Better lifestyle? EM vs Anesthesia

[docLuis]

As a medical student and mother, with an entrepreneur husband, I am interested in the lifestyle specifics of EM and Anesthesia.

-average salary of each?
-average hours/wk?
-How difficult to control schedule, taking vacations?
-job satisfaction?
-other factors that affect lifestyle, e.g. stress level, continuing interest in job, etc...

I understand the responses may vary drastically, this is fine. I would like a complete consensus =) THANKS!

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[jigga]

Read the FAQ's in the sticky sections in the anesthesiolgy and EM subgroups. You will find all your answers there. =)

 

[RussianJoo]

i personally don't think those are lifestyle specialties.. they all work hard and have very stressful jobs.

if you want lifestyle become a Radiologist or a Dermatologist or ophthomologist. in Rads you can do most of your work from home, technically you can be watching the kids who are playing in the back yard with the dog while you're working.. other fields that allow you to have an office is also more "lifestyle" oriented, you're your own boss and you can set whatever hours you want to work.. in both EM and Anesthesia you're working for someone else, other people tell you when you have to work and when you can be free. that doesn't sound like a "lifestyle" field to me.

 

[Rendar5]

umm...as an attending, you kind of have say in what days you're working and what days you aren't. in EM You just have to work it out with the other attendings. And you're working 3 days a week in community when you're working full-time. You can do part-time and work less. That said, you will have to work nights, weekends, and holidays at some point, but you still have a lot of days off for family.

 

[AK_MD2BE]

I agree with both RussianJoo and Bednar on this one.
For lifestyle fields, definitely Rads, Derm, Optho and I would add Path and Psych to the mix.
As far as Anesthesiology vs. EM, I would say EM has better "lifestyle" b/c they work less hours (probably an average of 35 vs. an average of 50 or so) and they are never on call (barring mass casualty or you have to cover for a sick co-worker).

 

[maceo]

I agree with both RussianJoo and Bednar on this one.
For lifestyle fields, definitely Rads, Derm, Optho and I would add Path and Psych to the mix.
As far as Anesthesiology vs. EM, I would say EM has better "lifestyle" b/c they work less hours (probably an average of 35 vs. an average of 50 or so) and they are never on call (barring mass casualty or you have to cover for a sick co-worker).

Im an anesthesiologist and I wo uld say EM hands down

NO CALL for EM. and you only work like half the month for full time pay.

anesthesia you have to take call.. and that call carries a high likelihood of having to come in to do cases in the middle of the night for a few hours. That gets old very quickly

 

[Museless]

I've never understood why medical students think of EM and Gas as lifestyle specialties. Anesthesia call mirrors surgery call, for good reason, right? And EM is only a cush lifestyle if don't mind still working Christmas Day when you're 50.

 

[Rendar5]

I actually like working Christmas day. One of the easiest days of the year to be working in the ED. It's practically a day off. Of course, if you celebrate christmas, I can see it being a pain. Just keep us non-Christians around to cover for you those days lol

 

[docLuis]

Rad, ophtho, and Derm are the specialties with the best lifestyles, which also explains why they are insanely competitive. I had a baby during my first year. As a result, my 1-2yr grades are not all H's and HP's, and so these specialties are out of the question for me.

Every anesthesiologist I have spoken with loves their job, salary, lifestyle, etc, and their job satisfaction ratings are among the highest. Why is this?

What about EM physicians being hired as private contractors? Does anyone have experience with this?

I am also very interested in business. Could someone provide some useful information regarding private practice? What is the financial potential?

 

[docLuis]

No. I am about to start 3rd year and take the step 1 exam. I have shadowed extensively in the ED, but that is all. The problem is that before I apply for residency, I will only be able to get LOR from either EM or anes. rotation, not both, due to time I took to study for Step. Therefore, I need to make a decision prior to 4th year.

 

[docB]

What about EM physicians being hired as private contractors? Does anyone have experience with this?

Independent Contractor info from the EM forum.

