Anesthesia<--->Surgery

[sleepwithme]

Please don't take this the wrong way, but what you said exemplifies what I have heard about people not being able to "hack it" as a surgeon even if they are interested in it. A surgeon once told me it's not enough to like it or be good at it, you need to have the ability to do it day in and day out.
QUOTE]

one other quality of a surgeon is to be able to sacrifice your family life, social life, basically your own life to be a surgeon. some people do not want to do this anymore. the USA is far behind most industrialized nations in vacation time, and being a doctor makes it worse. although the sacrifices of helping the sick is great, some people want to have only one wife, and you only have one shot at being a parent. if working 60-70 hours a week until you are 55 sounds like fun to you, then I am not only impressed by you, I encourage it. I plan on working 35-40, then spending the rest of my time with my aging parents, my trophy wife, and my beautiful kids when im 35 or so.
so in the end, to the dude asking about surgery vs. anesthesiology, ask what you want from your life long term. the implications of your profession go far deeper than the crappy hours of residency. every resident in the nation works hard, it is after residency that you should be planning for.

I'm in love with a stripper.. shes poppin shes rollin

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[Danger Man]

Well, let's end the debate right here
ABCDs of surgery
A= Assess
B= Blame
C= Criticize
D= Deny

ABCDs of anesthesia
A= Airway
B= Book
C= Coffee
D= Doughnut

This is really all you need to know folks.....Oh, yeah, to all you surgeons out there who are reading this post (or having it read to you), this post is called humor, if you need help ask your friendly anesthesiologist.

 

[rugtrousers]

ABCDs of anesthesia
A= Airway
B= Book
C= Coffee
D= Doughnut

I thought it was
A= Airway
B= Bagel
C= Coffee
D= Doughnut

 

[sleepwithme]

hopefully when i become a resident it will become
A= airway
b= bl*wjob
c=computer for email while getting bl*wjob
D= doughnut

 

[Misterioso]

one other quality of a surgeon is to be able to sacrifice your family life, social life, basically your own life to be a surgeon. some people do not want to do this anymore. the USA is far behind most industrialized nations in vacation time, and being a doctor makes it worse. although the sacrifices of helping the sick is great, some people want to have only one wife, and you only have one shot at being a parent. if working 60-70 hours a week until you are 55 sounds like fun to you, then I am not only impressed by you, I encourage it. I plan on working 35-40, then spending the rest of my time with my aging parents, my trophy wife, and my beautiful kids when im 35 or so.
so in the end, to the dude asking about surgery vs. anesthesiology, ask what you want from your life long term. the implications of your profession go far deeper than the crappy hours of residency. every resident in the nation works hard, it is after residency that you should be planning for.

That's not so true anymore. You don't need to work rediculous hours as a surgeon. That's one reason why general surgery has become very popular in the match since the 80 hour rule took effect (very few unmatched spots in the past few years). Surgery residents are under the 80 hour work week (like all residencies) and after they finish they can choose to work reasonable hours if they want and still make a lot of money. So the issue of overbearing work hours is fast becoming moot.

 

[miamidc]

Dude, you reallt think those 80 weeks are being followed. Hardly, not like they were, but 95 100 hrs are not unusual. As far as post-res goes, believe me the job market isn't even close to what it is for Gas. The job prospects and flexability in GAS is not enjoyed presently by general surgery. As a result, the cut you would be talking for trying to be flexible and cush is huge, and I doubt you would clear $200K starting out unless you get into a group which in that case you will be working no less than 60 hours, partner is years away and even that isn't as lovly as what you would see with Gas partnership and you still would be working more hours, including post ops and all that jazz. The nature of those hours is more labor intensive anyhow, and I could only assume that after my 1000th lap choley I would def want to slit my throat. Thats just my opinion, we do need surgeons out there, if not half my paycheck would disapear, so by no means do I hope to disuade you. Carry on.

 

[Misterioso]

Dude, you reallt think those 80 weeks are being followed. Hardly, not like they were, but 95 100 hrs are not unusual. As far as post-res goes, believe me the job market isn't even close to what it is for Gas. The job prospects and flexability in GAS is not enjoyed presently by general surgery. As a result, the cut you would be talking for trying to be flexible and cush is huge, and I doubt you would clear $200K starting out unless you get into a group which in that case you will be working no less than 60 hours, partner is years away and even that isn't as lovly as what you would see with Gas partnership and you still would be working more hours, including post ops and all that jazz. The nature of those hours is more labor intensive anyhow, and I could only assume that after my 1000th lap choley I would def want to slit my throat. Thats just my opinion, we do need surgeons out there, if not half my paycheck would disapear, so by no means do I hope to disuade you. Carry on.

