Anyone choose Anasthesia late 3rd yr ?

Discussion in 'Anesthesiology' started by ConfusedMD2009, Jun 2, 2008.

  1. ConfusedMD2009

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    So I have been on the Ortho train for all of med school, I have done well in my classes, a few honors and a 227 on step 1. As third year winds down I am realizing there are things I dont like about ortho.

    I have had a lot of time in the OR and always thought Anasthesia was cool, I think I would be good at it, and as a newly married dude it would be less stress on my family ( I think ).

    The problem is I have not done a rotation in anasthesia, all my letters have an ortho bent, all my away rotations are in ortho. Basically as I get closer to decision time lifestlye is becomming more and more of a factor. I was just looking for others that decided on anasthesia later in med school, what were your experiences, did you make the right decision ?

    > Sorry i cant spell
     
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  3. huktonfonix

    huktonfonix board certified!

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    I was deciding between ortho and anesthesia until september of fourth year. Best decision (work related anyway) of my life. do a subI in anesthesia. make sure it really is the right choice for you. If you want to do something more ortho related with better lifestyle PM&R with a sports med slant might also be a consideration.
     
  4. ConfusedMD2009

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    I am doing a surgical critical care Sub-I but all the anasthesia Slots are filled in my school, its insane, so many people want to do it. Is it unherd of to go into a field w/o doing a formal rotation ? kinda sounds like a red flag to me. I do have a lot of exposure to it, I really like physio and some but not all pharm, the main benifit I see are all the cool procedures , the fact that you can actually manage a patient, not just cure thier titanium deficiency and oh yeah, run a code. ( not to mention lifestyle which IMO is huge )

    >> HUK my other question is how did you go about telling the people that expect you to go into ortho ? I know it sems dumb but when you spend so much tiem w/ a department to turn around and do something else may not go over to well, but i guess in the end you got to look out 4 # 1
     
  5. DoctorPardi

    DoctorPardi In Memory of Riley Jane
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    I have a fear similar to this situation as an upcoming MS-1 . I am not 100% on any specialty now (although I believe it would be foolish for anyone to act as if they were). Though some of the things I am interested in (Anesthesia, EM) are not required electives for third year rotations. So I will only have one third year elective to choose and I may have to pick between ER and Anesthesia and go into 4th year with limited exposure to at least one specialty I am interested in.

    That may be the crazy ramblings of a soon to be medical student, but I am not 100% sure how the process of deciding on a specialty might take place if you aren't exposed to all of the ones you're interested in before 4th year.
     
  6. lane

    lane Passing gas

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    talk to the folks in your anesthesia department. they can probably overbook you into at least one rotation during 4th year. it's not uncommon for people to change their minds somewhat late in the game, and you NEED at least 1-2 letters from anesthesiologists. if for some reason they're unable to get you into a rotation, you may need to spend your weekends in the OR with anesthesia and find an advisor so you can make yourself known to at least a couple people in the department.

    and don't worry about the orthopods. it's not the first time someone has changed their minds and it won't be the last. you could probably still get a letter from one of them too.
     
  7. lane

    lane Passing gas

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    you have plenty of weekends as a 1st/2nd year, a summer break, and 2 winter vacations. you can easily spend a few hours a month in the ER or OR learning more about each specialty even before 3rd year starts
     
  8. ConfusedMD2009

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    Pardi dont even consider this now. Not to rain on your parade but you have a world of pain comming in august ( or whenever you start ) so my advice is get some friends, get some beers and PARDI, you got the rest of your life to worry about being an MD.
     
  9. DoctorPardi

    DoctorPardi In Memory of Riley Jane
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    Yeah I know what you're saying. I am going to be drowning in studying pretty soon and wont have the time to worry about this sort of silliness.

    I'll probably try to schedule some time during my vacations and weekends to shadow some EMs and anesthesiologists during 1st and 2nd year to help me make my 3rd year rotation decisions. (That is if I have any time during the weekend :thumbdown: )

    /thread hijack
     
  10. ConfusedMD2009

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    Good plan, your goal now is to survive gross anatomy - thats it.
     
  11. DoctorPardi

    DoctorPardi In Memory of Riley Jane
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    Well, either it is a good thing or bad thing, depending on how you look at it, but my school doesn't teach gross anatomy anymore. All systems based, even anatomy.

    I am sure I will be trying to survive something though.
     
  12. huktonfonix

    huktonfonix board certified!

