Advice about going into GS

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Chief Resident

Chief Resident

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I've wanted to be a surgeon ever since I was in high school. And in a way I still do, but I'm not as excited about it as I used to be. I've heard the saying that goes something like "If surgery is not the specialty you love, then do something else." Well I think surgery is still cool and something I would like to do, but from what I've seen it requires an immense dedication at the expense of other things in your life. Thus I've started looking into other specialties (family med or internal med). I could do these instead of surgery but I have a feeling that I might regret giving up on surgery. So I would like to ask if it's a good idea to go into general surgery even if you do not completely "love" it?
 
As an intern in general surgery, I would probably say go into something else if you don't love this stuff. I have been in love with the field since my 3rd year of medical school, yet there are still some days that I wonder why the hell I chose this field (only for a few seconds though...as an opportunity to put in a chest tube or do a colostomy reversal reminds me of how cool this stuff is). It is the desire and love for the field that keep me going. Again just my opinion though. I wish the best in finding a passion for whatever field you choose.

SE
Chief Resident said:
I've wanted to be a surgeon ever since I was in high school. And in a way I still do, but I'm not as excited about it as I used to be. I've heard the saying that goes something like "If surgery is not the specialty you love, then do something else." Well I think surgery is still cool and something I would like to do, but from what I've seen it requires an immense dedication at the expense of other things in your life. Thus I've started looking into other specialties (family med or internal med). I could do these instead of surgery but I have a feeling that I might regret giving up on surgery. So I would like to ask if it's a good idea to go into general surgery even if you do not completely "love" it?
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I'm just a fourth-year medical student applying in GS, so I'm not the most qualified person to answer this question, but I can pass on what others have advised me.

On the last day of one of my subIs, a pediatric surgery fellow looked me straight in the eyes and said, "If you could be HAPPY in ANY other field, don't go into general surgery. I'm not saying 'as happy,' or 'happier,' but HAPPY, period, in another field, then choose that field." Many other residents/ fellows/ attendings have reiterated his statement. Their rationale is that GS residency is arguably the most grueling, exhausting, life-sucking training program out there, and that it can be a pretty thankless field if you could see yourself happy anywhere else. The GS lifestyle partly explains why the subspecialties - ENT, ortho, uro, etc. - are so competitive. Surgeons in the subs have better hours, fewer complications, a smaller subset of clinical problems they have to address, yet they get to operate & have all the fun in the OR they want. As a GS, you're the one managing the post-op complicatioins for myriad patients with an equally broad array of clinical problems. You're the one called for most surgical emergencies, and for every trauma and questionably acute abdomen. You're consulted up the wazoo by other services on the floors, for chest tubes, lines, wound care.

I've chosen GS because when the peds surg fellow posed the above question to me, my answer was a resounding 'no' - I couldn't be happy doing anything else. I've done rotations with 9-5 schedules and been miserable out of my mind, while on surgery, when I'm working 18 hours daily, I'm exhausted but happy as a clam. I think this field would be much more difficult if you didn't love it.

What year are you in school? If you're having trouble deciding, I'd highly recommend a sub-I in surgery and another one in a field that interests you, and compare the two.
 
ExtraCrispy said:
I'm just a fourth-year medical student applying in GS, so I'm not the most qualified person to answer this question, but I can pass on what others have advised me.

On the last day of one of my subIs, a pediatric surgery fellow looked me straight in the eyes and said, "If you could be HAPPY in ANY other field, don't go into general surgery. I'm not saying 'as happy,' or 'happier,' but HAPPY, period, in another field, then choose that field." Many other residents/ fellows/ attendings have reiterated his statement. Their rationale is that GS residency is arguably the most grueling, exhausting, life-sucking training program out there, and that it can be a pretty thankless field if you could see yourself happy anywhere else.
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i have been told the same things multiple times by residents. some of them have doubts or moments of wondering if they had chosen another path. but all of them at the end of the day are ok with their decision. and that is because they love their work. when posed with the above question myself, i just sat there and said, "i really just don't know what else i could do". and that's the answer i have to stick with. it's a great job, but it does suck away much of your life, time, and effort. so make sure it's a match you can live with.
 
"Don't do general surgery if you could possibly be happy in doing something else..."

I've heard it multiple times, also, and recently came up zippo in the search for that "something else" I could be happy doing... so I too am applying for GS this year.

