Anesthesia vs Vascular Surgery

[NY172]

Hi, it was suggested by one of your colleagues that I post this question in this forum. I'm currently deciding between anesthesia and vascular surgery and I was wondering on what you people think about how anesthesia compares to vasc surg. I rarely hear good things about vasc surg and most people recommend anesthesia when I tell them that those are top 2 contenders. I started out wanting vascular and have decent exposure to field but am liking anesthesia more and more. It is the only specialty I have come across where I'd be more than happy doing a fellowship in any of its sub-specialty fields (i.e. peds, cards, OB, etc). I cannot say that about any other specialty. I was wondering what you all think about vasc surg vs anesthesia. thx.

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[Man o War]

Hi, it was suggested by one of your colleagues that I post this question in this forum. I'm currently deciding between anesthesia and vascular surgery and I was wondering on what you people think about how anesthesia compares to vasc surg. I rarely hear good things about vasc surg and most people recommend anesthesia when I tell them that those are top 2 contenders. I started out wanting vascular and have decent exposure to field but am liking anesthesia more and more. It is the only specialty I have come across where I'd be more than happy doing a fellowship in any of its sub-specialty fields (i.e. peds, cards, OB, etc). I cannot say that about any other specialty. I was wondering what you all think about vasc surg vs anesthesia. thx.

This is totally dependent on you.
I personally wouldn’t do vascular surgery if I were magically guaranteed a million a year for life. The patients are awful, the lifestyle is awful, and it’s generally a money loser for hospitals. You better be ok with frequent call and being up many nights, then working the next day.
Having said that....if you have a need for glory/recognition, anesthesia may not make you happy. Our job is very important, but it’s very much behind the scenes.

 

[anbuitachi]

Hi, it was suggested by one of your colleagues that I post this question in this forum. I'm currently deciding between anesthesia and vascular surgery and I was wondering on what you people think about how anesthesia compares to vasc surg. I rarely hear good things about vasc surg and most people recommend anesthesia when I tell them that those are top 2 contenders. I started out wanting vascular and have decent exposure to field but am liking anesthesia more and more. It is the only specialty I have come across where I'd be more than happy doing a fellowship in any of its sub-specialty fields (i.e. peds, cards, OB, etc). I cannot say that about any other specialty. I was wondering what you all think about vasc surg vs anesthesia. thx.

I think vascular surgery is one of the worst fields ever. High pay but one of the few specialities that work more than anesthesiology. I don't see outpatient stuff but at least in the OR its angiogram, then stent, then chop toes off until no toes left. Then TMA then bka then aka then hip. Until you have nothing left.. many cases also have high morbidity to it. Depressing

 

[deleted162650]

I think vascular surgery is one of the worst fields ever. High pay but one of the few specialities that work more than anesthesiology. I don't see outpatient stuff but at least in the OR its angiogram, then stent, then chop toes off until no toes left. Then TMA then bka then aka then hip. Until you have nothing left.. many cases also have high morbidity to it. Depressing

But there's always ALIF approaches and cash pay varicose vein stripping. I know a few guys whose practice is like 75% ALIF aproaches.

 

[facted]

There are MANY happy anesthesiologists. Of all the vascular surgeons I've met, two of them are happy with their careers. Vascular is a tough, miserable field.

 

[anbuitachi]

But there's always ALIF approaches and cash pay varicose vein stripping. I know a few guys whose practice is like 75% ALIF aproaches.

But then you have to work with spine surgeons . Awful

 

[AdmiralChz]

one of the few specialities that work more than anesthesiology

Classic grass-is-greener mentality, but Vascular is definitely a grind. Patients tend to be the worst of the worst in terms of overall health - typically bad diabetics, drinkers and smokers over many years. Woof.

 

[deleted162650]

But then you have to work with spine surgeons . Awful

Oh ya, I forgot - we never have to work with those guys.

 

[deleted171991]

If it's so bad, why do so many USMGs go into vascular?

 

[facted]

If it's so bad, why do so many USMGs go into vascular?

Same reason USMG go into a ton of terrible fields. Medical school does a TERRIBLE job of showing people what those fields will be like over you're an attending. In med school, you see them operate, MAYBE you see a morning of wound clinic. That's not even a glimpse of what vascular surgery really is.