You're incorrect on that. You can easily clear $200K working as a locum surgeon or covering trauma right out of residency.

 

[bubblegumbezoar]

Not to completely change the subject here, but do any of the anesthesiology residents or future anesthesiology residents have any idea of the reasons why nearly every person I run across who wants to switch residencies is switching to anesthesiology? Is it the fact that there are procedures involved, the fact that there is little patient contact (in the sense of asking a sexual history, doing a rectal, etc. I mean), the money potential, or just a re-assessment of their interests?

Thanks.

 

[miamidc]

You're incorrect on that. You can easily clear $200K working as a locum surgeon or covering trauma right out of residency.

Good luck with that

 

[Misterioso]

Not to completely change the subject here, but do any of the anesthesiology residents or future anesthesiology residents have any idea of the reasons why nearly every person I run across who wants to switch residencies is switching to anesthesiology? Is it the fact that there are procedures involved, the fact that there is little patient contact (in the sense of asking a sexual history, doing a rectal, etc. I mean), the money potential, or just a re-assessment of their interests?

Thanks.

The ones I know who switched from surgery to anesthesia did so because it wasn't as intensive as surgery and they didn't want as much responsibility that comes with being a surgeon. A few switched because their contracts were not renewed by their surgery programs.

 

[Misterioso]

Good luck with that

Don't need luck. Locum coverage and trauma call jobs are plentiful.

 

[ddmo]

The surgeon and the gas pusher are like a man and a woman driving around lost, with the surgeon/man driving.

The man knows he's lost, but his determination, pride, and stuborness prevent him from seeking help. Meanwhile, the woman just sits there rolling her eyes at the entire spectacle.

Despite this, the man's driving, and they're going wherever he wants, no matter how bad the destination is.

That being said, it can be quite an abusive relationship at times. Many times he doesn't trust her and might not even know her name.

Can't count all the times I've heard from the surgeon to the gas resident, "get what's his name, your attending, in here now" or even "would you get the f*** out of the way." And why is it that the gas guys will often call the surgeons Dr., but they reciprocate on a first name basis only, while the resident surgeon is also Dr.? Weird dynamics between these two, weird dynamics.

 

[miamidc]

The ones I know who switched from surgery to anesthesia did so because it wasn't as intensive as surgery and they didn't want as much responsibility that comes with being a surgeon. A few switched because their contracts were not renewed by their surgery programs.

So having the sole job of giving and maintining life for a person on the order of a couple of hours is not responsibility, think again. You are responsible for making the right cut, closing it right, and making sure they fart in a couple of days. Oh and doing stupid post of checks to make sure you got everything right or there wasn't some unexpected complication. Intensive is relative, if you mean having to take bull**** and becoming a master at giving it, and hating life for real during training, because of "tradition" or just the nature of your work than sure. But Gas is much more intensive on a cerebral level, it is of a shorter duration, and gives you the benefit of the opportunity for heroic measures if they should arise, which gives it the: I actually am doing something important feel. And Im sure their contracts werent renewed because they just didnt enjoy what they were doing and were going to leave anyway. Gas rocks and that is why people are switching. People were discouraged for a long time, now people are seeing how great it really is, and the immense job market afforded by. Many, many more pluses as compared with GS. Unlike you need to cut, then do surgery. Otherwise, enjoy life, we have more fun because we can. Good luck with that.

 

[toughlife]

The ones I know who switched from surgery to anesthesia did so because it wasn't as intensive as surgery and they didn't want as much responsibility that comes with being a surgeon. A few switched because their contracts were not renewed by their surgery programs.

so why do you bother coming to this forum to inquire whether we care about surgery? Aren't you smart enough to know we don't?

 

[Misterioso]

So having the sole job of giving and maintining life for a person on the order of a couple of hours is not responsibility, think again.

An anesthesiologist doesn't have the sole job of "giving and maintaining life". I don't know where you got the "giving" part from, but you are overemphasizing your role. Remember, a CNA can do almost everything an anesthesiologist does. In fact in some places they do.

Oh and doing stupid post of checks to make sure you got everything right or there wasn't some unexpected complication.

I didn't realize postop complications were "stupid".

And Im sure their contracts werent renewed because they just didnt enjoy what they were doing and were going to leave anyway.

You're "sure"? How would you know since you don't know them? Unless you're just assuming. Sloppy logic for you to assume contracts don't get renewed "because they just didnt enjoy what they were doing and were going to leave anyway". You might as well say they quit because they knew they were going to get fired.

