Anesthesia vs Gen. Surgery......... Looking for advice

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dp101

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Hello all,

I am a current 4th yr medical student who is currently participating in this years match. I am struggling to decide between anesthesia or surgery. I was always interested in surgery and have done several elective rotations. I love the adrenaline when you are first assist and not retracting the entire time. I hate the dreadful hours and being treated as a peasant by your seniors.
Then anesthesia caught my interest. I did a 4th year elective as well and I enjoyed it. The hours were great. If i stay late one day i was the first out the next day. Everyone was super friendly. Got to do a few hands on procedures and intubate, however sometimes it was a little boring.
I applied to both specialties and have a great opportunity for each, however I cant seem to decide which I want more. Ive read several forums from the past but would like to hear if anyone has some new input. It would be greatly appreciated.

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Hello all,

I am a current 4th yr medical student who is currently participating in this years match. I am struggling to decide between anesthesia or surgery. I was always interested in surgery and have done several elective rotations. I love the adrenaline when you are first assist and not retracting the entire time. I hate the dreadful hours and being treated as a peasant by your seniors.
Then anesthesia caught my interest. I did a 4th year elective as well and I enjoyed it. The hours were great. If i stay late one day i was the first out the next day. Everyone was super friendly. Got to do a few hands on procedures and intubate, however sometimes it was a little boring.
I applied to both specialties and have a great opportunity for each, however I cant seem to decide which I want more. Ive read several forums from the past but would like to hear if anyone has some new input. It would be greatly appreciated.
Anesthesia.
 
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Pretty sure you have to do ortho to do a hand fellowship, unless you're using "hand fellowship" as a euphemism in this context...

http://www.assh.org/About-ASSH/Join-ASSH/Become-a-Hand-Surgeon


TRAINING REQUIREMENTS
A career in hand surgery begins with a high school diploma, a four year college degree, and completion of medical school.

After medical school, you must attend a residency program, where you will receive clinical training in a specialized area. Training in hand surgery begins with one of the following ACGMEaccredited residencies:

  • Orthopaedic Surgery (5 years)
  • Plastic Surgery (5-7 years)
  • General Surgery (5 years)
After a residency is successfully completed, hand surgeons complete a one year ACGME accredited fellowship in hand surgery.
 
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Pretty sure you have to do ortho to do a hand fellowship, unless you're using "hand fellowship" as a euphemism in this context...

You can do a hand fellowship through multiple routes, ortho is just far and away the most common.
 
http://www.assh.org/About-ASSH/Join-ASSH/Become-a-Hand-Surgeon


TRAINING REQUIREMENTS
A career in hand surgery begins with a high school diploma, a four year college degree, and completion of medical school.

After medical school, you must attend a residency program, where you will receive clinical training in a specialized area. Training in hand surgery begins with one of the following ACGMEaccredited residencies:

  • Orthopaedic Surgery (5 years)
  • Plastic Surgery (5-7 years)
  • General Surgery (5 years)
After a residency is successfully completed, hand surgeons complete a one year ACGME accredited fellowship in hand surgery.

Wow, and I learned something today. I've only known ortho and plastics hand fellows; I wonder how many people from gen surg go into it...
 
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Isn't hand fellowship from GS more difficult to obtain due to bias from ortho depts? Kind of like going in Interventional Pain from PMR vs Anesthesia.
 
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Wow, and I learned something today. I've only known ortho and plastics hand fellows; I wonder how many people from gen surg go into it...

I'm assuming if you're a rockstar at gen surg, get great letter of recs and great connections then you'd be on a somewhat level playing field.
 
Hello all,

I am a current 4th yr medical student who is currently participating in this years match. I am struggling to decide between anesthesia or surgery. I was always interested in surgery and have done several elective rotations. I love the adrenaline when you are first assist and not retracting the entire time. I hate the dreadful hours and being treated as a peasant by your seniors.
Then anesthesia caught my interest. I did a 4th year elective as well and I enjoyed it. The hours were great. If i stay late one day i was the first out the next day. Everyone was super friendly. Got to do a few hands on procedures and intubate, however sometimes it was a little boring.
I applied to both specialties and have a great opportunity for each, however I cant seem to decide which I want more. Ive read several forums from the past but would like to hear if anyone has some new input. It would be greatly appreciated.
Respectfully, these are two completely different specialties. I mean one requires a really solid knowledge of medicine, physiology and pharmacology, way beyond the other, and the other requires great manual skills way beyond the other. While most anesthesiologists also love working with their hands, the big difference between an anesthesiologist and a CRNA is the capacity to work a lot with our brain, based on a lot of internal medicine (and some theoretical surgery) knowledge. So think hard whether you could become an excellent anesthesiologist, or just a mediocre CRNA replacement. This will be important especially if the specialty moves towards perioperative, not just intraop, care, and CRNAs become (more) independent.

I have a feeling you are attracted by anesthesia mostly because of the procedures, and because you have a false sense of lifestyle and "friendliness". About the latter: I have probably seen as many, if not more, dinguses in anesthesia as in surgery. And there is no lifestyle anymore, not unless you want to take a CRNA-level salary. And it's the "boring" part that is punctuated by the famous moments of sheer terror, so the more boring it seems the more vigilant one has to be.