 

[RussianJoo]

i think you should see what you get on step1 first. basic science grades aren't as important as step1 when applying.

 

[Rendar5]

.

 

[AK_MD2BE]

Congrats!!!!

What?

 

[Rendar5]

What?

...wrong thread. I thought I was typing on the drug tox thread...

 

[Mastashake]

A doctor I know said EM was MUCH better due to the lack of being on call. He said his friends in other specialties would get into fights about their call times and stuff. I don't know much about it, but he said that he's even heard of lawsuits over on-call time and other nasty things.

He was obviously biased, but he greatly enjoyed how his at-home time was his.

 

[Pir8DeacDoc]

Both are good fields in terms of lifestyle. One thing that no one will tell you that is a big factor is the ease with which you can take time off and no one will miss you. If you are a non-office based physician then take all the time off you want and non one will really care beyond your partners. No patient calls to catch up on and things like that. Forwhatever reason most gas groups offer insane amounts of vacation time per year (~8 weeks or something)

Anesthesia call only partly mirrors surgery call. First, most of the time there are many more providers to split call amongst with gas. Second, gas only sees the consults that make it to the OR. Many, many calls and problems are dealt with by surgeons that don't involve the OR.



Good luck, I think you would find either field to be accomodating. But do remember that there are other fields that are as much or more lifestyle friendly (as mentioned above by others)

 

[roja]

Keep in mind that the ease of 'taking time' off is actually a minor issue you should be considering.

What you are doing when you are work and how much you enjoy it, how much stress you deal with, are crucial questions.

EM and aneasthesia are both high stress levels for different reasons. And both deal with critically ill patients on a regular basis which can be stressful for some.

so, the most important thing for you to do is to do your rotations. It doesn't matter how 'cush' the life is, if you hate going into work.

 

[Pippy]

Having done both emergency medicine and anesthesia, I would have to say that anesthesia is hands down a more pleasant specialty. Keep in mind that you may work less hours in emergency medicine, but the bulk of those hours will be evening or night hours, weekends, and holidays. If your husband works a 9-5 M-F job, this could really cause havoc with family life. The other downside of emergency medicine is the lack of specialisation, you are a generalist dealing with everything that comes through the door, and honestly, most of it is a glorified urgent care. You have to have extremely broad knowledge of every specialty, and all of that comes with high liability with regards to appropriate treatment. Oftentimes it is difficult to get consultants to come in and further evaluate patients.

Anesthesiologists may have call, but the typical work week is early in the morning to mid afternoon, and as someone stated call is interspersed amongst a large number of people. Most anesthesiologists have the day after call off, and go home early pre call. Oftentimes they even come in late on the day of call. There is no paperwork to do at the end of the day. All holidays are days off (unless you are on call) again dispersed amongst the whole group. It is otherwise a 6:30-7:00A to 12:00-4:00P job, M-F. Rarely do you ever need to answer your pager. Also, it is much easier to feel that you have substantial knowledge of your specialty.

My only regret in going back to residency to do anesthesia was that I did not pick it as my specialty the first time around.

 

[yowhatup]

Having done both emergency medicine and anesthesia, I would have to say that anesthesia is hands down a more pleasant specialty. Keep in mind that you may work less hours in emergency medicine, but the bulk of those hours will be evening or night hours, weekends, and holidays. If your husband works a 9-5 M-F job, this could really cause havoc with family life. The other downside of emergency medicine is the lack of specialisation, you are a generalist dealing with everything that comes through the door, and honestly, most of it is a glorified urgent care. You have to have extremely broad knowledge of every specialty, and all of that comes with high liability with regards to appropriate treatment. Oftentimes it is difficult to get consultants to come in and further evaluate patients.

Anesthesiologists may have call, but the typical work week is early in the morning to mid afternoon, and as someone stated call is interspersed amongst a large number of people. Most anesthesiologists have the day after call off, and go home early pre call. Oftentimes they even come in late on the day of call. There is no paperwork to do at the end of the day. All holidays are days off (unless you are on call) again dispersed amongst the whole group. It is otherwise a 6:30-7:00A to 12:00-4:00P job, M-F. Rarely do you ever need to answer your pager. Also, it is much easier to feel that you have substantial knowledge of your specialty.