During my sub-I, one of my older attendings was reminiscing about his career, and then out of the blue, told me he didn't think he would want to do it all over again if he had the choice back. When I asked him what else he would have chosen, he looked thoughtful for a few moments, and then shrugged, said "Damn, can't think of anything else I would have been happy doing..."
 
I'm a fourth year, and I've heard the same thing the others have heard. I also cannot think of another field that would be right for me, and I love surgery, so it's pretty clear to me what I should do.

But to get back to chief resident's original question, let me add that I did not realize I would like surgery until I started clinical rotations. In fact, I was 99% sure that I would be going into another field. I didn't know anything about surgery except what I had heard, and what I had heard didn't seem appealing. But when I started the rotation, I loved it - I mean absolutely loved it - and I have not felt that way about any other rotation (not even close). I guess what I'm getting at is that you may not like what you think you will like once you actually start clinical rotations. For a short while I wasn't completely sure about applying to surgery because I was still caught up in my old beliefs about what I would like. Once I honestly asked myself what I wanted to do, though, my choice was obvious.
So this doesn't actually answer your question, but it is something to think about.
 
robotsonic said:
I'm a fourth year, and I've heard the same thing the others have heard. I also cannot think of another field that would be right for me, and I love surgery, so it's pretty clear to me what I should do.

But to get back to chief resident's original question, let me add that I did not realize I would like surgery until I started clinical rotations. In fact, I was 99% sure that I would be going into another field. I didn't know anything about surgery except what I had heard, and what I had heard didn't seem appealing. But when I started the rotation, I loved it - I mean absolutely loved it - and I have not felt that way about any other rotation (not even close). I guess what I'm getting at is that you may not like what you think you will like once you actually start clinical rotations. For a short while I wasn't completely sure about applying to surgery because I was still caught up in my old beliefs about what I would like. Once I honestly asked myself what I wanted to do, though, my choice was obvious.
So this doesn't actually answer your question, but it is something to think about.
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here here.
i thought i was gonna grow up to be a neurologist or something "cerebral" and here i am loving the OR.
you never know until you do it. that's truth.
 
There are tons of docs out there (including myself) who struggled with this question as a med student. I didn't decide until my 4th year and even then applied to both medicine and surg programs (dropped all my med interviews after the first one). I talked to my med school's chair of surg and he told me that he had the same dilemma when he was a med student!
I chose surg and couldn't be happier about my decision. Yeah, there are days that just suck and I'll admit I've had the what if thoughts. But honestly, if I would have chosen any other field, I would have had those what if thoughts about surg for the rest of my life. This was something that I couldn't accept.
What finally clinched it for me was knowing how much I enjoyed being in the OR. I figured if I love the OR when I'm just retracting, how much more will I love it when I'm actually the one operating? The answer is about 1000X more!
If you're just starting med school, don't sweat it too much. Just enjoy (haha) your first two years and see what you like during your 3rd year. Most people change their minds multiple times during med school (I considered everything but ob).
As far as the comment "if you're happy with anything else..." I wouldn't put too much weight on it. I'm pretty sure I would have been fairly happy in medicine, just not as much. And I would have regretted forever having not given surgery a shot.
 
I notice some of you have said how much you love the OR. But is that enough? Of course you should love to operate if you're going to be a surgeon, but what about all the other patient care responsibilities that I hear are just as important for a surgeon as operating.
 
Did any of you consider anesthesiology and if so why did you not chose it? Thanks.

Chief Resident, you are not alone in you dilemma. Believe me when I say that most of my days are spent trying to choose if I want to do general surgery or anesthesiology. I think it's harder than deciding whom to mary.
 
Chief Resident said:
I notice some of you have said how much you love the OR. But is that enough? Of course you should love to operate if you're going to be a surgeon, but what about all the other patient care responsibilities that I hear are just as important for a surgeon as operating.
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My mentor (vascular surgeon) told me that to do GS you MUST know your internal medicine.

I've always been good at learning procedures, so I know that that is not going to be the challenge in GS for me. But knowing that the opportunity to use medicine/patient care/management is the challenging aspect for me that I want to conquer.

