Anxiety help

[JonJ880]

---

Members don't see this ad.

I started med school in 2014 (US MD school) but left during my second year due to anxiety. During my second year I became really worried and began having "what if" thoughts about passing Step 1, Step 2, getting a residency, etc. The financial side was a huge part of my anxiety because my loans were going to be massive and if I didnt get a residency I would have no way of paying them off. It came to the point that I couldn't sleep well at night nor study during the day because my anxiety was so high. I saw a student from our university that got kicked out of residency and failed to land another one (with 200k+ in debt) which increased my anxiety. I still passed all my classes (up until second semester of second year when I withdrew).

I spoke to two psychiatrists and they stated that my anxiety was due to medical school and the financial fears I had of not matching. Since this time I have worked a job while doing my BSN which I am about to complete.

I wanted to get advice from you all regarding my future. I know I am reasonably smart (good undergrad GPA, passed first two years of med school, currently top of my BSN class). I currently have zero anxiety because I know as a nurse I'll be able to make at least 60-70k a year in my area. Also nursing is much easier and all of my practice NCLEX scores have been well above average (no worries about failing).

Should I aim for CRNA school? Is being a CRNA very anxiety provoking? I am very confident I'd pass all of the CRNA didactic coursework. Should I be worried that I'd develop anxiety in other parts of the job? I don't think it would be that anxiety provoking because the CRNA debt is much lower and I even know people that work during the first year of CRNA school. I spoke to a couple of CRNA schools in my area that said id be a good candidate if I got my ICU experience.

TL;DR - left med school as a second year due to anxiety from being in MASSIVE debt/not getting residency (passed all classes). Finishing BSN, currently no anxiety, should I aim for CRNA or would that make my anxiety return?

Also to avoid the politics I obviously do not support independent CRNA practice and CRNA training obviously does not make me a doctor (not even close). Being a CRNA would make me a midlevel and I personally would be happy with that.

 

[DirtDocMD]

There’s no “sure thing” in life. However, do you REALLY have “anxiety” (panic attacks/symptoms/etc), or are you just scared of financial debt?

After making it through med school (obviously), the folks I saw “fail” at residency usually did so, NOT because of failures of intellect, but due to personality defects and/or substance abuse.

The other folks who “failed”, were those who had the smarts, but not the “quick linear thinking” required for certain specialties. Some specialties allow you to tell folks “Let me review your exam and your studies, and we’ll come up with a plan.”. Other specialties (anesthesia, trauma surgery, EM), require you to make a diagnosis and act on a plan , NOW. Some folks just aren’t wired to do that.

Have you gone through “clinicals” in nursing school?? Your ability to perform academically doesn’t sound like a problem. My question is, do you get “anxiety” taking care of patients??

 

[JonJ880]

Other specialties (anesthesia, trauma surgery, EM), require you to make a diagnosis and act on a plan , NOW. Some folks just aren’t wired to do that.

Does being a CRNA require a lot of making diagnoses on the spot? Since it's less than being an anesthesiologist it might require less but idk.

Thank you for the advice.

Yes I have done clinicals in nursing school, I worked as a CNA, and in med school after our first year we had a "mini-rotation" which I enjoyed. I dont abuse any substances (I never even drink alcohol). I've always just had minor anxiety since college (hard time sleeping before exams, chest tightness when school piles up, etc.) but it was nothing major till my second year of med school.

Part of the reason might have been that Im not the smartest guy so when I saw that I might not pass boards I freaked out. Nursing school has given me a lot of confidence because I'm able to do well.

My current plan is to work as an ICU nurse and see how that goes. If I can handle that well then I think CRNA might be a good option.

 

[Consigliere]

Xanax 0.5 mg tid. Solved on SDN!

 

[deleted697127]

Does being a CRNA require a lot of making diagnoses on the spot? Since it's less than being an anesthesiologist it might require less but idk.

Thank you for the advice.

Yes I have done clinicals in nursing school, I worked as a CNA, and in med school after our first year we had a "mini-rotation" which I enjoyed. I dont abuse any substances (I never even drink alcohol). I've always just had minor anxiety since college (hard time sleeping before exams, chest tightness when school piles up, etc.) but it was nothing major till my second year of med school.

Part of the reason might have been that Im not the smartest guy so when I saw that I might not pass boards I freaked out. Nursing school has given me a lot of confidence because I'm able to do well.

My current plan is to work as an ICU nurse and see how that goes. If I can handle that well then I think CRNA might be a good option.

What do you like about anesthesia? Seems like an odd choice for someone worried about anxiety.

 

[PainDrain]

I started med school in 2014 (US MD school) but left during my second year due to anxiety. During my second year I became really worried and began having "what if" thoughts about passing Step 1, Step 2, getting a residency, etc. The financial side was a huge part of my anxiety because my loans were going to be massive and if I didnt get a residency I would have no way of paying them off. It came to the point that I couldn't sleep well at night nor study during the day because my anxiety was so high. I saw a student from our university that got kicked out of residency and failed to land another one (with 200k+ in debt) which increased my anxiety. I still passed all my classes (up until second semester of second year when I withdrew).

I spoke to two psychiatrists and they stated that my anxiety was due to medical school and the financial fears I had of not matching. Since this time I have worked a job while doing my BSN which I am about to complete.

I wanted to get advice from you all regarding my future. I know I am reasonably smart (good undergrad GPA, passed first two years of med school, currently top of my BSN class). I currently have zero anxiety because I know as a nurse I'll be able to make at least 60-70k a year in my area. Also nursing is much easier and all of my practice NCLEX scores have been well above average (no worries about failing).