My only regret in going back to residency to do anesthesia was that I did not pick it as my specialty the first time around.

Yes I agree anesthesia is better.... my concern is that my hands are very unstable and I am scared whenever I am doing procedures... BUT I LOVE ANESTHESIA!!!!!!!!!!.... my question is that with training can I become a competent anesthesiologist despite lack of dexterity???.... or does one need to be innately good with one's hands when doing anesthesia?... can the procedures of anesthesia be learned is basically my question???

 

[dragonfly99]

roja is totally right about the potential stress level in fields like anesthesia and ER. Remember also that ER deals with a lot of patients and families who don't have good problem solving skills and/or took stupid chances and that is why they are in the ER in the first place. The ER also tends to see a lot of drug addicts who come in there asking, or demanding, narcotics and benzos without a good indication for those, and who may become angry when you won't give them any. There is also a lot of liability. I personally think it's a cushier specialty than gas,though...or at least I would have chosen it over gas. I have a friend who is an anesthesiologist and she is in her 1st year out and I think gets 8 or 9 weeks of vacation and I think a very good salary (200's or 300's, I don't really know...). The call in private practice I don't think is too terrible, but you may still have to go in on some nights or weekends. Also, in anesthesia when things go wrong in the ER they can go very wrong, and you have to be able to deal with it, and quickly. This can happen in the ER too but depending on the ER you are in (litte 1 horse town vs. a bigger ER with lots of ancillary staff helping you) that could be heinous or not so much so. The thing with ER is that you have your shifts, you know when they are, you go there and do them, and then you leave.

I would say that aside from residencies like derm or pathology or ophthalmology, ER is also the cushiest residency. They take very little call and work far, far fewer hours than residents in a lot of other specialties. ER does require a lot of time on your feet and sometimes you can't really rest (to sit down and eat, etc.) during a shift so you have to have some tolerance for being physically not totally comfortable all the time, just like with being a surgeon (just on a lesser/lower level).

There are some medical subspecialties, like endocrinology, rheumatology or allergy/immuno, that also have a pretty cushy lifestyle, but you have to get through IM residency, which isn't that easy, to be able to get to those.

 

[AK_MD2BE]

Bump...thanks for the knowledge.

 

[Zuckman]

Psychiatry is quite lifestyle friendly too...

 

[pillowhead]

EM definitely has overall fewer hours than anesthesiology.

Anesthesiologists do usually get out reasonably early but they get to work damn early (our attendings are usually there by 6:30ish....generally the surgery attendings aren't there that early and on medicine, my attendings never came in before 8:00) so the overall hours aren't that different from say a hospitalist.

They require a totally different mindset and attitude though. The EM doc is a generalist who frequently must consult other specialists and mostly practices acute primary care. The anesthesiologist is a specialist in his own rights that only rarely consults other specialties (most commonly cards for risk stratification although I think anesthesiologists as a whole are taking on more of the pre-op responsibility than they used to) and is frequently consulted themselves. In the past year of anesthesiology residency, I have been consulted to:

1. General -- called for central lines, difficult IVs, help with sedation, and of course, airways, airways, airways, and more airways
2. Cardiac -- called for PA catheters
3. Pain -- acute and chronic consults, epidurals, blocks, etc
4. OB -- we have an OB ICU on our L&D floor which is co-managed by OB and anesthesia in addition to the usual OB stuff
5. Critical care -- general ICU management

Emergency medicine is great for someone who gets bored quickly and likes a lot of things going on and managing lots of different things at one time.

I think most anesthesiologists enjoy focusing intently on one patient at a time and will admit their OCD keeps them very busy in the OR (though it may seem boring for the less OCD person).

