Cardiology vs. Anesthesia

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GolDRoger

GolDRoger

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Hi everyone,

MS3 here trying to make a decision on the specialty I'd like to pursue. I'm really between anesthesia vs. cardiology. Have rotated through anesthesia and IM. Honestly, I loved both of these specialties and am having a really hard time deciding. I was mainly all in for anesthesia at first but every single anesthesiologist I've talked to has tried to convince me to do something else - they all had a pretty negative outlook on anesthesia and said if they were a med student today they would not pick it. Here are my thoughts:


Anesthesia pros for me: love the lifestyle and the fact that there's a great amount of break time everyday. loved intubating patients, putting in arterial lines, and overall just thought the procedure diversity was great (nerve blocks and always working with your hands). Obviously they can make a ton of $ and I'm seeing a lot of jobs for 500k+ starting, not to mention residency is just 4 years and I can be banking pretty quickly. I do value lifestyle and money a good amount. I do like the idea of supervision and not having to sit my own cases the whole time. But at the same time i'm also fine with sitting my cases.

Anesthesia cons: by the end of the rotation, was pretty bored. I feel like the procedures can get pretty repetitive and you're doing the same thing everyday. kind of hated how they were so nice to the surgeon but the surgeon wasn't necessarily nice to them and treated them like kids at times. don't like the fact that i'll never have my own patients. don't like the fact that there was hints of disrespect towards the anesthesiologists. really ridiculous when you've put so much time in and have to deal with disrespect.


Cardiology pros: same thing in terms of money. If i did cardio, would want to do IC or EP for sure, and they seem to make the same amount if not more. love the procedures (stenting, ablations, etc). love the respect that comes with cardiology and the fact that I can have great effects on people's lives. love the heart. i do also love teaching (have been doing teaching/tutoring as a side gig for most of my life) and realize that they are teaching to med students and residents/fellows a ton.

Cardiology cons: super long path... like i said I'd be looking at IC or EP and that's 7-8 years post med school. that is a very long time to me. I've heard lifestyle can be quite rough. Not sure how much midlevels are involved but have heard they are more involved and can be very annoying. The poor outcomes I feel could bother me but not so much that it would make me hate my life or anything. The amount of call (though I hear anesthesia is a lot of call too)


Sorry for the long post but just wanted to hear your guys thoughts. Thank you so much in advance
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Academic anesthesia is very different (worse treatment, longer cases, less respect)

PP anesthesia is great. Better than I ever expected.

Only downside is you don't necessarily control your schedule entirely

Boredom is less of an issue these days in PP. Cases faster.
 
Sounds like cardiology is for you. Personally speaking I advise people to perhaps not go into medicine but if you are in medicine I cannot imagine doing anything else other than anesthesiology.

Couple things though.. you do have your own patients in this field. In fact, you have more than just about any other specialty, albeit for the briefest and perhaps most intense portion of their life. But yeah, they are not going to call you at home for a refill on a medication or spend 10 minutes of their clinic visit talking about their constipation issues while you politely attempt to redirect 10 times over. So be careful what you wish for.

ANY speciality in medicine will get repetitive over time. YOU can make each case the best you can for each patient, and there is a tangible satisfaction in that, although that may be hard to see from afar or from certain people in practice. It is very boring as a student if you are not the one in control of making the decisions involved with the case, I agree and that is normal. IMO well done anesthesia care is a bit of an art and a science, and that is harder to appreciate in the role of a student, when you are only meant to be a sponge and learn the science.

Sounds like your exposure to our field has not been optimal, respect is generally earned. Rarely have I seen a strong anesthesiologist shown a "lack of respect" but I do think our field suffers from both a bit of a lack of backbone as a whole. Yes, we do have to deal with a-holes. Again, you will get that in any field, we are just stuck in the room with them.
 