Many, many more pluses as compared with GS.

That's a matter of opinion. But why are you so bitter about GS?

 

[miamidc]

An anesthesiologist doesn't have the sole job of "giving and maintaining life". I don't know where you got the "giving" part from, but you are overemphasizing your role. Remember, a CNA can do almost everything an anesthesiologist does. In fact in some places they do.




I didn't realize postop complications were "stupid".



You're "sure"? How would you know since you don't know them? Unless you're just assuming. Sloppy logic for you to assume contracts don't get renewed "because they just didnt enjoy what they were doing and were going to leave anyway". You might as well say they quit because they knew they were going to get fired.



That's a matter of opinion. But why are you so bitter about GS?

dude it kind of annoys me that you come to a gas forum to ask and muddle aloof in your sense of good grace. i would be much obliged if you simply went on your way and let this place recover from having you graze its presense. U r not going to have any luck here. peace sucker im

 

[Misterioso]

dude it kind of annoys me that you come to a gas forum to ask and muddle aloof in your sense of good grace. i would be much obliged if you simply went on your way and let this place recover from having you graze its presense. U r not going to have any luck here. peace sucker im

I'm responding to the issues posed in this thread. If it annoys you so much you don't have to keep replying to me.

 

[usnavdoc]

I'm responding to the issues posed in this thread. If it annoys you so much you don't have to keep replying to me.

Look what everyone is saying is we know you. You are the third year med student who thinks surgery is the end all be all of medicine. And thats fine. Shortsighted on your part but fine.

Just do surgery and enjoy yourself. We will enjoy what we do and thats that.

 

[Gimlet]

Don't even bother arguing with Misterioso, guys...it's like yelling at a brick wall. Here's a thread where he gets his $hit pwned and doesn't even realize it.

He has also started threads in the Gen Surg forum entitled "Is it possible to be a surgeon but let others do the postop care?" and "How limited can a general surgeon 'tailor' their practice after residency?" The question he asks in the latter thread is, "So I wonder is it possible for a general surgeon to do only the most basic/routine cases (appendectomies, hernias, gallbladders)?" I guess we can tell that Misterioso really thinks he will be able to "hack it" as a surgeon.

http://forums.studentdoctor.net/showthread.php?t=260826
http://forums.studentdoctor.net/showthread.php?t=253961

Stop trolling on the anesthesia board, Misterioso...It's obvious you have nothing constructive to contribute to our discussions.

 

[brisk80]

Don't even bother arguing with Misterioso, guys...it's like yelling at a brick wall. Here's a thread where he gets his $hit pwned and doesn't even realize it.

He has also started threads in the Gen Surg forum entitled "Is it possible to be a surgeon but let others do the postop care?" and "How limited can a general surgeon 'tailor' their practice after residency?" The question he asks in the latter thread is, "So I wonder is it possible for a general surgeon to do only the most basic/routine cases (appendectomies, hernias, gallbladders)?" I guess we can tell that Misterioso really thinks he will be able to "hack it" as a surgeon.

http://forums.studentdoctor.net/showthread.php?t=260826
http://forums.studentdoctor.net/showthread.php?t=253961

Stop trolling on the anesthesia board, Misterioso...It's obvious you have nothing constructive to contribute to our discussions.

I found these comments interesting as well: "not all of us want to sell our lives to our careers and be just another walking cliche of a surgeon"... "I'm interested in knowing if it's possible to mainly operate and leave most of the postop to other doctors".... "I don't see what the big fuss is if other doctor(s) handle the routine postop management"

 

[Magnus67]

Don't even bother arguing with Misterioso, guys...it's like yelling at a brick wall. Here's a thread where he gets his $hit pwned and doesn't even realize it.

He has also started threads in the Gen Surg forum entitled "Is it possible to be a surgeon but let others do the postop care?" and "How limited can a general surgeon 'tailor' their practice after residency?" The question he asks in the latter thread is, "So I wonder is it possible for a general surgeon to do only the most basic/routine cases (appendectomies, hernias, gallbladders)?" I guess we can tell that Misterioso really thinks he will be able to "hack it" as a surgeon.

http://forums.studentdoctor.net/showthread.php?t=260826
http://forums.studentdoctor.net/showthread.php?t=253961

Stop trolling on the anesthesia board, Misterioso...It's obvious you have nothing constructive to contribute to our discussions.

OMG that is funny, what a Poser. I really respect Bad-Ass surgeons that can live that lifestyle. That would be like me saying is there anyway I can do Anesthesia, but have someone else do IVs and Lines?, I dont like needles.

