anesthesiologists: which career should I pick?

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SandP

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I mean I'll find out after doing a sub-i in each one but I am going to be doing a subi in anesthesia, 1 in medicine, and 1 in ob/gyn. Based on your experience in anesthesia and you perception of its future direction, would you recommend anesthesia or 1 of the other 2?
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Go into medicine and sub-specialize. If patients come to the clinic/hospital to see you for what you do, you will always have job security. Bonus if there are procedures involved.
 
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Pick something you want to do and don’t mind doing for the next 20+ years. Understand what being an anesthesiologist is and is not is important. And try to figure out what attracts you to each field.
Good luck.
 
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If you look hard enough in any of the subs this question has been asked and answered 1000x.

I will give you my top three pros and cons for anesthesia vs IM.

Anes pro
1. I truly enjoy camaraderie in the OR.
2. I am the doctor in the OR, whether the surgeons, CRNA, RN admit it or not.
3. No rounds/patients. If I had to “round” again in my life, explain anything to demanding families, who was not there until the very end. I would shoot myself.

Anes cons:
1. You will never get the glory. “Because Dr. IMGASMD’s plan, the patient survived, did well, is alive....” vs “Dr. Bone, fixed the broken fractures, so mom can walk again....”
2. You are somewhat “replaceable”. With AMCs, CRNA, hospital employment, contract take over, not having your own patients. There are plenty of external forces to keep you on your toes.
3. Calls. Most of my older partners, if they could, would never want to take any calls again for rest of their lives. When you’re young it’s one thing, when you’re older the 2am c-section really wears on you.

IM/Traditionalist/Hospitalist pro
1. You have much more freedom. You can choose what your practice want to be. You’re not tied to any other entities. No hospital, no surgi centers, no partners even.
2. You own the patient. If you have a good population base and are good. You may have more business than you know what to do with.
3. You can have a deeper connection with your patients.

Cons:
1. Rounds, family, “begging” the consultants, just constant communications to people that you may or may not want to talk to.
2. Hospitalist, specifically, are also easily replaceable than some other specialities. Also there are plenty of big companies are buying, bidding for Hospitalists contracts.
3. I don’t have a good #3... maybe compensation? I would say starting salary is probably 20-30% less than an anesthesiologist? Time investment? 3 year IM+ 1 to 5 year fellowship?

That’s just my list. I hope you can make one for yourself and really figure out what is important to you now, and predict a little to the future.
 
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Gastroenterologists have the highest median net worth of all specialties (20% over $5 million).
 
IMGASMD said:
If you look hard enough in any of the subs this question has been asked and answered 1000x.

I will give you my top three pros and cons for anesthesia vs IM.

Anes pro
1. I truly enjoy camaraderie in the OR.
2. I am the doctor in the OR, whether the surgeons, CRNA, RN admit it or not.
3. No rounds/patients. If I had to “round” again in my life, explain anything to demanding families, who was not there until the very end. I would shoot myself.

Anes cons:
1. You will never get the glory. “Because Dr. IMGASMD’s plan, the patient survived, did well, is alive....” vs “Dr. Bone, fixed the broken fractures, so mom can walk again....”
2. You are somewhat “replaceable”. With AMCs, CRNA, hospital employment, contract take over, not having your own patients. There are plenty of external forces to keep you on your toes.
3. Calls. Most of my older partners, if they could, would never want to take any calls again for rest of their lives. When you’re young it’s one thing, when you’re older the 2am c-section really wears on you.

IM/Traditionalist/Hospitalist pro
1. You have much more freedom. You can choose what your practice want to be. You’re not tied to any other entities. No hospital, no surgi centers, no partners even.
2. You own the patient. If you have a good population base and are good. You may have more business than you know what to do with.
3. You can have a deeper connection with your patients.

Cons:
1. Rounds, family, “begging” the consultants, just constant communications to people that you may or may not want to talk to.
2. Hospitalist, specifically, are also easily replaceable than some other specialities. Also there are plenty of big companies are buying, bidding for Hospitalists contracts.
3. I don’t have a good #3... maybe compensation? I would say starting salary is probably 20-30% less than an anesthesiologist? Time investment? 3 year IM+ 1 to 5 year fellowship?

That’s just my list. I hope you can make one for yourself and really figure out what is important to you now, and predict a little to the future.
Click to expand...

I agree with this except I would move ‘3. You can have a deeper connection with your patients’ to the Cons list.
 