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I also was deciding between cards and anesthesia. It boiled down to the negatives of having to do IM endless rounds and the length of training vs the fact that there is really very little negative I could say about anesthesiology as a career and training. I don’t have a big ego so I didn’t mind the perceived lack of respect… I don’t feel disrespected at all.

I also like to train surgery residents that when they call me “Anesthesia” I simply ignore them. If they keep calling me anesthesia to ask for something I then say “oh I thought you were talking to the Propofol. Sorry, I am Dr so and so. Who are you?” That usually helps them learn to pay attention and I don’t have any issue with the surgeons at all.
 
Harpoon1 said:
Sounds like cardiology is for you. Personally speaking I advise people to perhaps not go into medicine but if you are in medicine I cannot imagine doing anything else other than anesthesiology.

Couple things though.. you do have your own patients in this field. In fact, you have more than just about any other specialty, albeit for the briefest and perhaps most intense portion of their life. But yeah, they are not going to call you at home for a refill on a medication or spend 10 minutes of their clinic visit talking about their constipation issues while you politely attempt to redirect 10 times over. So be careful what you wish for.

ANY speciality in medicine will get repetitive over time. YOU can make each case the best you can for each patient, and there is a tangible satisfaction in that, although that may be hard to see from afar or from certain people in practice. It is very boring as a student if you are not the one in control of making the decisions involved with the case, I agree and that is normal. IMO well done anesthesia care is a bit of an art and a science, and that is harder to appreciate in the role of a student, when you are only meant to be a sponge and learn the science.

Sounds like your exposure to our field has not been optimal, respect is generally earned. Rarely have I seen a strong anesthesiologist shown a "lack of respect" but I do think our field suffers from both a bit of a lack of backbone as a whole. Yes, we do have to deal with a-holes. Again, you will get that in any field, we are just stuck in the room with them.
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Thanks for the detailed reply - I'm definitely working with a more miserable group.. I'm actually working with a PP group which mainly consists of supervision. The guys in this particular group are just not happy, which I feel differs greatly from most. It is true that dealing with the phone calls at home and rambling in clinic will probably be annoying. I do like that anesthesia does not take any work home.

Do you think the salary/lifestyle for anesthesia will remain? I understand the market is pretty hot right now, but has it always been at a $500k+ mark? And are there opportunities for more lucrative practice as there is in cardiology? I guess one thing for me is if I did cardiology, after all those years I wouldn't want to have a salary that I could've obtained in 4 years had I done anesthesia.
 
UscGhost said:
Academic anesthesia is very different (worse treatment, longer cases, less respect)

PP anesthesia is great. Better than I ever expected.

Only downside is you don't necessarily control your schedule entirely

Boredom is less of an issue these days in PP. Cases faster.
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What is your lifestyle/salary/day-to-day like if you don't mind me asking? And how much are you really thrown off schedule?
 
GolDRoger said:
What is your lifestyle/salary/day-to-day like if you don't mind me asking? And how much are you really thrown off schedule?
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Avg person in my group takes 2-3 calls per month. Works about 30-50 hrs per week with a mix of long days and short days /days off.

You generally know roughly what time you will finish, within a couple hours.

Hard of you need to be done by specific times to pick up kids etc, but pretty easy if you need to be done by general times (off in the afternoon, day off, etc)

Surgeons chill and professional. Well respected if you're good at your job and helpful (don't cancel or delay unnecessarily). Pay is 400-550k depending on how much you work (not a very aggressive group)

Avg case is 1-2 hrs long. Some 3ish
 
My friend makes 1.5 million as employed w2 interventional cardiologist. But he works like a dog. 1 million base plus rvu incentives etc. Can literally round on 100 patients on the weekend across 3 hospitals as well. Including the big trauma one place. Crazy busy for him. Anywhere between 10-13 caths a day. It’s busy day for him. His other job he made much less. But worked less. 5-6 caths a day.
 