 

[militarymd]

I love it...this is sooooo funny....don't people ever think their previous threads won't be read by others.

 

[Misterioso]

You are the third year med student who thinks surgery is the end all be all of medicine.

That's not true. Every specialty has its role. Just that general surgeons can do more than other specialties.

 

[Stillinscrubs]

That's not true. Every specialty has its role. Just that general surgeons can do more than other specialties.

LMAO, weak.......

 

[geekgirl]

hello friends,
i'm not sure how i got sucked into reading this battle, but can't we all just get along (in the most cliche of terms)? but really cliches happen for a reason. and i know that surgeons would be nowhere without anesthesiologists. and vice versa.
i (and many others) view this process of patient care as a team endeavor. and i think we should struggle to avoid the "we are better than they" mentality and realize that as a team, we all kick fu*cking ass. no one program is better than the other. they are lost without the other. so here's to the rocking gas folks. and the wonderful cutters and pasters too.
here's to solidarity!
gg

 

[Danger Man]

No need to continue to argue with that clown Misterioso...the worst punishment that he will have will be to practice medicine with a piss-poor attitude like his. He will step on many toes in his career and, in the end, he will reap the pathetic harvest from the seeds that he sows. We are secure in our knowledge and our place in the medical world. Case closed.

 

[powermd]

Not to completely change the subject here, but do any of the anesthesiology residents or future anesthesiology residents have any idea of the reasons why nearly every person I run across who wants to switch residencies is switching to anesthesiology? Is it the fact that there are procedures involved, the fact that there is little patient contact (in the sense of asking a sexual history, doing a rectal, etc. I mean), the money potential, or just a re-assessment of their interests?

Thanks.

Why are people switching to anesthesiology?

The perception of lots of money and a controllable lifestyle is probably the most important reason. The specialty it's self is very cool, but I doubt the majority of those who dream of greener pastures in anesthesiology understand why. Patient contact- it's not that there's less patient contact in anesthesiology, it's that the contact is much more pleasant and fun. We don't spend a lot of time interrogating people about their chest pain, bowel habits, or sexual history.. etc. Personally I find it exhausting to ask patients what seem like a million questions to tease out a good history, or at a minimum, rule out bad stuff that's extrememly unlikely anyway. Patients are typically well worked up by the time they get to the OR, so much of that work has been done for us. We can focus on the issues most important to the anesthetic and critical care while they're asleep. Part of our job is to establish rapport and earn the confidence of the patient quickly, which is much more fun than doing a thorough review of systems. For many procedures we can keep the patient awake and talk to them throughout the surgery, which can be very rewarding. Anyone who minimizes the concept of patient contact in anesthesiology is either really bad at it, or has never practiced anesthesiology. The procedures are not as cool as what the surgeons get to do, but they are fun, require lots of practice to do well, and can be life-saving when the patient is in extremis. Developing and using the skills needed to take control of a life or death situation is very rewarding. The cerebral aspects of the specialty are hard to appreciate until you practice anesthesiology. It's a bit like a game of chess. You are constantly thinking a few steps ahead and formulating several alternative plans for different situations that can arise. The work tends to be relaxing, because anesthetics usually go as planned, and you're instincts are almost always right. It's the surprises that keep you on your toes, and responding to them quickly can be stressful if you're not prepared. It helps to have the kind of personality that doesn't crumble under pressure. People expect you to exude confidence and take action quickly when things go bad. Negative aspects of the specialty are mostly the flip-side of the positives. Long-term contact with patients doesn't exist (except in pain, but then again... few doctors want long-term contact with pain patients). Hours are controllable and the pay is good, but you're very busy when you're at work, and there's not a lot of downtime to just chill out with your colleagues. There will always be people criticizing the specialty and saying things like "a nurse can do your job." It's annoying, but these people just don't understand how we work. Anesthesiology is not a utopia, but for many doctors the postives far exceed the negatives. Wow, this was a really long post.

 

[miamidc]

Why are people switching to anesthesiology?

