There are always two sides to the story.
The people who are sour, are sour from experience, their own and their co-workers'.
The same can be true for those who are enjoying their current jobs. They are happy from experience.
As many have pointed out, it's either a matter of strong networking or going to BFE (the kind of job that stays unfilled on gaswork forever, so they are happy with any body - sic!).
You are absolutely right. Now more than ever, one needs to network and search out theses jobs. It's not circa late 90's early 2000's any more. Anesthesia will likely never enjoy that luxury again. It requires work that sometimes spans the course of many years until there is a job opening. On my last interview trail, it took me no less than 4 years of interaction with a quality group until someone actually retired and the door opened to me.
I am sure that it's easier to find a decent job in the Western half of the country, just because the ACT penetration is lower, and because the markets are generally better. But that doesn't apply to the East Coast, where I live.
You are right again. The East coast is probably the last place I would go searching for a job. Not only are the AMCs and the ACT model pervasive, it is also littered with low incomes coupled with a high price of living. If you know that going into it, then that is
your decision to stay there.
And, for families with two earners, it's not so easy to just move thousands of miles away, just because it looks good on paper and at the interview. It takes at least a few months to figure out whether a job was all that you were promised and, even if it's all that and more, the spouse could be miserable there.
Yes. I would agree that it's not easy. Even with two of you picking up and moving. Yet, that is exactly what I did. Both of us quit our jobs and moved 1500 miles across the country. I guess you never know until you try. If you are stuck in a place you don't like, then you owe it to yourself to look for something better.
I am not a leftist, but the emphasized part in your post is ridiculous.
In the end it is you who is striking pen to paper and willing to accept whatever terms you have agreed to.
In certain markets, making partner in a good group has about the same chance nowadays as being accepted to Harvard or Yale. There will always be people who do, but let's not generalize. There can't be so many of us with problems "of our own doing". While its normal that people who make a ton of money as partners won't waste their time here, there are still too many unhappy people.
Then move to a different market. You can't "generalize" east coast groups to the rest of the country. Here is my experience:
First job: Partner from day one.
Second Job: Partner from day one with limited voting rights until one year. Then, fully vested partner.
Let me expand a little on your point:
- Last round of job hunting was done over many years and through networking- yes I worked on it. Sure it took time but in the end (2 years ago), I had options in great locations with what I consider great partnerships. All in 400-600k range with 8-12 weeks. Of the 5 interviews I went on, only one was advertised on gasworks. All offered me jobs.
- Now, I just helped place a friend on mine land in a great practice. Right off the bat he has 10-14 weeks of vaca.
- Furthermore, our group has hired 10 new FTEs due to expansion. Let's just say they are all doing well.
- I personally know a handfull of SDNs who frequently and not so frequently post here. Without exception, they all have great gigs.
So to say that landing one of these jobs is like winning the lottery isn't exactly true. It's not easy, but with the right attitude and flexibility it's certainly not that difficult to land even in todays terms- with or without a fellowship.
It's no surprise that academic jobs are more difficult to get than 5 years ago. We are overproducing anesthesiologists and CRNAs, and it's only going to get worse. At least in most other specialties they can't replace the doctor with a nurse, yet. Even if I made twice the money I make, I still wouldn't advise anybody to go into anesthesiology now. This specialty is dying. Give it 5-10 years and we will make less than hospitalists, on average, when adjusted for the amount of work (heck, we may even do the same kind of work).
I would say that you are absolutely right in that things are getting tougher and tougher due to our specialty having to morph based on new CMS rules, overproduction of CRNAs, AANA, and M&As. To say that the specialty is "dead" is definitely generalizing. Except for the AMCs, these issues have been in anesthesia since the dawn of time and there have always been a vociforous doom and gloom faction. Again, it's not 2001 anymore, but I can guarantee you that great jobs are still out there. You will however, have to look a lot harder than you used to have to back then. You will likely need to be flexible with regards to practice location and timing.
If you decided not to do either of those, then you are stuck- this makes it different from years past.
While I understand the sour tone within this forum, just remember that ALL specialties are under siege- not just us. Gawd... look at FP, IM, EM, Cards, Rads, etc.
Can a nurse replace a Gen Surgeon? No. Would I want to be a GS? NO!
Even now, I would never do an IM residency over Anesthesia. But that's just me, I fully enjoy the job.
I like the OR and what we do there. So even if I didn't land a stellar job, I would still be happy doing the everyday work. We are highly specialized physicians that do a lot of cool stuff. Having the pressure of seeing 40 patients a day on the floor or at the office is just not for me.