UscGhost said:
Avg person in my group takes 2-3 calls per month. Works about 30-50 hrs per week with a mix of long days and short days /days off.

You generally know roughly what time you will finish, within a couple hours.

Hard of you need to be done by specific times to pick up kids etc, but pretty easy if you need to be done by general times (off in the afternoon, day off, etc)

Surgeons chill and professional. Well respected if you're good at your job and helpful (don't cancel or delay unnecessarily). Pay is 400-550k depending on how much you work (not a very aggressive group)

Avg case is 1-2 hrs long. Some 3ish
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Sounds like a great schedule. Is it pretty easy in anesthesia to pursue side hustles / gigs if someone wanted to do so? Perhaps some work from home stuff or even locums
 
aneftp said:
My friend makes 1.5 million as employed w2 interventional cardiologist. But he works like a dog. 1 million base plus rvu incentives etc. Can literally round on 100 patients on the weekend across 3 hospitals as well. Including the big trauma one place. Crazy busy for him. Anywhere between 10-13 caths a day. It’s busy day for him. His other job he made much less. But worked less. 5-6 caths a day.
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How many hours does this look like a week? 70? Would 50 as an IC be able to pull 800+?
 
GolDRoger said:
Sounds like a great schedule. Is it pretty easy in anesthesia to pursue side hustles / gigs if someone wanted to do so? Perhaps some work from home stuff or even locums
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Anesthesia jobs can be highly variable in terms of scheduling/lifestyle, which is a great thing. You can go to gaswork to get an idea. Most jobs should have 9/10+ vacation weeks with 40-50hr work week and variable call. Can also do a night float job where you are 26week on, 26week off. And a lot of in between (I've seen the 13week vacation and 17 week vacation job). Just know that with these high vacation week jobs, you are essentially compressing hours together to make the increased vacation week. So a 26week job with 7 days of 12hr shifts is 2184hrs a year, whereas a 40hr/week with 10 weeks vacation is much less hours worked/year. Not sure of any other specialty that allows this type of scheduling variation/flexibility
 
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1. You will never sleep in the hospital after you become an attending cardiologist.

2. As a cardiologist, you will get out of your bed at home for STEMI call unless you are EP or structural.

3. You will get endless consults. Hopefully you’ll have an NP to triage them for you. Midlevels are a godsend to our surgeons and proceduralists. They function as residents for our PP docs.

4. You will likely make more money in cardiology. 7 figures is not uncommon in cardiology but it is uncommon in anesthesia.

5. Do you like clinic?

6. It’s much easier (requires less work) to match anesthesia than it is to match cardiology.
 
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AppTrail said:
Anesthesia jobs can be highly variable in terms of scheduling/lifestyle, which is a great thing. You can go to gaswork to get an idea. Most jobs should have 9/10+ vacation weeks with 40-50hr work week and variable call. Can also do a night float job where you are 26week on, 26week off. And a lot of in between (I've seen the 13week vacation and 17 week vacation job). Just know that with these high vacation week jobs, you are essentially compressing hours together to make the increased vacation week. So a 26week job with 7 days of 12hr shifts is 2184hrs a year, whereas a 40hr/week with 10 weeks vacation is much less hours worked/year. Not sure of any other specialty that allows this type of scheduling variation/flexibility
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Hospitalist, OB hospitalist, trauma/ACS, ortho trauma, radiology, ?ICU.
 
Cardiology. You are much more valuable in the hospital admin's eyes. They have any resource they need, Np's and pa's to do the scut. At my surgery center I wipe my machine, change my circuit and change the suction. You think any cardiologist would be caught dead doing that? The ep guys don't even get access themselves half the time. I've had to push an anesthesia machine and cart down the hallway to another room due to a lack of tech support. Anesthesia is considered a necessary evil for hospitals. You have to make yourself as cheap as possible to the hospital to prove your worth and even then they'll come and kick you out without a moment's notice. Cardiologists on the other hand are one of the hospitals cash cows.