SaltyDog said:
Seriously. I have a buddy that organizes EDM festivals and is tour manager for some big acts. It's crazy what those DJ's pull in.
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I DJ'd in college. I'm seriously convinced I've made all the wrong choices in life. #firstworldproblems
 
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SaltyDog said:
Seriously. I have a buddy that organizes EDM festivals and is tour manager for some big acts. It's crazy what those DJ's pull in.
Click to expand...

How do you set up a bus that administers IV hydration and MVI at these parties is MY question......
 
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SandP said:
I mean I'll find out after doing a sub-i in each one but I am going to be doing a subi in anesthesia, 1 in medicine, and 1 in ob/gyn. Based on your experience in anesthesia and you perception of its future direction, would you recommend anesthesia or 1 of the other 2?
Click to expand...

SDN (as a whole, not limited to the anesthesia forum) is an excellent place to develop a healthy skepticism of the myth of physician life you were sold somewhere along your journey to becoming a doctor. In my opinion, that's where it's utility stops. Do the rest of your investigation in the real world, talking to real people who have walked these different paths.

Don't make the mistake of jumping into bed with the first specialty that winks at you- really dig into the specialties that are mostly hidden from MS3s (naming a few of the many for no particular reason: interventional cards, ENT, rad-onc, etc). A mistake I see a lot of medical students make (and nearly made myself) is identifying a charismatic mentor (every school has a few) and blindly following them into a field without asking the tough questions, doing themselves a huge disservice. This is how the competitive marathoner who hopes to be an attentive mother of three winds up in a cardiac surgery residency, to give one example. There are only a certain number of hours in a week- pick a job that requires 70-80 hours of work and tradeoffs will need to be made.

The quicker you learn that everyone is full of sh** in medicine, the better. If you can see through the sneering confidence, crisp white coat, and medical word-salad of senior consulting residents as an intern, you'll be a step ahead of your peers. Faking it till you make it is a legitimate survival strategy out here, if one can cope with the imposter syndrome that comes with it. I mention this because of the rampant tendency on this board for anesthesiologists to wax poetic about how great it is to be surgeons, dermatologists, and investment bankers (and *shudder*: GI docs). Anesthesiologists are qualified to tell you what life is like for them as anesthesiologists- that's all, and based on my years combing this board for guidance, my sense is it skews towards the dissatisfied.

For me personally, some days I think I have the best job in the hospital, and some days I feel like literally any other specialty choice would have been better. The frequency of these two extremes more or less balance each other out. I would probably pick a different speciality if I could choose again, only because of things I learned about myself along the way that I didn't know when I applied, knowing full well I'd probably discover a lot of unpleasantness under that rock, too.

Apologies for the melancholy tone- it's been a long, dark tunnel, and now the sun's giving me a headache.
 
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IMGASMD said:
How do you set up a bus that administers IV hydration and MVI at these parties is MY question......
Click to expand...


It's easy. Our hydration business side-hustle went on the road to Coachella this year. Overall though, the hydration gig hasn't been too profitable. The ketamine clinic is doing well though.

I think for hydration to really make money you've got to be in Vegas or somewhere similar.
 
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Twiggidy said:
I DJ'd in college. I'm seriously convinced I've made all the wrong choices in life. #firstworldproblems
Click to expand...

Ya, but it's high risk high reward. For every Calvin Harris there's a 1000 wannabe's still living in mom's basement. Have you considered setting up the 1's and 2's in the OR next to your cart??
 
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Nivens said:
SDN (as a whole, not limited to the anesthesia forum) is an excellent place to develop a healthy skepticism of the myth of physician life you were sold somewhere along your journey to becoming a doctor. In my opinion, that's where it's utility stops. Do the rest of your investigation in the real world, talking to real people who have walked these different paths.

Don't make the mistake of jumping into bed with the first specialty that winks at you- really dig into the specialties that are mostly hidden from MS3s (naming a few of the many for no particular reason: interventional cards, ENT, rad-onc, etc). A mistake I see a lot of medical students make (and nearly made myself) is identifying a charismatic mentor (every school has a few) and blindly following them into a field without asking the tough questions, doing themselves a huge disservice. This is how the competitive marathoner who hopes to be an attentive mother of three winds up in a cardiac surgery residency, to give one example. There are only a certain number of hours in a week- pick a job that requires 70-80 hours of work and tradeoffs will need to be made.