Over the last few days I've mentioned more than once to people that I'm really excited about my future career in surgery.
 
my true and real perspective on surg -

i know i'm a good thinker, problem solver, big picture person. i like surgery because surprisingly it makes sense to me. the timeframe for solutions are short (i.e. you go in and do the procedure and hopefully solve the problem). and this i find satisfying.
also, i love the patient contact. and was surprised at how much "medicine" and "human contact" you can get/give in surgery. our patients are sick and in dire need of some consolation/understanding/support.
i personally don't like the subspecialties because the fields and/or the patient populations are too specific. i think gen surgery rocks because i like a challenge. and if you're a good general surgeon, you're a medicine doctor who can operate too. and that is hot. and you can specialize later.
my background is in basic science, so i knew i could think. but with surgery skills i can act. and the combination of the two is hard to beat. and honestly, the days are a joy, even when they're hard. surgery was the only rotation where i never "clock-watched". that too was part of my decision.

sorry to ramble. but that's the truth. my gut told me that surgery was right. and it still is. but do what feels right for you as a whole person. i don't have kids right now. and the time sacrifice is not a big deal. but i have friends who have chosen different paths because of where their life and time committments are/were right now.

so best of luck. and regardless, do what makes you happy.
 
MD Dreams said:
Did any of you consider anesthesiology and if so why did you not chose it? Thanks.
.
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I briefly thought about it, but then came to a realization... when doing an anesthesia rotation (I'm on one now), I keep looking over the other side of the curtain. THAT'S what's interesting to me.
 
geekgirl said:
i know i'm a good thinker, problem solver, big picture person. i like surgery because surprisingly it makes sense to me. the timeframe for solutions are short (i.e. you go in and do the procedure and hopefully solve the problem). and this i find satisfying.

also, i love the patient contact. and was surprised at how much "medicine" and "human contact" you can get/give in surgery. our patients are sick and in dire need of some consolation/understanding/support.

if you're a good general surgeon, you're a medicine doctor who can operate too. and that is hot.
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agree 100%
 
RichL025 said:
I briefly thought about it, but then came to a realization... when doing an anesthesia rotation (I'm on one now), I keep looking over the other side of the curtain. THAT'S what's interesting to me.
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If you love being in the OR, I would give a second and third thought to anesthesiology. The problem with the perception of our field by med students is that there's really no way to truly understand or appreciate it until you actually start doing it. Of course surgery "looks" more exciting. It's visual, action packed, and there's lots of ways a med student can participate in the procedure. Don't forget that part of the deal is rounding in the hospital and ICU, and seeing zillions of patients in clinic, and that's not what most of us like to be doing. I love surgery, but after seeing the 5th knee scope, the 2nd crani, the nth whatever, the magic fades and it just becomes part of a job. Unlike surgeons, we spend 95% of our time actually IN the OR, so if that's where you want to be, think about that. All the anesthesiology residents I know are a cool headed bunch that don't need the glory of being the person holding the knife. The quiet satisfaction of placing the tube and running the case well is enough for us. When I picked anesthesiology I was assured of my decision by the fact that my personality clicks with the people in the field, EVERY anesthesiologist I met was basically happy, and had a life outside the hospital, the residents love it, and wouldn't stop talking about how great the lifestyle is, and the money is obviously good. I've been doing anesthesiology for four months now at a place that works us pretty hard, and I can honestly say I love what I do. I look forward to going to the OR every day. We get lots of weekend days off, and that leads to a very well-balanced lifestyle that I love as well.
 
Obviously there's a difference between being in the OR and operating. If you just love being in the OR just be a scrub tech. They're in the OR all the time. The janitorial staff that cleans up after cases also spends quite a bit of time in the OR. You should go into surg if you love participating in the operation, even if it's just retracting during your med school years. If you're bored with surg after watching a few procedures you SHOULD go into a different field. I logged in over 250 cases in my first two years and I'm still psyched to go into the OR everytime. Well, maybe not as much for breast cases...but it still beats anything else.
 
ivan lewis said:
Obviously there's a difference between being in the OR and operating. If you just love being in the OR just be a scrub tech. They're in the OR all the time. The janitorial staff that cleans up after cases also spends quite a bit of time in the OR.
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How silly of me, I could have saved so much time in my quest for a job in the OR. Trouble is, neither the scrub tech, nor the janitor can out-earn the surgeon, save the patient's life, and be home in time for soccer practice. But I know someone who can...
 
powermd said:
How silly of me, I could have saved so much time in my quest for a job in the OR. Trouble is, neither the scrub tech, nor the janitor can out-earn the surgeon, save the patient's life, and be home in time for soccer practice. But I know someone who can...
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Sounds like you may be one of those anesthesiologists who has an inferiority complex towards surgeons.
 