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    I thanked them for all their help and told them that I had decided on anesthesiology. One ortho guy was really disappointed, but I had known him for a few years and he understood my decision. As far as the anesthesia rotation, its really more for you so you know what youre getting into although Im sure it looks good for letters or interviews.
     
  13. amyl

    amyl ASA Member

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    you have to do a rotation, if not at home at an away institution, for two reasons: you must get first hand knowledge of anesthesiology as its really not for everyone and two, you really need a letter of rec from an anesthesiologist, even if its a generic one, especially if your existing letters mention ortho. if they do and you have a good repore with the docs, esp if they are medicine or something, maybe they would re-write you a letter with anesthesiology in it. an interviewer told me that he just looks at the bottom of LORs for the name, title and department of the letter writer and then scans for the word anesthesiology...he assumes the rest will say you are wonderful but the word anesthesiology shows you are really interested in the field.
     
  14. cchoukal

    cchoukal Senior Member
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    This part is hard. I had the same situation with ENT and even went so far as to interview in it. My ENT mentors found out on ENT match day that I was doing something else. One of them said to me, "I was surprised not to see you on a match list anywhere because I knew where we ranked you and I knew where a bunch of other places rankes you. What gives?" I would say that's probably NOT the way to inform them. They were very upfront with me that they felt I was making a huge mistake and throwing my career away and all that. It was a real drag. I guess if I had any advice, it would be to make sure you want to switch and then be honest with your mentors.

    A few people have alluded to the idea of making sure you want to switch and making sure anesthesiology is the right fit for you. Orthos get to do some really cool stuff and there are few things in medicine that have as much impact on patient's lives as fixing their hands, ankles, knees, and hips. I would think that would be very satisfying. That titanium deficiency you mentioned is one of the highest-yield things in medicine in terms of improving quality of life. On top of that, you can actually have a fairly controllable life (do hand, sports, etc.) and make a lot of money. You sure you wanna give all that up?
     
  15. coprolalia

    coprolalia Bored Certified

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    If my CV had been strong enough to be considered for Ortho or ENT, especially knowing what I know now, there's no way I would've chosen gas.

    Don't get me wrong, love my field and chosen profession, am dedicated, hard working, and am good at it. But in those two you definitely have less B.S. to deal with. You work hard (probably harder) during residency picking ortho or ENT, but it's a smaller cadre of folks who'll shepherd you through the process, and you'll get a more intimate residency experience. Likewise, the demand for your services and the ultimate benefit to both you and your patients will be much greater, and more appreciated, in the end.

    But, I picked gas because it was the best of choices available to me. Everything else paled in comparison.

    -copro
     
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  17. cchoukal

    cchoukal Senior Member
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    yeah, I really struggled for a long time with whether or not I made the right choice, especially after my mentor told me I would've matched in ENT. In the end, most days, I'm pretty confident I made the right choice, but it took awhile...
     
  18. cockblockandrun

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    Why on god's green earth are you even contemplating what specialty you want to go into? When I was a MS-1, I had no idea what an anesthesiologist did. When I started clinicals, I still had no idea what anesthesiology was all about. Then did a week of it in surgery, and then a 5 week rotation and another 5 week rotation... so after 11 weeks of anesthesia, I figured its what I wanted to go into. But it was really late in the game I zeroed in. I was prolly going to go for EM but realized anesthesia was my calling. Take your time, brother. Smoke up, get drunk, get laid, study hard.... and everything will eventually fall into place!
     
  19. huktonfonix

    huktonfonix board certified!

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    to the OP. I would very likely have matched to ortho, but chose anesthesiology for lifestyle reasons. while it is true that you can choose certain subspecialties in ortho more amenable to lifestyle, the question is can you do them in an area that you want to? Since youve mentioned having a family consider an ortho residency + fellowship will be 6-8 years vs 4-5 for anesthesiology. After this period of time, depending on family circumstances it may or may not be easy to move. Or perhaps you have a specific area you plan to practice in. Take a look at the ortho market in that area. Are they already saturated with sports med docs? Then your chances of starting off a practice in that area may be limited. In the area I was looking at going to, I would have started off doing general ortho with lots of trauma and horrible hours for at least 3-4 years before even thinking about doing what I wanted to do. At that point I decided that it wasnt worth it. Then again in certain areas, you might have to have long hours in anesthesiology before or even after making partner also. It will really depend on what kind of job you want and where you want to do it. I have friends heading off to 40-50 hour a week jobs while others are off to 80-100 hour jobs.
     
  20. m3unsure

    m3unsure Junior Member

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    Ortho and ENT residency ain't a joke. I would say eons harder than anyone can imagine. I don't know any happy residents in these two areas. They get worked to the bone.

