fact is the less competitive a specialty is or becomes the worse the credentials of those who will be able to match into the field.

For example, IM may not be very competitive but try matching at a top 5 IM program. Ditto for Anesthesiology now or a In few years.

These days there are more qualified DOs and IMGs than the past and there are more med students in the match than just a few years ago. The bottom line is every residency is likely to become more competitive especially the more lucrative ones.

AMG students are doing what they have always done: match into the best specialty possible.

 

[deleted126335]

What scares me the most about this field is the quality of applicants that are allowed into the specialty. DOs, IMGs, caribs MDs, US MDs in the lower quartiles of their class -they're all fair game to anesthesiology. Derm ortho, uro and radonc will use your app as toilet paper if you fall into any of those categories.

These "sellouts" we talk about on this forum that lead this specialty into its present and future state? I am willing to bet the majority of them fall within those types of applicants mentioned above based on conversations I've had on the interview trail.

"Meh I'll take 250K working at a surgicenter and call it a day" - carib student on an interview day where I was the only us allo among 9 interviewees.

Some of the smartest and most talented anesthesiologists I have ever known have been some have been some of the biggest rapists of their fellow docs, and most effective in the expansion of CRNAs in the name of lining their own pockets. A few have just been lucky enough to be in the right place in the right time and had good marketing skills with marginal clinical skills, but that was not the majority. Plenty were really smart for themselves. Call 'em what you will but they were not "poor quality" docs. Just poor quality men.

 

[Yo GabbaPentin]

What scares me the most about this field is the quality of applicants that are allowed into the specialty. DOs, IMGs, caribs MDs, US MDs in the lower quartiles of their class -they're all fair game to anesthesiology. Derm ortho, uro and radonc will use your app as toilet paper if you fall into any of those categories.

These "sellouts" we talk about on this forum that lead this specialty into its present and future state? I am willing to bet the majority of them fall within those types of applicants mentioned above based on conversations I've had on the interview trail.

"Meh I'll take 250K working at a surgicenter and call it a day" - carib student on an interview day where I was the only us allo among 9 interviewees.

Wow. I am in absolute awe that you truly believe someone's character can be related to their school or degree. I've heard a lot of dumb things said in my life but just ... Wow. Bravo!

 

[Yo GabbaPentin]

What scares me the most about this field is the quality of applicants that are allowed into the specialty. DOs, IMGs, caribs MDs, US MDs in the lower quartiles of their class -they're all fair game to anesthesiology. Derm ortho, uro and radonc will use your app as toilet paper if you fall into any of those categories.

These "sellouts" we talk about on this forum that lead this specialty into its present and future state? I am willing to bet the majority of them fall within those types of applicants mentioned above based on conversations I've had on the interview trail.

"Meh I'll take 250K working at a surgicenter and call it a day" - carib student on an interview day where I was the only us allo among 9 interviewees.

I'm going to give you two tips which will tremendously help you (and all future anesthesia residents) along in your career.

1. Read Jet's infamous post on "keeping your head down." Memorize it and follow it to the letter.

2. Up to this point, the hierarchy looks something like .... top tier MD>state school MD>>>>>>>>>>DO>IMG>FMG. The day you graduate, all of those > than signs turn into = signs. All of those lowly DOs, FMGs, etc immediately become you colleagues. You will be in the trenches with these other physicians. Some of them will be smarter than you and better physicians than you. NO ONE will give two ****s about where you went to med school or what your step one score was. This way of thinking is something you have to seriously change because others will be able to smell it on you from a mile away. You don't want that. It's an ugly attitude and will never benefit you in any way. I used to take joy in making the call schedule for certain residents. Trust me, you don't want to be that resident.

The fact that you conclude that DO/IMG/FMG equates to scumbags who sell out the profession is seriously concerning.

Enjoy the rest of MSIV and get all this **** out of your system. But please please follow both points above.

 

[AngryBird69]

YGP, I apparently hit a nerve and when you catch your breath you'll realize I didnt call you or your colleagues scumbags. In fact, I actually apologized for the rather admittedly inflammatory manner in which I came across in my original post. In no way or form did I state that you are less of a physician for being a DO or IMG. My point was that I think that anesthesia is in the state in which its in because of the lower quality of the applicants, many of whom come from (not exclusively) the aforementioned ranks.

Since you like giving unsolicited advice here's some for you: don't give unsolicited advice lol

 

[kazuma]

What scares me the most about this field is the quality of applicants that are allowed into the specialty. DOs, IMGs, caribs MDs, US MDs in the lower quartiles of their class -they're all fair game to anesthesiology. Derm ortho, uro and radonc will use your app as toilet paper if you fall into any of those categories.

These "sellouts" we talk about on this forum that lead this specialty into its present and future state? I am willing to bet the majority of them fall within those types of applicants mentioned above based on conversations I've had on the interview trail.

"Meh I'll take 250K working at a surgicenter and call it a day" - carib student on an interview day where I was the only us allo among 9 interviewees.

I'm amazed with your reasoning skills based on a conversation you had with one individual. I know of many DO's/IMG's/Carrib's who have top notch board scores that go on to score in the top 10 percentile on the ITE's, become chief residents, and ultimately score great fellowships and jobs with some of the best groups in the country. I have a hard time seeing how these folks are "selling out" the field. Do yourself a favor and follow Yo GabbaPentin's advice. Someday one of these "sellouts" might be making your call schedule, interviewing you for a fellowship or job, or be your boss.

