any anaesthesiologists who wish they did surgery instead after a few years into it?

[ALTorGT]

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trying to make this big decision as to which one to sign up for....always hear of those who switched from surg to anaesthesia. anyone here who's a few years in and wishes they did surg instead? I know I've never been a surgeon, never been on call at home, never come in for a post op complication, never done clinics, never done post op rounds for the 2386th time, but for some reason (even though I love the idea of managing a patient's haemodynamics and providing a safe anaesthetic), there's this gnawing feeling that I would regret not being the one who uses the knife sooner or later.

 

[Pir8DeacDoc]

having this same debate with myself right now. I think both are good fields. The hard part is making the decision on gas with a fair bit less information than surgery. All of us had a ton of surgery as part of our core rotations. I respect surgery and the things surgeons can do but I'm just not sure I'm willing to sign up for the hours and lifestyle they have to take on. For right now, I've got an application turned in for gas.

 

[supahfresh]

i think about this everyday. i worked hard during my surgery internship, but i really liked what i was doing. now, when i get out earlier and get up later than the surgery residents, have time to take a bartending class on the side, not to mention go surfing on the weekends, and still get lots of reading done....it's hard to convince myself to switch back into surgery.

 

[lvspro]

trying to make this big decision as to which one to sign up for....always hear of those who switched from surg to anaesthesia. anyone here who's a few years in and wishes they did surg instead? I know I've never been a surgeon, never been on call at home, never come in for a post op complication, never done clinics, never done post op rounds for the 2386th time, but for some reason (even though I love the idea of managing a patient's haemodynamics and providing a safe anaesthetic), there's this gnawing feeling that I would regret not being the one who uses the knife sooner or later.

You've obviously been bit by the surgery bug. I was once envenomated by that little bugger, but then I figured out that you don't just operate, and you spend a majority of your time in OP settings. If it wasn't for clinic, I would definitely be considering surgery, but I just don't see myself in the outpatient setting.
One thing I was told during my rotations that makes sense is "try to picture yourself as the attending in a rotation, and also picture yourself doing the bread and butter cases day after day for the rest of your career." I was not able to see myself doing clinic, and the hernias for the rest of my life. I was, on the other hand, able to picture pushing meds, managing CRNA's, popping in epidurals etc... though. So I guess it all boils down to what you see yourself doing 20,30,40 yrs from now.

 

[jetproppilot]

trying to make this big decision as to which one to sign up for....always hear of those who switched from surg to anaesthesia. anyone here who's a few years in and wishes they did surg instead? I know I've never been a surgeon, never been on call at home, never come in for a post op complication, never done clinics, never done post op rounds for the 2386th time, but for some reason (even though I love the idea of managing a patient's haemodynamics and providing a safe anaesthetic), there's this gnawing feeling that I would regret not being the one who uses the knife sooner or later.

Nope.

It was either ER or anesthesia for me....really wanted to do ER since I was a firefighter paramedic for a cuppla years...U of Miami didnt have an ER residency, they had a huge anesthesia residency, had some positive experiences during my rotations, liked the people that seem to pick anesthesia, and the rest is history.

Still glad I picked anesthesia over ER to. Moonlighted heavily in an ER during my residency and, although I liked it, I was glad I wasnt gonna be doing ER for 20 years.

 

[Tenesma]

you could do interventional pain and spend most of your time in the OR doing vertebroplasty/kyphoplasty/spinal cord stimulator implants/intrathecal pump implants and if you want you can be even more daring and do percutaneous foraminotomies, percutaneous discectomies etc...

and the best of it is that you won't have the headaches of following wound management patients🙂

 

[lvspro]

you could do interventional pain and spend most of your time in the OR doing vertebroplasty/kyphoplasty/spinal cord stimulator implants/intrathecal pump implants and if you want you can be even more daring and do percutaneous foraminotomies, percutaneous discectomies etc...

and the best of it is that you won't have the headaches of following wound management patients🙂

I've been looking up the above procedures for quite some time, and would definitely prefer those over hernias, and a whipple once a month. Just another affirmation of my decision to go into anesthesia. The only problem is that tons of people are doing pain mgmt, and I can see it getting real competitive by the time I get there. Even so, I tink I may just try for it. I think it would be cool to be able to do OR gas 3x/wk, and procedural pn mgmt for like 2 or 3 days.

