Career flexibility in anesthesia

[Eye-eye]

Hello all,

I'm an MS4 who was hoping to go into ophtho until our match kicked me on my ass this week and it was suggested to me that I consider another field. As such, I'm considering trying to SOAP into another field if I can get my **** together in time and figure out what else I would want to do with my life with enough certainty to take the plunge. I never really considered anesthesia all that much previously, to be completely honest. I always loved the OR, and always assumed I would be a surgeon of some sort, but found the more that I looked into different surgical subspecialties that I wasn't going to want to make a career in such brutal fields, in terms of either lifestyle or the other crap they have to deal with as an integral part of the job (not a big fan of rounding, managing your own inpatients, etc). Now that ophtho, the one surgical specialty which really clicked with me, may be completely out of the picture, I find myself wondering about anesthesia.

However, there is one thing that concerns me: the ability to have flexibility in where and how I might want to practice. Obviously in gas, you're practicing only when and where someone else is in need of your services, and there's no such thing (to my knowledge) as hanging up your own shingle, which is what I was planning to do in ophtho. I'm from a pretty rural background, and would want to go back there to be closer to family. There are a few hospitals out there, but not many, and who knows how those few jobs would be. I guess what I'm getting at is that I don't know what other options are out there for you guys. I'd imagine it's feasible to make a good living working at an ASC, but could something like dental anesthesia be a full time gig? Are there any good office/clinic-based jobs available through anesthesia, either as a primary provider (I think pain is an option here, if I'm not mistaken?) or doing quick sedations or procedures for another primary provider? I'm just hesitant to enter a field that typically is so inextricably linked with the hospital, when I'm trying to get back to a specific, rural area.

What other issues do you think are important to consider before entering the field? How much do things like the rise of CRNAs threaten job security - or on the flipside, do they allow you to hire and manage midlevels and make some profit off of them? Are there any other issues specific to anesthesia that could really threaten its future (huge, imminent reimbursement cuts; PE taking over all the PP jobs, etc)? I know you have to be humble as an anesthesiologist, as a lot of surgeons can be ***holes to anesthesia, and I think a lot of patients don't understand your value as a physician either - are there any other interpersonal things inherent to the job that I should be thinking about?

I know this is an extremely broad question, but if anyone can speak to these issues, and any other thoughts on the field that you think I should be thinking about, I would greatly appreciate it! I have been looking around on the forums a bit, but haven't gotten a great sense for a lot of these issues. Unfortunately there's limited time before the SOAP, and I'm scrambling in 15 different directions trying to figure out what I'm doing with my life, so I'm trying to gather as much information as I can as quickly as I can.

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[GassYous]

Dental anesthesia is generally done by dentists who do extra anesthesia training. Pain is a field where you can pick a place to practice and hang a shingle but I'm guessing there are a lot fewer whiners with chronic back pain in rural areas than in the cities.

I think the best option for you if you're an otherwise competitive applicant is to take a year of research near where you want to practice, make some connections and reapply ophtho. It's tougher to get in the second time but it's been done successfully.

 

[Katheudontas parateroumen]

Pain is really the only option for anesthesia to make their own practice. You could go off the beaten path and do hospice/palliative, sleep, addiction but I’m sure that’s way less common than the other traditional specialities that go into those. To do anesthesia though for your sake, I think you actually have to like the field to say it bluntly. It may seem people just jump ship into anesthesia all the time but it’s a field of many flaws as you have already noted. Personally, I would try matching into a good prelim medicine program and then just reapply optho. I’ve seen it done a few times successfully.

 

[GassYous]

Pain is really the only option for anesthesia to make their own practice. You could go off the beaten path and do hospice/palliative, sleep, addiction but I’m sure that’s way less common than the other traditional specialities that go into those. To do anesthesia though for your sake, I think you actually have to like the field to say it bluntly. It may seem people just jump ship into anesthesia all the time but it’s a field of many flaws as you have already noted. Personally, I would try matching into a good prelim medicine program and then just reapply optho. I’ve seen it done a few times successfully.

Or surgery although that's much worse

 

[abolt18]

I won't address any of your questions. I'm sorry you're in this situation. No doubt it's disheartening.

