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Any Anesthesiology folks out there?.I m thinking of changing

Discussion in 'Clinical Rotations' started by InFluxMD, Sep 21, 2001.

  1. InFluxMD

    InFluxMD New Member

    Sep 20, 2001
    US trained,ABIM certified internal med physician considering changing to anest.
    Back in early 90's the prospect of no jobs kept me away.IM is becoming increasingly dissatisfying.
    Will I have a difficult time finding a program? It s been a few years out of can I get the rust off my procedural skills..or will I find support to get back to speed if i go back to do an anesthesiology residency?
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  3. Test Boy

    Test Boy Senior Member 10+ Year Member

    Mar 30, 1999
    Just curious, can you tell me why IM is dissatisfying for you? Thanks.
  4. scrubs

    scrubs Junior Member 7+ Year Member

    Sep 14, 2001
    Hi InFlux!

    I am currently a first-year anesthesia resident. Interestingly I am considering a switch to internal medicine (with subsequent fellowship in something). I, too, am curious about what you find dissatisfying about medicine and why you are not considering subspecializing versus changing to anesthesiology?

    As for you switching into anesthesia (if you are positive that is what you want to do), it has been my experience that anesthesia programs like people who have had backgrounds in other specialties especially internal medicine - it will really help when you have very sick patients and understand the pathophysiology of their diseases. I would not worry about procedural skills. Most people who go into anesthesia have no skills prior to entering the field - I certainly did not. In my first 3 months thus far I have done at least 100 intubations, put in 10 arterial lines, and 5 central lines. Your attendings will guide you through these procedures.

    What I would be more concerned about are why you want to enter this field. I have written my opinions about this field in the thread entitled "switching into anesthesiology." In brief, here are the negatives:
    1) Extremely stressful
    2) No autonomy
    3) No respect
    4) You are replaceable by CRNAs
    5) It is lonely and frustrating being in one room the entire day
    6) It is a completely different mentality and approach to patient management than IM - you may find yourself cringing at some things your attending will tell you to do because it goes against all that you have been taught in IM. Also, there will be no diagnosis concluded, no treatments instituted, and no relationships fostered.

    Having said that, there are some great positives:
    1) you essentially have no responsibility for the patient as soon as you drop them off in the recovery room. No one will be calling you in the middle of the night - unless you are on call (and attendings take in-house call in anesthesia)
    2) The pay will get better as an attending, but I'm serious when I say that you are replaceable by CRNAs.

    Anyway, please share your opinions. I have rambled on long enough. Take care and good luck!
  5. InFluxMD

    InFluxMD New Member

    Sep 20, 2001
    thanks for your thoughts.Dont lose sight of wanting to help patients regardless of specialty
    check out check out the feature by mass medical society
    "the practice of medicine in massachusetts"
    also check out the california med assoc. "widespread pessimism survey"

    unfortunately the Primary care physician is the one hit hardest,,pressures to see more patients,increasing multi- tasking despite good ofice support and technologic advances,paperwork and the time needed to do it..tripling,forcing a more rushed approach to seeing patients...while the social issues of an aging population become more complex,
    declining re-imbursements while practice overhead goes up,resulting in declining wages,declining satisfaction in primary care.
  6. jylu

    jylu Junior Member 7+ Year Member

    Sep 2, 2001
    A number of anesthesiology programs will not take applicants who are more than 7-8 years out from finishing medical school, regardless of experience.
  7. Neville Sarkari

    Neville Sarkari Junior Member 7+ Year Member

    Sep 21, 2001
    Owensboro, KY

    Maybe you need a change of location, rather than a change of specialty. I practice IM and enjoy it greatly. Very little (basically none) managed care and HMO's. Gratitude and respect of patients, decent hours etc. . .

    Neville S.
  8. scrubs

    scrubs Junior Member 7+ Year Member

    Sep 14, 2001
    Hi Dr. Sakari!

    I previously posted in this thread as I am an anesthesia resident and I am very seriously considering a switch to IM because of all of the reasons I have listed above (extremely stressful, little respect, no autonomy, etc.).

    You seem happy and I was wondering if you could tell me about your practice: types of patients, work schedule, how you take call, how you manage to avoid managed care. I did IM as an intern and really liked managing inpatients - do you know if there is much of a market for hospitalists? And what are their responsibilities usually like?

    I hope these are not too many questions to answer, but I would really appreciate the information! Thank you in advance!
  9. DO2

    DO2 Junior Member 10+ Year Member

    May 18, 1999
    Report: U.S. Facing Shortage of Anesthesiologists
    NEW YORK (Reuters Health) - There is a shortage of anesthesiologists in the US that will continue for years unless more people are attracted to the field, according to a report in the October issue of the Mayo Clinic Proceedings.

    ``It appears now that, in addition to focusing on the financial resources needed to support the healthcare needs of an aging population, national health policymakers need to re-examine whether the number of healthcare professionals is sufficient to care for the elderly, in particular when they require surgery, are afflicted by painful conditions, or become critically ill,'' Dr. Armin Schubert from the Cleveland Clinic Foundation said in a clinic statement.

    Schubert and colleagues used data from federal agencies, the American Medical Association and the American Society of Anesthesiologists to estimate the supply of anesthesiologists in 2001 and beyond.

    Based on the growth of the need for anesthesia since 1994, there is currently a shortage of anesthesiologists that ranges from 1,200 to 3,800, the investigators determined. They calculated that by 2005, assuming continued growth, the shortage will increase to between 1,000 and 4,500 anesthesiologists.

    However, by 2010 the shortage may disappear or be reduced to a shortfall of 1,000 anesthesiologists, assuming that the number of residency positions increases by 15% per year until 2006, Schubert's team notes.

    The researchers believe that to address the shortage, almost 60% more anesthesiologists will need to be trained by 2005 than were graduated in 2000, and almost 100% more will need to be trained by 2010.

    The need to increase the number of anesthesiologists suggests that training programs should admit more graduates of foreign medical schools, according to the authors. They add that the Medicare fee structure needs to be modified to allow anesthesiologists to earn more, in order to attract people to the field.

    In an accompanying editorial, Dr. Ronald D. Miller from the University of California, San Francisco and Dr. William L. Lanier, editor-in-chief of the journal, note that the shortfall of anesthesiologists results from policies in the 1990s that encouraged a return to general practice.

    ``It can happen in other specialties as well,'' Miller and Lanier note. ``Ultimately, the erosion of any important component specialty will do harm to the future intellectual and service missions of medicine and, unfortunately, the patients we serve.''

    SOURCE: Mayo Clinic Proceedings 2001;76:969-970, 995-1010.

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