Plus you don't have the personality that would be happy in anesthesia, however interventional cards is generally a poor lifestyle.
 
Unsure how competitive cards fellowship vs. anesthesia residency is these days, but cardiology used to be a fairly competitive IM fellowship. Don't discount the disastrous possibility of doing 3 years of IM to then not match cards.
 
If I could have tolerated going through 3 years of medicine, I would have pursued cardiology. Probably the only thing I'd have liked to do if I didn't do anesthesia. Always loved everything cardiac related. Loved my cardiology rotation in med school (and residency!), loved cardiac surgery, loved cardiac anesthesia. Ended up in anesthesia and did cardiac anesthesia fellowship. I love what I do. I appreciate the collegiality between me, our cardiac surgeons, and our cardiologists.

Cardiology has a lot of diversity within it, which can cause substantial variability in call, overnight work, consults, etc. some strictly do outpatient clinic. Some focus largely on imaging and spend a lot more time in an echo lab reading all varieties of echos and cardiac MRIs etc. Some will staff ICUs. IC can do a TON of procedures (ECMO, balloon pump, impella, pfo/asd closures, stents, TAVRs, mitra-clips, watchman's, peripheral vascular work (angio, stenting), thrombectomies, etc. possibilities are endless! Haven't even touched on EP yet.

If you love them both, I'd suggest cardiology, as you can find a practice that suits your needs more. Also, cardiologists can truly make a killing. 7 figures is very much within reach if you are a proceduralist. I'd have to work like a complete dog to break 7 figures in my work, and I'm paid very well.
 
I was in a similar position. Loved Cards and Anesthesiology. My decision was made because I entered med school much later, and couldn't stomach a 6-7 year training path. I also couldn't stomach clinic, writing notes, H&P's, admission, etc.

Have you considered Cardiothoracic Anesthesia? 1-yr fellowship. As others have said, PP anesthesiologists are respected much higher than anything you see in training. You'll never make as much as an IC or EP doc. They bank. But you've probably got a better chance of getting an ACA fellowship than Cardiology fellowship. You should have better control over your lifestyle, and you'll have a 2-3 year head start on income.
 
NICMAN said:
I also like to train surgery residents that when they call me “Anesthesia” I simply ignore them. If they keep calling me anesthesia to ask for something I then say “oh I thought you were talking to the Propofol. Sorry, I am Dr so and so. Who are you?” That usually helps them learn to pay attention and I don’t have any issue with the surgeons at all.
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This damn trope has been repeated so many times it's almost an urban myth.
 
GolDRoger said:
Sounds like a great schedule. Is it pretty easy in anesthesia to pursue side hustles / gigs if someone wanted to do so? Perhaps some work from home stuff or even locums
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Depends on how your group is structured.

You can definitely create you own blend of per diem, side hustle, but requires local knowledge and some connections that can be built over time.

The best and most stable pay is hospital based. You sacrifice some of that for healthier patients and no nights/weekends in ASCs.
 
GolDRoger said:
Hi everyone,

MS3 here trying to make a decision on the specialty I'd like to pursue. I'm really between anesthesia vs. cardiology. Have rotated through anesthesia and IM. Honestly, I loved both of these specialties and am having a really hard time deciding. I was mainly all in for anesthesia at first but every single anesthesiologist I've talked to has tried to convince me to do something else - they all had a pretty negative outlook on anesthesia and said if they were a med student today they would not pick it. Here are my thoughts:


Anesthesia pros for me: love the lifestyle and the fact that there's a great amount of break time everyday. loved intubating patients, putting in arterial lines, and overall just thought the procedure diversity was great (nerve blocks and always working with your hands). Obviously they can make a ton of $ and I'm seeing a lot of jobs for 500k+ starting, not to mention residency is just 4 years and I can be banking pretty quickly. I do value lifestyle and money a good amount. I do like the idea of supervision and not having to sit my own cases the whole time. But at the same time i'm also fine with sitting my cases.