I'll only say that ophtho was what made me pursue med school. I loved many things in the OR but have a family and had no desire to go through all the brutalities of surgical residencies. Ultimately, I ended up narrowing my selection down to either ophtho or anesthesia. I hated clinic and decided anesthesia was a better overall fit for me. I have never regretted it. I love what I do. I find great satisfaction in it every day.

 

[abolt18]

Something to consider: It's unlikely they'll have Anesthesia spots in the SOAP. Last year they had a grand total of 2 spots

Might wanna have a backup plan if Anesthesia is your goal

I disagree. I suspect there will be way more spots this year because a lot of the stellar applicants took 20+ interviews. They didn't have to travel do they just kept doing more interviews instead of cancelling them like they would normally. I know our program interviewed ~10% more people than usual this year, but I can only imagine that because people hoarded interviews more, less stellar applicants are going to have a lot of soap opportunities. This is only speculation.

 

[dabears505]

Sorry to hear that man. As far as flexibility, you can find day hour jobs, but the pay is honestly like family practice. Otherwise call taking jobs can be brutal. Why not do IM and try for cards or gi?

 

[IMGASMD]

Hello all,

I'm an MS4 who was hoping to go into ophtho until our match kicked me on my ass this week and it was suggested to me that I consider another field. As such, I'm considering trying to SOAP into another field if I can get my **** together in time and figure out what else I would want to do with my life with enough certainty to take the plunge. I never really considered anesthesia all that much previously, to be completely honest. I always loved the OR, and always assumed I would be a surgeon of some sort, but found the more that I looked into different surgical subspecialties that I wasn't going to want to make a career in such brutal fields, in terms of either lifestyle or the other crap they have to deal with as an integral part of the job (not a big fan of rounding, managing your own inpatients, etc). Now that ophtho, the one surgical specialty which really clicked with me, may be completely out of the picture, I find myself wondering about anesthesia.

However, there is one thing that concerns me: the ability to have flexibility in where and how I might want to practice. Obviously in gas, you're practicing only when and where someone else is in need of your services, and there's no such thing (to my knowledge) as hanging up your own shingle, which is what I was planning to do in ophtho. I'm from a pretty rural background, and would want to go back there to be closer to family. There are a few hospitals out there, but not many, and who knows how those few jobs would be. I guess what I'm getting at is that I don't know what other options are out there for you guys. I'd imagine it's feasible to make a good living working at an ASC, but could something like dental anesthesia be a full time gig? Are there any good office/clinic-based jobs available through anesthesia, either as a primary provider (I think pain is an option here, if I'm not mistaken?) or doing quick sedations or procedures for another primary provider? I'm just hesitant to enter a field that typically is so inextricably linked with the hospital, when I'm trying to get back to a specific, rural area.

What other issues do you think are important to consider before entering the field? How much do things like the rise of CRNAs threaten job security - or on the flipside, do they allow you to hire and manage midlevels and make some profit off of them? Are there any other issues specific to anesthesia that could really threaten its future (huge, imminent reimbursement cuts; PE taking over all the PP jobs, etc)? I know you have to be humble as an anesthesiologist, as a lot of surgeons can be ***holes to anesthesia, and I think a lot of patients don't understand your value as a physician either - are there any other interpersonal things inherent to the job that I should be thinking about?

I know this is an extremely broad question, but if anyone can speak to these issues, and any other thoughts on the field that you think I should be thinking about, I would greatly appreciate it! I have been looking around on the forums a bit, but haven't gotten a great sense for a lot of these issues. Unfortunately there's limited time before the SOAP, and I'm scrambling in 15 different directions trying to figure out what I'm doing with my life, so I'm trying to gather as much information as I can as quickly as I can.

Sounds like you really have your heart set in ophtho? Are you you totally out of it? Even if you take a research year? How about a prelim surgical year? I assume your step scores are good enough for ophtho, therefore good enough for scramble into anesthesia.

Few things. 1. Most people don’t like people refer to anesthesia as gas. Just if I refer to ophtho as eyes. Or stomach, or bladder. (Yes you may call me a hypocrite, but I am already in..... you’re not)
2. Choose something you like, I feel miserable after reading your post. I really don’t want you as a colleague, when it’s obvious your heart is not in it. I have a feeling you never investigated nor thought about applying to the field before today.
3. There are many jobs, whether you like them or not, no one knows. As people like to say, location, money, lifestyle. Pick 2. Sounds like you already have two picked out.

