Anesthesia vs. IM

[drseanlive]

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I've been going between gas and IM (cards/gi) for a while...It seems like at the moment they are making comparible $$ and it seems like the gas lifestyle is ultimately better.

I like both fields about equally, and I would like to go for anesthesia. However it seems to me that everyone and their mother is wanting to go into anesthesia lately. Has it always been like this?

More importantly, I am seriously concerned about the future of this field. All I read about are CRNAs and how salaries are going to plummet as soon as the current shortage is filled. Are these problems serious enough to consider getting into a different field? Has there always been hype on these topics? Or is it all just hype like much of the other stuff written on sdn?

How many of you in gas would recommend doing something else? How many of you wouldnt?

 

[coprolalia]

D.A.S.

"Do A Search"... These topics have been covered ad nauseum on this forum.

-copro

 

[fakin' the funk]

I've been going between gas and IM (cards/gi) for a while...It seems like at the moment they are making comparible $$ and it seems like the gas lifestyle is ultimately better.

I like both fields about equally, and I would like to go for anesthesia. However it seems to me that everyone and their mother is wanting to go into anesthesia lately. Has it always been like this?

More importantly, I am seriously concerned about the future of this field. All I read about are CRNAs and how salaries are going to plummet as soon as the current shortage is filled. Are these problems serious enough to consider getting into a different field? Has there always been hype on these topics? Or is it all just hype like much of the other stuff written on sdn?

A true devotee to the field.

 

[treasurefull2]

A true devotee to the field.

Well, this bothers me too, but it seems like every other post on here praises these aspects of the field as the EXACT reason to go into anesthesia... I mean, take a look at some of the most viewed threads...

 

[911_turbo]

Do a prelim year in medicine and see if it changes your mind.

 

[treasurefull2]

maybe or maybe not👎

 

[drseanlive]

to fakin' the funk-

i think you are coming to an unfair conclusion by saying "a true devotee to the field". It would be a waste of energy to point out why i like anesthesia as well as IM, as everyone has their own personal reasons.

Whats wrong with asking about what the future of anesthesia is?

As I learn more about the field I get more nervous about pursuing it. Besides the CRNA issue which is in the air, there seems to be a huge flood of students interested in the field. I am unsure if it has always been like this, but MANY MANY people are interested in anesthesia, I believe 20+ people in last year's match got into it.

I think a legit questions to ask are:
1) has there always been this interest in anesthesia
2) is this field going to be stable relative to other fields, or is there an exceptional risk in terms of its future.

 

[fakin' the funk]

My was reflective of these points:
1. Money and lifestyle were the first items you mentioned
2. Whether or not anesthesiology is popular is not a good reason to consider it or not as a career
3. You already have some pretty significant misgivings about the future of the field

Point being, I hope your interest in a field (any field) is guided by more than money, lifestyle, popularity. The role of advanced practice nurses, maybe.

 

[powermd]

My last year at Columbia, we had three CA-1 residents, who were definitely medicine inclined, leave the field. Two went into IM, one took a business job.

Anesthesiology is NOT right for everyone. If you like another field equally, but are swayed by the bucks and perceived lifestyle of gas, think hard.

 

[coldweatherblue]

there seems to be a huge flood of students interested in the field. I am unsure if it has always been like this, but MANY MANY people are interested in anesthesia, I believe 20+ people in last year's match got into it.

But what does it matter if there's more interest from U.S. allopathic students? Unless there is a marked increase in anesthesia residency slots, there shouldn't be any effect on ultimate job availability. More interest from students doesn't equal more anesthesiologists. If MANY more people apply anesthesia may become more competitive, but the job market shouldn't be affected.

 

[RxBoy]

I take it you're a 3rd year because you would of already made up your mind at this point. If thats the case... I was in your same shoes.

Money shouldn't mean everything... but some of these old timers don't understand that 200k debt is no longer the exception, but the rule. So as far as monetary concern... Anesthesia is better (as of now of course). Its better in the sense of work hours/compensation. With that said, everyone knows a private practice Cards center is practically a money machine.

I wanted to do Cardiology too... that is until I did a rotation in it. Its a very interesting field, and a powerful field too. I always felt like the Cardiologists are the rockstars of the hospital. But one thing I found out, Cardiologists work like dogs. Like I mean, they are always in demand. If your a cardiologist on call... don't expect a night of sleep. You'll always be paged for a potential MI n in the ER. I remember I asked my very blunt attending, why do you guys work so many hours. His response:

Lets say there was a room filled with hundred dollar bills, and your job was to pick up hundred dollar bills and put them in your bottomless pockets. The only thing stopping you is leaving the room... How long would you want to stay in that room?... altruistic no, realist yes.


Another important thing to remember... Cardiology is very tough to match. Your internal medicine years will be another medical school competition. You'll have to beef up your resume with all that extracirc crap so that you can match into cards. GI is pretty tough too. The other ones not so much (except pulm and sleep are moderately competitive).

But honestly the only way to know, do a rotation in both. I did a rotation in Cards and was like I GUESS I can see myself doing this for the rest of my life. Then I did a rotation in anesthesia, and was like I KNOW I can see myself doing this for the rest of my life.

 

[amyl]

endless walk rounds. endless non compliance issues. endless social issues. endless placement issues. endless demented old people issues. endless placement issues that turn into pts really getting sick after being in a hospital for a week for no good reason other than awaiting placement. endless other services trying to turf what is rightfully their pt to some other service for some stupid reason. medicine sucks. if you feel this way too, than anesthesia might be for you. if not then stick to medicine.
and please, please don't pick a career with money as number one. you really do have to like what you do and it IS worth a little less green for that.
i know several doctors, gi guys, cardio guys, various subspecialty surgeons that don't love it and only do it for the cash...they are miserable. i know you think you can do anything if the paycheck is right but trust me, the thinking is naive and you will feel differently a few years in...i have been there.

 

[ozzie20]

Financially speaking, whats the point of doing FP or IM???

I mean honestly, if you dropped out of your residency after your intern year and moonlighted making 80-100$/hour @ 40 hours a week, you'd end up with as much money as an FP or IM doc makes working full time. Pair that with being able to invest a LOT more money earlier (you'd be able to invest huge chunks of cash vs your counterparts in residency who couldn't cause they make residency money) you'd make a LOT more money than they would on the tail end of things, IE retirement age.

 

[Magnus67]

Do a prelim year in medicine and see if it changes your mind.

LOL totally agree, if you finish your IM intern year without scars on your wrists and rope burns on your neck, than just stay in medicine.😛 If your deciding between the two, your pretty undecided in general.

 

[dragonfly99]

Agree with rxboy and amyl, though medicine isn't quite as bad as what amyl is making it out to be (LOL!). He's pointing out the bad aspects of IM pretty well, though.
I'd say the bad aspects of anesthesia include some surgeons can be jerks to you, and there is stress from patients crashing in the middle of surgery. Also, difficult airway issues.

Of course, patients crash in the MICU and on the medicine floor as well, but if someone found out they don't enjoy emergencies, he/she could ultimately become an allergist, all-outpatient doc, whatever.

One advantage of IM is that you could either stay a general IM physician, hospitalist, or choose a specialty. That's probably why a lot of students who are undecided end up in IM. Rxboy is spot on about the fact that IM residency often seems like an extended working interview (at least the first 2 years of it), which can get old.

Anesthesia is different than IM in that it tends to attract people who like to do a lot of procedures and don't necessarily need the gratification of providing continuity of care. You probably don't have a lot of patients bringing you presents like some of my patients used to do when I had a general IM resident clinic...