Didn't you say you were an anesthesiologist? I've come across more than a few anesthesiologists who think like you do.
 
powermd said:
How silly of me, I could have saved so much time in my quest for a job in the OR. Trouble is, neither the scrub tech, nor the janitor can out-earn the surgeon, save the patient's life, and be home in time for soccer practice. But I know someone who can...
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And the last time you "saved" someone's life was when??? When you were frantically searching for something, anything to reverse the anesthetic overload you gave the pt as the surgeon was barking at you. Is that what you mean? That you "saved" your own life?
I wonder if that's what you said at your med school interview. "I want to go into medicine so that I can out earn the surgeon and be home on time for soccer practice." I'm glad one of us wasn't bull****ting at his interview.
 
Can we PLEASE abandon this tired, immature, tedious argument about anesthesiologists vs. surgeons???

Anesthesiologists DO save lives - in many hospitals they run the SICU. During an operation with a patient who has 600+ comorbidities, with labile blood pressures, etc., it's the diligence of the anesthesiologist that keeps the patient alive. Sure, during easy cases they get to sit and read the paper. But difficult cases can be scary as hell.

I'm speaking of this as a future surgeon. Surgery and anesthesia are *entirely* different fields, attracting people with different talents and interests, but who inarguably need each other. They need to work as a team to provide care to the same patients. Period.

Now knock it off. Start thinking about your patients instead of ruminating on your own egoes.
 
ExtraCrispy said:
Now knock it off. Start thinking about your patients instead of ruminating on your own egoes.
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Isn't it contraindicated not to have a big ego and go into surgery as a career?
 
powermd said:
How silly of me, I could have saved so much time in my quest for a job in the OR. Trouble is, neither the scrub tech, nor the janitor can out-earn the surgeon, save the patient's life, and be home in time for soccer practice. But I know someone who can...
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It's great that you love your job, but you need to realize that some of us are also interested in doing things on the other end of the curtain. No offense, it doesn't mean we think you're less of a man or anything (or woman, if that applies 😉 ), it's just that for whatever reason, being a surgeon is what we want to do.

I think some of the other replies meant to point out that when we say "I love being in the OR" we mean operating, not just physically being in the room.
 
powermd said:
How silly of me, I could have saved so much time in my quest for a job in the OR. Trouble is, neither the scrub tech, nor the janitor can out-earn the surgeon, save the patient's life, and be home in time for soccer practice. But I know someone who can...
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you must have dreamed this up while you were checking the pulse-ox on the patient in between reading ladies' home journal behind the blue curtain.
 
mmmmdonuts said:
you must have dreamed this up while you were checking the pulse-ox on the patient in between reading ladies' home journal behind the blue curtain.
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:laugh: 👍
 
RichL025 said:
It's great that you love your job, but you need to realize that some of us are also interested in doing things on the other end of the curtain. No offense, it doesn't mean we think you're less of a man or anything (or woman, if that applies 😉 ), it's just that for whatever reason, being a surgeon is what we want to do.

I think some of the other replies meant to point out that when we say "I love being in the OR" we mean operating, not just physically being in the room.
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Well duh. Of course performing an operation is a very different job than performing an anesthetic. In no way did I attack surgery as a field or suggest lack of respect for my surgical colleagues. I have great respect for their committment to their work, their technical excellence, and the sacrifices they make to do what they do. However- surgery is NOT for everyone who "enjoys being in the OR" as a med student. Anyone who CAN be counseled out of surgery based on lifestyle concerns probably should be. It's not often obvious to medical students what a cool field anesthesiology is, particularly when they are exposed to it in the context of surgery, which is way more hands-on. My point, originally, was that as a med student, if you enjoy being in the OR, you ought to consider anesthesiology.

No, I don't have some inferiority complex about not being a surgeon. I laughed when I saw that. I do find it slightly offensive when a surgeon minimizes what I say by suggesting that "being in the OR" as a scrub tech, or janitor is in some way comparable to being an anesthesiologist. I'm surprised the rest of you failed to notice how childish your colleague's comment was.
 
Powermd,

I apologize for my colleagues' insulting remarks on this thread. Although I want to be a surgeon, it is certainly not because I think that anesthesiologists are somehow not as intelligent, ambitious, whatever.

I do wonder, though, how it is that anesthesiology and surgery can be compared. They seem like two very different fields to me, and I do not understand how someone could be torn between the two. I really want to be the one doing the bowel repair, or sarcoma resection, or whatever. It would make me unhappy to spend my career watching someone else do that.

