Program Director Said Don't Do Anesthesia

[deleted171991]

What is more relevant is his age. I bet 90% of his age group would say the same. They have had a great career and life.

If I were a student deciding about my career choices, I would rather listen to what the junior attendings here are saying, the ones who are employed, working in an ACT model. Because that would be my future, not that of a fat cat partner, no offense.

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[bashwell]

I believe the ACT model is currently (at least) 50% of all practices right now. It's only growing.

 

[amLOLdipine]

What is more relevant is his age. I bet 90% of his age group would say the same. They have had a great career and life.

If I were a student deciding about my career choices, I would rather listen to what the junior attendings here are saying, the ones who are employed, working in an ACT model. Because that would be my future, not that of a fat cat partner, no offense.

I've spoken with several of those guys. The most recent one is in his mid 30s and working in a MD-CRNA ACT practice. Occasionally does own cases but mostly supervision of CRNAs. Takes call about once every 10 days. Otherwise, usually gets done before 5pm and rarely works weekends. Said he's paid off all of his student loans and just recently upgraded houses. Overall he seems very laid back and happy with his choices. He told me straight up if he could do it again he would still choose anesthesia.

But according to you, he must be lying to me. So, please educate me on what I've been missing.

 

[kazuma]

#14 is also wrong if you are in a busy physician only practice. Try doing 10 pediatric ENT cases with 5-8 min turnovers before noon. I barely have a chance to pee, which usually isn't much of a problem because I don't have time for a drink of water either.

 

[Ezekiel2517]

What is more relevant is his age. I bet 90% of his age group would say the same. They have had a great career and life.

If I were a student deciding about my career choices, I would rather listen to what the junior attendings here are saying, the ones who are employed, working in an ACT model. Because that would be my future, not that of a fat cat partner, no offense.

While that may be true generally speaking, not the case with Tolentino. I prolly made more my first year out than he was making mid career but I guess I'm lucky. He not only likes the specialty for the things he mentioned but he was one of the first anesthesiologists I met who genuinely loved the art and the practice of anesthesia. And it showed in his work everyday. He was one of those guys everyone in the hospital knows and loves and can't say a single bad word about. One thing I remember was how he would take time out of his schedule (weekends, nights) to help a couple of his colleagues who were not native english speakers prepare for the oral boards, and they all passed. For some rare people, it's not entirely about the money.

 

[sloh]

What is more relevant is his age. I bet 90% of his age group would say the same. They have had a great career and life.

If I were a student deciding about my career choices, I would rather listen to what the junior attendings here are saying, the ones who are employed, working in an ACT model. Because that would be my future, not that of a fat cat partner, no offense.

ivory tower is only nice if you're sitting in it

 

[Carbocation1]

ASA CA-3 JOB SURVEY

http://www.blog.greatzs.com/2016/03/where-anesthesia-residents-go-after.html

"When the survey was sent out, 97% had confirmed job offers. More than 55% of the residents joined anesthesia groups with partnership tracks while 20% joined groups with no partnership track, 18% are becoming employees of health care organizations, and the rest joined anesthesia staffing companies. The mean starting salary was over $289,000 which was virtually unchanged from 2014. But if you want to make more money, then head West with a reported mean salary of almost $315,000."

 

[Carbocation1]

• "Fellowship not necessary in this market."
• "Okay, but certainly not flourishing."
• "Very difficult job market; practice models are mostly employment with very few partnership tracks available; management companies seem to be taking over."
• "I took a lot less money to supervise fewer CRNA's."
• "Tighter than most years but improving. National anesthesia companies providing much worse benefits and lifestyle than any other groups."
• "Get involved in your state society to network. Do your residency in a region you'd like to work. Don't be a complainer or a lazy resident. Work hard and be a team player."

 

[Turtlez]

ASA CA-3 JOB SURVEY

http://www.blog.greatzs.com/2016/03/where-anesthesia-residents-go-after.html

"When the survey was sent out, 97% had confirmed job offers. More than 55% of the residents joined anesthesia groups with partnership tracks while 20% joined groups with no partnership track, 18% are becoming employees of health care organizations, and the rest joined anesthesia staffing companies. The mean starting salary was over $289,000 which was virtually unchanged from 2014. But if you want to make more money, then head West with a reported mean salary of almost $315,000."

Fantastic Link! I'm curious whether fellowship completion actually correlate with better job offers though.

 

[IlDestriero]

This is already happening. As was noted in another thread: If a CRNA is making $150k with 6 weeks of vacation that is $81 per hour for a 40 hour work week. Multiply $81 per hour x 60 hours a week (with call) x 46 weeks with time and a half for overtime and you get $260k. Now look on Gaswork and find an Anesthesiologist job that pays $260k.

You can get a mommy track job for 300+ in my hood. If any sucker is working full time outside of a partner track for under 300, they're a fool.


--
Il Destriero

 

[patriot6]

ASA CA-3 JOB SURVEY

http://www.blog.greatzs.com/2016/03/where-anesthesia-residents-go-after.html

"When the survey was sent out, 97% had confirmed job offers. More than 55% of the residents joined anesthesia groups with partnership tracks while 20% joined groups with no partnership track, 18% are becoming employees of health care organizations, and the rest joined anesthesia staffing companies. The mean starting salary was over $289,000 which was virtually unchanged from 2014. But if you want to make more money, then head West with a reported mean salary of almost $315,000."

Compared to 2013, it seems like the job market is getting a bit better for graduates...

"Less than half (38 percent) of residents were joining anesthesiology groups with plans to become a partner, while a majority (62 percent) has accepted group employee positions. The starting salary showed a mean of $252,986 with some regional differences."

