The doom and gloom worked at my school

[donkeykong1]

I don't post much but try to stay very informed and read this forum quite a bit. I thank Blade and everyone else who contributes to these forums and will start posting more. I will need to make a decision soon but I really like gas. While I am not disagreeing with the bold statement of Blade I just don't see a higher income potential for an average medical student other than gas.

Some IM sub specialties can compete with the surgical sub specialties along with rad onc and derm but other than that, gas I feel is a great option. Here is my list for best options for the average med student. In order. (say 225 step 1, average extras). Opinions?

1. IM- Cards, GI,
2. IM- Heme/onc, Pulm/cc
2. Anes- Pain
3. Anes- Peds, cards
4. Radiology
5. Anes-general
6. Anes- CC
7. EM
8. OB/Gyn
9. Gen Surg- (certain fellowships like hand could move this way up if you can bear the residency)
10. PM &R - pain

idk if the avg med student can land a gi, cards, heme/onc fellowship these days

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[bronx43]

idk if the avg med student can land a gi, cards, heme/onc fellowship these days

Depends on how "average." If you are "average" but can land an academic institution, then you are golden for a cardio or heme/onc fellowship (GI is difficult regardless.) If you go to a community program, all bets are off.

 

[donkeykong1]

Depends on how "average." If you are "average" but can land an academic institution, then you are golden for a cardio or heme/onc fellowship (GI is difficult regardless.) If you go to a community program, all bets are off.

got stats? i heard the fellowship match for high end IM subspecialties was brutal this yr

 

[bronx43]

got stats? i heard the fellowship match for high end IM subspecialties was brutal this yr

I saw the stats, but don't feel like rummaging through my email to find it. It was overall not drastically different from prior years. The fact of the matter is that an AMG from an academic institution should not go unmatched, unless there are red flags on your transcript. You may not get the program that you were gunning for, but you should match if you apply realistically.

 

[Ezekiel2517]

Yah cardiologists seem like a real happy group, lol. esp. the ones coming out now. Couldn't pay me enough to do most of the specialties listed.
Do something you love. If you don't you're just wasting your f*cking time

 

[risnwb]

Yah cardiologists seem like a real happy group, lol. esp. the ones coming out now. Couldn't pay me enough to do most of the specialties listed.
Do something you love. If you don't you're just wasting your f*cking time

The problem with the "do what you love" med-student mentality that many of us once had is the fact
that you are overlooking the impact working conditions and reimbursement have in how much you love it. Anesthesiology is a fantastic field when practiced in a efficient place where the physicians are respected and paid a salary which reflects their work and training. Working for an AMC (where many of the new jobs are) where corners are cut at every turn to save a buck, where your time is not respected, where you supervise 4/1 , where you have no room to increase salary, where you could be cut loose at any moment for cheap labor in the form of newer grads/CRNA's, is a dead end "job", not a career.



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[donkeykong1]

The problem with the "do what you love" med-student mentality that many of us once had is the fact
that you are overlooking the impact working conditions and reimbursement have in how much you love it. Anesthesiology is a fantastic field when practiced in a efficient place where the physicians are respected and paid a salary which reflects their work and training. Working for an AMC (where many of the new jobs are) where corners are cut at every turn to save a buck, where your time is not respected, where you supervise 4/1 , where you have no room to increase salary, where you could be cut loose at any moment for cheap labor in the form of newer grads/CRNA's, is a dead end "job", not a career.




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ok, so whats stopping anesthesiologists from partnering up and practicing in a private setting right now? why cant they just bleed those amc dry of physician services and see what happens to productivity when crna, aa are left alone

 

[gasdoc77]

ok, so whats stopping anesthesiologists from partnering up and practicing in a private setting right now? why cant they just bleed those amc dry of physician services and see what happens to productivity when crna, aa are left alone

AMC's are in a position to negotiate better reimbursement rates from insurers. They also can negotiate better rates on benefits, etc. They use these economies of scale to get their foot in the door. They are a trojan horse. The best deal you will ever get from them will be your first one. Thereafter, they have you and they know it. Hospitals with a poor payer mix would have to subsidize their lines of service for a PP group, and AMC's offer coverage without subsidy. You would have to partner up with people and break into a hospital with a good payer mix or a surgery center (s). It then comes back to who you know, not what you know, which is the unfortunate summary of the field of anesthesia, as difficult as that might be to accept for current and future (potential) trainees. Therein lies why anesthesia can be so frustrating for those that can and do produce. For the rest, its a great place to participate in an experiment in socialism