 

[jetproppilot]

I've been looking up the above procedures for quite some time, and would definitely prefer those over hernias, and a whipple once a month. Just another affirmation of my decision to go into anesthesia. The only problem is that tons of people are doing pain mgmt, and I can see it getting real competitive by the time I get there. Even so, I tink I may just try for it. I think it would be cool to be able to do OR gas 3x/wk, and procedural pn mgmt for like 2 or 3 days.

Don't let competition deter you. If you wanna do it, and you're great at what you do, you'll prosper.

 

[MD Dreams]

Almost every doctor that I've talked to who has been in medicine for a while only seems to focus on two things: Money and lifestyle. I have yet to meet a seasoned doctor who says man I'm so glad I became so and so. They all seem jaded, none of them have that spark in their eyes or that burning passion that us young folks have. They tell me that when we are young we don't think straight. We want to be surgeons, to save people, etc. etc. But when we get older we realize what is really important and by that time it's too late.

After hearing and seeing all of this, I still cannot convince myself to abandon surgery and commit to anesthesiology. Right now I'm working 12 hours a day in my clerkship, which for others may not be much, but it's the most I've done. However, when I come home I'm so happy. Yes, I get tired, but I love every minute that I'm in the hospital. But right now I don't have a wife, no kids, not older. Will I still feel the same ten years from now, will I have anything left in me after a surgical residency? I don't know, but no matter how much others warn me, I'm still blinded by my passion. I wish I had a crystal ball.

 

[lvspro]

Don't let competition deter you. If you wanna do it, and you're great at what you do, you'll prosper.

Words to live by

 

[lvspro]

Almost every doctor that I've talked to who has been in medicine for a while only seems to focus on two things: Money and lifestyle. I have yet to meet a seasoned doctor who says man I'm so glad I became so and so. They all seem jaded, none of them have that spark in their eyes or that burning passion that us young folks have. They tell me that when we are young we don't think straight. We want to be surgeons, to save people, etc. etc. But when we get older we realize what is really important and by that time it's too late.

After hearing and seeing all of this, I still cannot convince myself to abandon surgery and commit to anesthesiology. Right now I'm working 12 hours a day in my clerkship, which for others may not be much, but it's the most I've done. However, when I come home I'm so happy. Yes, I get tired, but I love every minute that I'm in the hospital. But right now I don't have a wife, no kids, not older. Will I still feel the same ten years from now, will I have anything left in me after a surgical residency? I don't know, but no matter how much others warn me, I'm still blinded by my passion. I wish I had a crystal ball.

On the contrary, with almost every doc I worked with, I had an opportunity to have a little casual conversation with, and I found that a large percentage of them still love what they do, and would never do anything else. The lifestyle and money thing is what everyone in any profession says after they've been doin' it for a while. I think what they lack is the original excitement of doing the procedure itself. Your 1st hernia rules, your 501'st hernia may not be as exciting, but I'll bet it's still pretty darn fun.

On another note, I have noticed that a lot of physicians are quite jaded about the reimbursement issues. I'm not too sure who it is, but someone on this forum has a link in their signature which leads you to a graph of physician income change over the last 20 yrs, and health management industry salary changes. One look at this graph will explain why most doc's are upset with the compensation... and rightly so. Doc salaries have stayed pretty level, while hlth mgmt $$ has went through the roof. If we spent the money on healthcare that's gobbled up by health mgmt, then I think our system may be helped a little. If I can find that graph, I'll edit this post, and paste it on.

 

[redstorm]

Hey I know plenty of happy surgeons.. and happy obstetricians who picked it because it was there calling... IF you like what you do you like what you do... period..

I like what I DO..