The perception of lots of money and a controllable lifestyle is probably the most important reason. The specialty it's self is very cool, but I doubt the majority of those who dream of greener pastures in anesthesiology understand why. Patient contact- it's not that there's less patient contact in anesthesiology, it's that the contact is much more pleasant and fun. We don't spend a lot of time interrogating people about their chest pain, bowel habits, or sexual history.. etc. Personally I find it exhausting to ask patients what seem like a million questions to tease out a good history, or at a minimum, rule out bad stuff that's extrememly unlikely anyway. Patients are typically well worked up by the time they get to the OR, so much of that work has been done for us. We can focus on the issues most important to the anesthetic and critical care while they're asleep. Part of our job is to establish rapport and earn the confidence of the patient quickly, which is much more fun than doing a thorough review of systems. For many procedures we can keep the patient awake and talk to them throughout the surgery, which can be very rewarding. Anyone who minimizes the concept of patient concept in anesthesiology is either really bad at it, or has never practiced anesthesiology. The procedures are not as cool as what the surgeons get to do, but they are fun, require lots of practice to do well, and can be life-saving when the patient is in extremis. Developing and using the skills needed to take control of a life or death situation is very rewarding. The cerebral aspects of the specialty are hard to appreciate until you practice anesthesiology. It's a bit like a game of chess. You are constantly thinking a few steps ahead and formulating several alternative plans for different situations that can arise. The work tends to be relaxing, because anesthetics usually go as planned, and you're instincts are almost always right. It's the surprises that keep you on your toes, and responding to them quickly can be stressful if you're not prepared. It helps to have the kind of personality that doesn't crumble under pressure. People expect you to exude confidence and take action quickly when things go bad. Negative aspects of the specialty are mostly the flip-side of the positives. Long-term contact with patients doesn't exist (except in pain, but then again... few doctors want long-term contact with pain patients). Hours are controllable and the pay is good, but you're very busy when you're at work, and there's not a lot of downtime to just chill out with your colleagues. There will always be people criticizing the specialty and saying things like "a nurse can do your job." It's annoying, but these people just don't understand how we work. Anesthesiology is not a utopia, but for many doctors the postives far exceed the negatives. Wow, this was a really long post.

I agree 100%

 

[ReefTiger]

I'll throw in my 2 cents. I totally agree with powermd, and I'll continue with some of my thoughts.

First, misterioso is just someone that has no frame of referece. Surgeons just get to do more is not true. They just get to do more general surgery. They have the same amount of responsibility as everyone else does relative to their jobs. Once he becomes a doctor and has to work he will realize the vast amount of knowledge all physicians must attain. I personally have a ton of respect for every field for a) learning the vast amounts of information relative to that specialty and b) having a desire to do what it takes to be successful in that field. Just because you dislike a field of medicine does not make it any less important, it should make you appreciate what your desired field encompasses.

With that being said, I think the confusing thing about anesthesia is conveying to someone who's never done it exactly what is enjoyable. Most anesthesia residents are overall very happy (especially compared to surgical residents) and for several reasons.

Most people outside the field want to switch because of many of the things powermd said, but I'll add (or rephrase) more. Residents in other fields often hear anesthesia talking about how great their jobs are. I love my job! I never shy away from telling people who ask either. Unfortunately, you really don't get much response from telling people you get to play with real time physiology. The usual responses that are tangible they can relate to are:

You get to do procedures (with the upside of minimal documentation)
Minimal pager hassle
Very focused H&P
24 hour call with post op day off
Financial reimbursement outlook

Other things I find enticing:

One patient at a time
Control of drugs, ventilator, vital sign monitoring
I can sit down a fair amount of time
Many preformed documentation sheets
Minimal nurse dependence (unless you count CRNAs which don't pertain to residency)
Days off are days off (meaning never a page or need to come in)
NO ROUNDING

I think that these are some of the reasons people in other fields find anesthesia a viable option. These are also the reasons a lot of medical students like it or choose it as a specialty. The most common reasons people
dislike anes are:

perception it could be/is boring
too repetitive or want more variety
no long term patient contact
perception they are second fiddle to surgeons
unfounded CRNA paranoia
unrealistic med school exposure

Unfortunately, there is no way for students or anyone to know what anesthesia's really about until one "walks the walk". By that I mean you are in the room without anyone else for an extended period of time. Every single resident or attending or CRNA will tell you that the first month of anesthesia is an undescribable, terror filled, pressure packed month. At the same time it is rewarding because only then can one appreciate the "little victories" like having a bougie ready in a sticky situation. These "little" things, in addition to major things like doing fiber optic intubations are examples of what residents can talk about that can build confidence and serious comraderie.
The other unfortunate perception is that we get to sit around. I won't lie about it, as a med student I did think it would be a little more lax than it is. It is well documented on this forum that we work our asses off, and it's true.
Once again, until you're doing it you'll never realize it. This isn't to say that other specialties don't work hard, just that anesthesia has more of a "laid back" reputation concerning work (unfortunately a lot of which is due to our chair sitting).