Stick to ophtho for another year, if you were not over-reaching. If you were and didn’t have a back-up, then you’re a fool.

Good luck.

 

[vector2]

Hello all,

I'm an MS4 who was hoping to go into ophtho until our match kicked me on my ass this week and it was suggested to me that I consider another field. As such, I'm considering trying to SOAP into another field if I can get my **** together in time and figure out what else I would want to do with my life with enough certainty to take the plunge. I never really considered anesthesia all that much previously, to be completely honest. I always loved the OR, and always assumed I would be a surgeon of some sort, but found the more that I looked into different surgical subspecialties that I wasn't going to want to make a career in such brutal fields, in terms of either lifestyle or the other crap they have to deal with as an integral part of the job (not a big fan of rounding, managing your own inpatients, etc). Now that ophtho, the one surgical specialty which really clicked with me, may be completely out of the picture, I find myself wondering about anesthesia.

However, there is one thing that concerns me: the ability to have flexibility in where and how I might want to practice. Obviously in gas, you're practicing only when and where someone else is in need of your services, and there's no such thing (to my knowledge) as hanging up your own shingle, which is what I was planning to do in ophtho. I'm from a pretty rural background, and would want to go back there to be closer to family. There are a few hospitals out there, but not many, and who knows how those few jobs would be. I guess what I'm getting at is that I don't know what other options are out there for you guys. I'd imagine it's feasible to make a good living working at an ASC, but could something like dental anesthesia be a full time gig? Are there any good office/clinic-based jobs available through anesthesia, either as a primary provider (I think pain is an option here, if I'm not mistaken?) or doing quick sedations or procedures for another primary provider? I'm just hesitant to enter a field that typically is so inextricably linked with the hospital, when I'm trying to get back to a specific, rural area.

What other issues do you think are important to consider before entering the field? How much do things like the rise of CRNAs threaten job security - or on the flipside, do they allow you to hire and manage midlevels and make some profit off of them? Are there any other issues specific to anesthesia that could really threaten its future (huge, imminent reimbursement cuts; PE taking over all the PP jobs, etc)? I know you have to be humble as an anesthesiologist, as a lot of surgeons can be ***holes to anesthesia, and I think a lot of patients don't understand your value as a physician either - are there any other interpersonal things inherent to the job that I should be thinking about?

I know this is an extremely broad question, but if anyone can speak to these issues, and any other thoughts on the field that you think I should be thinking about, I would greatly appreciate it! I have been looking around on the forums a bit, but haven't gotten a great sense for a lot of these issues. Unfortunately there's limited time before the SOAP, and I'm scrambling in 15 different directions trying to figure out what I'm doing with my life, so I'm trying to gather as much information as I can as quickly as I can.

Do a prelim surg year. Apply again to ophtho. You are not going to be happy in anesthesia, especially if your goal is to move back to a small town rural area and hang up your own shingle.

 

[Eye-eye]

Sorry to hear that man. As far as flexibility, you can find day hour jobs, but the pay is honestly like family practice. Otherwise call taking jobs can be brutal. Why not do IM and try for cards or gi?

Thank you for the information. Unfortunately, I really did not like IM. Rounding all day is not my idea of a good time. I am considering other specialties, too - just trying to get a sense for some of the concerns I had about anesthesia, and scope out if it could be a potential path for me or not.

 

[Eye-eye]

Sounds like you really have your heart set in ophtho? Are you you totally out of it? Even if you take a research year? How about a prelim surgical year? I assume your step scores are good enough for ophtho, therefore good enough for scramble into anesthesia.

Few things. 1. Most people don’t like people refer to anesthesia as gas. Just if I refer to ophtho as eyes. Or stomach, or bladder. (Yes you may call me a hypocrite, but I am already in..... you’re not)
2. Choose something you like, I feel miserable after reading your post. I really don’t want you as a colleague, when it’s obvious your heart is not in it. I have a feeling you never investigated nor thought about applying to the field before today.
3. There are many jobs, whether you like them or not, no one knows. As people like to say, location, money, lifestyle. Pick 2. Sounds like you already have two picked out.

Stick to ophtho for another year, if you were not over-reaching. If you were and didn’t have a back-up, then you’re a fool.

Good luck.