Should I aim for CRNA school? Is being a CRNA very anxiety provoking? I am very confident I'd pass all of the CRNA didactic coursework. Should I be worried that I'd develop anxiety in other parts of the job? I don't think it would be that anxiety provoking because the CRNA debt is much lower and I even know people that work during the first year of CRNA school. I spoke to a couple of CRNA schools in my area that said id be a good candidate if I got my ICU experience.

TL;DR - left med school as a second year due to anxiety from being in MASSIVE debt/not getting residency (passed all classes). Finishing BSN, currently no anxiety, should I aim for CRNA or would that make my anxiety return?

Also to avoid the politics I obviously do not support independent CRNA practice and CRNA training obviously does not make me a doctor (not even close). Being a CRNA would make me a midlevel and I personally would be happy with that.

This entire post makes no sense. You were doing well and afraid you wouldnt get a residency spot and be stuck with debt, so instead you left and started a degree (more money)? Even the guy in my class who was asked to repeat 3rd year and was on the spectrum got a residency spot.

 

[Zekchar]

Does being a CRNA require a lot of making diagnoses on the spot? Since it's less than being an anesthesiologist it might require less but idk.

Thank you for the advice.

Yes I have done clinicals in nursing school, I worked as a CNA, and in med school after our first year we had a "mini-rotation" which I enjoyed. I dont abuse any substances (I never even drink alcohol). I've always just had minor anxiety since college (hard time sleeping before exams, chest tightness when school piles up, etc.) but it was nothing major till my second year of med school.

Part of the reason might have been that Im not the smartest guy so when I saw that I might not pass boards I freaked out. Nursing school has given me a lot of confidence because I'm able to do well.

My current plan is to work as an ICU nurse and see how that goes. If I can handle that well then I think CRNA might be a good option.

Less anxiety as a CRNA as your responsibility is minimal and you always have a "fall man" with a MD degree. Imagine being able to do the best parts of a job, the comfort of a relaxed air conditioned setting where you get to sit on a comfy chair, and if anything ever goes wrong or becomes challenging you get to hit the Staples "EASY" button and get bailed out. You don't learn from that challenge and continue to be weak at your job, but so long as nothing goes wrong all too often you keep your job and even get to be snarky with the boss who has fixed your errors on multiple occasions. That's the life of a CRNA.

If you have anxiety and can't make solid and timely decisions on your feet, I don't want you as my anesthesia provider. That goes for CRNAs and Anesthesiologists alike. If you're being honest with yourself, you wouldn't want that person for your parents, siblings, or kids either.

 

[anbuitachi]

I started med school in 2014 (US MD school) but left during my second year due to anxiety. During my second year I became really worried and began having "what if" thoughts about passing Step 1, Step 2, getting a residency, etc. The financial side was a huge part of my anxiety because my loans were going to be massive and if I didnt get a residency I would have no way of paying them off. It came to the point that I couldn't sleep well at night nor study during the day because my anxiety was so high. I saw a student from our university that got kicked out of residency and failed to land another one (with 200k+ in debt) which increased my anxiety. I still passed all my classes (up until second semester of second year when I withdrew).

I spoke to two psychiatrists and they stated that my anxiety was due to medical school and the financial fears I had of not matching. Since this time I have worked a job while doing my BSN which I am about to complete.

I wanted to get advice from you all regarding my future. I know I am reasonably smart (good undergrad GPA, passed first two years of med school, currently top of my BSN class). I currently have zero anxiety because I know as a nurse I'll be able to make at least 60-70k a year in my area. Also nursing is much easier and all of my practice NCLEX scores have been well above average (no worries about failing).

Should I aim for CRNA school? Is being a CRNA very anxiety provoking? I am very confident I'd pass all of the CRNA didactic coursework. Should I be worried that I'd develop anxiety in other parts of the job? I don't think it would be that anxiety provoking because the CRNA debt is much lower and I even know people that work during the first year of CRNA school. I spoke to a couple of CRNA schools in my area that said id be a good candidate if I got my ICU experience.

TL;DR - left med school as a second year due to anxiety from being in MASSIVE debt/not getting residency (passed all classes). Finishing BSN, currently no anxiety, should I aim for CRNA or would that make my anxiety return?

Also to avoid the politics I obviously do not support independent CRNA practice and CRNA training obviously does not make me a doctor (not even close). Being a CRNA would make me a midlevel and I personally would be happy with that.

i think the situation couldve been improved if you had a mentor of some sort who could guide you thru the process and calm you down.. .
it sounds more like stress than pure anxiety. your problems are the same problems that all your peers go thru. everyone has tons of loans. worst case scenario, med school is P=MD, and majority of US grads match. not sure why you would think you wouldnt.

but either way, if you believe it is truly mostly anxiety, anesthesia is not the best field for you. it's a stressful job.
while crna is much less stressful than MD, it can still vary a lot on your personality. while its true you have a MD to help you out in most situations, a bad outcome can stress some people out even if they are not the responsible person on teh chart..

imagine the scenario where something bad is happening to the patient in the OR, and you arent sure what to do, and you call the MD, who may take several minutes to be there, and in critical situations in anesthesia, several minutes can be a long time, and while you are waiting, the patient is getting worse and worse, would imagining yourself in that situation cause anxiety?

 

[dabears505]

I would stay away from anesthesia. I'm not even anxious and very relaxed, but in hairy situations I can feel stressed and anxious. I think it's a normal feeling, but with someone with issues, it will make your life miserable. Just go into administrative work. The only anxiety you will have is if you can make it home by 4 everyday to beat traffic.