“Very tough year for jobs! Seems like no one was hiring. Often referenced the outcome of the presidential election and health care reform as a reason not to hire. Thankful to have a job.”

“Midwest market wide open and great jobs. Southeast jobs there, but paying less – mostly supervision – lots of call and need for fellowship for job protection vs. CRNAs.”

“Stressful process. Tougher than expected but ended up getting job I wanted.”

“Good that I have a job, but frustrating.”

 

[deleted126335]

You can get a mommy track job for 300+ in my hood. If any sucker is working full time outside of a partner track for under 300, they're a fool.


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Il Destriero

There are plenty of neighborhoods where 300k for a mommy track job just plain don't exist.


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[bashwell]

There are plenty of neighborhoods where 300k for a mommy track job just plain don't exist.


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Friend in the Seattle area has a mommy track job. She tells me she makes low/mid $200s.

 

[Consigliere]

44% of residents are doing fellowships. If the job market was so wonderful, that number would be closer to 20%. Job market blows; graduating, in debt, naïve residents will take whatever job they can.

 

[Random Anesthesiologist]

Do they include fellowships as a job offer in that 97%? If so, do they also average in the GME salary for that?


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[pgg]

44% of residents are doing fellowships.

I don't believe that.

That figure is from a survey. I don't care enough to look at the survey methodology, but if it was like most surveys, they only got answers from 10% or fewer of the people surveyed, and you don't have to be a genius to guess which way the responder bias lies.

44% doesn't come close to passing the sniff test to me. There are what, 1400-1500 or so new anesthesiology grads per year in the US? Are there even 700 fellowship positions in all subspecialties in the country? I would wildly guess there might be 350 or 400.


Certainly, more residents are doing fellowships now than 10 years ago. Securing a fellowship is more competitive now than it was. I have no doubt that the job market is piece of that ... just look at the disaster radiology has become.

 

[deleted171991]

I don't believe that.

That figure is from a survey. I don't care enough to look at the survey methodology, but if it was like most surveys, they only got answers from 10% or fewer of the people surveyed, and you don't have to be a genius to guess which way the responder bias lies.

44% doesn't come close to passing the sniff test to me. There are what, 1400-1500 or so new anesthesiology grads per year in the US? Are there even 700 fellowship positions in all subspecialties in the country? I would wildly guess there might be 350 or 400.


Certainly, more residents are doing fellowships now than 10 years ago. Securing a fellowship is more competitive now than it was. I have no doubt that the job market is piece of that ... just look at the disaster radiology has become.

There were at least 167 positions in critical care, 183 in cardiac, 305 in pain (including all specialties), 190 in peds, 48 for OB. And these are just the positions in the match. There are 60+ regional fellowship programs (with at least 150 fellows, I would assume). Plus palliative. Plus neuro. Plus all the even more worthless ones. So 700 is a very likely number.

 

[psychbender]

PGG, it looks like there are that many fellowship positions. I just checked SF data, and for the 2015 match, there were 183 spots for CT, 167 spots for CCM. According to a brief look at NRMP for that year, there were 48 OB anesthesiology fellowship positions, 190 Pediatrics, and 305 Pain spots. Now, not all Pain spots go to anesthesiologists, and not all fellowship spots go to residents, and some programs leave spots outside of the match. There are also the non-accredited fellowships like Liver Transplant and Trauma, and I didn't look for data on Regional/Acute Pain. All of this means that it could actually be possible for 44% of graduating residents to go straight into fellowship, as fellowship had become much more popular lately.

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[pgg]

Interesting, I stand corrected.

Have those numbers increased a lot in the last 5-10 years? Or is the difference just that they're all filling now?

 

[deleted171991]

Interesting, I stand corrected.

Have those numbers increased a lot in the last 5-10 years? Or is the difference just that they're all filling now?

AFAIK they've been going up for a while. Cheap labor. The programs don't give a crap that you waste 200K+ and a year, for a piece of paper that probably won't change your life much (because almost everybody will have one in the future).

 

[Turtlez]

AFAIK they've been going up for a while. Cheap labor. The programs don't give a crap that you waste 200K+ and a year, for a piece of paper that probably won't change your life much (because almost everybody will have one in the future).

If the trend continues, I assume not having a piece of paper might hurt us in the future?

 

[deleted171991]

If the trend continues, I assume not having a piece of paper might hurt us in the future?

See Internal Medicine.

 

[Turtlez]

See Internal Medicine.

Sorry I'm not sure what you meant. Was that a yes?

 

[Twiggidy]

Pick a specialty where you are higher up in the food chain. If you aren't at the table then you are on the menu.

most correct statement in the entire thread

Take a deep breath. The bell curve for medicine (any specialty) is far to the right, with a short tail on the left. If you're reasonably smart, have ass-calluses tough enough to endure med school, medicine is still about the surest attainable thing out there. The major difficulty is in convincing the average med student, resident, or attending with wistful woulda-coulda-shoulda dreams about being an entrepreneur or i-banker that they probably would've failed at those endeavors.

also a correct statement


Medicine is arguable the most secure job out there. Graduate and don't intentionally hurt people, and you will have work. It may not always be in the most cosmopolitan area or the area of the country you want to live, but someone will pay you a check (that's six figures) to practice medicine. What you define as "glory" is up to you and goes back to Blade's quote.....anesthesiology is not a glory field. In some way, shape, or form you're always working FOR someone, with maybe pain medicine being the exception.

If you want to be a boss, you probably need to be a surgeon, even more so, a specialty surgeon. Perhaps a cardiologist or interventional cardiologist too. Anesthesiology won't get you to the top of the food chain, unless you chair an academic department, even then, you're still appeasing people.