I am a 4th year med student going for anesthesiology, but that is not up there. I like anesthesiology because:
1. Pharmacology and Physiology - I liked these basic science subjects more so than anatomy and I would love to apply this knowledge to real patients.
2. Medicine - I like internal medicine in theory, but not practice. Too much paperwork, noncompliant patients, and low sense of accomplishment. On my medicine rotation, I felt like nobody was doing anything for the patient, but with anesthesiology, I am completely in charge of the patient from a medical point of view. If something goes wrong, I fix it (or at least try). If I give a drug, I have instant feedback. In addition, anesthesiologists need to have knowledge of a broad spectrum of pathologic conditions.
3. Patient relationship - Sounds weird, but I like the brief and intense relationship. I may not get to follow-up with the patient every 3-6 mos. like other docs, but that 3-6 hours I spend with the patient in the OR is exhilarating, even if nothing happens. Just the thought that I am the pilot of the plane is exciting enough for me.
4. Lifestyle - Anesthesiologists work longer hours than radiologists or dermatologists, but not as long as surgeons. For me, it's a compromise. I can live with these hours since I love it.
Honestly, I could go on and on. There are some downsides to anesthesiology, such as the moody surgeons, constant stress, expectation of perfection, cyclical job market, etc. But I love what they do, so I want to do it. Plain and simple.
By the way, I am in the top quartile of my class, but I am still weary of this year's match due to the increased competition. There are a ton of qualified candidates out there, so we'll have to see what happens.