Anesthesia requires a healthy combination of doing and thinking, but the latter is more important than the former IMO. You are an intensivist in the OR; you are not a surgeon. Most of what you do will have to do with drugs, not procedures; the procedures will be mostly needle-based or airway-related, and mostly repetitive (i.e. possibly boring). If you find the science behind internal medicine boring, anesthesia will not be interesting either. You'll need to excel at things that require a physician, things that cannot be digested down to a protocol, and that's where surgery is at a fantastic advantage (nobody thinks a surgeon could/should be replaced with a midlevel, yet).

So think long about the two specialties, about your own strengths and weaknesses, read this forum extensively. There are tons of threads warning students about the specialty, and some seasoned anesthesiologists (not me) would not go into the specialty today, the way the future looks. Good luck!
 
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It's all about your expectations: If you enjoy being THE DOCTOR, the captain of the ship, or the big dog... then you will not be happy doing anesthesia.
In anesthesia you are rarely the center of attention and most your patients have no idea what you actually do.
They are sometimes shocked when they find out that you are a physician, and secretly wonder if it really takes going to medical school to give the sleeping medicine ordered by a real doctor!
Hospital administrators feel they can do to you what they can't do to the real doctors, since you don't really bring them business, and you can be replaced very easily.
Nurses think they can do your job, and many other people in the hospital feel they can do it as well or better: GI doctors, cardiologists, radiologists, ICU nurses, janitors...
So... think hard my friend!
 
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I listened as a senior general surgery resident talked with one of the medical students recently. His advice was that if you can't imagine yourself doing anything else, go into general surgery. If you have any other interests, do that. He stated that he couldn't see himself enjoying anything else or he would have gladly done a different specialty. I found that interesting from someone who was very much a surgery or nothing type. I don't say that to indicate that you have to go into anesthesia because there certainly is a lot of questions in our field, but you should think long and hard before you go into general surgery. Many, many residency programs treat their GS residents poorly and they all pretty much ignore duty hour restrictions.
 
I listened as a senior general surgery resident talked with one of the medical students recently. His advice was that if you can't imagine yourself doing anything else, go into general surgery. If you have any other interests, do that. He stated that he couldn't see himself enjoying anything else or he would have gladly done a different specialty. I found that interesting from someone who was very much a surgery or nothing type. I don't say that to indicate that you have to go into anesthesia because there certainly is a lot of questions in our field, but you should think long and hard before you go into general surgery. Many, many residency programs treat their GS residents poorly and they all pretty much ignore duty hour restrictions.
One doesn't go into a specialty or field because one likes the training. One does it because one likes what comes AFTER the training. One shouldn't make the mistake of choosing a nice training program with crappy "afterlife", but the other way round.

Most people will never tell one not to do something, because no good deed goes unpunished. But let me be your friend here and tell you in no uncertain terms: stay away from anesthesiology, if you can. Do something where you can have a chance at being your own boss, at having your patients judge you instead of some bean counter or owner. No one can serve two masters.
 
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One doesn't go into a specialty or field because one likes the training. One does it because one likes what comes AFTER the training. One shouldn't make the mistake of choosing a nice training program with crappy "afterlife", but the other way round.

While I agree with this, you do have to consider what your life will be like during training. 5 years (minimum) is a large chunk of your life, and a major portion of your prime. I personally love anesthesia, but the future of our profession does cast doubts over where we will be down the road. The future of surgery is not as bleak, although medicine in general across the board is taking a hit. OP, you are getting some of the negatives of both sides of the argument. There's a good chance that either discipline would work for you, but you will have to deal with the drawbacks of whatever you choose. Do you want a better lifestyle during residency in a discipline with a ton of uncertainty? Would you prefer a longer and more difficult residency in a discipline with less mid-level competition? Decide what is most important to you, pick a path and don't second guess yourself. If you have the right personality for either profession, you'll likely be happy in either.
 
Do you like to solve physiologic problems or anatomic ones? The fields are really very different.
 
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I landed in anesthesia in 1997. Before that year program directors were giving bonuses to residents to sign up for anesthesia. I love anesthesia. I turn the damn beeper and have turn down service when my call is over. But thats just me. Will that work for you in the long run? Only you can answer.

How can you get to your own answer? Think what makes you happy in the long run. If hands on surgery is what you love no matter what, spend 5 years in residency and another 5 years working from some other surgeon before starting your own.

Sometimes it is glamarous/feel good to say i am surgeon. Does that pay well to be your own boss? To rent out a practice and set it up costs upward of 200,000$ per year before you can take salary. You are allways paying the land lords. That said all my surgeon friends are very happy to be surgeons. Some of them are in Kaiser, some work for themselves, some have signed up with a group.

Going forward, my prediction is that even surgeons are going to be hospital employees to avoid all the hassles of overhead, decreasing reimbursements, insurance denials etc. figure out a speciality that is going to be in demand and train broadly. Just my 2 cents
 
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Easy. Surgery. Anesthesia is dead.
 
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Neither. Quit, sell your body to pay off your loans, then go into investment banking. Retire when you're 50. I just saved you 40 years of hell.
 
These threads are getting old. This horse has been beaten numerous times....but if you want a quick answer look at @Consigliere reply.....

Life advice
Acquire as little debt as possible
Live in a low cost of living city with a good school system and by an inexpensive home in a nice or up and coming neighborhood.
 
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