The quicker you learn that everyone is full of sh** in medicine, the better. If you can see through the sneering confidence, crisp white coat, and medical word-salad of senior consulting residents as an intern, you'll be a step ahead of your peers. Faking it till you make it is a legitimate survival strategy out here, if one can cope with the imposter syndrome that comes with it. I mention this because of the rampant tendency on this board for anesthesiologists to wax poetic about how great it is to be surgeons, dermatologists, and investment bankers (and *shudder*: GI docs). Anesthesiologists are qualified to tell you what life is like for them as anesthesiologists- that's all, and based on my years combing this board for guidance, my sense is it skews towards the dissatisfied.

For me personally, some days I think I have the best job in the hospital, and some days I feel like literally any other specialty choice would have been better. The frequency of these two extremes more or less balance each other out. I would probably pick a different speciality if I could choose again, only because of things I learned about myself along the way that I didn't know when I applied, knowing full well I'd probably discover a lot of unpleasantness under that rock, too.

Apologies for the melancholy tone- it's been a long, dark tunnel, and now the sun's giving me a headache.
Click to expand...

Every #%*(@Ing syllable of this true. This should just be stickied or auto-pasted in response to every one of these threads.
 
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SaltyDog said:
It's easy. Our hydration business side-hustle went on the road to Coachella this year. Overall though, the hydration gig hasn't been too profitable. The ketamine clinic is doing well though.

I think for hydration to really make money you've got to be in Vegas or somewhere similar.
Click to expand...

If you actually travel and becomes groupie with bigger gigs, do you think it would work better? I can drive and administer fluid. You’d save cost for driver. I can learn how to use a credit card machine too. No cashier needed.
Ketamine clinic, for pain, depression? Do you guys work with psychiatrists? Do private insurance pay? Cash only?
 
IMGASMD said:
Ketamine clinic, for pain, depression? Do you guys work with psychiatrists? Do private insurance pay? Cash only?
Click to expand...

Vast majority are refractory depression, but we also have some chronic pain/CRPS patients (different protocols). Some patients are referred by psych, but many are self-referred. Private insurance does cover it often times, but we always collect payment from patients and give them the super bill to submit to insurance so they can get reimbursed.

IMGASMD said:
If you actually travel and becomes groupie with bigger gigs, do you think it would work better?
Click to expand...

I think if you just wanted to live the Bohemian van-life and travel around to festivals living out of your decked Sprinter Infusion Van you could certainly support yourself. Don't expect to make nearly as much as you would at your normal Anesthesia gig. I think the better way to do it would just be to work locums from Oct.- March and then take the summer festival season off to travel with the acts and forget about the infusion business if that's really what you're after.

There was actually a surprising amount of competition at Coachella - each with a more extravagant Sprinter van/bus than the last. Giving IM gluteal B12 shots through fishnets was kinda cool though. :cool:
 
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I knew people open acupuncture suite, all cash. Don't know how profitable it is. It helps if you are an Asian.

Acupuncture for IVF if nearby has a big IVF clinic.

There are courses offered by big academics.
 
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narcotics999 said:
I knew people open acupuncture suite, all cash. Don't know how profitable it is. It helps if you are an Asian.

Acupuncture for IVF if nearby has a big IVF clinic.

There are courses offered by big academics.
Click to expand...

For IVF? Wow. I knew there were evidence for pain, but ivf? Will look into it!
 
Acupuncture for IVF?

Isn't poking someone the normal way to impregnate them??
 
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Do the field of medicine that has the highest income-per-hour or income-per-catecholamibe-expended. Use that money to have as many kids as possible/ invest in something that actually makes money. For example, I make more money from the Chik-Fil-A I run than I make in medicine
 
Section31 said:
Do the field of medicine that has the highest income-per-hour or income-per-catecholamibe-expended. Use that money to have as many kids as possible/ invest in something that actually makes money. For example, I make more money from the Chik-Fil-A I run than I make in medicine
Click to expand...
As many kids as possible? I have one and he is making me age twice as fast.
 
narcotics999 said:
As many kids as possible? I have one and he is making me age twice as fast.
Click to expand...

I believe that kids (or specifically genetics) are the only legacy any of us leave. None of us remember all of our ancestors, but if any one of them hadn’t existed neither would we.

I also believe that doctors specifically don’t reproduce in sufficient numbers. Two doctors who marry one another and have one child is unacceptable. They didn’t even replace themselves. Two kids, at minimum. And let’s face it: one kid is gonna be a dud and for whatever reason not reproduce. So you need three. Three minimum.

I plan to have as many as possible (within the confines of marriage and reason).
 
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IMGASMD said:
For IVF? Wow. I knew there were evidence for pain, but ivf? Will look into it!
Click to expand...
I don't know if it works or not. But heard IVF women do take it. Hey, they spend $$$ to get a baby. An additional couple of hundred is no big deal for a possible boost.
 
