Are these feelings normal? Should I back out while I still can?

[BLADEMDA]

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😕 I'm not sure what you're trying to say with this post... I'm an MS4 at a highly regarded medical school, ranked in the middle of my class and have a 250's Step I... are you saying I shouldn't do anesthesiology? Are you saying smart medical students, in general, don't do anesthesiology? Are you saying most of us who end up an anesthesiology are not qualified to do other things?

My post was not directed at you. I was speaking in general terms.

You have the grades and scores to choose many specialties. I can see why this is such a tough decision. Choose wisely.

I like Anesthesiology as a specialty and in terms of what I do every day. I do not like the politics of this field or where we sit in terms of Medicare reimbursement. We are near the bottom in terms of CMS reimbursement. Hence, if Medicare rates become the norm for all physicians Anesthesiology will suffer worse than most other specialties. That is a fact.

Now if you don't mind making a low wage compared to the other specialties on top of dealing wth the most militant nurses in the world claiming to be your equal then this field is for you😉

Next to picking your spouse Follwed by deciding to go to medical school this is the biggest decision of your life. It will have far reaching implications for decades.

With a Step Score of 230 your choices are more limited than with a 250. Will a few Medical students with high step scores choose this specialty? Of course. But, some will choose potentially lucrative specialties better situated for the Medicare Option for all and the upcoming ACOs.

Do you go wth the woman you love or do you marry the rich woman you just like a lot?

 

[medstudent87]

So what other options are there for someone in the 230s?

I wanna make as much money as possible since i grew up lower-middle class and want to live significantly better than that. More importantly, though, I want tio enjoy my job...and so far, I really haven't enjoyed any other specialty. Surgery was a nightmare, medicine was an ongoing headache,peds sucks, family sucked, psych sucked...rads seems cool but I think its incredibly boring, EM seems OK but I would like to be an expert in something, not a "jack-of-trades". Plus I hate the "clientele" that tends to walk through the ER. I feel like I'm stuck choosing a field that I enjoy but has so many problems with it....

 

[BLADEMDA]

I'm an MS2 considering Anesthesia and Critical Care, so I don't pretend to know anything about how this works, but I do have a question for the debate going on..

What do other surgeons think about this? Having a patient in the OR on the table crash and looking up to see a nurse at the head of the bed with **** hitting the fan? How do they react to that or what's their feelings about that type of situation?

I've got a question for you. When the Federal govt/CMS decides that the CRNA can and should do anesthesia solo with only 1 Anesthesiologist acting as a fireman will anyone care?
Will the patients even know Obamacare has screwed them over is so many ways?

Surgeons like other doctors are going to be told what they are permitted to do and how they do it or they won't get paid.

 

[BLADEMDA]

So what other options are there for someone in the 230s?

I wanna make as much money as possible since i grew up lower-middle class and want to live significantly better than that. More importantly, though, I want tio enjoy my job...and so far, I really haven't enjoyed any other specialty. Surgery was a nightmare, medicine was an ongoing headache,peds sucks, family sucked, psych sucked...rads seems cool but I think its incredibly boring, EM seems OK but I would like to be an expert in something, not a "jack-of-trades". Plus I hate the "clientele" that tends to walk through the ER. I feel like I'm stuck choosing a field that I enjoy but has so many problems with it....

Roll the dice and welcome to the club. It won't be an easy battle to win but together we may just do it.

Interventional radiology is boring? Those guys are the baddest mofos in my hospital.

 

[medstudent87]

Nah, i was just talking about diagnostic radiology. Interventional seems cool

 

[partydoc]

Roll the dice and welcome to the club. It won't be an easy battle to win but together we may just do it.

Interventional radiology is boring? Those guys are the baddest mofos in my hospital.

Whenever I talk to any rads guys, they keep talking about how bleak the job market is right now. Maybe the older generation is getting set to retire and there will be a glut of job openings by the time I would finish residency.

 

[partydoc]

Surgery was a nightmare, medicine was an ongoing headache,peds sucks, family sucked, psych sucked...rads seems cool but I think its incredibly boring, EM seems OK but I would like to be an expert in something, not a "jack-of-trades". Plus I hate the "clientele" that tends to walk through the ER. I feel like I'm stuck choosing a field that I enjoy but has so many problems with it....

Me too bro. Let's roll the dice and join Blade's club.

 

[BLADEMDA]

So what other options are there for someone in the 230s?

I wanna make as much money as possible since i grew up lower-middle class and want to live significantly better than that. More importantly, though, I want tio enjoy my job...and so far, I really haven't enjoyed any other specialty. Surgery was a nightmare, medicine was an ongoing headache,peds sucks, family sucked, psych sucked...rads seems cool but I think its incredibly boring, EM seems OK but I would like to be an expert in something, not a "jack-of-trades". Plus I hate the "clientele" that tends to walk through the ER. I feel like I'm stuck choosing a field that I enjoy but has so many problems with it....

I grew up lower middle class. Never had much money. I considered an academic career but simply couldn't pass up the cash in private practice. I had loans (most of you understand even better than me about that). Hence, I worked my ass off in medical school, scored well on my exams and landed a top residency. From there I worked my ass off more than I ever imagined but got that pot of gold. I now earn more in a month than my father did in a year.

Let's hope hard work and success is still rewarded by the Socialist system we are headed towards. I fear that won't be the case. After all, we need to "spread the wealth around" but not the work and dedication it takes most of us to accumulate it

 

[WashMe]

My post was not directed at you. I was speaking in general terms.

You have the grades and scores to choose many specialties. I can see why this is such a tough decision. Choose wisely.