I honestly feel if all surgery residents had to do a month of anesthesia solo with attendings rather than the "floating intubator" role there would be magnitudes more respect than many percieve. Actually, most of the surgeons I work with including attendings are respectful (at least with me). I think a lot of that also has to do with how you do your job and carry yourself.

Sorry for the long post, but that's my 2 cents. If you want more just ask.

 

[toughlife]

Thanks for the outstanding posts!

 

[Magnus67]

Great Couple of posts, really insightful. Being a third year reading that stuff really makes me want to jump in with both feet. Thanks

 

[jetproppilot]

Thanks for the outstanding posts!

I agree. Reef and Power, come up to the stage and get your Grammy for those informative, well written, non-provocative posts that provided alotta insight.

Again, like I've said before, alotta the "perception worries" one has as a fourth year med student or a new resident is almost exclusively an academic entity. Once you finish residency and start working, your life, and your partners, crna/aa colleagues, surgeon colleagues, lives "broaden" beyond this. Nobody cares anymore who does more/less work, whose job has less variety, whose job is "boring", who rounds and who doesnt, etc etc.

Anyway, nice posts.

 

[ThinkFast007]

I agree. Reef and Power, come up to the stage and get your Grammy for those informative, well written, non-provocative posts that provided alotta insight.

Again, like I've said before, alotta the "perception worries" one has as a fourth year med student or a new resident is almost exclusively an academic entity. Once you finish residency and start working, your life, and your partners, crna/aa colleagues, surgeon colleagues, lives "broaden" beyond this. Nobody cares anymore who does more/less work, whose job has less variety, whose job is "boring", who rounds and who doesnt, etc etc.

Anyway, nice posts.

hey Jet...q for ya.

I never asked this to an attending in private practice (well cuz my anesthesiology private practice exposure was somewhat limited). But how often are YOU on call (I'm sure it varies from group,etc). But also, this business about having the 'post call day off"....that's only in residency right? I'd imagine as an attending in private practice you still have to come in? From what I gather, you all take call from your house and only must drive in if there's an emergency,etc???

Again, my exposure is limited to academia so i'm sorta ignorant about hte private pract world.

 

[jetproppilot]

hey Jet...q for ya.

I never asked this to an attending in private practice (well cuz my anesthesiology private practice exposure was somewhat limited). But how often are YOU on call (I'm sure it varies from group,etc). But also, this business about having the 'post call day off"....that's only in residency right? I'd imagine as an attending in private practice you still have to come in? From what I gather, you all take call from your house and only must drive in if there's an emergency,etc???

Again, my exposure is limited to academia so i'm sorta ignorant about hte private pract world.

Nice question, Think.

And the answer to your question is, well, its totally dependent on where you practice.

My current gig is we have 4 doctors in a team-approach model.

We work 2 weeks of days, a week of nights, then a week off.

Heres the translation:

2 doctors work 2 weeks of days. Mon Wed Fri I'll work 6am-6pm. At 6pm the night dude comes on.

Tues Thurs I'll leave around 3pm.

Those are the day weeks.

Then comes my night week.

I'm resposible for Sat and Sun. Could be bad, could be ok.

Then I come to work at 6pm, Mon-Fri.

The bad news is I could get slaughtered Sat and Sun, then be up every night Mon-Fri.

The good news is I get nine days off in a row after my tortuous week. Which equates to 13 weeks vacation.

Whats the alternative? Every 4th night call, with post call day off. But if one of my partners is on vacation, then the remainding 3 partners would take every 3rd night call.

There it is. A real world private practice schedule. We've chosen to sequester our "misery night life" into one week, enabling us to group our off-days into a continuous cycle.

But the sky's the limit, as long as we have the OR covered.

In the southeast, where the team-model is ubiquitous, MDs are privy to coordinate their schedule however they want, as long as the OR is covered. Not saying its better or worse, just telling you how it is.

Noyac, in Colorado, who practices all-MD anesthesia, will give you a different scheme.

Hopefully he'll chime in to tell you how his schedule works.

Bottom line, NIGHT CALL is the nemesis of anesthesia. I guess we're a "lifestyle" specialty, because of our flexibility, but lemme tell you, theres a price to pay. I deplore my weekend/night week. It sucks. I'd give my left testicle to make it go away. It makes me old before my time. For 7 days straight, I usually am in bed with my wife, asleep, and am awakened, along with my wife, 2 or three times a night, to BEEEEEP BEEEEEEP BEEEEEEP BEEEEP . i really shouldda been a cfa...couldda been reporting on biotech stocks during the daytime hours...

But the time off is awesome. I work hard during my weeks at work. But I get more time off a year than a school teacher. Just the way we've tweeked our practice.