Also, the two fields have very different schedules and lifestyles. I don't know about attendings, but the surgery resident's worklife is pretty busy (even if just doing scut work) while the anesthesiology resident's life is much more laid-back. For example, when I was working with the surgeons, a coffee break meant quickly grabbing a cup before rushing off to the next thing that needed to be done, wasting no time. With the anesthesiology residents, a coffee break meant leaving someone else in charge of the OR patient and taking 10 or 15 minutes to get a cup, check email, etc. It was a different world.

Maybe someone can explain to me how these fields are actually comparable.
 
1. Both fields involve generally brief but meaningful interactions with patients.

2. Both fields are procedure oriented, although surgery obviously moreso.

3. Minimal clinic in both fields (usually none for gas unless you do pain)

4. Both involve a fair amount of liability.



Sure there are more, but this is just off the top of my head.
 
robotsonic said:
With the anesthesiology residents, a coffee break meant leaving someone else in charge of the OR patient and taking 10 or 15 minutes to get a cup, check email, etc. It was a different world.
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now that's dedication to saving lives, well done.
 
automaton said:
now that's dedication to saving lives, well done.
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Unlike surgeons we don't have much downtime between cases when we're not in the OR. All the time we have to eat, hit the head, talk to people, check our email, or whatever, is the time we get on breaks. I get 45 minutes of my workday, when I'm not signing out patients in the PACU, outside the OR. That's it! Feel free to continue questioning my dedication, if you like. I couldn't care less what you think.
 
powermd said:
I'm surprised the rest of you failed to notice how childish your colleague's comment was.
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Believe me, we noticed. People like this are an embarrassment to surgery.

For all the people denigrating anesthesiology, try operating without them. See how well that works out for you. 🙄
 
Smoke This said:
For all the people denigrating anesthesiology, try operating without them. See how well that works out for you. 🙄
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Works out fine without them when they're replaced by CNAs! 🙂
 
Smoke This said:
For all the people denigrating anesthesiology, try operating without them. See how well that works out for you. 🙄
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uh oh we have to start our own ivs and put on the bp cuff ourselves guys. my eyes are opened.
 
mmmmdonuts said:
uh oh we have to start our own ivs and put on the bp cuff ourselves guys. my eyes are opened.
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But surgeons aren't allowed to doze off to sleep while reading the newspaper during the case, so there will always be a need for anesthesiologists!
 
don't forget the pulse ox, that's a year's worth of training at least

just kidding

i didn't know that your breaks total 45 minutes a day. my bad if that's true.

anyway, my deal with anesthesiology is that i feel like you don't accomplish anything at the end of the day. i guess you can say you allowed them to get surgery and whatever, but that doesn't impress me personally. i'm sure that is gratifying to others, but not for me. it's like a zero-sum thing at best - you put them under and hopefully bring them back like they were before. that's just the way i view it, not necessarily how it is. just trying to explain why i think doing anesthesia and surgery is different. no doubt anesthesia is a great gig, if you enjoy it.
 
powermd said:
Well duh. Of course performing an operation is a very different job than performing an anesthetic. .... However- surgery is NOT for everyone who "enjoys being in the OR" as a med student. ... My point, originally, was that as a med student, if you enjoy being in the OR, you ought to consider anesthesiology.
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I'm sorry I wasn't clear enough in my reply.

What I was trying to point out (and obviously not very well) was that for many of us, when we say that we "love being in the OR", we are not simply referring to the physical location. It's not the room that interests us as much as the particular role of a surgeon in the OR.

I have the utmost respect for anesthesia (both MDs and CRNAs), I'm doing an elective right now in it because (as a future hopeful surgeon) it's a field I want to be more familiar with. I was merely pointing out that we seem to be meaning different things when we both say we "love being in the OR" - you seemed to be thinking people meant they just like being in that physical location...
 
Come on fellas let's be realistic, everybody knows it's the anesthesiologist who does all the real work during the operation and cures the patient but the surgeon gets all the undeserved credit. 😉
 
For everyone who has provided a clever reply to power MD, what is your level of training and experience in the medical field? Me? Graduated from GS residency in '93 (pre-80 hour work week), academics for 3 yrs, now a full partner in a 6 partner private practice group.

automaton, Chief, pir8, mmmdonuts, robots... your turns.
 
chowhound said:
You guys are really making asses out of yourselves.