 

[LunchMD]

If it's so bad, why do so many USMGs go into vascular?

Did 2 months of vascular as an intern. I'd say the surgeries are really cool (minus the endovascular stuff, just not my cup of tea) ie bypass, amputations, open AAA repairs. I think people like the straightforward logic behind it, you see a blockage and fix it kind of thing. People like the idea of being a badass and sewing on the aorta etc. If you like high acuity, it doesn't get much higher than vascular. Even routine patients can crump fast. But ya the patients all pretty much inflict their disease on themselves and personalities often are a pain. Also high acuity means more stress, more time working.

 

[drmwvr]

Success in anesthesia is easily recognizable and is identifiable through self-evident, rationally based metrics. So is the satisfaction/gratification.

If the idea that A + effort and formidable successes are C minus or even D+ results, vascular surgery may be for you.

 

[Southpaw]

Medical students typically aren’t prepared to make such life altering decisions as specialty choice. I’d encourage you to get as much exposure to these two fields as possible, speak with actual attendings, and try see which specialty best fits both your personality and desires for life.

Anesthesiology - like Emergency Medicine, we are absolutely essential to the hospital. We will almost never, ever be thanked (occasionally by a patient) for the work we do. The OR can provide 60% or more of the revenue for the hospital. The anesthesiology group SHOULD make it work smoothly and efficiently. One prominent poster, JPP, often said we are the offensive lineman of the OR. No one remembers our names but we make it happen. We are typically relaxed, laid back individuals (not always of course...) and enjoy life outside of the OR and the hospital. Most anesthesiologists continue to work nights and weekends as attendings, and many are required to stay in-house (as opposed to home call).

Vascular surgery - stressful, demanding, long hours. Your patients don’t come to you healthy and you never ‘cure their disease’. It’s been said before that vascular patients never get better, they just get shorter. Some big, open procedures. Some super cool endovascular procedures. You are the boss, the ultimate end point for your patients. If you want/need the satisfaction of being THE DOCTOR your patients depend on, then perhaps lean toward VS and away from ANES.

I really can’t emphasize enough how vastly different these two fields are, so if you just peel the layers back even a little you should be able to figure out quickly which you’re more likely to find greater enjoyment.

 

[anbuitachi]

If it's so bad, why do so many USMGs go into vascular?

Probably same reason why so many college students go to med school.

 

[deleted875186]

Did 2 months of vascular as an intern. I'd say the surgeries are really cool (minus the endovascular stuff, just not my cup of tea)

Endovascular seems like the future, probably shouldn’t do vascular if you don’t like it.

 

[Psai]

But then you have to work with spine surgeons . Awful

Our spine surgeons are cool. Never had a problem with them.

 

[jeesapeesa]

But then you have to work with spine surgeons . Awful

never had any problems with spine surgeons - neuro or ortho. usually they are pretty chill. vascular surgeons are usually the most overworked and miserable ones. there are exceptions of course, but usually the field sucks out the life of the more pleasant ones.

 

[turnupthegas]

I’ve met one nice vascular surgeon out of many. Most of them are miserable


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[Velefunt]

Agree that most vascular surgeons are fairly miserable people. It almost seems like polar opposites to be considering anesthesiology vs vascular.

 

[Wolverines83]

Get a stick and a pocket knife.

Whittle away the stick until its a useless nub.

Now you’re a vascular surgeon!

 

[acidbase1]

There are MANY happy anesthesiologists. Of all the vascular surgeons I've met, two of them are happy with their careers. Vascular is a tough, miserable field.

More miserable than cardiothoracic surgery?

 

[facted]

More miserable than cardiothoracic surgery?

Definitely more miserable I think. I would guess it must be because CT patients usually improve and are usually pretty grateful. Vascular pts often don't.