And for every practice, you'll hear several other potential tweeks.

I work to live.

Not the opposite.

 

[ckyuen]

Depends on what field. I have 11 cases in the OR next week and about 7-10 more in the office, and I won't work 40 hours next week. But I'm in a surgical subspecialty, ophtho.

 

[jetproppilot]

hey Jet...q for ya.

I never asked this to an attending in private practice (well cuz my anesthesiology private practice exposure was somewhat limited). But how often are YOU on call (I'm sure it varies from group,etc). But also, this business about having the 'post call day off"....that's only in residency right? I'd imagine as an attending in private practice you still have to come in? From what I gather, you all take call from your house and only must drive in if there's an emergency,etc???

Again, my exposure is limited to academia so i'm sorta ignorant about hte private pract world.

Again, variable. Many practices have the post call doc off on his post call day. Other practices have you come to work and usually have you out before noon.

When you go on on interview for a private practice job, obviously you wouldnt wanna say "do you guys get your post call off?" as it may be perceived in the wrong way. Rather, "how do the docs do their schedule?" is a lighter way to find out the same info.

 

[threepeas]

great recent posts. regarding patient interrogation: for me this is one of the big issues that racks my brain when deciding on anesthesiology or not. i acutually enjoy the questioning of patients in the traditional interview format. I find it very challenging both on an intellectul level and a communication level. I enjoy illiciting histories from patients that are more accurate than the next guy. its amazing how many versions a patient will give of their history if you dont ask the right questions, but i really like being the person that got it right. being a great interviewer is very challenging and can make you a very good physician compared to others all else being equal. As a PA i have seen useless tests and surgeries avoided b/c a good interviewer was able to get a more accurate picture. i also enjoy checking things off in my differential dx as i am interviewing hoping to narrow things down and limit useless tests. i love anesthesiology, the skills they learn, the meds they push, the procedures they perform, and the services they provide, but i might not go into it because of how much I enjoy doing a traditional H and P, developing a DDx, ordering tests, deciding on a Dx, and formulating and implemating a Rx plan which is what we spend most of our time doing in medschool. some of these activities do occur in anesthesiology of course but i feel on a more limited basis. anyway just food for thought for those comparing anesthesiology with other more traditional fields of medicine. A CCM fellowship may allow me to practice both and balance my need to do the above mentioned stuff, so who knows.

 

[miamidc]

Hey buddy where did you go, guess you just couldn't believe how good GAS is compared to Surg after these posts huh. I miss you.

 

[Misterioso]

Hey buddy where did you go, guess you just couldn't believe how good GAS is compared to Surg after these posts huh. I miss you.

It's a matter of opinion "how good" surg and anesthesiology are compared to each other. But the fact that surg is both more popular and more competetive to get into than anesthesiology speaks for itself.

 

[CameronFrye]

It's a matter of opinion "how good" surg and anesthesiology are compared to each other. But the fact that surg is both more popular and more competetive to get into than anesthesiology speaks for itself.

Good one.

 

[cchoukal]

the issues of "popularity" and "competitiveness" are complicated ones. The true measure of popularity in this case would be the number or percent of applicants that rank GS vs Anesth programs. And as near as I can tell from the NRMP website, those numbers are not available publicly. Perhaps websites devoted to each specialty might have those date, but the NRMP doesn't seem to keep that.

The issue of competitiveness is even more muddled. There are a lot of different ways to slice it. One way is to look at the "positions offered and percent filled" tables. It shows that GS filled more of their spots (99.3% vs 94.8%) than did anesth programs, and furthermore they filled a greater percentage of their slots with US grads (80% vs 70%). This is at least somewhat misleading, though, because there are a couple hundred more anesth spots than GS spots (although I was surprised at how small the difference was; I had assumed there were a LOT more anesth spots than GS spots offered). Still, I think most people would admit that the % filled by US grads is probably a decent proxy for the nebulous concept of "competitiveness."

Of course, the larger issue is whether this difference is meaningful in a "larger scope" sense and, if so, who, besides misterioso, gives a flying F. I peruse a few different forums, as I was previously interested in a pretty wide range of specialties as a med student, and I don't see much of this kind of pointless drivel elsewhere. I'm a little older and I've done a few different things, so my perspective might be different from that of the majority, but what I've noticed is that the people with the biggest balls and the most competence usually go about their business with a quiet efficiency, reasoned process, and effectiveness that others can't help but pick up on. In contrast, the yappers, taunters, and instigators tend not to "have it."