Anesthesia is different from surgery... You have less of a relationship with the patients.. you dont see them post op.. in the office.. etc.. I kind of miss that sometimes... But i do enjjoy anesthesia... It can get stressful at times.. if you really sit around and reflect on what it is you do all day long for these patients..

 

[jetproppilot]

On another note, I have noticed that a lot of physicians are quite jaded about the reimbursement issues. I'm not too sure who it is, but someone on this forum has a link in their signature which leads you to a graph of physician income change over the last 20 yrs, and health management industry salary changes. One look at this graph will explain why most doc's are upset with the compensation... and rightly so. Doc salaries have stayed pretty level, while hlth mgmt $$ has went through the roof. If we spent the money on healthcare that's gobbled up by health mgmt, then I think our system may be helped a little. If I can find that graph, I'll edit this post, and paste it on.

Heart surgeon dude I know....good surgeon...guess he's 55 or so...always wanted to be a heart surgeon...

BEFORE he was a heart surgeon (med school), 8-10 k per case

When he STARTED doing heart surgery, albeit as a fellow so not reaping the financial reward: 6-8K per case

Dude FINALLY starts doing his own cases: 5-6 K per case

Over the last 20 years, he's watched his income go lower, and lower, and lower.

NOW, medicare pays him 1800 bucks for a CABG WHICH INCLUDES 99 days of post op care (the immediate, time consuming ICU stay, floor visits, office visits are ALL included in this 1800 bucks)

Gimme a break. Its sad when an ENT dude can do a FESS on your 20 year old, 120 pound, ASA 1 sister and make more cash than Dr. Jones operating on the 80 year old 230 pound hypertensive, diabetic dude who will eat up most waking moments Dr Jone's has during the 48 hours following the CABG.

 

[lvspro]

Heart surgeon dude I know....good surgeon...guess he's 55 or so...always wanted to be a heart surgeon...

BEFORE he was a heart surgeon (med school), 8-10 k per case

When he STARTED doing heart surgery, albeit as a fellow so not reaping the financial reward: 6-8K per case

Dude FINALLY starts doing his own cases: 5-6 K per case

Over the last 20 years, he's watched his income go lower, and lower, and lower.

NOW, medicare pays him 1800 bucks for a CABG WHICH INCLUDES 99 days of post op care (the immediate, time consuming ICU stay, floor visits, office visits are ALL included in this 1800 bucks)

Gimme a break. Its sad when an ENT dude can do a FESS on your 20 year old, 120 pound, ASA 1 sister and make more cash than Dr. Jones operating on the 80 year old 230 pound hypertensive, diabetic dude who will eat up most waking moments Dr Jone's has during the 48 hours following the CABG.

This is a sad state of affairs.

 

[pillowhead]

Nope.

It was either ER or anesthesia for me....really wanted to do ER since I was a firefighter paramedic for a cuppla years...U of Miami didnt have an ER residency, they had a huge anesthesia residency, had some positive experiences during my rotations, liked the people that seem to pick anesthesia, and the rest is history.

Still glad I picked anesthesia over ER to. Moonlighted heavily in an ER during my residency and, although I liked it, I was glad I wasnt gonna be doing ER for 20 years.

Do you mind telling us how you finally came to this decision? I'm having the same dilemma. I did emergency research between 1st and 2nd years and did an emergency elective second year (not a rotation but just a 1 or 2 times a week thing) and I really enjoy being in the ER. On my surgery rotation, I was always ready to jump down there for consults. However, I enjoyed my week on anesthesia a lot, too. I liked the anesthesia work but am not sure how "passionate" about it I would be compared to emergency. But then I don't know how I feel about working weird hours for the next 35 years or so once I have kids. I think I could be happy in either, but I keep going back and forth.

 

[jetproppilot]

Do you mind telling us how you finally came to this decision? I'm having the same dilemma. I did emergency research between 1st and 2nd years and did an emergency elective second year (not a rotation but just a 1 or 2 times a week thing) and I really enjoy being in the ER. On my surgery rotation, I was always ready to jump down there for consults. However, I enjoyed my week on anesthesia a lot, too. I liked the anesthesia work but am not sure how "passionate" about it I would be compared to emergency. But then I don't know how I feel about working weird hours for the next 35 years or so once I have kids. I think I could be happy in either, but I keep going back and forth.