    Whatever way you look at, medicine just stinks in general.
     
  21. ConfusedMD2009

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    Thanks for all the replys, Man I am so confused, its like being a pre-med, thinking I have a clue what medical school ( or in this case residency ) will be like, I dont. For now I just got to roll w/ the punches and see where I end up. Ugh
     
  22. ConfusedMD2009

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    yea the mantra at my hospital is " DO WORK SON" , and they mean it.
     
  23. jetproppilot

    jetproppilot Turboprop Driver

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    WHOA.

    Nice thread.

    Common dilemma.

    Time for me to speak up.

    Med school......just talked to wanna my med school buddies an hour ago.....the only guy from my big class at Da U I'm in contact with.....seems like eons ago (1988-1992)....

    Trouble is, Confused, you are forced to make a decision that'll impact the rest of your life when you are a 3rd year med student...and yet the forces influencing your decision may, or may not be the best thing for you.

    So lets focus on that subject for a minute. Yeah, its hard, since you've been trained to please everyone around you during your med school years, but lets put that aside for a minute.

    And focus on

    YOU.

    Not a common thought when in med school.

    To think about yourself.

    S hit, you've blasted thru your bachelors degree, youre a med student now....you've been trained to DELIVER THE GOODS!

    And you have.

    So now with delivered goods comes more pressures....like I CAN PICK ANY SPECIALTY I WANT.....BUT WHICH ONE?

    Sit back a minute.

    Sip on a St. Pauli Girl.

    Hell, fire up a cigar. INHALE.

    Forget about the rat race for a while. You've done it. You've put yourself in the enviable position of being able to pick WHATEVER specialty you wanna be in.

    Lemme let you in on a little secret that theres no way you could know, because noone in physician education focuses on it:

    YOU NEED TO SELECT A SPECIALTY THAT YOU WILL BE HAPPY DOING FIVE TO TEN YEARS FROM NOW.

    WHOA!

    WHAT DOES THAT MEAN?

    It means, independent of your specialty choice as a third year med student, what with all the excitement, new horizons, etc,

    EVERY SPECIALTY BECOMES A JOB AFTER A WHILE.

    Heart surgery. Neurosurgery. Gyn-Onc surgery. Family Med. Internal Med. ER. Anesthesiology.

    They all become jobs.

    What does that mean?

    It means you're human.

    Things change after residency.

    You get out, you start your heavily anticipated private practice gig, and its DA BOMB!!!! Earning money, taking care of patients like you've trained to do....

    FIVE YEARS into your gig you realize what you've sacrificed to get where you are.

    THIS IS WHERE I WANNA GET YOUR ATTENTION.

    I want you to envision where you'll be FIVE years after you finish whatever residency you do.

    Do you envision happiness?

    Do you really love ortho, or does ortho love you because of your success?

    Think about that, Dude.

    I respect your foresight....thinking about future lifestyle with family, etc.

    I think if ortho is your passion you can make it work. I work with a few orthopedists that are successful...AND have a doable lifestyle.

    So it can be done.

    The most important part of the puzzle you are trying to solve is YOU.
     
    #21 jetproppilot, Jun 3, 2008
    Last edited: Jun 4, 2008
  24. Dr Serenity

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    As a corollary to what Jet said above (good stuff), I'll also throw this in (take this "advice" for what it's worth from a newbie doctor-about-to-start-internship)...

    Don't let the perceived lifestyle of (insert specialty here) residents be the ONLY thing that influences your choice of what specialty you wish to pursue. No matter what type of residency you pursue (or which program you end up matcing at), it's gonna suck at times (as someone about to start internship, I'm sure I'm about to learn that in spades...:scared:)

    Surgery and surgical subspecialties (for example) have a reputation for having long, tough residencies, but there are surgeons in private practice who can't imagine doing anything else...and they have GREAT lifestyles to boot (I think Jet's SO can attest to that).

    So, in short, when thinking about a specialty (whether it's anesthesia or something else), think NOT ONLY about the residency training (how long, how gruesome, etc) and/or your med school rotations (which really only show a sliver of the possibilities available with specialty X), but also think about what you'd like to be doing 5, 10, 20 years after leaving residency.

    Not to say that the residency experience and your med school rotations aren't important to consider in the decision...they are, but they aren't the only things to consider.