For everyone who has provided a clever reply to power MD, what is your level of training and experience in the medical field? Me? Graduated from GS residency in '93 (pre-80 hour work week), academics for 3 yrs, now a full partner in a 6 partner private practice group.

automaton, Chief, pir8, mmmdonuts, robots... your turns.
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lighten up boss, you want to bust out the rulers now or what?
 
automaton said:
don't forget the pulse ox, that's a year's worth of training at least
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im planning on advanced fellowship training that will allow me to take down the curtain clamps at the end of the case
 
Alright, I know this thread has been denegrating both surgeons and anesthesia, but I have a funny CRNA story.....

I was scrubbed on a radical prostatectomy retracting like a pro. I leaned back a little to stretch my back and neck and shoulder muscles and turned my head toward anesthesia. I did a double take. There sitting like a big blob monster on her chair was the CRNA, mask off, eating ice cream. As I looked at her twice she glared at me while slapping another little scoop onto her tongue. Feeling like I'd made eye contact with medusa, I quicky returned my focus to the surgery and smiled under my mask. And took one more peek at her, of course. Still eating. :laugh:

I 😍 the OR.
 
chowhound said:
You guys are really making asses out of yourselves.

For everyone who has provided a clever reply to power MD, what is your level of training and experience in the medical field? Me? Graduated from GS residency in '93 (pre-80 hour work week), academics for 3 yrs, now a full partner in a 6 partner private practice group.

automaton, Chief, pir8, mmmdonuts, robots... your turns.
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Hey, why are you targeting me? I think the insults are ridiculous and unnecessary also. And I make no claim to be an expert on the fields - I was asking a basic question about surgery vs. anesthesiology. All I know is what I have observed from my friends who are surgeons and anesthesiology residents. So leave me out of the asses category. Thanks.
 
robotsonic said:
Hey, why are you targeting me? I think the insults are ridiculous and unnecessary also. And I make no claim to be an expert on the fields - I was asking a basic question about surgery vs. anesthesiology. All I know is what I have observed from my friends who are surgeons and anesthesiology residents. So leave me out of the asses category. Thanks.
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Robot,

NOT targeting YOU. Just trying to understand everyone's perspective. That's all.
 
DrMaryC said:
There sitting like a big blob monster on her chair was the CRNA, mask off, eating ice cream. As I looked at her twice she glared at me while slapping another little scoop onto her tongue.
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usually they try to eat the ice cream through the mask.
 
powermd said:
Unlike surgeons we don't have much downtime between cases when we're not in the OR. All the time we have to eat, hit the head, talk to people, check our email, or whatever, is the time we get on breaks. I get 45 minutes of my workday, when I'm not signing out patients in the PACU, outside the OR. That's it! Feel free to continue questioning my dedication, if you like. I couldn't care less what you think.
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Hmmm...I don't get ANY downtime in many days as a 3rd year surgery resident - when we're not in the OR we're seeing consults, handling issues in the ICU's or floors - often not even having 5 mintues to get lunch much less sit down and eat it and I can't think of the last time I checked email on an OR day. Maybe some of the attendings are sipping coffee in the lounge or their officies, but at least at the resident end we have less free time than anesthesia residents by far (not even getting into the obvious fact that total hours and call frequency is generally much less in anesthesia residency). But now I'm just contributing to the deterioration of this thread....

Back to the original topic though...I think anesthesia to me is the specialty most procedure-oriented outside the surgical specialties - they can put a central line in as well as surgeons, better at arterial lines sometimes, certainly better at IV's...and they can get the airway almost everytime, which is the basis of maintaing life support in a critically ill patient. They are also trained to aggressively and appropriately resuccitate patients - fluids and electrolyte managment, BP managment on multiple drips - just as good as surgeons with maintaining the stability of an unstable paitent in this area, and often at the time they are critacally needed to manage this (i.e. surgeon is busy operating and can't be spending time deciding what to do to increase or decrease unstable pt's BP). If I were an unstable patient the next person I'd want caring for me in any area of the hospital (ED, ICU, PACU, OR wherever), besides a surgeon would be an anesthesiologist - NOT an emergency physician or medicine critical care specialits -in my opinion anesthesiologists and surgeons are similarly trained in the non-operative agressive managment of stabalizing the unstable patient and they do a great job at it, better than any other specialist in the hospital. If this is appealing to you, anesthesia may be an exciting alternative to surgery.