 

[ThinkFast007]

It's a matter of opinion "how good" surg and anesthesiology are compared to each other. But the fact that surg is both more popular and more competetive to get into than anesthesiology speaks for itself.

SIG E CAPS

Are you feeling excessively sleepy?
interest kinda low?
Feelings of guilt?

How's the energy level bro?
Can you concentrate?
That activity level, how's that been?
Look kinda jittery there fella
Attempted suicide lately?

 

[jetproppilot]

SIG E CAPS

Are you feeling excessively sleepy?
interest kinda low?
Feelings of guilt?

How's the energy level bro?
Can you concentrate?
That activity level, how's that been?
Look kinda jittery there fella
Attempted suicide lately?

the world needs surgeons and anesthesiologists. One cannot function without the other.

So pick your specialty and stop worrying about who has the bigger ball sac. A few months from now, noone will care who went into what.

And congratulate your surgeon colleague (if you matched anesthesia); and congratulate your anesthesiologist colleague (if you matched surgery).

Better to realize reality now. You need each other.

Your time is better spent opening Corona's, preferably with some ice crystals floating on the top.

 

[The_Sensei]

...Corona's, preferably with some ice crystals floating on the top.

Abso-f ucking-lutely!!

 

[lvspro]

the world needs surgeons and anesthesiologists. One cannot function without the other.

So pick your specialty and stop worrying about who has the bigger ball sac. A few months from now, noone will care who went into what.

And congratulate your surgeon colleague (if you matched anesthesia); and congratulate your anesthesiologist colleague (if you matched surgery).

Better to realize reality now. You need each other.

Your time is better spent opening Corona's, preferably with some ice crystals floating on the top.

mmmmmm.... beer.

 

[toughlife]

Abso-f ucking-lutely!!

..forgot the slice of lime

 

[The_Sensei]

..forgot the slice of lime

Yes! If you are man anyway...

 

[ReefTiger]

Thanks for the good word Jet, I can't wait to put my Grammy on the mantel!!
I was worried it may have been a little long winded.

Oh, I forgot to correct the others before:

it's
A=airway
B=book
C=chair
D=dollars
E=envy


Jet, I'm from Louisiana (Baton Rouge) and was wondering how the job market is around NO and BR. Especially post Katrina. Thanks!!

 

[jetproppilot]

Thanks for the good word Jet, I can't wait to put my Grammy on the mantel!!
I was worried it may have been a little long winded.

Oh, I forgot to correct the others before:

it's
A=airway
B=book
C=chair
D=dollars
E=envy


Jet, I'm from Louisiana (Baton Rouge) and was wondering how the job market is around NO and BR. Especially post Katrina. Thanks!!

Tight right now in New Orleans, reef. I'm not sure about BR.

 

[toxic-megacolon]

SIG E CAPS

Are you feeling excessively sleepy?
interest kinda low?
Feelings of guilt?

How's the energy level bro?
Can you concentrate?
That activity level, how's that been?
Look kinda jittery there fella
Attempted suicide lately?

If all you care about is lifestyle, why not CRNA over Anethesiology? Of course the reasons are obvious. But it amazes me how many Anesthesia residents can't comprehend why someone would rather do surgery than anesthesiology. Its along the same continuum.

Reasons to do Anethesia over CRNA
1. More autonomy
2. More procedures
3. Don't have to put up with as many orders/demands/requests from others
4. More competitive
5. More prestigious
6. More memorable to their patents than CRNA
7. Longer, tougher training, but its worth it to many.
8. Longer hours, but worth it.


Reasons to do Surgery over Anethesiology
1. More autonomy (In the end, its the surgeon's patient)
2. More procedures (The damn operation vs. a 60 second intubation or line)
3. Don't have to put up with demands (Bed up please, don't give him any more phenylephrine, dammit!)
4. More competitive (scrambling into a CATEGORICAL surgery spot is very difficult unlike Anethesia)
5. More prestigious (They make shows like ER, Gray's about cracking chests, not induction for a reason)
6. More memorable to their patients most of the time. (Self explanatory)
7. Longer, thougher training, but worth it to many.
8. Longer hours, but worth it (Time flies when you operate)

Look familiar??? Many, many identical reasons.

I don't point this out because one specialty is ultimately better than another. But realize that everything (even good lifestyle and money) comes with a price. So before thinking that you have it all figured out by doing anethesiology, maybe consider CRNA, then you can laugh at ALL those sucker doctors for going to school and doing all that silly learning'n'stuff.

And on the lifestyle thing, Working long-ass hours is a personal choice, not required by the specialty. Many anesthesiologists do it, and many surgeons don't.