 

[coffeebythelake]

I would stay away from anesthesia. I'm not even anxious and very relaxed, but in hairy situations I can feel stressed and anxious. I think it's a normal feeling, but with someone with issues, it will make your life miserable. Just go into administrative work. The only anxiety you will have is if you can make it home by 4 everyday to beat traffic.

Agree. Anesthesiology is not a great field for those with significant anxiety issues. You are the person everyone in the room looks to when **** hits the fan. Thats when you need to stay composed when others freeze. Thats definitely true for anesthesiologists and somewhat true for cRNas

 

[JonJ880]

i think the situation couldve been improved if you had a mentor of some sort who could guide you thru the process and calm you down.. .
it sounds more like stress than pure anxiety. your problems are the same problems that all your peers go thru. everyone has tons of loans. worst case scenario, med school is P=MD, and majority of US grads match. not sure why you would think you wouldnt.

but either way, if you believe it is truly mostly anxiety, anesthesia is not the best field for you. it's a stressful job.
while crna is much less stressful than MD, it can still vary a lot on your personality. while its true you have a MD to help you out in most situations, a bad outcome can stress some people out even if they are not the responsible person on teh chart..

imagine the scenario where something bad is happening to the patient in the OR, and you arent sure what to do, and you call the MD, who may take several minutes to be there, and in critical situations in anesthesia, several minutes can be a long time, and while you are waiting, the patient is getting worse and worse, would imagining yourself in that situation cause anxiety?

The thing is I feared all of these things coming into med school. I was actually planning on doing PA originally but I had a great deal of pressure from parents to pursue this path. I know it's my fault and I'm trying my best to fix my career situation now.

I like anesthesia cuz phys and pharm interested me and when I shadowed an anesthesiologist I loved watching her do procedures. She explained head and neck anatomy to me as a pre-med and I saw her to central lines and other procedures. I also loved being in the OR (I remember telling my friends I had a huge smile on behind my mask cuz of how cool it was to see all that stuff). Also I genuinely care about patients and I think that if I can overcome my anxiety I can be a good anesthesia provider.

My anxiety was weird because I began having obsessive thoughts about not matching and having massive debt with a useless bio degree. I KNEW the thoughts were irrational but my mind literally would not stop playing those thoughts in my mind. It has never happened before nor since and if it ever happened again I now know of resources like a psychiatrist (or meds/therapy) that can help.

imagine the scenario where something bad is happening to the patient in the OR, and you arent sure what to do, and you call the MD, who may take several minutes to be there, and in critical situations in anesthesia, several minutes can be a long time, and while you are waiting, the patient is getting worse and worse, would imagining yourself in that situation cause anxiety?

Yes I imagine that situation would cause anxiety but I would think that I could use my training to take the correct steps in that situation. As long as I studied hard in CRNA school, wouldn't my job be just to deliver the standard of care? I know that that would be stressful to do in that situation which is why I am genuinely asking.

I think anesthesia looks really cool, I'm always watching youtube videos about day in the life of anesthesiologists, and I'm very sure I'd pass CRNA school and CRNA boards. However, if the career is really too anxiety provoking then maybe I should do something else.

 

[Candidate2017]

This entire post makes no sense. You were doing well and afraid you wouldnt get a residency spot and be stuck with debt, so instead you left and started a degree (more money)? Even the guy in my class who was asked to repeat 3rd year and was on the spectrum got a residency spot.

People with anxiety disorders experience anxiety from their spiraling anxiety. Their actions, which seem illogical, are actually designed to bring relief through avoidance.

For example: I'm not smart enough => I'm going to fail => even if I graduate, I may fail in residency => I can't get a job => I can't pay back my $500k loans => OMG OMG OMG => quits med school => relief from distress from anxiety.

Whereas, the usual anxious med student does not feel this anxiety superimposed on anxiety. They wallow in the anxiety and then take actions such as study more etc.

 

[Candidate2017]

OP, I would engage with a psychiatrist who does therapy or a PhD therapist, whom you can work with to address some of your cognitive distortions, while retaining the useful portions of your anxiety.

I disagree that people with anxiety disorders can't be anesthesiologists.

 

[Consigliere]

People with anxiety disorders experience anxiety from their spiraling anxiety. Their actions, which seem illogical, are actually designed to bring relief through avoidance.

For example: I'm not smart enough => I'm going to fail => even if I graduate, I may fail in residency => I can't get a job => I can't pay back my $500k loans => OMG OMG OMG => quits med school => relief from distress from anxiety.

Whereas, the usual anxious med student does not feel this anxiety superimposed on anxiety. They wallow in the anxiety and then take actions such as study more etc.

Check out the big brain on Candidate2017!

 

[Consigliere]

OP, I would engage with a psychiatrist who does therapy or a PhD therapist, whom you can work with to address some of your cognitive distortions, while retaining the useful portions of your anxiety.

I disagree that people with anxiety disorders can't be anesthesiologists.

I would recommend he engage with YOU.

 

[JonJ880]

People with anxiety disorders experience anxiety from their spiraling anxiety. Their actions, which seem illogical, are actually designed to bring relief through avoidance.

For example: I'm not smart enough => I'm going to fail => even if I graduate, I may fail in residency => I can't get a job => I can't pay back my $500k loans => OMG OMG OMG => quits med school => relief from distress from anxiety.

Whereas, the usual anxious med student does not feel this anxiety superimposed on anxiety. They wallow in the anxiety and then take actions such as study more etc.