Anesthesia cons: by the end of the rotation, was pretty bored. I feel like the procedures can get pretty repetitive and you're doing the same thing everyday. kind of hated how they were so nice to the surgeon but the surgeon wasn't necessarily nice to them and treated them like kids at times. don't like the fact that i'll never have my own patients. don't like the fact that there was hints of disrespect towards the anesthesiologists. really ridiculous when you've put so much time in and have to deal with disrespect.


Cardiology pros: same thing in terms of money. If i did cardio, would want to do IC or EP for sure, and they seem to make the same amount if not more. love the procedures (stenting, ablations, etc). love the respect that comes with cardiology and the fact that I can have great effects on people's lives. love the heart. i do also love teaching (have been doing teaching/tutoring as a side gig for most of my life) and realize that they are teaching to med students and residents/fellows a ton.

Cardiology cons: super long path... like i said I'd be looking at IC or EP and that's 7-8 years post med school. that is a very long time to me. I've heard lifestyle can be quite rough. Not sure how much midlevels are involved but have heard they are more involved and can be very annoying. The poor outcomes I feel could bother me but not so much that it would make me hate my life or anything. The amount of call (though I hear anesthesia is a lot of call too)


Sorry for the long post but just wanted to hear your guys thoughts. Thank you so much in advance
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Sounds like you need to go to law school ..... if you are afraid of outcomes. respect is earned if you don't like to be disrespected don't allow it. Your pro and cons list sounds like a typical millennial, medicine is not a job its a profession... this is not Cutting Trees vs Pouring concrete slabs... d what you like..... by the sound of it psychiatry is for you
 
aneftp said:
My friend makes 1.5 million as employed w2 interventional cardiologist. But he works like a dog. 1 million base plus rvu incentives etc. Can literally round on 100 patients on the weekend across 3 hospitals as well. Including the big trauma one place. Crazy busy for him. Anywhere between 10-13 caths a day. It’s busy day for him. His other job he made much less. But worked less. 5-6 caths a day.
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How is his blood pressure?😉

Does the hospital provide an NP?
 
lotsapain said:
Sounds like you need to go to law school ..... if you are afraid of outcomes. respect is earned if you don't like to be disrespected don't allow it. Your pro and cons list sounds like a typical millennial, medicine is not a job its a profession... this is not Cutting Trees vs Pouring concrete slabs... d what you like..... by the sound of it psychiatry is for you
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Lol every single one of your posts on your account make me realize how pitiful of a human being you are, your username truly checks out. Take a chill pill little guy
 
lotsapain said:
Sounds like you need to go to law school ..... if you are afraid of outcomes. respect is earned if you don't like to be disrespected don't allow it. Your pro and cons list sounds like a typical millennial, medicine is not a job its a profession... this is not Cutting Trees vs Pouring concrete slabs... d what you like..... by the sound of it psychiatry is for you
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Lmao thanks for the laugh
 
NICMAN said:
I also was deciding between cards and anesthesia. It boiled down to the negatives of having to do IM endless rounds and the length of training vs the fact that there is really very little negative I could say about anesthesiology as a career and training. I don’t have a big ego so I didn’t mind the perceived lack of respect… I don’t feel disrespected at all.

I also like to train surgery residents that when they call me “Anesthesia” I simply ignore them. If they keep calling me anesthesia to ask for something I then say “oh I thought you were talking to the Propofol. Sorry, I am Dr so and so. Who are you?” That usually helps them learn to pay attention and I don’t have any issue with the surgeons at all.
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love this! I do a puppet show using the drapes where the propofol talks back to them (yes, I'm a pediatric anesthesiologist)
 
I took a long time to digest what you wrote. There's a lot to unpack here. If you don't want my whole explanation then TL;DR, you should do Cardiology, Radiology, or Derm based on your post.