You're not wrong, I really didn't consider anesthesia much before this week, as I stated in my original post. I do have my heart set on ophtho, but for many reasons I won't go into here (unless y'all want me to, in which case I can), it sounds like my chances are pretty slim unless I get into a good research fellowship - which I'm trying for, but which are also quite competitive. Barring that, it sounds like a normal research year would at best give me a better shot at that institution, and certainly a pgy1 is unlikely to help.

1. My apologies. I did not realize "gas" was pejorative, and will not use the term in the future.
2. I hear you. I'd also love to go into a field I love. But when that field says "**** you, find something else," then I'm going to look hard for something I could still enjoy that will provide well for my family. I'm still trying for ophtho, but unless the stars align just right, the chances look fairly slim, despite me having had pretty good chances this year (per the match data and multiple PDs).
3. Yeah, I guess that's what I'm trying to figure out, if I can't do what I really love.

Thanks for the comments (both you and everyone who has been posting here - sorry for not replying to you all individually)!

 

[IMGASMD]

(per the match data and multiple PDs).

Can you ask those PDs why they didn’t rank you? Also home institution, couldn’t get you a spot for this year or next year?

I hope you’ve already done those things for your own sake.

Anesthesia is a great field with all the great reasons you’ve already listed. No round, no clinic, at least for most people who don’t do pain. You’re close to physiology than a lot of other fields. There are fellowships that will enable you to do certain things better, cardiac, peds, pain, critical care.

Bad parts, you’ve already mentioned as well. Second fiddle, crnas, respect, to certain extent, “inflexibility” of your schedule. If you’re at a ASC, your surgeon runs late, guess what? You’re stuck. If you’re coming off an overnight call, at the last minute a trauma comes in.... and none of your colleagues/partners want to get their hands dirty in the sh!+show. It’s your patient now. Certainly there’s lots of local differences, but in general, everyone respect their own schedules more than yours.

I don’t practice in a rural area, so I can’t really comment. But look into “opt-out” states. If your home is in one of those states, there is a possibility your home town may even have crna run practices, you may not be welcomed. Someone also mentioned you can be part time, or non call taker? Your rate will average out to be maybe little more than $130/hr. If you were expecting getting $600-800/cataract, my friend, you’re certainly in for an rude awakening.

You sounded crushed. I really don’t think it’s the “right” time for you to think of a back up field. I maintain my original post. I think you should pursue your dream, as long as it was a realistic one. Do a year in research/lab rat/kiss ass/whatever to get in. You can think of your back up field during that year.

Good luck.

 

[Eye-eye]

Can you ask those PDs why they didn’t rank you? Also home institution, couldn’t get you a spot for this year or next year?

I hope you’ve already done those things for your own sake.

Anesthesia is a great field with all the great reasons you’ve already listed. No round, no clinic, at least for most people who don’t do pain. You’re close to physiology than a lot of other fields. There are fellowships that will enable you to do certain things better, cardiac, peds, pain, critical care.

Bad parts, you’ve already mentioned as well. Second fiddle, crnas, respect, to certain extent, “inflexibility” of your schedule. If you’re at a ASC, your surgeon runs late, guess what? You’re stuck. If you’re coming off an overnight call, at the last minute a trauma comes in.... and none of your colleagues/partners want to get their hands dirty in the sh!+show. It’s your patient now. Certainly there’s lots of local differences, but in general, everyone respect their own schedules more than yours.

I don’t practice in a rural area, so I can’t really comment. But look into “opt-out” states. If your home is in one of those states, there is a possibility your home town may even have crna run practices, you may not be welcomed. Someone also mentioned you can be part time, or non call taker? Your rate will average out to be maybe little more than $130/hr. If you were expecting getting $600-800/cataract, my friend, you’re certainly in for an rude awakening.

You sounded crushed. I really don’t think it’s the “right” time for you to think of a back up field. I maintain my original post. I think you should pursue your dream, as long as it was a realistic one. Do a year in research/lab rat/kiss ass/whatever to get in. You can think of your back up field during that year.

Good luck.

I did ask them, and they pretty much all said my scores were slightly lower because it was stiff competition, but I was ranked to match still in a normal year, and they were surprised I didn't match. But at least one said bluntly he just doesn't interview people they've interviewed before, and when I posed the question to other PDs, they suddenly dropped out of the conversation - and my PD confirmed that it's fairly common practice not to interview anyone twice, with so many other qualified applicants to choose from. Since most of my interviews were regional, having all these programs unwilling to interview me next year (except my home program) would be a big hit. Thus I could do a research year at home, but it would probably only give me a real shot at home. I'm really hoping for one of the fellowships, but don't really dare hope.