This is exactly how I felt. In the past whenever I had anxiety the thing that would calm me down is studying more. My thought process was always, "if I study more then at least I can say I tried my best even if I fail". However, towards the end I just kept thinking of all the negatives like how a close friend of mine failed Step 2 CS or how ppl on sdn talk about how a residency shortage is coming.

With nursing its just a year and a half to get by BSN and then i get a job that pays well (versus my useless bio degree). Also, I've never frozen up due to anxiety in the moment. It's always been longterm stuff like what if I dont get a residency, or what if I can never pay back my loans. When i'm stressed in the moment i just focus on the task at hand.

idk I just feel like it would be a waste for me to just be a floor nurse. i think i have the mental capability to do more and I anesthesia looks like an option but we'll see

 

[coffeebythelake]

I disagree that people with anxiety disorders can't be anesthesiologists.

Those with such crippling anxiety such that they have to take time off of school is not the standard variety anxiety. Everyone in med school has some degree of uncertainty and angst. But part of our work involves being able to handle it. Sure work it out with a psychiatrist, but this variety of anxiety typically does not resolve itself so easily.

 

[Candidate2017]

Check out the big brain on Candidate2017!

I stayed at a Holiday Inn Express last night.

 

[Candidate2017]

Those with such crippling anxiety such that they have to take time off of school is not the standard variety anxiety. Everyone in med school has some degree of uncertainty and angst. But part of our work involves being able to handle it. Sure work it out with a psychiatrist, but this variety of anxiety typically does not resolve itself so easily.

A decent number of attending physicians and med students have crippling anxiety disorders. I treat them.

Again, I would encourage OP to seek help, as venting on SDN and/or seeking reassurance is actually a form of avoidance/mere temporary relief. You can do it if you put in the work.

 

[ryanjmy]

Go to apn school. You can work for a surgeon in whatever field interests you. I don't think you'll be a good fit for anesthesia.

 

[coffeebythelake]

A decent number of attending physicians and med students have crippling anxiety disorders. I treat them.

That may be true, and there is a place in medicine where they might fit in and not have to deal with anxiety triggers and stressors every day.

And I absolutely agree they should seek professional help and try to work through their anxieties.

But "working through" is still a coping mechanism, isn't it?

The bigger question (and more relevant to the OP's question) is how many recognize this problem early on and still choose to go into stressful fields such as emergency medicine, trauma surgery or anesthesia? T

 

[PainDrain]

This is exactly how I felt. In the past whenever I had anxiety the thing that would calm me down is studying more. My thought process was always, "if I study more then at least I can say I tried my best even if I fail". However, towards the end I just kept thinking of all the negatives like how a close friend of mine failed Step 2 CS or how ppl on sdn talk about how a residency shortage is coming.

With nursing its just a year and a half to get by BSN and then i get a job that pays well (versus my useless bio degree). Also, I've never frozen up due to anxiety in the moment. It's always been longterm stuff like what if I dont get a residency, or what if I can never pay back my loans. When i'm stressed in the moment i just focus on the task at hand.

idk I just feel like it would be a waste for me to just be a floor nurse. i think i have the mental capability to do more and I anesthesia looks like an option but we'll see

Let me tell you this. If anxiety about your life’s direction and potential pitfalls is crippling then I wouldn’t go into anesthesia or become a crna.

 

[nimbus]

Agree anesthesia is not a good fit for people with severe anxiety issues. Anxiety can turn what is a fun job into misery for some people. I’ve seen this in real life. There are many advanced practice nursing options that are a better fit for someone with anxiety issues.

 

[BLADEMDA]

I think the OP should be posting this in the psychiatry forum not here. What the OP needs is a good therapist like Consigliere. 😉

 

[anbuitachi]

A decent number of attending physicians and med students have crippling anxiety disorders. I treat them.

Again, I would encourage OP to seek help, as venting on SDN and/or seeking reassurance is actually a form of avoidance/mere temporary relief. You can do it if you put in the work.

There are also numbers of anesthesiologists who are addicted to drugs. I wouldnt recommend drug addicts to become anesthesiologists.. it doesnt mean they will necessarily fail if they do pursue

 

[anbuitachi]

This is exactly how I felt. In the past whenever I had anxiety the thing that would calm me down is studying more. My thought process was always, "if I study more then at least I can say I tried my best even if I fail". However, towards the end I just kept thinking of all the negatives like how a close friend of mine failed Step 2 CS or how ppl on sdn talk about how a residency shortage is coming.

With nursing its just a year and a half to get by BSN and then i get a job that pays well (versus my useless bio degree). Also, I've never frozen up due to anxiety in the moment. It's always been longterm stuff like what if I dont get a residency, or what if I can never pay back my loans. When i'm stressed in the moment i just focus on the task at hand.

idk I just feel like it would be a waste for me to just be a floor nurse. i think i have the mental capability to do more and I anesthesia looks like an option but we'll see

Well at this point, you can give it a shot. you can always stop practicing and do other nursing jobs.
there are many CRNA jobs these days, you may be able to find one that fits your needs

 

[chocomorsel]

Those with such crippling anxiety such that they have to take time off of school is not the standard variety anxiety. Everyone in med school has some degree of uncertainty and angst. But part of our work involves being able to handle it. Sure work it out with a psychiatrist, but this variety of anxiety typically does not resolve itself so easily.

I actually had a similar anxiety situation in residency. Actually took some time off and saw a shrink and took meds. Pretty sure I have talked about it on here and some jerk poster tried to use my use of Prozac to attempt to make me look unhinged and crazy. However, once out of residency, my anxiety tremendously improved. I had a terrible time in residency and I know that had I stayed at my medical school, I would not have had the same issues.