Anesthsiologists are obviosly more limited in the types of procedures they do, however, so to me they don't have as much fun as surgeons do b/c they don't get nearly the variety of procedures - simply put, they don't get to do surgery, and I have fun doing surgery, so that's what I want to do. But, lifestyle and pay in anesthesiology far surpass surgery, and the per hour pay- no contest...so if you can do without doing surgery yet like the OR enviornment (the teamwork aspect of the OR is actually something I really like too and I think of anesthesia as a clearly integral part of this) and want to do some limited procedures and manage critically ill patient, anesthesia is a great option.
 
any ideas what I said that was construed as inflammatory?

I am actually having a serious debate with myself right now over whether I want to do surgery or anesthesia. Oh well, whatever.
 
Since I started this flame war, I'll end it 🙂 . Powermd, obviously my comment about the janitorial staff, etc was written in jest, to get under your skin (mission accomplished!). I just found it funny that you took the phrase "being in the OR" literally.
Anyhoo, I apologize for any hurt feelings, etc.... kiss kiss hug hug
And for all you med students out there, anesthesiology is a great career choice! It's the second best job in the OR... 😉
 
Wow. I leave for a few hours and look at this mess! This whole debate/flame war/whatever is pretty pointless. There is nothing wrong with doing either job. Obviously if you have a deep need to be the person who does the cutting- anesthesiology is not going to satisfy you. If you love being a part of the team that cares for a surgical patient, but don't have this need, anesthesiology might be a good choice. I don't think I ever tried to make the point that surgeons do less work than anesthesiologists, but don't mistake a few breaks from the OR during the day for an easy workload, or (??) lack of dedication to patient care.

To the member who raised the question about job satisfaction at the end of the day- you might be surprised how satisfying it is to run a good anesthetic. It's all about taking care of the patient. I get enormous satisfaction from the 'human' side of patient care in this field. From the pre-op visit to the OR, you have a great opportunity to ease your patient's fears of the OR, and instill confidence that you will be there to protect them at all times. Patients care about this more than you think. And they remember. When I see patients postoperatively, they are almost universally thankful for the way I cared for them on the way to the OR. The never seem to forget my name (surprising even me)- weeks later patients have come up to me on the street near the hospital and address me by name, usually to offer thanks once again. There are plenty of other satisfactions in the course of my day- successfully optimizing unstable hemodynamics, intubating/extubating well, having a good emergence, placing lines successfully, spinals, nerve blocks, anticipating and heading off problems before they are noticed by anyone else... the list goes on. The common theme is that most of the rewards in anesthesiology are personal, and unnoticed by others. That is probably why you couldn't imagine them.
 
I think it really doesn't matter what field of medicine one is in, it matters how dedicated that person is. For example, I just finished my psychiatry clerkship. Now, many people tend to look down upon psychiatry. But I will tell you that a psychiatrist who is dedicated to the field has all of my respect. I've met some of these people, but I've also seen psychiatrists that are not dedicated, are poor clinicians, lack deep knowledge of the field, and most of all lack respect from others because their complaicancy shows. The point I'm trying to make is that I've seen good doctors and bad doctors in EVERY field. I've seen good surgeons (who meticulously perfomed a lumpectomy to minimize scarring of a young woman's breast), and I've seen bad surgeons (who literally butchered another young lady doing the same procedure). I've seen good anesthesiologists and I've seen some that I wouldn't trust my worst enemy to.

Having said that I also think that it's important to give due credit to certain fields which are more demanding than others. I think general surgeons, and some other type of surgeons, deserve a unique type of respect simply because they have to sacrifice so much of themselves to do what they do. An analogy would be the special forces vs. the regular infantry. They are both important, but the special forces deserve a little added credit. However, this does not mean that surgeons should go around putting others down. In fact, I think to really be powerful, to really gain others respect, one needs to be humble. No one likes a jerk, no matter how much dedication or training they have. By being abusive to others, you are only degrading your own status.

In summary, I think doctors should be judged by their dedication to their chosen field vs. the field which they have chosen. If I were a surgeon, nothing would piss me off more than having a mediocre anesthesiologist taking care of the patient. But I would have the utmost respect for the anesthesiologist who is dedicated to the patients well being and to their field. Nothing ticks me off more than complaicancy!

Sorry for the long and kind of cheezy post, just trying to make a point.
 
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