GolDRoger said:
Hi everyone,

MS3 here trying to make a decision on the specialty I'd like to pursue. I'm really between anesthesia vs. cardiology. Have rotated through anesthesia and IM. Honestly, I loved both of these specialties and am having a really hard time deciding. I was mainly all in for anesthesia at first but every single anesthesiologist I've talked to has tried to convince me to do something else - they all had a pretty negative outlook on anesthesia and said if they were a med student today they would not pick it. Here are my thoughts:
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I don't have a negative outlook on anesthesia. I love what I do and I'm 6yrs out of training. There's not another job in the world I'd rather do (maybe internationally acclaimed DJ). I think you should do it but you have to have the right motivations. I'd rather be shorthanded working more shifts, than be stuck with a colleague who is disgruntled because they chose anesthesia for the wrong reasons.

GolDRoger said:
Anesthesia pros for me: love the lifestyle and the fact that there's a great amount of break time everyday. loved intubating patients, putting in arterial lines, and overall just thought the procedure diversity was great (nerve blocks and always working with your hands). Obviously they can make a ton of $ and I'm seeing a lot of jobs for 500k+ starting, not to mention residency is just 4 years and I can be banking pretty quickly. I do value lifestyle and money a good amount. I do like the idea of supervision and not having to sit my own cases the whole time. But at the same time i'm also fine with sitting my cases.
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I would disagree that "there's a great amount of break time everyday." Either you're at an inefficient academic site, or you're just watching someone supervise two rooms. Either way, that's probably not an accurate estimation of what you will be doing in real-life. Realistically, if you're taking long breaks it's because surgery isn't happening. Other people want to go home so there's a constant push to get things done.
You seem exceptionally $$$ driven. I'm not criticizing, I like money too. I'm just observing the fact you use the word "banking" as a verb. Things are good right now, but this isn't going to last forever. Other people can chime in, but no one is going to pay you $500k to watch two rooms, take long breaks, and go home at 1500 everyday. You're going to be working, that's reality. Don't get sucked up into the random, one-off, unique SDN jobs that people talk about (I even have a side gig like that). Those are the outliers, not the norm. You need to be ready for what the latter 4/5 of your career is going to look like when you're actually covering 4 rooms or sitting your own extended-length robot hernia at 2100....

GolDRoger said:
Anesthesia cons: by the end of the rotation, was pretty bored. I feel like the procedures can get pretty repetitive and you're doing the same thing everyday. kind of hated how they were so nice to the surgeon but the surgeon wasn't necessarily nice to them and treated them like kids at times. don't like the fact that i'll never have my own patients. don't like the fact that there was hints of disrespect towards the anesthesiologists. really ridiculous when you've put so much time in and have to deal with disrespect.
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You might be bored because you're not the one actually doing the physical or mental activities. Anesthesia can be boring to watch much of the time, but that generally means the anesthesiologist is doing a good job. Reperfusion on my last liver transplant looked "boring," but there was actually a ton of work to make it appear that way. Everything in medicine gets repetitive, you just have to find content that doesn't bore you. At this point a critical AS patient is repetitive; doesn't mean I don't still love the case or find something else new to learn about it.
Yes, you have to cater to a variety of personalities. Some may be rude surgeons, some may be incompetent hospital administrators. Unfortunately they have a large sway over your continued employment. If this bothers you then please don't do anesthesia. You need to have thick skin to succeed in the OR, even in 2025. Disrespect is going to happen, deal with it. At the end of the day I know I did an excellent job providing high-quality care to exceptionally sick patients, and that's good enough for me. I don't care what some surgeon thinks. Guess what? When you work with the same surgeons over years, they come to respect you and your opinion. Even if it gets heated in the OR at times, when we leave the OR we're quite friendly and even exchange Christmas gifts. Real disrespect is rare.
You do have your own patients, but only for a few hours at a time. For me, that's perfect. I love being able to mentally check out at the end of my shift. If long-term ongoing management is important to you then look elsewhere.