I am a pretty high strung person in life, but somehow I am surviving behind the ether drape and don't dread getting up in the mornings to go to work on most days. Of course I do prefer the ICU where I don't have to deal with egotistical surgeons often. But most surgeons are tolerable or even nice in private practice. Or they mind their business leave you alone which works just fine with me.

All this to say, anxiety can be managed, and sometimes it's just situational. Rarely I would say is it crippling enough to hinder one from performing well even in a semi stressful job like ours.

If you want to be a CRNA, then do it. I think with the right therapist and possibly meds, you will be fine. Just don't be cocky. Call for help when you need it, and make sure you can think and act on your feet and not go into panic mode when s hit hits the roof or when things are starting to look bad.
Seems like you have already improved since leaving medical school. Good luck.

 

[chocomorsel]

That may be true, and there is a place in medicine where they might fit in and not have to deal with anxiety triggers and stressors every day.

And I absolutely agree they should seek professional help and try to work through their anxieties.

But "working through" is still a coping mechanism, isn't it?

The bigger question (and more relevant to the OP's question) is how many recognize this problem early on and still choose to go into stressful fields such as emergency medicine, trauma surgery or anesthesia? T

Let's be honest. Are you dealing with stressful patient situations every day or is that a bit of a stretch? I mean most our days are filled with straight forward, appys, choles, broken bones, epidurals, Csections, kidney stones, lamis, tonsils. Unless you are a cardiac doc, a pedi doc in academics, a high risk OB doc, you aren't dealing with stressful situations every day.
Let's be honest here. In the past three months, I have had four stressful cases that I called other colleagues for help to pick their brains and see what I could be missing and only two that I really needed an extra hand in due to a true emergency (airway, anaphylaxis). So, not often stressful, but when it is, it can be bad. Some full time PP practice people with an exclusive contract may get their share of sepsis, knife wounds, emergency floor airways, but it's not that often. Certainly not daily.

But the stress of moving the meat, turning over, faster, faster, why did it take twenty minutes to get in the room, is the real deal every day. Can you handle that OP?

 

[JonJ880]

Let's be honest. Are you dealing with stressful patient situations every day or is that a bit of a stretch? I mean most our days are filled with straight forward, appys, choles, broken bones, epidurals, Csections, kidney stones, lamis, tonsils. Unless you are a cardiac doc, a pedi doc in academics, a high risk OB doc, you aren't dealing with stressful situations every day.
Let's be honest here. In the past three months, I have had four stressful cases that I called other colleagues for help to pick their brains and see what I could be missing and only two that I really needed an extra hand in due to a true emergency (airway, anaphylaxis). So, not often stressful, but when it is, it can be bad. Some full time PP practice people with an exclusive contract may get their share of sepsis, knife wounds, emergency floor airways, but it's not that often. Certainly not daily.

But the stress of moving the meat, turning over, faster, faster, why did it take twenty minutes to get in the room, is the real deal every day. Can you handle that OP?

I think working as an ICU nurse will allow me to get a sense of how well I can handle it. The CRNAs I've spoken to all said being an ICU nurse is stressful and gives a good idea of how well one can tolerate stress.

 

[anbuitachi]

Let's be honest. Are you dealing with stressful patient situations every day or is that a bit of a stretch? I mean most our days are filled with straight forward, appys, choles, broken bones, epidurals, Csections, kidney stones, lamis, tonsils. Unless you are a cardiac doc, a pedi doc in academics, a high risk OB doc, you aren't dealing with stressful situations every day.
Let's be honest here. In the past three months, I have had four stressful cases that I called other colleagues for help to pick their brains and see what I could be missing and only two that I really needed an extra hand in due to a true emergency (airway, anaphylaxis). So, not often stressful, but when it is, it can be bad. Some full time PP practice people with an exclusive contract may get their share of sepsis, knife wounds, emergency floor airways, but it's not that often. Certainly not daily.

But the stress of moving the meat, turning over, faster, faster, why did it take twenty minutes to get in the room, is the real deal every day. Can you handle that OP?

true but you are a well trained anesthesiologist. CRNAs may run into more problems due to lower requirements for graduation, but yes should be able to find a low stress job since there are so many CRNA jobs... way more than anesthesiologist jobs where im at

 

[GA8314]

OP it really sounds like you may be suffering from an anxiety disorder, likely Generalized Anxiety Disorder. I recommend revisiting things with a psychiatrist. I also recommend you discuss with you Dr. an SSRI. You will be amazed how much of a difference SSRI's can make, and while they do have side effects usually you can find the right one at the right dose to limit SE's.

GAD can be debilitating but meds are very effective. Then you can better assess how you respond to your environment and make other types of changes. But, first IMHO, you need to get out of the woods and let your brain heal.

 

[Candidate2017]

Disclaimer: as this is the internets, nothing I say/said is to be construed as a diagnosis or medical advice; I am to be treated as any random internet poster spewing utter nonsense; OP should only rely on advice from their own physician/therapist.

It seems to me OP doesn't really voice anxiety about performance in emergent situations or crashing patients. If anything, OP seems quite excited about anesthesiology. Their anxiety has more of a projective, ruminative quality to it related to self worth.

Even if OP has tremendous anxiety about emergent situations, they wouldn't necessarily be precluded from anesthesiology or anything else, if they work on it. Many athletes suffer from even more extreme anxiety, panic attacks, depression, and self-doubt but are still able to perform at a very high level with help from their psychiatrist/therapist.