I think a med students experiences during the 3rd year has the most influence on what specialty is selected. For me, U of Miami had no ER rotation, no residency, so I wasnt influenced by an ER environment. Had they had an ER residency at my med-school, I very well may have ended up an ER doc.

But I gotta tell you...again, referring to my heavy ER moonlighting during residency...the first 2 years were fun, the 3rd year wasnt...I still vividly remember sitting at the desk where doctors wrote on charts after seeing patients...and I had had a big run of troll patients...and mind you it doesnt matter where the ER is...Beverly Hills or Bum^&ck Louisiana, all ERs see the same clientele...anyway, I started thinking..."WTF am I doing here???? I dont like this. I'm so glad I don't have to do this for the next 20 years."

Although I very much realize there is no utopia, I've never thought the same negative stuff about anesthesia, and I've been in practice since July, 1996. And this statement is coming from a dude who literally went to med school with SOLID aspirations of becoming a medical director of a big EMS system...man, I loved my firefighter/paramedic days...

Now that I'm 41 years old, I dont know if I'd be as happy as I am now had I gone into ER...I still HATE nights, but in my current gig have been able to cancel out the misery of nights with a ridiculous amount of time off...and every ER doc I know does some weird swing shift stuff...I've got a buddy who is a state trooper and he had to do that 2-days-of-days,three-nights-of-nights,-three-days-off, crap, and if you want to inflict damage on your body's internal clock, thats the way to do it...

Guess what I'm saying is ER is cool...and to be The Man in charge of an aggressive pre-hospital system would be really cool...but the trade-offs are too steep...endless erratic schedule, 2% really cool cases and 98% family practice for the indigent. Those are the 2 big negatives about ER in my opinion.

Again, there is no utopia...and anesthesia has its negatives too. To me, the anesthesia negatives are more palatable, at least to me.

If you are looking for a doctor position where you are The Man, anesthesia is not for you. You are a consultant.

That being said, if you stay in the same place for a long period, say several years, if you are good clinically and are a good people person, you will be respected. If you wanna cancel a case, which should be a rare occurrance, noone will argue with you. If you are having an intraoperative problem and you tell the surgeon "Dude, I've got issues up here. I need you to hurry.", he will hurry. If you are unhappy about turnover time, when you direct your unhappiness to the charge nurse, she will fix it. Etc Etc.

My exposure to difficult patients is very minimal. I can tolerate a miserable person during the pre-op...because I know thats the last time I have to see them. And my longest pre-op eval with an aggressive patient is no longer than 5-10 minutes. If you cant find out everything you need to know in five minutes then you are not focused enough. I've spent as much as 20 minutes with patients on pre-ops...but only when I want to. Interesting patient? I put to sleep this dude before the storm who was in the sewage-pipe restoration business...did work all over the world...he was describing to me how the process he patented worked...very interesting and a very easy-to-talk-to-dude.
Are you a truly scared, non-manipulative/aggressive/threatening patient? I'll sit there as long as you want, and reassure you.....we are all board certified physicians...you'll be constantly monitored....yes, there are risks, but anesthesia is the safest its ever been....etc etc.

Another "negative" is you are at the beckon call of the surgeon. If you are attending mass on your Sunday call day and the surgeon wants to work, you leave. Thats why there are groups so the miserable call is split up to a tolerable level...

and IMHO the rewards far exceed the negatives.

Again, there is no utopia. If you think there is, than you are too green.

 

[davvid2700]

Believe it or not.. I was a sub stellar student and very jaded early and i was encouraged to do anesthesia.. I bumped into the chairman of anesthesia down at the poool hall. and he sold me. This was when like 10 us seniors went into anesthesia.. SO i think historically anesthesiologists were the flunkies of the medical world. IF you couldnt do anything else you would do anesthesia.. anyway, Im happy there is a resurgence of interest.. Maybe when stronger caliber candidates come out we can shake our reputation