anesthesia vs surgical specialty

[Sammich81]

For those of you who have already chosen anesthesiology, can you offer some guidance? I'm an MS3 trying to get off the fence about anesthesiology vs a surgical specialtly. Do you think it's true that if ever you wanted to be a surgeon you won't be happy on the other side of the curtain? I like both fields for different reasons. Love pharm, phys, airway stuff, the focused pt contact, the chance to be really comforting at a stressful time. But also love cutting, sewing, seeing the immediate results of your work, and the dirty sense of humor all surgeons seem to share.

Also, any thoughts about peds anesthesia? That's what I think I would like to do. Is it possible to do a fellowship and wind up as PICU attending?

Finally- I want to match in Cleveland. Anyone know how competitive the Cleveland Clinic and Case Western- University Hospitals are?

Oh and one more thing...do you have to deal with people like misterioso a lot?

Thanks!

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[threepeas]

obviously no easy answer to this except research the fields extensively. do as many rotations as it takes, talk to as many people in the fields as it takes until you get the answers you want. this research is something you have to actively pursue. i think it is inherently easier to see the fun side of a surgical speciality because its very visual, but to give anesthesiology a fair shake you need to really try to imagine yourself in charge of the patients life when under the gas. it has been said many times before that the thrill of GAS is hard to appreciate until your actually doing it which makes it tough to evaluate.

many surgeons tell me: if you love something else in medicine go do it over surgery. most surgeons feel, surgery was the ONLY thing that interested them. regardless of the speciality in surgery the residency is long and tough, and running a practice in the real world is no easy task so it should be something you really love. try and judge the fields 10 years out. the challenge and fun of learning a specific field can be different from how you practice it 10 years out. talk to people who have been out for 10 or so years and see what they say about their field. consider speaking to people doing community surgery or anesthesiology as most of us will find ourselves away from academia when it is all said and done.

its hard to really compare the two fields though because they are so different. that being said i have toyed with the surgery/anesthesia thing. i am a physiology/procedure/relieve pain kind of guy. surgery is too static for me, anesthesiology seems more dynamic. that's sort of cliche i know but that is one way i separate the two fields. surgeons have a fixed problem in front of them that needs their attention, an anesthesiologist has the patients physiology to contend with and maintain which can change at any moment. the bottom line is i want to know what the anesthesiologist knows: deep physiology and pharmacology, procedures, and functional anatomy for regional anesthesia, etc. i am also very interested in critical care which adds another interesting professional dynamic for me and I will probally be someone who tries to find a job that i can work part time anesthesia and part time critical care.

 

[2ndyear]

Yes, you can do PICU, but it will be at least 3 years of PICU fellowship following your residency and likely 1 year of peds anesthesia fellowship. Very very few people choose this route from anesthesia. If nothing makes you happy like PICU, go for it. Here's a link:

http://www.ccm.upmc.edu/education/peds/fellowship_pcc.html#srd

I thought I would do peds anesthesia in med school too. Now as a CA1 I don't think so. Kids scare the crap out of me. Fine as a resident but when I'm done...no thanks.

 

[ThinkFast007]

i think CCF and Case are great programs. I know you are 'earlier' on in your med school career...but definitely do your reserach. I didnt have the best scores or anything, but got invites to both. I guess if you are a US allo you prolly dont have to have that 279 on Step 1 and 2 score to land an interview there.

Friggin state of the, class A programs at any rate (hheheh atleast from hwo they look).

 

[jetproppilot]

Yes, you can do PICU, but it will be at least 3 years of PICU fellowship following your residency and likely 1 year of peds anesthesia fellowship. Very very few people choose this route from anesthesia. If nothing makes you happy like PICU, go for it. Here's a link:

http://www.ccm.upmc.edu/education/peds/fellowship_pcc.html#srd

I thought I would do peds anesthesia in med school too. Now as a CA1 I don't think so. Kids scare the crap out of me. Fine as a resident but when I'm done...no thanks.

3 years of PICU fellowship?



Thats hard to believe, bro, considering you can learn how to do a heart transplant in a cuppla years following a gen surg residency.

 

[toughlife]

For those of you who have already chosen anesthesiology, can you offer some guidance? I'm an MS3 trying to get off the fence about anesthesiology vs a surgical specialtly. Do you think it's true that if ever you wanted to be a surgeon you won't be happy on the other side of the curtain? I like both fields for different reasons. Love pharm, phys, airway stuff, the focused pt contact, the chance to be really comforting at a stressful time. But also love cutting, sewing, seeing the immediate results of your work, and the dirty sense of humor all surgeons seem to share.

Also, any thoughts about peds anesthesia? That's what I think I would like to do. Is it possible to do a fellowship and wind up as PICU attending?

Finally- I want to match in Cleveland. Anyone know how competitive the Cleveland Clinic and Case Western- University Hospitals are?

Oh and one more thing...do you have to deal with people like misterioso a lot?

Thanks!

I matched at CCF and I think it is a great program. I am sure the exposure to great cases is outstanding at both CCF and Case. Don't know much about CWRU though.

As far as why CCF, I must say I was impressed by the strong presence of the dept, the no-BS attitude of the leadership and the opportunity to work hard and learn more than I ever imagined learning. Having interviewed at other strong program like Upenn, Columbia, UW-seattle, WashU, etc showed me that besides location, the opportunities available at CCF were equal or better.

I wanted to be in a program where you work hard and are exposed to sick patients early on. I really liked the intense exposure to critical care (6-7 months) you get in your first year. As an intern you do one month in each of the following: surgical ICU, Peds ICU, Neuro ICU, neonatal ICU, cardiac ICU, cardiothoracic ICU and respiratory special care. This may be discouraging to some since you work hard when you are in the ICU. To me however, it was an opportunity to learn to manage really sick patients.

Also, the people were great during my interview there and I felt that I would fit into the program. The program leaders are known in the field (Dr. Roizen et al) and CCF is known for being an innovative, dynamic and top-rated medical center.

All in all, I say do some rotations there and find out whether it's the kind of place you see yourself at.

Based on your interests, you sound like a procedure-oriented kinda person. As you know, anesthesiology involves tons and tons of procedures. After residency, there are pain fellowships available which would provide plenty of procedures as well. So just expose yourself to as many subspecialty areas of anesthesiology and try to get the full flavor of what it has to offer.

If you have any more questions, feel free to PM me.

 

[RonaldColeman]

many surgeons tell me: if you love something else in medicine go do it over surgery. most surgeons feel, surgery was the ONLY thing that interested them. regardless of the speciality in surgery the residency is long and tough, and running a practice in the real world is no easy task so it should be something you really love. try and judge the fields 10 years out. the challenge and fun of learning a specific field can be different from how you practice it 10 years out. talk to people who have been out for 10 or so years and see what they say about their field. consider speaking to people doing community surgery or anesthesiology as most of us will find ourselves away from academia when it is all said and done.

This is very good advice. Make sure you know what you are getting yourself into when you choose surgery. One advice that I was given is to do multiple sub-Is in surgery at the most difficult location that your school offers. At my school, almost 1/2 of the general surgery residents quit, including a 4th year. 1 medical school rotation is not enough to test your willingness to endure the 5 or more years of absolute hell that is surgery.