After having spent four months in an ED setting in med school and intern year and then finishing my 1st year of anesthesia, I'd say they're very very different and have a hard time seeing how someone would really enjoy both once they had more experience with both fields. Other than the fact they probably are associated with airway management more than any other specialties and they get to turn off their pager at the end of the day, they don't have much in common.

 

[docLuis]

"other fields that allow you to have an office is also more "lifestyle" oriented, you're your own boss and you can set whatever hours you want to work.. in both EM and Anesthesia you're working for someone else, other people tell you when you have to work and when you can be free. that doesn't sound like a "lifestyle" field to me.[/QUOTE]

RussianJoo, I have family in the affluent suburbs, and have recently noticed EM clinics popping up in the area. The idea of private EM clinics seems like a very promising business venture, and I also have an immense interest in business, like my husband.

Does anyone else have any information about these private EM clinics? I am strongly considering embarking on this project shortly after practicing in the hospital a while.

 

[RussianJoo]

"other fields that allow you to have an office is also more "lifestyle" oriented, you're your own boss and you can set whatever hours you want to work.. in both EM and Anesthesia you're working for someone else, other people tell you when you have to work and when you can be free. that doesn't sound like a "lifestyle" field to me.

RussianJoo, I have family in the affluent suburbs, and have recently noticed EM clinics popping up in the area. The idea of private EM clinics seems like a very promising business venture, and I also have an immense interest in business, like my husband.

Does anyone else have any information about these private EM clinics? I am strongly considering embarking on this project shortly after practicing in the hospital a while.[/QUOTE]

you don't need to be a board certified EM doc to open one of those clinics. those clinics are basically family practice offices. what's the point of going to a stand alone clinic instead of a doctors office? it's not like that clinic will be able to get you a surgical consult with in the next 30min.. or cardiologist consult, like you would by going to a hospital... basically if you really have an emergency you will not be going to one of those clinics because they simply won't be able to do anything for you except tell you to go to a real hospital. You'll be just as well trained to open an EM clinic as a family practice doc as you would an EM doc, they're both generalists and both require help from other specialties to cure their patients.

 

[docB]

"other fields that allow you to have an office is also more "lifestyle" oriented, you're your own boss and you can set whatever hours you want to work.. in both EM and Anesthesia you're working for someone else, other people tell you when you have to work and when you can be free. that doesn't sound like a "lifestyle" field to me.

RussianJoo, I have family in the affluent suburbs, and have recently noticed EM clinics popping up in the area. The idea of private EM clinics seems like a very promising business venture, and I also have an immense interest in business, like my husband.

Does anyone else have any information about these private EM clinics? I am strongly considering embarking on this project shortly after practicing in the hospital a while.[/QUOTE]

Are you talking about Urgent Cares or actual freestanding EDs? They're very different. Urgent Cares tend to be staffed by any specialty and they don't do "emergent" care, they refer to EDs for that and they don't receive ambulances. Free standing EDs are usually staffed by board certified Emergency Physicians (not always, not a debate for this thread) and they do receive ambulances, do "emergent" care, etc.

Here are some threads about freestanding EDs fromt he EM forum:
http://forums.studentdoctor.net/showthread.php?t=487420
http://forums.studentdoctor.net/showthread.php?t=589893

 

[docLuis]

Thanks, docB, for the clarification. I apologize, I was referring to urgent care clinics, not private ER's. Urgent care clinics seem to be very lucrative in the suburbs, since most people have health insurance and seek instant gratification, (rather than waiting for an appointment with their PCP). Ideally, I would like to practice EM 2-3 days/week and own an urgent care clinic (not actually work there). My husband has a law degree and could help significantly with management.

Anyone have useful information/links to threads regarding owning and operating urgent care clinics?

 

[docB]

Anyone have useful information/links to threads regarding owning and operating urgent care clinics?

There are a number of threads in the EM forum about who is qualified to work in an Urgent Care but there are fewer about the actual management. I'd seach the EM forum or start a thread an ask if anyone knows anything about the actual management.