GolDRoger said:
Cardiology pros: same thing in terms of money. If i did cardio, would want to do IC or EP for sure, and they seem to make the same amount if not more. love the procedures (stenting, ablations, etc). love the respect that comes with cardiology and the fact that I can have great effects on people's lives. love the heart. i do also love teaching (have been doing teaching/tutoring as a side gig for most of my life) and realize that they are teaching to med students and residents/fellows a ton.

Cardiology cons: super long path... like i said I'd be looking at IC or EP and that's 7-8 years post med school. that is a very long time to me. I've heard lifestyle can be quite rough. Not sure how much midlevels are involved but have heard they are more involved and can be very annoying. The poor outcomes I feel could bother me but not so much that it would make me hate my life or anything. The amount of call (though I hear anesthesia is a lot of call too)
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Your earnings ceiling is almost definitely higher in Cards, particularly if you subspecialize. When you say "respect," what you actually mean is "recognition." Again, you just need to be honest with what you want out of a career. Personally, I don't really care if anybody outside my department knows my name; I kinda prefer it that way. There's absolutely stellar anesthesiologists out there who have saved 100s of lives, but you will likely never know their names. That's just how it is. The fact you don't recognize that anesthesiologists have "great effects on people's lives," shows that you don't really understand the field. There's nothing wrong with wanting to be recognized for your work, but if that is something really important to you then you'll likely find more happiness in surgery or Cards.
I think people get too bent out of shape about an extra 2yrs of training. I did 5yr (residency + ACTA). I'm doing exactly what I want to do. I would have still chosen the exact same path even if it took 7yrs. Unless you're doing this s*** for fun, you've got a 25+ year career ahead of you. Who cares about an extra two years if it spares you from being miserable in a profession you hate? You'll make more than enough money as an attending to make up for 'lost earning potential years' as long as you live a somewhat reasonable lifestyle that excludes multiple alimonies and Ferrari leases.
Not sure what you mean by 'annoying midlevels?' I find most people annoying, but typically their degree isn't the reason. Midlevels are here to stay in medicine. Many are actually quite helpful.
Also, there's bad outcomes in anesthesia too. They can be equally catastrophic or worse than EP. I've already seen stuff that I prefer not to think about. I might not be the person who should be giving advice about this specific aspect, but you will need to learn to compartmentalize whichever path you choose.


Alright, that's enough. I'm writing this in the hospital on-call. I'm sure I'll get 🔥, but I felt I said what needed to be said.
 
Biochemist21 said:
I took a long time to digest what you wrote. There's a lot to unpack here. If you don't want my whole explanation then TL;DR, you should do Cardiology, Radiology, or Derm based on your post.



I don't have a negative outlook on anesthesia. I love what I do and I'm 6yrs out of training. There's not another job in the world I'd rather do (maybe internationally acclaimed DJ). I think you should do it but you have to have the right motivations. I'd rather be shorthanded working more shifts, than be stuck with a colleague who is disgruntled because they chose anesthesia for the wrong reasons.



I would disagree that "there's a great amount of break time everyday." Either you're at an inefficient academic site, or you're just watching someone supervise two rooms. Either way, that's probably not an accurate estimation of what you will be doing in real-life. Realistically, if you're taking long breaks it's because surgery isn't happening. Other people want to go home so there's a constant push to get things done.
You seem exceptionally $$$ driven. I'm not criticizing, I like money too. I'm just observing the fact you use the word "banking" as a verb. Things are good right now, but this isn't going to last forever. Other people can chime in, but no one is going to pay you $500k to watch two rooms, take long breaks, and go home at 1500 everyday. You're going to be working, that's reality. Don't get sucked up into the random, one-off, unique SDN jobs that people talk about (I even have a side gig like that). Those are the outliers, not the norm. You need to be ready for what the latter 4/5 of your career is going to look like when you're actually covering 4 rooms or sitting your own extended-length robot hernia at 2100....