Section31 said:
I believe that kids (or specifically genetics) are the only legacy any of us leave. None of us remember all of our ancestors, but if any one of them hadn’t existed neither would we.

I also believe that doctors specifically don’t reproduce in sufficient numbers. Two doctors who marry one another and have one child is unacceptable. They didn’t even replace themselves. Two kids, at minimum. And let’s face it: one kid is gonna be a dud and for whatever reason not reproduce. So you need three. Three minimum.

I plan to have as many as possible (within the confines of marriage and reason).
Click to expand...


You’re a strange dude.
 
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anyone have any other thoughts on the original question?
 
What are your thoughts? I hope you’ve also read other posts as recent as top regarding the same topic/discussion.
 
Section31 said:
I believe that kids (or specifically genetics) are the only legacy any of us leave. None of us remember all of our ancestors, but if any one of them hadn’t existed neither would we.

I also believe that doctors specifically don’t reproduce in sufficient numbers. Two doctors who marry one another and have one child is unacceptable. They didn’t even replace themselves. Two kids, at minimum. And let’s face it: one kid is gonna be a dud and for whatever reason not reproduce. So you need three. Three minimum.

I plan to have as many as possible (within the confines of marriage and reason).
Click to expand...
do you also believe that a parent is only as happy as their least happy child? If so, don’t more kids at some point increase your likelihood of significant heartache?
 
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Nivens said:
SDN (as a whole, not limited to the anesthesia forum) is an excellent place to develop a healthy skepticism of the myth of physician life you were sold somewhere along your journey to becoming a doctor. In my opinion, that's where it's utility stops. Do the rest of your investigation in the real world, talking to real people who have walked these different paths.

Don't make the mistake of jumping into bed with the first specialty that winks at you- really dig into the specialties that are mostly hidden from MS3s (naming a few of the many for no particular reason: interventional cards, ENT, rad-onc, etc). A mistake I see a lot of medical students make (and nearly made myself) is identifying a charismatic mentor (every school has a few) and blindly following them into a field without asking the tough questions, doing themselves a huge disservice. This is how the competitive marathoner who hopes to be an attentive mother of three winds up in a cardiac surgery residency, to give one example. There are only a certain number of hours in a week- pick a job that requires 70-80 hours of work and tradeoffs will need to be made.

The quicker you learn that everyone is full of sh** in medicine, the better. If you can see through the sneering confidence, crisp white coat, and medical word-salad of senior consulting residents as an intern, you'll be a step ahead of your peers. Faking it till you make it is a legitimate survival strategy out here, if one can cope with the imposter syndrome that comes with it. I mention this because of the rampant tendency on this board for anesthesiologists to wax poetic about how great it is to be surgeons, dermatologists, and investment bankers (and *shudder*: GI docs). Anesthesiologists are qualified to tell you what life is like for them as anesthesiologists- that's all, and based on my years combing this board for guidance, my sense is it skews towards the dissatisfied.

For me personally, some days I think I have the best job in the hospital, and some days I feel like literally any other specialty choice would have been better. The frequency of these two extremes more or less balance each other out. I would probably pick a different speciality if I could choose again, only because of things I learned about myself along the way that I didn't know when I applied, knowing full well I'd probably discover a lot of unpleasantness under that rock, too.

Apologies for the melancholy tone- it's been a long, dark tunnel, and now the sun's giving me a headache.
Click to expand...
This is all correct. ALL of it
 
SaltyDog said:
Ya, but it's high risk high reward. For every Calvin Harris there's a 1000 wannabe's still living in mom's basement. Have you considered setting up the 1's and 2's in the OR next to your cart??
Click to expand...
Isn’t this pretty much what we do everyday? Put them to sleep and turn on the music.
 
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SandP said:
anyone have any other thoughts on the original question?
Click to expand...
It really depends on your personality and they type of work you want to do. Those are three VERY different fields and no one on the forum will recommend you do OB. Hell, the OB forum may not recommend you do OB. I’m an anesthesiologists so my answer to your question will always be:
1) Anesthesiology
2) A specialty of IM
3) DJ

My ranking is solely based on the fact that I like the OR, I hate rounds, and I hate clinic. So I didn’t have many options besides circulator nurse or anesthesiologist. I went with the latter.
 
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Consigliere said:
Use to be a Tiesto man for awhile but lately it's all Paul van Dyk's VONYC sessions. It's all I listen to when I work out.
Click to expand...
I like Armin Van Buren and used to run to Oakenfold a lot. It’s all about Bonobo when I want to mellow out
 
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