Anesthesia Residency - Worried I'm making the wrong decision

[Swimmer122]

Hi Everyone,

I'm a 4th year medical student. I had been choosing between applying in Anesthesia or Radiology. I had been settled on Anesthesia after enjoying my rotation, but then I did a Pain Medicine rotation and hated it, and now I'm doing a SICU rotation and also not liking it. Not to sound weak, but I'm worried about whether I will be able to adjust to a lifetime of getting up super-early.

I really enjoyed my initial Anesthesia rotation, but now I wonder if it's really right for me. Any advice?

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[boggy]

If you are not liking SICU and Pain forget about anesthesiology---you will spend the next 30 years dealing with sick patients in pain--if you think as an anesthesiologist you are going to get to do healthy lap choles all day forget about it--you are going to be covering up to 10 independently practicing crnas doing the healthy cases--and all anyone is going to want you to do is to take care of those patients too sick for the routine crna to handle or to serve as some sort of backup physician when they get into trouble.

Simply put if you are not prepared to take care of SICU style patients in the future I would not go into anesthesiology.

 

[Bertelman]

There is a difference between taking care of ICU patients in the OR and actually rounding on these patients in the SICU.

I hate internal medicine, but that doesn't mean I can't take care of a patient with DM, CHF and HTN in the OR. I think I actually do it just about every day, but shoot me if I have to round on that patient every day up on the wards.

 

[lfesiam]

Hi Everyone,

I'm a 4th year medical student. I had been choosing between applying in Anesthesia or Radiology. I had been settled on Anesthesia after enjoying my rotation, but then I did a Pain Medicine rotation and hated it, and now I'm doing a SICU rotation and also not liking it. Not to sound weak, but I'm worried about whether I will be able to adjust to a lifetime of getting up super-early.

I really enjoyed my initial Anesthesia rotation, but now I wonder if it's really right for me. Any advice?

Hi OP! I had a similar problem for different reasons, liked ICU/Pain but had rads in the back of my head due to my art background:

Surg vs. Anes vs. ER (my action side)
vs. Rads (my visual/art side).

What nailed Anesthesiology for me = Mentor/friend/role model + Setting/Nature of the work + great potential in the field for contributing to other areas of medicine. Had an awesome anesthesiology mentor. I would advise you to talk to an approachable attending in both fields at your medical school to get their perspectives.

Surg=I love my wife more than surgery
ER=lots of patients that are not "emergency" material
Rads=was thinking IR, but gen rad is too dark, literally.

If you are not a morning person, I would advise you against anesthesiology. Also second the comment about ICU patients. As for Pain patients, after residency, you can choose what you do.

good luck with your decision👍

A more expensive option if you can't decide = apply to both specialties, rank both and see what the supercomputer say.

 

[Planktonmd]

So,
You don't like critical care, you don't like pain and you hate getting up early!
You will be a great radiologist in my opinion.

 

[CambieMD]

If you are not liking SICU and Pain forget about anesthesiology---you will spend the next 30 years dealing with sick patients in pain--if you think as an anesthesiologist you are going to get to do healthy lap choles all day forget about it--you are going to be covering up to 10 independently practicing crnas doing the healthy cases--and all anyone is going to want you to do is to take care of those patients too sick for the routine crna to handle or to serve as some sort of backup physician when they get into trouble.

Simply put if you are not prepared to take care of SICU style patients in the future I would not go into anesthesiology.

Go into radiology.

Cambie

p.s. pain and the sicu is the bread and butter of anesthesia

 

[Jeff05]

you don't have to do any pain management if you don't want to in anesthesia. yea your patients will be in pain, but you'll always be in a setting where you will either put them to sleep - OR, or quickly titrate meds and leave - PACU. I also didn't love the SICU, again, you will not have to do long term critical care in anesthesiology.

in anesthesia, you will take care of sick patients for brief periods of time, without any continuity.

pain is the bread and butter of pain management.
sicu is the bread and butter of critical care.
most anesthesiologists do neither.

my recommendation is to to radiology and do an interventional fellowship - you will be irreplaceable and un-outsourcable.

 

[Impromptu]

I cringe when I get fibromyalgia, Crohn's disease, or other chronic pain patients in the hospital. While I love relieving pain, I don't think I could constantly deal with those types of patients. Who manages your SICU? Our trauma SICU is run by trauma surgeons, and our normal SICU is run by anesthesiologists. I prefer the latter.

 

[pgg]

I did a Pain Medicine rotation and hated it, and now I'm doing a SICU rotation and also not liking it.