I am absolutely crushed. Cynical. Defeated. So you're right, probably the worst time to make this decision. Also don't want to waste yet another year. Might be worth it to take the time in order to make a better decision, but I doubt there's a ton of leeway in a research position to go do clinical electives to help figure **** out. I don't know... about a lot of things right now, to be honest.

Sorry to waste you guys' time. I appreciate the honest comments.

 

[Consigliere]

Do anything BUT anesthesia - you'll thank me later.

 

[abolt18]

I did ask them, and they pretty much all said my scores were slightly lower because it was stiff competition, but I was ranked to match still in a normal year, and they were surprised I didn't match. But at least one said bluntly he just doesn't interview people they've interviewed before, and when I posed the question to other PDs, they suddenly dropped out of the conversation - and my PD confirmed that it's fairly common practice not to interview anyone twice, with so many other qualified applicants to choose from. Since most of my interviews were regional, having all these programs unwilling to interview me next year (except my home program) would be a big hit. Thus I could do a research year at home, but it would probably only give me a real shot at home. I'm really hoping for one of the fellowships, but don't really dare hope.

I am absolutely crushed. Cynical. Defeated. So you're right, probably the worst time to make this decision. Also don't want to waste yet another year. Might be worth it to take the time in order to make a better decision, but I doubt there's a ton of leeway in a research position to go do clinical electives to help figure **** out. I don't know... about a lot of things right now, to be honest.

Sorry to waste you guys' time. I appreciate the honest comments.

Countless people have failed to match into their surgical subspecialty and subsequently become an excellent anesthesiologist.

Best of luck with the upcoming decisions. Not easy. Obviously very defeating. But all in all, you'll be alright. Keep your head up and talk to some of the people closest to you to work through this. They can often lend some very good insight and advice.

 

[YCAGA]

Can you ask those PDs why they didn’t rank you? Also home institution, couldn’t get you a spot for this year or next year?

I hope you’ve already done those things for your own sake.

Anesthesia is a great field with all the great reasons you’ve already listed. No round, no clinic, at least for most people who don’t do pain. You’re close to physiology than a lot of other fields. There are fellowships that will enable you to do certain things better, cardiac, peds, pain, critical care.

Bad parts, you’ve already mentioned as well. Second fiddle, crnas, respect, to certain extent, “inflexibility” of your schedule. If you’re at a ASC, your surgeon runs late, guess what? You’re stuck. If you’re coming off an overnight call, at the last minute a trauma comes in.... and none of your colleagues/partners want to get their hands dirty in the sh!+show. It’s your patient now. Certainly there’s lots of local differences, but in general, everyone respect their own schedules more than yours.

I don’t practice in a rural area, so I can’t really comment. But look into “opt-out” states. If your home is in one of those states, there is a possibility your home town may even have crna run practices, you may not be welcomed. Someone also mentioned you can be part time, or non call taker? Your rate will average out to be maybe little more than $130/hr. If you were expecting getting $600-800/cataract, my friend, you’re certainly in for an rude awakening.

You sounded crushed. I really don’t think it’s the “right” time for you to think of a back up field. I maintain my original post. I think you should pursue your dream, as long as it was a realistic one. Do a year in research/lab rat/kiss ass/whatever to get in. You can think of your back up field during that year.

Good luck.

Do you mind elaborating why you will make $130/hr if want to work part time in anesthesia? From MGMA data, 50hrs/week and 6 weeks vacation, anesthesia seems to pay $200/hr at the median. Are part-timers that useless to a practice that a FT anesthesiologist makes 50% more per hour than someone part-time? I can understand why not taking call means a big hit to your salary, but I don’t see any reason why you can’t take call and also work time. Hell, I would probably be happy taking full-time call burden if it mean I could work part-time otherwise.

 

[IMGASMD]

Do you mind elaborating why you will make $130/hr if want to work part time in anesthesia? From MGMA data, 50hrs/week and 6 weeks vacation, anesthesia seems to pay $200/hr at the median. Are part-timers that useless to a practice that a FT anesthesiologist makes 50% more per hour than someone part-time? I can understand why not taking call means a big hit to your salary, but I don’t see any reason why you can’t take call and also work time. Hell, I would probably be happy taking full-time call burden if it mean I could work part-time otherwise.