You might be bored because you're not the one actually doing the physical or mental activities. Anesthesia can be boring to watch much of the time, but that generally means the anesthesiologist is doing a good job. Reperfusion on my last liver transplant looked "boring," but there was actually a ton of work to make it appear that way. Everything in medicine gets repetitive, you just have to find content that doesn't bore you. At this point a critical AS patient is repetitive; doesn't mean I don't still love the case or find something else new to learn about it.
Yes, you have to cater to a variety of personalities. Some may be rude surgeons, some may be incompetent hospital administrators. Unfortunately they have a large sway over your continued employment. If this bothers you then please don't do anesthesia. You need to have thick skin to succeed in the OR, even in 2025. Disrespect is going to happen, deal with it. At the end of the day I know I did an excellent job providing high-quality care to exceptionally sick patients, and that's good enough for me. I don't care what some surgeon thinks. Guess what? When you work with the same surgeons over years, they come to respect you and your opinion. Even if it gets heated in the OR at times, when we leave the OR we're quite friendly and even exchange Christmas gifts. Real disrespect is rare.
You do have your own patients, but only for a few hours at a time. For me, that's perfect. I love being able to mentally check out at the end of my shift. If long-term ongoing management is important to you then look elsewhere.



Your earnings ceiling is almost definitely higher in Cards, particularly if you subspecialize. When you say "respect," what you actually mean is "recognition." Again, you just need to be honest with what you want out of a career. Personally, I don't really care if anybody outside my department knows my name; I kinda prefer it that way. There's absolutely stellar anesthesiologists out there who have saved 100s of lives, but you will likely never know their names. That's just how it is. The fact you don't recognize that anesthesiologists have "great effects on people's lives," shows that you don't really understand the field. There's nothing wrong with wanting to be recognized for your work, but if that is something really important to you then you'll likely find more happiness in surgery or Cards.
I think people get too bent out of shape about an extra 2yrs of training. I did 5yr (residency + ACTA). I'm doing exactly what I want to do. I would have still chosen the exact same path even if it took 7yrs. Unless you're doing this s*** for fun, you've got a 25+ year career ahead of you. Who cares about an extra two years if it spares you from being miserable in a profession you hate? You'll make more than enough money as an attending to make up for 'lost earning potential years' as long as you live a somewhat reasonable lifestyle that excludes multiple alimonies and Ferrari leases.
Not sure what you mean by 'annoying midlevels?' I find most people annoying, but typically their degree isn't the reason. Midlevels are here to stay in medicine. Many are actually quite helpful.
Also, there's bad outcomes in anesthesia too. They can be equally catastrophic or worse than EP. I've already seen stuff that I prefer not to think about. I might not be the person who should be giving advice about this specific aspect, but you will need to learn to compartmentalize whichever path you choose.


Alright, that's enough. I'm writing this in the hospital on-call. I'm sure I'll get 🔥, but I felt I said what needed to be said.
Click to expand...
THANK YOU SO SO MUCH FOR THIS! You are awesome and I really appreciate you taking the time to write this up. I definitely am motivated by money a good amount, and definitely do care about recognition a lot, so I will listen to your recommendation. Have a great day
 
GolDRoger said:
THANK YOU SO SO MUCH FOR THIS! You are awesome and I really appreciate you taking the time to write this up. I definitely am motivated by money a good amount, and definitely do care about recognition a lot, so I will listen to your recommendation. Have a great day
Click to expand...
Money + Recognition = Cards

Easy choice.
 
GolDRoger said:
Lol every single one of your posts on your account make me realize how pitiful of a human being you are, your username truly checks out. Take a chill pill little guy
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Thank you for the psychoanalysis and most importantly for taking the time to go read all my posts.... I wonder who is pitiful here? Get a hobby....
 
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