I like Anesthesiology as a specialty and in terms of what I do every day. I do not like the politics of this field or where we sit in terms of Medicare reimbursement. We are near the bottom in terms of CMS reimbursement. Hence, if Medicare rates become the norm for all physicians Anesthesiology will suffer worse than most other specialties. That is a fact.

Now if you don't mind making a low wage compared to the other specialties on top of dealing wth the most militant nurses in the world claiming to be your equal then this field is for you😉

Next to picking your spouse Follwed by deciding to go to medical school this is the biggest decision of your life. It will have far reaching implications for decades.

With a Step Score of 230 your choices are more limited than with a 250. Will a few Medical students with high step scores choose this specialty? Of course. But, some will choose potentially lucrative specialties better situated for the Medicare Option for all and the upcoming ACOs.

Do you go wth the woman you love or do you marry the rich woman you just like a lot?

Good point, looks like I'm going with anesthesiology! The fact is, it DOES matter to me that anesthesiology reimbursements may drop a lot. However, there is nothing else in medicine I would rather do at this point even if you paid me a million dollars per year. I love this stuff; the physiology, the pharmacology, the procedures... all of it.

I think I'll always have a job, and I'll always be able to put food on the table. I'm willing to drive a Toyota Camry rather than a BMW M5. I believe I will be able to perform in this specialty at a world-class level, and I don't think I can say that about anything else in medicine (or outside of medicine, for that matter).

 

[BLADEMDA]

Good point, looks like I'm going with anesthesiology! The fact is, it DOES matter to me that anesthesiology reimbursements may drop a lot. However, there is nothing else in medicine I would rather do at this point even if you paid me a million dollars per year. I love this stuff; the physiology, the pharmacology, the procedures... all of it.

I think I'll always have a job, and I'll always be able to put food on the table. I'm willing to drive a Toyota Camry rather than a BMW M5. I believe I will be able to perform in this specialty at a world-class level, and I don't think I can say that about anything else in medicine (or outside of medicine, for that matter).

The M5 is a lot more fun. 🙂

 

[darby11]

Good point, looks like I'm going with anesthesiology! The fact is, it DOES matter to me that anesthesiology reimbursements may drop a lot. However, there is nothing else in medicine I would rather do at this point even if you paid me a million dollars per year. I love this stuff; the physiology, the pharmacology, the procedures... all of it.

I think I'll always have a job, and I'll always be able to put food on the table. I'm willing to drive a Toyota Camry rather than a BMW M5. I believe I will be able to perform in this specialty at a world-class level, and I don't think I can say that about anything else in medicine (or outside of medicine, for that matter).

There is something wrong with you.!

 

[BLADEMDA]

Good point, looks like I'm going with anesthesiology! The fact is, it DOES matter to me that anesthesiology reimbursements may drop a lot. However, there is nothing else in medicine I would rather do at this point even if you paid me a million dollars per year. I love this stuff; the physiology, the pharmacology, the procedures... all of it.

I think I'll always have a job, and I'll always be able to put food on the table. I'm willing to drive a Toyota Camry rather than a BMW M5. I believe I will be able to perform in this specialty at a world-class level, and I don't think I can say that about anything else in medicine (or outside of medicine, for that matter).

Since your goal is "world class level" please consider a fellowship as part of that goal

 

[jwk]

So what other options are there for someone in the 230s?

I wanna make as much money as possible since i grew up lower-middle class and want to live significantly better than that. More importantly, though, I want tio enjoy my job...and so far, I really haven't enjoyed any other specialty. Surgery was a nightmare, medicine was an ongoing headache,peds sucks, family sucked, psych sucked...rads seems cool but I think its incredibly boring, EM seems OK but I would like to be an expert in something, not a "jack-of-trades". Plus I hate the "clientele" that tends to walk through the ER. I feel like I'm stuck choosing a field that I enjoy but has so many problems with it....

One thing you should remember is WHERE you live makes a HUGE difference. You can make $400k in New York City or San Francisco and still be in an 800 sq ft apartment paying $3k/month in rent - or you can live in a medium-sized city in the south (say Augusta, GA or Mobile or Huntsville, AL) and start at $300k and live like a king in a McMansion from day 1.

 

[WashMe]

The M5 is a lot more fun. 🙂

haha I don't doubt it... but early retirement is probably more fun 😉

There is something wrong with you.!

Just one thing? I guess I'm happy that the one thing is over-enthusiasm

Since your goal is "world class level" please consider a fellowship as part of that goal

Will do! Not sure where my interests lie yet... probably CT for the physiology. Critical Care seems like a good area if I enjoy it (rotating through it next month for the first time). Pain always pays, but it has more continuity of care than I'm really interested in. I don't know much about other things like neuroanesthesiology, I generally don't like peds, and I don't think fellowships in things like OB and regional are necessary (doesn't everyone get trained in this?).

 

[Consigliere]

Oh for the love of God you MS-3's and 4's DO NOT go into anesthesiology. You will be miserable doing this for what you will be paid when you are done. Ignore this advice at your peril...

 

[saratoga733]

You have some people here who is all gloom and doom and you have other folks loving life. This is probably true for all fields of medicine when you poll a representative cross section. For example, I think you would be hard pressed to find one single post by Consigliere that is remotely positive about our field. If I'm not mistaken, Anesthesiology has one of the highest job satisfaction rates in medicine. I don't know one unemployed anesthesiologist and of those that complain most are making 300-400k per year. My brother is an internist and trust me he works darn hard for his sub 200k salary. I have friends who entered radiology where basically no fellowship = no job. I even know some pathologists who had to do TWO fellowships to land a job! Do what you love and the rest will fall in place.