 

[Consigliere]

I think the OP should be posting this in the psychiatry forum not here. What the OP needs is a good therapist like Consigliere. 😉

Appreciate the concern but it is completely unnecessary. I'm one of the most well adjusted individuals out there😉

 

[Consigliere]

There are also numbers of anesthesiologists who are addicted to drugs. I wouldnt recommend drug addicts to become anesthesiologists.. it doesnt mean they will necessarily fail if they do pursue

Let's drop that stigmatizing term and refer to them as the DSM-V does: person with a substance use disorder. Drug and alcohol use disorders are DISEASES and should be treated as such. I have no opinion as to whether or not someone with a substance use disorder should pursue anesthesiology as a career.

 

[epidural man]

I started med school in 2014 (US MD school) but left during my second year due to anxiety. During my second year I became really worried and began having "what if" thoughts about passing Step 1, Step 2, getting a residency, etc. The financial side was a huge part of my anxiety because my loans were going to be massive and if I didnt get a residency I would have no way of paying them off. It came to the point that I couldn't sleep well at night nor study during the day because my anxiety was so high. I saw a student from our university that got kicked out of residency and failed to land another one (with 200k+ in debt) which increased my anxiety. I still passed all my classes (up until second semester of second year when I withdrew).

I spoke to two psychiatrists and they stated that my anxiety was due to medical school and the financial fears I had of not matching. Since this time I have worked a job while doing my BSN which I am about to complete.

I wanted to get advice from you all regarding my future. I know I am reasonably smart (good undergrad GPA, passed first two years of med school, currently top of my BSN class). I currently have zero anxiety because I know as a nurse I'll be able to make at least 60-70k a year in my area. Also nursing is much easier and all of my practice NCLEX scores have been well above average (no worries about failing).

Should I aim for CRNA school? Is being a CRNA very anxiety provoking? I am very confident I'd pass all of the CRNA didactic coursework. Should I be worried that I'd develop anxiety in other parts of the job? I don't think it would be that anxiety provoking because the CRNA debt is much lower and I even know people that work during the first year of CRNA school. I spoke to a couple of CRNA schools in my area that said id be a good candidate if I got my ICU experience.

TL;DR - left med school as a second year due to anxiety from being in MASSIVE debt/not getting residency (passed all classes). Finishing BSN, currently no anxiety, should I aim for CRNA or would that make my anxiety return?

Also to avoid the politics I obviously do not support independent CRNA practice and CRNA training obviously does not make me a doctor (not even close). Being a CRNA would make me a midlevel and I personally would be happy with that.

your psych doc is wrong.

You don’t have anxiety from all those things. You have anxiety because you are a Millenial.

Not sure how one fixes that issue.

 

[deleted162650]

your psych doc is wrong.

You don’t have anxiety from all those things. You have anxiety because you are a Millenial.

Not sure how one fixes that issue.

OK Boomer.

 

[deleted697127]

OK Boomer.

lol someone expresses rational concern over the absurd cost of medical school and debilitating student loan crisis created by boomers and they’re criticized for being a millennial... Pretty much sums up the frustration between generations right there.

 

[Consigliere]

lol someone expresses rational concern over the absurd cost of medical school and debilitating student loan crisis created by boomers and they’re criticized for being a millennial... Pretty much sums up the frustration between generations right there.

OK Boomer.

 

[Hoya11]

I started med school in 2014 (US MD school) but left during my second year due to anxiety. During my second year I became really worried and began having "what if" thoughts about passing Step 1, Step 2, getting a residency, etc. The financial side was a huge part of my anxiety because my loans were going to be massive and if I didnt get a residency I would have no way of paying them off. It came to the point that I couldn't sleep well at night nor study during the day because my anxiety was so high. I saw a student from our university that got kicked out of residency and failed to land another one (with 200k+ in debt) which increased my anxiety. I still passed all my classes (up until second semester of second year when I withdrew).

I spoke to two psychiatrists and they stated that my anxiety was due to medical school and the financial fears I had of not matching. Since this time I have worked a job while doing my BSN which I am about to complete.

I wanted to get advice from you all regarding my future. I know I am reasonably smart (good undergrad GPA, passed first two years of med school, currently top of my BSN class). I currently have zero anxiety because I know as a nurse I'll be able to make at least 60-70k a year in my area. Also nursing is much easier and all of my practice NCLEX scores have been well above average (no worries about failing).

Should I aim for CRNA school? Is being a CRNA very anxiety provoking? I am very confident I'd pass all of the CRNA didactic coursework. Should I be worried that I'd develop anxiety in other parts of the job? I don't think it would be that anxiety provoking because the CRNA debt is much lower and I even know people that work during the first year of CRNA school. I spoke to a couple of CRNA schools in my area that said id be a good candidate if I got my ICU experience.

TL;DR - left med school as a second year due to anxiety from being in MASSIVE debt/not getting residency (passed all classes). Finishing BSN, currently no anxiety, should I aim for CRNA or would that make my anxiety return?

Also to avoid the politics I obviously do not support independent CRNA practice and CRNA training obviously does not make me a doctor (not even close). Being a CRNA would make me a midlevel and I personally would be happy with that.

It sounds like you made the best decision for yourself. It sounds like med school was not working for you, it IS stressful and a lot of work and a lot of anxiety for anyone. Some part of you realized that this commitment/situation just was not going to work for you. LOTS of people in those shoes, you just made it farther along than they did. Med school/residency, while effective, is in many ways antiquated and needlessly unpleasant.