 

[acidbase1]

I’ve seen some miserable CT surgeons

 

[VascularSurgeon]

Randomly ran across this forum looking for something else and was utterly apalled at the responses. I'm a board certified vascular surgeon in an academic setting. The responses for the above are extremely ignorant and not based on first hand experiences. I can tell you I have a fantastic lifestyle, am not miserable, am happily married 12 years with 3 kids, and feel that my patients are grateful for the limb and life saving procedures that I do. You can modify your lifestyle and do anything from a vein practice to an endovascular only practice to a hard core open thoracoabdominal practice. Is the training as cush as anesthesia? NO. You will work 80 hours per week and take care of sick and dying patients (without a guaranteed lunch break!). Is the field for everybody? NO, as above all the anesthesiologists who answered clearly picked the right field for them. But if you like continuity of care (you have life long patients), helping a patients with symptomatic (carotid artery, peripheral artery, varicose veins) or life threatening (aortic aneurysm, etc.) disease, you like using cutting edge technology (endovascular stents, balloons, atherectomy), then consider vascular. Likely if you are trying to decide between a surgical field and ANESTHESIA, then surgery isn't for you, because in any surgical field you will work hard.... but it is satisfying work. However, to be frank, if you are trying to decide about a medical field based off lifestyle maybe you should have considered something other than medicine to begin with.

 

[Ezekiel2517]

Randomly ran across this forum looking for something else and was utterly apalled at the responses. I'm a board certified vascular surgeon in an academic setting. The responses for the above are extremely ignorant and not based on first hand experiences. I can tell you I have a fantastic lifestyle, am not miserable, am happily married 12 years with 3 kids, and feel that my patients are grateful for the limb and life saving procedures that I do. You can modify your lifestyle and do anything from a vein practice to an endovascular only practice to a hard core open thoracoabdominal practice. Is the training as cush as anesthesia? NO. You will work 80 hours per week and take care of sick and dying patients (without a guaranteed lunch break!). Is the field for everybody? NO, as above all the anesthesiologists who answered clearly picked the right field for them. But if you like continuity of care (you have life long patients), helping a patients with symptomatic (carotid artery, peripheral artery, varicose veins) or life threatening (aortic aneurysm, etc.) disease, you like using cutting edge technology (endovascular stents, balloons, atherectomy), then consider vascular. Likely if you are trying to decide between a surgical field and ANESTHESIA, then surgery isn't for you, because in any surgical field you will work hard.... but it is satisfying work. However, to be frank, if you are trying to decide about a medical field based off lifestyle maybe you should have considered something other than medicine to begin with.

Take it easy dude. It's just the internet. Any idiot out there can get on it.

 

[Southpaw]

Randomly ran across this forum looking for something else and was utterly apalled at the responses. I'm a board certified vascular surgeon in an academic setting. The responses for the above are extremely ignorant and not based on first hand experiences. I can tell you I have a fantastic lifestyle, am not miserable, am happily married 12 years with 3 kids, and feel that my patients are grateful for the limb and life saving procedures that I do. You can modify your lifestyle and do anything from a vein practice to an endovascular only practice to a hard core open thoracoabdominal practice. Is the training as cush as anesthesia? NO. You will work 80 hours per week and take care of sick and dying patients (without a guaranteed lunch break!). Is the field for everybody? NO, as above all the anesthesiologists who answered clearly picked the right field for them. But if you like continuity of care (you have life long patients), helping a patients with symptomatic (carotid artery, peripheral artery, varicose veins) or life threatening (aortic aneurysm, etc.) disease, you like using cutting edge technology (endovascular stents, balloons, atherectomy), then consider vascular. Likely if you are trying to decide between a surgical field and ANESTHESIA, then surgery isn't for you, because in any surgical field you will work hard.... but it is satisfying work. However, to be frank, if you are trying to decide about a medical field based off lifestyle maybe you should have considered something other than medicine to begin with.

This isn't an unreasonable response, especially from a surgeon with a clear negative slant towards anesthesiology ('ANESTHESIA', 'lunch breaks', etc). Whatevs bro. I have no insight into the difficulties of surgery. I readily acknowledge the training is difficult and it requires dedication. However, as an attending, each and every night that I'm on call in-house covering OB and/or the OR rarely if ever is a surgeon in the hospital.

