Thoughts on new combined Anesthesia/IM programs?

[ihearttriangles]

Not trying to start another thread on which residency is the best prep for CCM but more specifically I was wondering if some of the seasoned CCM vets wouldn't mind sharing their thoughts/feelings/gestalt on how useful the new combined anesthesia/IM residencies are for those of us med students who plan on eventually practicing CCM. It seems like you get the best of both worlds: 1) The rigorous understanding of medicine a la the internist and 2) the facility with procedures and quick thinking of the anesthesiologist. Isn't this what a lot of the old school CCM folks did anyway? But, they had to do it as two separate residencies. Granted it will end up taking you six years to get boarded in CCM which is one year longer than either the straight gas or IM pathway but something about it just seems really awesome to me. What are everyone's thoughts?

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[jdh71]

I like it. Gives you options too. If you were a glutton you could always do pulm + CC for instance if you ended up liking pulm, or one of the more critical care orientated anesthesia fellowships on top.

 

[Dwindlin]

I wish very badly I had known about these when I applied :/


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[step213]

I wish very badly I had known about these when I applied :/


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If you are a resident now, then you couldn't have known about these programs. This year is the first year they are matching applicants. UCSD converted one person from a previous class to combined but they didn't match into the combined.

 

[ORL10]

I am still undecided on the integrated combined programs. My institution has an Anes/IM program and a great 4th year is going into it from here, his reasoning was similar to as above.

My thought process is if afterwards you want to be in the OR you obviously need to do anesthesia. If you don't want to do OR then why do the extra anesthesia training? You can learn "to think quickly" and "do procedures" well in a good fellowship. Yes you wont be a master at the art of intubating, but the reality is most of your intubations are likely to be with the aid of video laryngoscopy going foward, and the anticipated difficult ones 5% of the time or so you can have a friend at the bedside with you.

If you just want to work in the ICU then it seems to make more sense to do a longer ICU fellowship than just one year, you'll be better served doing a variety of ICUs at a big program over two years. This way you get 18 months over 9 months of ICU experience. You can do this by doing cardiac anesthesia and CCM, 6 years via anesthesia, or by doing IM/CC, 5 years, and a sub-fellowship if you still feel the need in your area of interest (ECMO, transplant, sicu, trauma etc..)

If you want to do pulmonary then obviously go the IM route.

I don't see many people going to the OR, attending the ICU and rounding on the floors or pulm consults, but maybe I'm wrong?

 

[step213]

Not trying to start another thread on which residency is the best prep for CCM but more specifically I was wondering if some of the seasoned CCM vets wouldn't mind sharing their thoughts/feelings/gestalt on how useful the new combined anesthesia/IM residencies are for those of us med students who plan on eventually practicing CCM. It seems like you get the best of both worlds: 1) The rigorous understanding of medicine a la the internist and 2) the facility with procedures and quick thinking of the anesthesiologist. Isn't this what a lot of the old school CCM folks did anyway? But, they had to do it as two separate residencies. Granted it will end up taking you six years to get boarded in CCM which is one year longer than either the straight gas or IM pathway but something about it just seems really awesome to me. What are everyone's thoughts?

I'd also add, if you are interested its best to find out early. Strengthen your application with research and strong letters from both specialties. If you didn't honor medicine, do a subi and blow it away with honors and great letters. These programs are competitive, more competitive then matching into either IM or Anesth alone at that institution. I met a lot of people on the trail who interviewed anesth but couldn't land a combined interview. It seems they are looking for superstar applicants who won't have trouble balancing learning both specialties at once (So a high pass in medicine would be a red flag). It seemed that AOA/3rd year honors/high board scores are what it takes to land an interview in this track at the most competitive places.

 

[kpxjisoo90x]

What if you love primary care, but also love perioperative care that you get to do as an anesthesiologist?
May be you can do primary care few days out of the week as an internist and do anesthesia for private clinic surgeons who only operate day or two out of the week?
I'm not sure how well this can work out, but it seems possible.

Also, wouldn't this be great for people who wants to do global health since they can accommodate for both shortage of general practitioners and anesthesiologists as needed in the third world country?

 

[deuist]

May be you can do primary care few days out of the week as an internist and do anesthesia for private clinic surgeons who only operate day or two out of the week?

This program and its reasoning sound a lot like the combined emergency medicine programs with med students' saying, "I could work two days a week in the ED and the rest of the time in a clinic." That setup sounds like it might work to a student who has never spent a significant amount of time in either setting, but it sounds like murder now that I'm an attending. The only use I can see for this residency would be to become an expert in perioperative medicine.As surgeons routinely call upon internists for "clearance" prior to an operation, an anesthesiologist who went through the combined path could theoretically provide all of the preop workup.