Now, It must feel good to feel confident about passing your upcoming exams, confident about your performance clinically, confident about your position relative to your peers, and confident knowing you will very likely get a good job when its done and can pay off your debt. I mean how long can you go on mentally and not be assured of those things? Thats a big load to carry.. "Im going to fail, Im going to be in debt, Im going to hurt someone" Those things could really happen ...

CRNA school sounds like a great option for you IMO. Personally, I think that a lot of CRNAs are of the same mindset. They want to play at that high level, but when it gets to be a lot of work or pressure - im out. Nothing wrong with that. Good luck and enjoy your life in your new path, CRNA is a great job and I would encourage you to at least try that route.

 

[shepardsun]

I think there are two significant types of anxiety in anesthesia, as @chocomorsel already basically described.

Can you handle the daily, passive aggressive bullsh*t that arises from the combination of personalities in the OR, production pressures, system inefficiencies, etc? Some people who are conflict averse, or with low self esteem, or poor intrapersonal skills may be at risk for anxiety or depression just by virtue of the atmosphere of the environment.

Then there are the true uncommon but not rare "hours of boredom, moments of sheer terror" situations where the **** hits the fan and you have a few seconds to intervene before a bad situation becomes a worse one. If you're a CRNA in an ancillary GI suite and your patient suddenly obstructs and desats to the 40s during your propofol MAC and your staff is halfway across the hospital, you have to do something in the next thirty seconds before the desat becomes a respiratory arrest. Drilling and practicing and doing sims and whatever is good to help prepare you for that, but until you've actually been in a situation like that you don't know how you're going to react. Having a big smile on your face after a day shadowing in the OR doesn't really say much about how you are able to handle a crisis situation. I've seen some of the smoothest, most self assured and technically skilled people freeze like a deer in headlights when the chips are really down.

I don't know if there's correlation or causation or higher risk of that with a baseline anxiety disorder, and I'm sure plenty of us have issues with anxiety of various types and are able to successfully do our jobs, but I certainly don't imagine it helps.

 

[deleted697535]

Every job could have conflict and stress or not depending on the person.
Anesthesia doesnt have to be stressful.

At the end of the day we have a handful of things we can ever do to 'fix' really bad situations - oxygen, blood or some fluid, pressors & inotropes. All the rest is just nonsense we make up to seem smart. you could simplify it to oxygen, blood epi. That surely not hard is it?

You could find a nice number doing lower acuity cases and probably make a killing on it. But residency will be hard...

Personally i drink a lot and dont give a **** about anything other than my deck and my dog. If you can adopt that type of not giving a **** attitude it might be better. Idk, im definelty not one to take advice from probably

 

[JonJ880]

It sounds like you made the best decision for yourself. It sounds like med school was not working for you, it IS stressful and a lot of work and a lot of anxiety for anyone. Some part of you realized that this commitment/situation just was not going to work for you. LOTS of people in those shoes, you just made it farther along than they did. Med school/residency, while effective, is in many ways antiquated and needlessly unpleasant.

Now, It must feel good to feel confident about passing your upcoming exams, confident about your performance clinically, confident about your position relative to your peers, and confident knowing you will very likely get a good job when its done and can pay off your debt. I mean how long can you go on mentally and not be assured of those things? Thats a big load to carry.. "Im going to fail, Im going to be in debt, Im going to hurt someone" Those things could really happen ...

CRNA school sounds like a great option for you IMO. Personally, I think that a lot of CRNAs are of the same mindset. They want to play at that high level, but when it gets to be a lot of work or pressure - im out. Nothing wrong with that. Good luck and enjoy your life in your new path, CRNA is a great job and I would encourage you to at least try that route.

I think there are two significant types of anxiety in anesthesia, as @chocomorsel already basically described.

Can you handle the daily, passive aggressive bullsh*t that arises from the combination of personalities in the OR, production pressures, system inefficiencies, etc? Some people who are conflict averse, or with low self esteem, or poor intrapersonal skills may be at risk for anxiety or depression just by virtue of the atmosphere of the environment.

Then there are the true uncommon but not rare "hours of boredom, moments of sheer terror" situations where the **** hits the fan and you have a few seconds to intervene before a bad situation becomes a worse one. If you're a CRNA in an ancillary GI suite and your patient suddenly obstructs and desats to the 40s during your propofol MAC and your staff is halfway across the hospital, you have to do something in the next thirty seconds before the desat becomes a respiratory arrest. Drilling and practicing and doing sims and whatever is good to help prepare you for that, but until you've actually been in a situation like that you don't know how you're going to react. Having a big smile on your face after a day shadowing in the OR doesn't really say much about how you are able to handle a crisis situation. I've seen some of the smoothest, most self assured and technically skilled people freeze like a deer in headlights when the chips are really down.

I don't know if there's correlation or causation or higher risk of that with a baseline anxiety disorder, and I'm sure plenty of us have issues with anxiety of various types and are able to successfully do our jobs, but I certainly don't imagine it helps.

Thank you for the advice. I once shadowed in the ER and a lady came in with a aortic dissection (iirc) and the family med docs running the ER (rural ER) just seemed out of place and worried. The anesthesia team looked like heroes when they came in and put in a central line and intubated the patient. I was amazed to see their skills and enjoyed being in that environment as I watched them try to save this woman's life. But obviously my license wasn't on the line and I had nothing to lose so my stress was low. I assume I can find CRNA positions that dont involve this level of pressure?