What didn't you like about the SICU?

Being an anesthesiologist in the OR is just like being in the SICU, except there aren't any ICU nurses to get in the way, there's no social work, no annoying family members to put up with, no "rocks" on the service that sit vented & trached for weeks on end, no AM rounds, no PM rounds, no nutrition consults, no multidisciplinary rounds where the social worker and pharmacist bicker about 1 expensive pill vs 2 cheap pills while you fantasize about a life that doesn't so closely resemble hell.

Wait, I guess being an anesthesiologist in the OR is nothing like running a SICU after all! Seriously, there is a world of difference between taking a sick-as-hell SICU patient to the OR and owning that patient (and a dozen others) 24/7.

And lots of us aren't interested in chronic pain clinic work. If the pain clinic and the SICU aren't your favorite places to be, you can still be an anesthesiologist. I did some extra elective SICU time as a resident because I thought it would be good for me, and it was, but I ain't never going back (unless it's a brief stint as a CT fellow).

But I love being an anesthesiologist.

I'm worried about whether I will be able to adjust to a lifetime of getting up super-early.

Well, that's a problem. But someone's got to read films at 4 AM, too. Just set the DVR to record the Colber Repor and go to bed earlier. You'll be fine.

 

[Consigliere]

Radiology for you my friend. 3 reasons: more money, more vacation, no CRNAs.

 

[maceo]

Radiology for you my friend. 3 reasons: more money, more vacation, no CRNAs.

if you hate getting up early.. damn is anesthesia not for you. I too hate getting up early. despise it. Im dreading getting up early tomorrow to attend a grand rounds on why the surgical cap (ones that guys use) causes more infection. can you believe how far down my life has become. moreover, there is very very little tolerance for tardiness. even the slightest bit of tardiness. not even 10 minutes late will be a huge deal to the point that you will be terminated. Im not kidding. so taht sucks too when you see the surgeons and the gi guys saunter in 30 mins late routinely and nothing is done.so totally i would go into radilogy even if i had to do it again even though my brain doesnt think like that at all. they cana teach you. there are so many drawbacks to a career in anesthesia i wont even list them.. the least of being getting up early. there are a lot more serious problems than that

 

[2ndyear]

SICU (the rotation) can be difficult, demanding and not much fun. SICU (the physiology), not to mention procedures can be very fun. As a med student you don't get to do too many lines usually, or intubations. That part gets better as an intern/resident. You also don't get to experience the feeling of a critical patient crashing and having to make decisions in seconds that can mean life or death as a med student.

As for pain, nothing is more boring than watching people do procedures and talk to patients. There just isn't many things for students to do on pain rotations. The actual procedures are fun, when you are the one doing them. Even getting to work up the patients and take some ownership makes a rotation better. Maybe it is the environment of the rotation that you don't like, not the actual material?

 

[mille125]

Hi Everyone,

I'm a 4th year medical student. I had been choosing between applying in Anesthesia or Radiology. I had been settled on Anesthesia after enjoying my rotation, but then I did a Pain Medicine rotation and hated it, and now I'm doing a SICU rotation and also not liking it. Not to sound weak, but I'm worried about whether I will be able to adjust to a lifetime of getting up super-early.

I really enjoyed my initial Anesthesia rotation, but now I wonder if it's really right for me. Any advice?

The Pain part doesnt bother me as much as SICU. I assume that you were on a chronic pain rotation. There are many many anesthesiologists who would cringe at seeing low back pain patients for the rest of their life. You can be a fine anesthesiologist without an interest in chronic pain. Interestingly, I am a chronic pain physician and absolutely love it (but wait we are talking about you).


The SICU part is more troubling. I really cant see you being happy in anesthesiology while totally disliking SICU. It is very intertwined in everything you do. I am going to have to second the majority of the people on the forum who voted for radiology for you. Just make sure that you dont lose your mind in those dark rooms (which was my problem).


Good luck..

 

[michigangirl]

Agree with what most others are saying--don't like chronic pain? no biggie-- i don't think most anesthesia residents enjoy it, and the ones that do end up doing chronic pain as a living. the SICU? depends on what you don't like about it...if you don't like the patient population-- don't do anesthesia. if it's more the climate you're working in and rounding, then i think anesthesia is still worth a whirl--you'll learn a ton during your sicu rotations as a resident, and use that knowledge as an anesthesiologist througout your life, but never have to round again if you don't want to. if you don't like getting up before 6 a.m.-- forget anesthesia.