 

[anbuitachi]

Randomly ran across this forum looking for something else and was utterly apalled at the responses. I'm a board certified vascular surgeon in an academic setting. The responses for the above are extremely ignorant and not based on first hand experiences. I can tell you I have a fantastic lifestyle, am not miserable, am happily married 12 years with 3 kids, and feel that my patients are grateful for the limb and life saving procedures that I do. You can modify your lifestyle and do anything from a vein practice to an endovascular only practice to a hard core open thoracoabdominal practice. Is the training as cush as anesthesia? NO. You will work 80 hours per week and take care of sick and dying patients (without a guaranteed lunch break!). Is the field for everybody? NO, as above all the anesthesiologists who answered clearly picked the right field for them. But if you like continuity of care (you have life long patients), helping a patients with symptomatic (carotid artery, peripheral artery, varicose veins) or life threatening (aortic aneurysm, etc.) disease, you like using cutting edge technology (endovascular stents, balloons, atherectomy), then consider vascular. Likely if you are trying to decide between a surgical field and ANESTHESIA, then surgery isn't for you, because in any surgical field you will work hard.... but it is satisfying work. However, to be frank, if you are trying to decide about a medical field based off lifestyle maybe you should have considered something other than medicine to begin with.

so n = 1! I dont think anyone said you can' t be happy as a vascular surgeon. and it's foolish to think every field is equally happy. the point is vascular surgery is one of those fields that seems more unhappy than others. If you look at the average hours worked, not many fields are more than anesthesiology, including most surgery fields. but vascular (and CT surgery) is one that works more than anesthesiologists!

And you are board certified vascular surgeon who seems to have a good # of years of experience.. why would you go to the anesthesiology forum and insult anesthesiologists by calling them anesthesia??

 

[deleted162650]

my patients are grateful for the limb and life saving procedures that I do.

Oh Dr., thank you so much for cutting off some of my toes!! I'm feeling so much better! In fact, it was so amazing I'm thinking I'll come back in a few months so you can take off a few more.

 

[narcotics999]

Randomly ran across this forum looking for something else and was utterly apalled at the responses. I'm a board certified vascular surgeon in an academic setting. The responses for the above are extremely ignorant and not based on first hand experiences. I can tell you I have a fantastic lifestyle, am not miserable, am happily married 12 years with 3 kids, and feel that my patients are grateful for the limb and life saving procedures that I do. You can modify your lifestyle and do anything from a vein practice to an endovascular only practice to a hard core open thoracoabdominal practice. Is the training as cush as anesthesia? NO. You will work 80 hours per week and take care of sick and dying patients (without a guaranteed lunch break!). Is the field for everybody? NO, as above all the anesthesiologists who answered clearly picked the right field for them. But if you like continuity of care (you have life long patients), helping a patients with symptomatic (carotid artery, peripheral artery, varicose veins) or life threatening (aortic aneurysm, etc.) disease, you like using cutting edge technology (endovascular stents, balloons, atherectomy), then consider vascular. Likely if you are trying to decide between a surgical field and ANESTHESIA, then surgery isn't for you, because in any surgical field you will work hard.... but it is satisfying work. However, to be frank, if you are trying to decide about a medical field based off lifestyle maybe you should have considered something other than medicine to begin with.

Very good for recruiting new vascular residents and fellows.

 

[facted]

Randomly ran across this forum looking for something else and was utterly apalled at the responses. I'm a board certified vascular surgeon in an academic setting. The responses for the above are extremely ignorant and not based on first hand experiences. I can tell you I have a fantastic lifestyle, am not miserable, am happily married 12 years with 3 kids, and feel that my patients are grateful for the limb and life saving procedures that I do. You can modify your lifestyle and do anything from a vein practice to an endovascular only practice to a hard core open thoracoabdominal practice. Is the training as cush as anesthesia? NO. You will work 80 hours per week and take care of sick and dying patients (without a guaranteed lunch break!). Is the field for everybody? NO, as above all the anesthesiologists who answered clearly picked the right field for them. But if you like continuity of care (you have life long patients), helping a patients with symptomatic (carotid artery, peripheral artery, varicose veins) or life threatening (aortic aneurysm, etc.) disease, you like using cutting edge technology (endovascular stents, balloons, atherectomy), then consider vascular. Likely if you are trying to decide between a surgical field and ANESTHESIA, then surgery isn't for you, because in any surgical field you will work hard.... but it is satisfying work. However, to be frank, if you are trying to decide about a medical field based off lifestyle maybe you should have considered something other than medicine to begin with.

The fact you came to this forum and wrote this post pretty much sums up my experience with the vast majority of vascular surgeons: cocky, condescending douchebags who need to take out their misery on those around them.