My main concern about being a CRNA is, 'what happens if I'm slow on a procedure'? For example, what happens if I have an elderly dehydrated patient that I'm having a hard time getting an IV in and the surgeon is waiting on me? Or even from watching central lines, I'm curious about how they get it in at the exact correct position w/o causing a pneumothorax? I have steady hands and good hand eye coordination...but I have no clue if thats going to help with procedures.

I'm 99% positive I can do well in CRNA school academically and pass boards but I'm not sure how well I'd be with my hands because I've never done those procedures.

As far as reacting in an emergency situation in the OR...I wont know till I'm in it. My car once started to skid out on an icy day and I reacted quickly by steering into the slide and not braking hard. That's the closest thing I can think of in terms of my reaction to an emergency situation.

 

[deleted162650]

my license wasn't on the line

You’re already starting to sound like a nurse. 👍

 

[vector2]

I assume I can find CRNA positions that dont involve this level of pressure?

My main concern about being a CRNA is, 'what happens if I'm slow on a procedure'?d quickly by steering into the slide and not braking hard. That's the closest thing I can think of in terms of my reaction to an emergency situation.

I work in a high acuity center and the CRNAs never have to sweat, even in pressure cooker situations. Difficult intubation? I'm standing right there to take over. Needs awake fiberoptic? Call me. Unable to get an IV? Call me. Unable to get an a-line? Call me. Pt needs a central line? Call me. Pt is in shock? Call me. Unable to integrate all the information and wondering if resuscitation is adequate? Call me. Pt ends up having a bad outcome? "Well, Dr. vector2 was the anesthesiologist of record on the case"

If you are a CRNA in a care team practice, you get to take care of patients, still do some procedures and a lot of the fun stuff, punch a clock, make pretty good money and always have that mental safety net of knowing there is an expert in anesthesia watching over the case. Other than the path you have to take to get there, CRNA is a pretty sweet gig.

 

[JonJ880]

I work in a high acuity center and the CRNAs never have to sweat, even in pressure cooker situations. Difficult intubation? I'm standing right there to take over. Needs awake fiberoptic? Call me. Unable to get an IV? Call me. Unable to get an a-line? Call me. Pt needs a central line? Call me. Pt is in shock? Call me. Unable to integrate all the information and wondering if resuscitation is adequate? Call me. Pt ends up having a bad outcome? "Well, Dr. vector2 was the anesthesiologist of record on the case"

If you are a CRNA in a care team practice, you get to take care of patients, still do some procedures and a lot of the fun stuff, punch a clock, make pretty good money and always have that mental safety net of knowing there is an expert in anesthesia watching over the case. Other than the path you have to take to get there, CRNA is a pretty sweet gig.

Wow that's amazing. However, if a CRNA calls you for help on an IV dont they look really incompetent? Like couldn't they get fired for that?

In the video below (from 14:30-16:00) this new CRNA describes her first week (she just graduated from CRNA school). She said that she had an "oh crap moment" during a case but she figured it out on her own and made the right decision. She also says she cant give details but any crna/srna or MD/DO would know what she's talking about...if you know could you tell me what she means? Im curious to know what decisions she had to make in the OR.

 

[deleted162650]

This dude just keeps gettin’ trollier.

 

[secretasianman]

The circuit probably disconnected from the tube. Good thing she thought quickly on her feet !

Wow that's amazing. However, if a CRNA calls you for help on an IV dont they look really incompetent? Like couldn't they get fired for that?

In the video below (from 14:30-16:00) this new CRNA describes her first week (she just graduated from CRNA school). She said that she had an "oh crap moment" during a case but she figured it out on her own and made the right decision. She also says she cant give details but any crna/srna or MD/DO would know what she's talking about...if you know could you tell me what she means? Im curious to know what decisions she had to make in the OR.

 

[Consigliere]

Im curious to know what decisions she had to make in the OR.

If she'll be taking 2 or 3 fifteen minute breaks, if her supervising anesthesiologist is an as_shole or a d_ick, whether or not to tell the truth about the 15 mg of metoprolol she indiscriminately gave the patient on emergence as the reason for the current HR of 41 in the PACU ("he was fine when he left the OR"), which orthopedic surgeon she'll flirt with today....certainly nothing requiring any degree of critical thinking skills.

 

[coffeebythelake]

Wow that's amazing. However, if a CRNA calls you for help on an IV dont they look really incompetent? Like couldn't they get fired for that?

In the video below (from 14:30-16:00) this new CRNA describes her first week (she just graduated from CRNA school). She said that she had an "oh crap moment" during a case but she figured it out on her own and made the right decision. She also says she cant give details but any crna/srna or MD/DO would know what she's talking about...if you know could you tell me what she means? Im curious to know what decisions she had to make in the OR.

If you know what you are doing and have a good differential diagnosis and plan it shouldnt become an oh crap moment.

 

[coffeebythelake]

I work in a high acuity center and the CRNAs never have to sweat, even in pressure cooker situations. Difficult intubation? I'm standing right there to take over. Needs awake fiberoptic? Call me. Unable to get an IV? Call me. Unable to get an a-line? Call me. Pt needs a central line? Call me. Pt is in shock? Call me. Unable to integrate all the information and wondering if resuscitation is adequate? Call me. Pt ends up having a bad outcome? "Well, Dr. vector2 was the anesthesiologist of record on the case"

If you are a CRNA in a care team practice, you get to take care of patients, still do some procedures and a lot of the fun stuff, punch a clock, make pretty good money and always have that mental safety net of knowing there is an expert in anesthesia watching over the case. Other than the path you have to take to get there, CRNA is a pretty sweet gig.

Yep.