How far are you in your training?

Don’t matter.
Anesthesiologist “historically” is paid by cases they do, and only generate money when they’re working. They are being paid by “units”. So an abdominal surgery can be 4 units then you also get time units at 15 min increments.
So a “simple” hernia repair for an hour is worth 8 units.
You get to negotiate your unit value with insurance company. Range from $60-120/unit roughly.

Great I just established my rate at $500/hr!
What if that’s the only case for you that day?
What if your next patient doesn’t have insurance.... and under going a ex-lap for the next 4 hours? How would you establish your rate or how much did you get paid for your 5 hour day?

You have overheads that day too, don’t forget. Your billing company takes 3-10% of what they collect.

So here comes the partnership/pooled units model. 5 of us work in the same area, covering the same hospital. We will take turns to take calls/vacations. We will share the overhead, hits from Medicaid/Medicare. In this model, still more you work, more you get. Higher risk cases come with higher rewards.

So how do I arrived at $130/hr part time/day doc position? You’re a salaried doctor in my practice. I pay you 275K a year, nah, I like you. 300K a year. But since you’re part time/associate/day doc, I don’t really pay you for your lunch. So you’re actually in the hospital for 45hr/week. You’re also not a full partner, you only get 4 weeks vacation to start. You earn one week per two years of service. With 7 as maximum. Lastly, since my company only pay for your health insurance, you have family? Sure I will deduct some for providing your family health insurance. Oh, since you’re salaried, can’t you just stay to finish this case? The other partner have a dental appointment and have to leave.

Sure a lot of these things may not happen to you, if the group is good/equal/democratic, but those qualities aren’t a “right” when you’re looking for a job.

Don’t get me started on AMCs.

MGMA is also a survey, that’s filled out by different people who may or may not have their own agenda when they present you “data”.

 

[ItBurnsInMyHand]

Ha. I’d say this is pretty accurate from my experience as a non-partner not taking call. Unless it’s a uniquely busy day, or things don’t wrap up by 4-5, I’m basically their late person.

 

[deleted126335]

Do you mind elaborating why you will make $130/hr if want to work part time in anesthesia? From MGMA data, 50hrs/week and 6 weeks vacation, anesthesia seems to pay $200/hr at the median. Are part-timers that useless to a practice that a FT anesthesiologist makes 50% more per hour than someone part-time? I can understand why not taking call means a big hit to your salary, but I don’t see any reason why you can’t take call and also work time. Hell, I would probably be happy taking full-time call burden if it mean I could work part-time otherwise.

Night/weekend time is paid a significant premium. Although there are exceptions, M-F no call slots are the traditional way one works part time in this field. Part time positions with call do exist. But usually after one has worked with the same group for a long time and is winding down their career. Hiring a newbie for a call position but less than full time is uncommon.

You can make better money and take call as a locum tenens, but frequent travel is involved.

 

[YCAGA]

How far are you in your training?

Don’t matter.
Anesthesiologist “historically” is paid by cases they do, and only generate money when they’re working. They are being paid by “units”. So an abdominal surgery can be 4 units then you also get time units at 15 min increments.
So a “simple” hernia repair for an hour is worth 8 units.
You get to negotiate your unit value with insurance company. Range from $60-120/unit roughly.

Great I just established my rate at $500/hr!
What if that’s the only case for you that day?
What if your next patient doesn’t have insurance.... and under going a ex-lap for the next 4 hours? How would you establish your rate or how much did you get paid for your 5 hour day?

You have overheads that day too, don’t forget. Your billing company takes 3-10% of what they collect.

So here comes the partnership/pooled units model. 5 of us work in the same area, covering the same hospital. We will take turns to take calls/vacations. We will share the overhead, hits from Medicaid/Medicare. In this model, still more you work, more you get. Higher risk cases come with higher rewards.

So how do I arrived at $130/hr part time/day doc position? You’re a salaried doctor in my practice. I pay you 275K a year, nah, I like you. 300K a year. But since you’re part time/associate/day doc, I don’t really pay you for your lunch. So you’re actually in the hospital for 45hr/week. You’re also not a full partner, you only get 4 weeks vacation to start. You earn one week per two years of service. With 7 as maximum. Lastly, since my company only pay for your health insurance, you have family? Sure I will deduct some for providing your family health insurance. Oh, since you’re salaried, can’t you just stay to finish this case? The other partner have a dental appointment and have to leave.