 

[Psai]

My lifestyle is also fantastic and not miserable to the point where I have to tell internet people about it

 

[ProRealDoc]

Never seen a vascular surgeon touch an open thoracoabdominal case.

 

[jthedestroyr]

Never seen a vascular surgeon touch an open thoracoabdominal case.

Let me introduce you to ours. He has the hubris to pretty much try anything.

He was once introduced as, "our next speaker is another vascular surgeon." This made him incredibly angry with his opening as, "I am not just another vascular surgeon, I am THE vascular surgeon."

He does work hard though. I dont envy his life style one bit, nor need the glory he seeks.

 

[agammaglobulin]

Randomly ran across this forum looking for something else and was utterly apalled at the responses. I'm a board certified vascular surgeon in an academic setting. The responses for the above are extremely ignorant and not based on first hand experiences. I can tell you I have a fantastic lifestyle, am not miserable, am happily married 12 years with 3 kids, and feel that my patients are grateful for the limb and life saving procedures that I do. You can modify your lifestyle and do anything from a vein practice to an endovascular only practice to a hard core open thoracoabdominal practice. Is the training as cush as anesthesia? NO. You will work 80 hours per week and take care of sick and dying patients (without a guaranteed lunch break!). Is the field for everybody? NO, as above all the anesthesiologists who answered clearly picked the right field for them. But if you like continuity of care (you have life long patients), helping a patients with symptomatic (carotid artery, peripheral artery, varicose veins) or life threatening (aortic aneurysm, etc.) disease, you like using cutting edge technology (endovascular stents, balloons, atherectomy), then consider vascular. Likely if you are trying to decide between a surgical field and ANESTHESIA, then surgery isn't for you, because in any surgical field you will work hard.... but it is satisfying work. However, to be frank, if you are trying to decide about a medical field based off lifestyle maybe you should have considered something other than medicine to begin with.

If someone told me I had to work 80 hours per work for 7 years (5 years surg, 2 years fellowship), taking care of 'sick and dying patients' I would RUN. I don't care how 'great' it is when you're finished, how thankful the patients are, how much RNs kiss my ass, or how much money I'm going to earn. Why would you ever want to sign up for that willingly? I wonder if Dr. Vascular Surgeon was married or had kids during residency/fellowship? Putting my life on hold until I'm 35 is something I'm glad I didn't do.

 

[Twiggidy]

Randomly ran across this forum looking for something else and was utterly apalled at the responses. I'm a board certified vascular surgeon in an academic setting. The responses for the above are extremely ignorant and not based on first hand experiences. I can tell you I have a fantastic lifestyle, am not miserable, am happily married 12 years with 3 kids, and feel that my patients are grateful for the limb and life saving procedures that I do. You can modify your lifestyle and do anything from a vein practice to an endovascular only practice to a hard core open thoracoabdominal practice. Is the training as cush as anesthesia? NO. You will work 80 hours per week and take care of sick and dying patients (without a guaranteed lunch break!). Is the field for everybody? NO, as above all the anesthesiologists who answered clearly picked the right field for them. But if you like continuity of care (you have life long patients), helping a patients with symptomatic (carotid artery, peripheral artery, varicose veins) or life threatening (aortic aneurysm, etc.) disease, you like using cutting edge technology (endovascular stents, balloons, atherectomy), then consider vascular. Likely if you are trying to decide between a surgical field and ANESTHESIA, then surgery isn't for you, because in any surgical field you will work hard.... but it is satisfying work. However, to be frank, if you are trying to decide about a medical field based off lifestyle maybe you should have considered something other than medicine to begin with.

Classic. ACADEMIC surgeon response. This is someone who sees anesthesia residents get a break and scoffs. Homeboy (girl), I sit the stool through all the long fem-pops, fem-tibs, endovascular stent, etc, etc starving and doing the pee pee dance many days a week. I think you highly underestimate what an anesthesiologist does for your otherwise sick patients who would be dying if we weren't there so you can chop their leg off. But again, that's academics for you. A private practice surgeon, though probably no less jerk-y, knows he'd be no where without a good anesthesiologist.

The beauty of my field is, when I walk away from that AAA that's in the ICU, no matter what, that's the last I hear of it.

 

[drmwvr]

...pretty sure he's long gone...