    Good luck to those of you in the midst of making the specialty decision...it's a tough one that requires some thought and soul-searching.:thumbup:
     
    #22 Dr Serenity, Jun 6, 2008
    Last edited: Jun 6, 2008
  25. Coastie

    Coastie Junior Member

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    The sweet ENT programs are oh so sweet, with people working q14 call, 3 weekends a year, massive operating experience, and landing top, top, top jobs and fellowships. Doubt me? Give one of the Vandy ENT guys a call: they will probably be on the golf course. :laugh:

    Ortho is another story.

     
  26. coprolalia

    coprolalia Bored Certified

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    Awesome advice, Jet. As usual. It's very hard to look five years down the road, but you're right. Picture yourself in the "daily grind" and try, as hard as it may be, to figure out what you'll be happiest doing.

    It's a simple question that I answered for myself when I was in a position of choosing a specialty: If you rue the thought of going home and routinely thinking about work, patients, etc. - or the threat of being called at ungodly hours and perhaps even having to go back in to the hospital - then the only specialties you should consider are radiology, anesthesiology, and EM.

    That made my choice easier. Good luck, whatever you decide.

    -copro
     
  27. cchoukal

    cchoukal Senior Member
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    or path, radonc, occ med, prev med...

    But these points are true... the further along I get, the more I realize that the vast, vast, vast majority of physicians are not going to cure cancer and that if you're looking to justify your existence on this earth by how much you martyr yourself to you practice and patients, you might wind up pretty disappointed. Here's a hint: you could never give enough to your practice for it to be enough, and you'll never get enough appreciation from your patients (many of whom, at least where I sit, think you're an arrogant, rich a-hole who deserves to be sued) to fill the hole.

    Absent that, you have to do what makes YOU happy, but because you don't owe the world much, and it owes you even less.

    sorry if that sounds bitter...
     
  28. Dr Serenity

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    I don't think it sounds bitter at all...sounds like someone who's been through the grind long enough to speak about medicine with some shred of reason.

    If you (not you, cchoukal, but "you" in general) are going into medicine for chicks, money, power, glory, and/or chicks, then STOP NOW. Are you really going to be happy doing the sort of stuff medicine involves/requires day in and day out, despite the the increasing government intrusion, declining pay, and patients out to sue you for everything you have? Are you going to be happy in medicine when it's become "just a job"? When you're exhausted from being up for nearly two days straight without so much as a wink of sleep, are you still going to be happy you got into medicine? These are some of the things one needs to think about when making the decision to pursue medicine (or when making the decision as to what specialty one wants to get into).

    For some, the answer to those questions is indeed a resounding "yes"...and to those, I say, "more power to you". Personally, I still see myself as happy to be practicing medicine despite the crap I mentioned above. Hopefully that will remain the case after four years of residency.

    </ramble>
     
  29. Phineas

    Phineas Miss Crankypants

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    To the OP, I am finishing up my third year, and I only just decided on anesthesiology. I'm scrambling to set up externships, and it's not going so well, so I'll just have to hope something comes through or make the best of things without an away rotation. I am doing a gas rotation at my home institution, though. I don't know if it will hurt me or not, not doing an away. I am completely average, academically. I'm not bad, but I'm definitely not great, so it's not like I can slack on trying to show my interest and fall back on a 260 step 1. Reading these forums freaks me out, because it makes gas look sooooo competitive. Hope I'm just being neurotic, and it's not actually out of my league.
     
  30. 71263

    71263 Guest

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    I am in a similar position. Fortunately, I developed an interest early enough to pull off an early M4 anesthesia away elective (my school doesn't have intramural anesthesia). The results of my elective will help me determine whether i do that or ER...
     
  31. akpete

    akpete Drinks, anyone?

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    This thread has some great advice. I have always planned on going into ortho - I was an athletic trainer prior to med school. But now I'm not so sure. We have a couple weeks of anesthesia during 3rd year, which I anticipated liking, and did. I am on my ortho sub-I currently and have an anesthesia elective in July, so hopefully I'll be able to make my decision. I am extremely torn between the two.

    Good to know there are others debating between these two specialties. When I tell people they give me a funny look and tell me how different the two are and how can I possibly be interested in both.

    One thing that sucks about not having made a decision is that I delayed scheduling an away elective and now I don't have one in either anesthesia or ortho, and the month I have available is Sept so there probably aren't too many openings out there.

    How big is an away in anesthesia in one's app?
     
  32. SleepIsGood

    SleepIsGood Support the ASA !

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    To the OP

    dont worry about it. do an anesthesia rotation. explain to your programs that you apply to what happened..be honest.. it's all good!
     

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