Any specific reason you would recommend against this? My general impression has been that most people are satisfied in anesthesiology.
I have thoroughly looked into the IM specialities and none are that appealing to me.
Any recommendations on pursing this beyond sending out "cold" emails to programs?
Lost salary isn't necessarily an issue for me. It'd be the same situation to do a 3 year IM fellowship. Also an anesthesiologist seems to have a higher earning potential than many if not most of the IM fellowships. Although I realize things could change with CRNAs and such.....
I would highly recommend going thru this forum and also following around anesthesiologists in real life in different settings if you are really interested. it seems like there are a lot of stuff you dont know about the specialty which is fine...
if it were me id just stay in IM and work. The salary loss is A LOT. If you absolutely hate it, then do IM fellowships. If you dont think you can get into IM fellowships and hate IM, then consider Anes.
3 years of working as IM can be easily 900k lost, plenty of cush hospitalist positions out there for ~300k as im sure you know. 900k BEFORE compounding, NOT including if you take any time off for rotations, shadowing, applying, etc.
Other things to consider... Anesthesiologists work on average, long hours even as attendings compared to most fields. AAMC puts us at 61 hours per week, which is only below a few fields (i think it was vasc surg, thoracic surg, CCM). Overall salary is lower than fields like GI, cardiology, hematology, especially if you count $$ per hour instead of absolute amount, and MUCH lower than if you are procedural heavy in those fields (scope heavy GI, interventional cards, etc). Lower paying fellowships in IM is not so much because they are low paying but because they are CUSH ( low hours, low emergency) - rheum, allergy comes to mind. obviously you also have low paying ones like ID. But in any of those fields you can easily boost your income by working more. I wont be surprised if salary isn't much different from ours if they worked 60 hr a week and took weekend/night calls..
future of the field is bleak, due to CRNAs, lack of field expansion/new innovations that affects pay. Number of jobs available is much less than in medicine, so to get a decent job you'll likely move to some random area, or get a mediocre job in the location you want.
Job is stressful. you did medicine residency, do you even know how you'd like interacting with egotistic surgeons all day? also there's heavy production pressure in anesthesiology that's not really present in medicine IMO.
Daily schedule is unpredictable, can end very late, can end early. you are rarely in control. days usually start earlier than medicine as well. Most jobs have 24 hr calls which throws off sleep rhythm, similar to EM.
You can start your own clinic/practice and be the boss in medicine. can't do it in anesthesiology. you'll forever be an employee. your salary depends on the surgeon. you'll have surgeons who just like to operate on weekends. there goes your weekend. you have surgeons that dont mind starting cases at 12am. there goes your sleep, while asking why you are doing this. obviously some jobs prevent this but you may not get that job.