 

[sheeed]

Why didnt you do one of those specialties? I don't think this field needs more self righteous di**s like you.

LOL.

 

[MaximusD]

What scares me the most about this field is the quality of applicants that are allowed into the specialty. DOs, IMGs, caribs MDs, US MDs in the lower quartiles of their class -they're all fair game to anesthesiology. Derm ortho, uro and radonc will use your app as toilet paper if you fall into any of those categories.

These "sellouts" we talk about on this forum that lead this specialty into its present and future state? I am willing to bet the majority of them fall within those types of applicants mentioned above based on conversations I've had on the interview trail.

"Meh I'll take 250K working at a surgicenter and call it a day" - carib student on an interview day where I was the only us allo among 9 interviewees.

Do you think these are a majority? As a recent applicant, this was not my experience on the interview trail. I did see DOs (I am one..) and IMGs, but I don't think they were from the bottom of their class and I am confident they at least made avg scores on the USMLE/COMLEX.

 

[Yo GabbaPentin]

YGP, I apparently hit a nerve and when you catch your breath you'll realize I didnt call you or your colleagues scumbags. In fact, I actually apologized for the rather admittedly inflammatory manner in which I came across in my original post. In no way or form did I state that you are less of a physician for being a DO or IMG. My point was that I think that anesthesia is in the state in which its in because of the lower quality of the applicants, many of whom come from (not exclusively) the aforementioned ranks.

Since you like giving unsolicited advice here's some for you: don't give unsolicited advice lol

PHEEEW! I was extremely concerned over what your thoughts of me as a physician were! I get really upset if middle school students, premeds or MSIVs have a negative opinion of me.

None of this is personal. It is your other reasoning which is astounding.

Go to the premed forums if you want to bash on "lesser" degrees. I'm telling you that your arrogance and logical thinking (ie IMG/etc = scumbag) will be picked up immediately by your colleagues, attendings and PD. Change it .... Or don't! We would all love to hear about the FP interview trail a couple years down the line. That is not an exaggeration. If you find yourself on the blacklist at your program, you will be in for a world of hurt, even if you are a clinical rock star.

Here is another piece of unsolicited advice for you. Don't say things you could not defend to your PD. These forums are not 100% anonymous.

 

[deleted171991]

What scares me the most about this field is the quality of applicants that are allowed into the specialty. DOs, IMGs, caribs MDs, US MDs in the lower quartiles of their class -they're all fair game to anesthesiology. Derm ortho, uro and radonc will use your app as toilet paper if you fall into any of those categories.

That is the future of anesthesia. It has also been its past, in the 90's. I tend to agree with you that people who score low on their USMLE steps tend to have poorer medical knowledge as residents and attendings (that has been my own experience). In no way is that related to their degree (a Step 2 200 AMG usually sucks as much as a Step 2 200 IMG/FMG/DO/whatever).

These "sellouts" we talk about on this forum that lead this specialty into its present and future state? I am willing to bet the majority of them fall within those types of applicants mentioned above based on conversations I've had on the interview trail.

You are not only wrong, but also blinded by arrogance/anger. Actually, most of the people who sold us out belong to the same "I am perfect" mentality as YOU.

"Meh I'll take 250K working at a surgicenter and call it a day" - carib student on an interview day where I was the only us allo among 9 interviewees.

That is a realistic person. Because that's exactly the salary you will see for a mommy-track job (or even less in a few years). And surgicenters need this kind of people, too, for the 3-4 days/week part-time jobs, to compensate for the variation in surgical demand during the week. The alternative is that YOU, the big star, is furloughed 1 day/week or so, because the center does not have enough volume on particular days. Also, please observe that this kind of job brings way more happiness and peace of mind than the stress of a big corporate hospital; and to normal people, that matters A LOT.

I apologize for the inflammatory nature of my post as I know it couldn't have been interpreted otherwise. It wasn't my objective to insult. Nonetheless I think our "farm system" is killing us.

It's killing the entire medical field, good morning. We are going through the same "revolution" as the automotive and other industries went through. We are switching to "assembly-lane", "you are just a replaceable body/worker bee" mentality, and the worst part is that it's dictated by people who are less knowledgeable than we are, while we are the ones responsible legally for the poor outcomes generated by our leaders' stupidity/greed.

Since you like giving unsolicited advice here's some for you: don't give unsolicited advice lol

Do yourself a favor: SHUT UP! You got some really great advice from some really smart people above, and you should just breathe it all in and meditate. Don't talk back, except to ask smart questions. You have to realize that, as smart as you may be, nothing replaces experience. Be grateful when your elders try to teach you something.

I work solo in a surgicenter for less than $250K/year (because I don't have the leverage to pressure my corporate boss into paying me more, plus life is about more than money). I love my work and what I am able to do personally for my patients, and you cannot pay me enough to feel the same way working with CRNAs (at least not for now, and not in a surgicenter). It's not about the money; it's about helping people. They are not just a sum in my pocket; they are human beings, somebody else's child/spouse/sibling/parent/grandparent/entire world. One can pay me less for my solo work, but I am not just a slave on the plantation, and the patient is more than just cotton. I would rather be paid less than risk having bad outcomes from improperly supervised midlevels. THAT is my sell-out mentality.