It is in the "ROAD" to success, so it is a very COMMON, if not wrong, misconception that anesthesia is one of the easier specialties. I think your post did give a good argument, and is true you don't just do cases... you also forgot about ICU time if that is part of your residency (more and more Anesthesia runs ICU's out there... they run the CT ICU here, Surg runs SICU, Med runs MICU...). But, here are a few counterpoints to show why others might perceive it as a lifestyle specialty...
It is a common misconception. The point of my posting about anesthesiology is two fold: a) to help medical students see through the misconceptions and sense a bit of reality, and b) to keep the lifestylers out of our field.
Hours hours hours... especially surgical specialties see that Gas has become shift work. Residents are there from 7 til 3, maybe 7 til 5, and then get subbed out.
Anesthesiology can sub people out, that's one of the strengths of it. I'd say a typical day is working 6 am to 5 pm when not on call, til 6 pm as a junior resident.
As the above mentioned ENT resident said, if the case goes for 20hours (and for ENT, Composite Resection with free flap can easily go 20 hours... I have seen it) that resident is in the case from start to finish (unless you have a nice attending who lets you scrub out when plastics is doing the free flap... then you go to the bathroom, eat, and come back for another 6-8 hours of reconstruction).
For long flaps, residents and attendings have the opportunity to scrub out as well. I'd wager to say that anyone who goes 20 hours without scrubbing out for bathroom/water/food, is putting the patient at risk. Nobody is superhuman. In anesthesiology, you generally have a 15 minute morning break, and a 30 minute lunch break, for the 12 hour day, or, if on call, throughout call, with dinner coming anywhere from 530 pm til much later, depending on the case loads.
On call residents are also shift work, so if it isn't pure night float (meaning fresh crew from 5 til 7, or whenever) then the residents definately leave at 7am with no turnover, no rounding, etc.
This is generally not true. The on call residents are the ones who came in @ 0600 and stay til 0700 or later the next day. There is no rounding, except ICU and Pain, which is a definite bonus of the specialty.
Med, Surg, Peds, if they are Q3 or Q4, they are putting in 30 hours days regularly and leave when work is done, not when time is up... but if it were all hours, then the easiest specialty is EM hands down... they only work 56 hours a week during residency... but then again, 1 hour in the ER feels like 20 hours in the OR...
Anesthesiology is often q3 during residency, averages out to q4-q5, with no consult months. I loved the ER, almost went into it, and while busy, anesthesiology is a different sort of busy. Some cases can be non-stop crazy (generally not the ENT ones...most surg subspecs like ENT/ophtho have healthy patients, so the cases aren't that exciting from an anesthesia standpoint. Therefore, the misconception of us not really doing anything). I'm being honest when I tell you that my hardest 36 hour internal medicine call as an intern didn't compare to my hardest 24 (25) hour anesthesiology call, in terms of stress/physical toll/difficulty. This is really important for med students to understand!
Gas residents are working from when they get in til leaving besides food breaks, where as I have seen surg, med, etc residents sitting in call rooms waiting for stuff, or chilling for the hour in between cases while Gas is doing their preop thing...
Anesthesiology is generally pretty non-stop, while there are slow down times within medicine/surg rounding, during the day...In the rare instance where there are no cases in the OR overnight, you're obviously chillin, as long as you dont have other duties.
to quote you... "but imagine having to be vigilant and 100% on the ball from the second you start a case" I will counter this with an anedot that represent the exception, not the rule, but perpetuate the idea that this is BS...
He's right...and the idea isn't BS.
I have, on more than 1 occasion, seen Gas asleep at the wheel, only woken up when the surgeon asks them about a hr, bp, o2 sat, or something.
Wow, are you serious? The resident would be kicked out of the program immediately at any of the places I'm familiar with. This is NOT the norm.
Yeah, theoretically the gas should be paying attention and vigilant 100% of the time, but you are telling me you have never got some shut eye, or read (even if it is educational reading) during a case? There is a reason CRNA's can observe during the case...
Never gotten any shut eye. Read some? Yes. Studies have been performed and shown that reading does not effect the ability of residents to focus in on the case. If you see us reading (which is only during relatively stable times), we are still paying attention to every little detail.
To seriously counter this idea though, again, for the surgical specialties out there, while you are ALWAYS prepared for something to go wrong, the surgeons are always vigilant and 100% on the ball for the entire case, since they are performing surgery, will be cutting and putting a back screw near the aorta... and if it does happen, while Gas provides the support needed, if the patient lives, it is because the surgeon fixed that hole in the aorta... it is a cooperative, and if that is your only reason why it is a hard specialty, then any surgeon will argue (not necessarily correctly) that your life is much easier than theirs.
The surgeons focus on their work, we focus on ours. It's really two completely different things we are both focusing on. If things go wrong, outside of a massive bleeder, the surgeon backs away while the anesthesiologist fixes it. Or, more usual and ideally, the surgeon never has to hear about something going wrong, because we've already fixed it before it became a huge issue.
Again to quote you "Cases done on call are potentially more complicated, sicker patients, and higher risk. Plus, while ENT might only have 1 emergent case to do, we cover all surgical specialties, so if ortho has 3 cases and ENT has 1 and gyn has 1 and surgery had 3" I will refer to the above 2 arguements as well, since same applies, but also, those emergent cases likely came in thru the ER or was a patient on the floor who decompensated, which means the resident already put a lot of high stress energy and effort into the patient evaluating and working up, and then now has to do an emergent case, which, as I stated above, is likely much more stressful and anxioty ridden for the surgeon than the gas.
The work up may or may not (likely) have been done on this patient. Why should this be more stressful on the surgeon? Once again, they have a surgical problem to deal with, we take care of the medical/physiological issues that are, as you say, decompensated, to enable this to happen. This can be stressful for all involved, but the anesthesiologist is the primary physician responsible for the patient making it out of the OR alive and in good shape.
But, conversely, gas will likely get a case every night... ENT residents don't do call cases that often (but often have cases that last until the call team). There isn't an acute appy every night. So again, steady stressful work vs patchy very stressful work... both sucks, both work hard, there is no easy thing in medicine
Steady stressful work describes anesthesiology. Benefits are no rounding, and a bit more of a controllable lifestyle, in that you and your partners can break up call easier than a surgical group.
Am I saying Gas is easy? Definately not. I wouldn't argue that any medical field, even the ROAD is easy. They all work their arses off. They all have their things that they dread happening or dread coming in. Each field has its benefits and perks, and its drawbacks. People should go into a field where they love the benefits (be it not rounding, managing vital signs like its an opera, procedures like lines, intubations, the hours) and can handle the drawbacks (being treated like ancillary members of the team, no direct patients, no respect on SDN forums, not knowing what to do with all your money and free time...) and all this macho strutting their stuff and trying to prove whose the manliest (or womanliest) of the men (or women) is all BS. And if you are miserable, you will think your life is so much harder and painful.
You had a lot of misconceptions above, and I hope the above post helps you and other medical students out in making your decision. Once again, the drawbacks do not include being "treated like ancillary members": that's ridiculous. Also, we have direct patient contact, but not having our own "patients" is a huge benefit. "No respect on SDN forums": That's stupid, and who cares if some young ENT resident or others berate anesthesiology? I want to get the truth out for any med students considering the field.
The macho stuff? I think you were looking at posts from people in other fields.
Once again, there are criticisms of every field, lets just keep them accurate.
Hope this helped.
this.
