Ranking: Should I delay start of CA1 year (Advanced vs. R Position?)

[surg_to_anesthesia]

Hello. Coming over from the surgery world. I’d like to start by saying that I have been a long time reader of this forum and highly respect the expertise and opinions of many of you seasoned anesthesiologists on this board. Your comments on a variety of topics have been some of the most intelligent and well thought out on the internet period.

I am switching to anesthesia after a few years from a surgical subspecialty. I am on a research year and have applied to both advanced and R positions. My current favorite program is an advanced position to start 2021 and my number 2 is an R position that will start later this year. Both are good programs, neither is in my desired location but #1 is closer.

My question is, if I rank the advanced position #1 and match there, how will having a 2 year gap between my surgical training and anesthesia training look for potential jobs and/or fellowship programs?

Let’s assume that I would find part time locums here or there or another research opportunity during this time, but would like to have that as a personal time off where I do not work full time during this period. For example, if I choose to travel, spend time with friends &family, study anesthesia in preparation for CA1, etc. How would that look to potential future employers if I eventually start, do well, finish my training program and pass my boards?

Similarly, how would a 2 year gap of clinical training look to potential fellowship programs instead of a 1 year gap assuming that time is truly a gap with no clinical responsibility?

I have no hard reasons for needing an extra year off; it’s just based on preference of programs. But if having that gap would significantly impact my future in ways I might not think of (besides delay in practice), then I might reconsider my rank list. I know that the match is the match and ultimately my fate is set by an algorithm so anything could happen in the end.

Any advice would be appreciated. Thank you.

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[Mman]

We all understand how the match process works. I would just be ready to tell people why you preferred one program over another. You can't really help if one is advanced and one is categorical.

 

[JiPo]

I agree with Mman, but if the difference between #1 and #2 is minimal, I would recommend ranking the R program higher. Taking additional year off means you will graduate 1 year later, which means you are losing out on $350,000. It could be a significant difference later down the road.

 

[IMGASMD]

Not sure what you’re “really” asking. In general, anesthesia fellowships aren’t hard to get. (Compare to cardiology or GI, let’s say). So your chances of a competitive fellowship is probably the same.

I am also assuming you’re competitive in your own right, (surgical sub, so ent, ophthalmology). If both programs you’re considering at the same caliber, the question becomes which programs you like better and/or how much down time you want to have.

Can you really get a Locum job? As a what? Do you want to do research? Can you find a research job? Urgent care job pays much better than research, but not as good as anesthesiologists.

I think training is training is training, especially it both programs are the same tier. I’d rather have an extra year earning as a fellowship trained anesthesiologists.... but I also understand completely where you’re coming from, you’ve been in school/training for a long time without any breaks. Your call.

Good luck.