Sure a lot of these things may not happen to you, if the group is good/equal/democratic, but those qualities aren’t a “right” when you’re looking for a job.

Don’t get me started on AMCs.

MGMA is also a survey, that’s filled out by different people who may or may not have their own agenda when they present you “data”.

I’m a med student.

I’m confused though, someone is part-time but in the hospital 45hrs/week? If you’re saying that’s what ends happening when you try to go part-time then that’s a pretty silly example because at that point only an idiot would not either 1) go back to “full time” of 50hrs/week and much higher pay or 2) find a new job.

Also MGMA is the best data we have and is what many recruiters use to negotiate pay, so it’s in many people’s best interest for it to not be inflated. If it was seriously inflated, no one would use it.

 

[GassYous]

How far are you in your training?

Don’t matter.
Anesthesiologist “historically” is paid by cases they do, and only generate money when they’re working. They are being paid by “units”. So an abdominal surgery can be 4 units then you also get time units at 15 min increments.
So a “simple” hernia repair for an hour is worth 8 units.
You get to negotiate your unit value with insurance company. Range from $60-120/unit roughly.

Great I just established my rate at $500/hr!
What if that’s the only case for you that day?
What if your next patient doesn’t have insurance.... and under going a ex-lap for the next 4 hours? How would you establish your rate or how much did you get paid for your 5 hour day?

You have overheads that day too, don’t forget. Your billing company takes 3-10% of what they collect.

So here comes the partnership/pooled units model. 5 of us work in the same area, covering the same hospital. We will take turns to take calls/vacations. We will share the overhead, hits from Medicaid/Medicare. In this model, still more you work, more you get. Higher risk cases come with higher rewards.

So how do I arrived at $130/hr part time/day doc position? You’re a salaried doctor in my practice. I pay you 275K a year, nah, I like you. 300K a year. But since you’re part time/associate/day doc, I don’t really pay you for your lunch. So you’re actually in the hospital for 45hr/week. You’re also not a full partner, you only get 4 weeks vacation to start. You earn one week per two years of service. With 7 as maximum. Lastly, since my company only pay for your health insurance, you have family? Sure I will deduct some for providing your family health insurance. Oh, since you’re salaried, can’t you just stay to finish this case? The other partner have a dental appointment and have to leave.

Sure a lot of these things may not happen to you, if the group is good/equal/democratic, but those qualities aren’t a “right” when you’re looking for a job.

Don’t get me started on AMCs.

MGMA is also a survey, that’s filled out by different people who may or may not have their own agenda when they present you “data”.

Wow that is horrible.

 

[YCAGA]

Night/weekend time is paid a significant premium. Although there are exceptions, M-F no call slots are the traditional way one works part time in this field. Part time positions with call do exist. But usually after one has worked with the same group for a long time and is winding down their career. Hiring a newbie for a call position but less than full time is uncommon.

You can make better money and take call as a locum tenens, but frequent travel is involved.

Gotcha. Thanks for the reply. Good to know that anesthesia isn’t as part-time friendly as many medical student tout it to be. Then again, the common line at my medical school (and I have read this online too), is that once you’re an attending “you can pretty much set up your schedule however you want.” Insert the anecdote of the general surgeon their uncle’s neighbor knew who worked 30hrs/week straight out of residency and made $700k/yr and that’s basically when I stop listening. I wish the dynamics of other partners, administration, market forces, etc just magically went away when we became attendings like many medical students/residents think.

 

[IMGASMD]

I’m a med student.

I’m confused though, someone is part-time but in the hospital 45hrs/week? If you’re saying that’s what ends happening when you try to go part-time then that’s a pretty silly example because at that point only an idiot would not either 1) go back to “full time” of 50hrs/week and much higher pay or 2) find a new job.

Also MGMA is the best data we have and is what many recruiters use to negotiate pay, so it’s in many people’s best interest for it to not be inflated. If it was seriously inflated, no one would use it.

Who are you working for? A private group? Hospital? AMC?

What’s your definition of part time?
Are you salaried full time? Are you a day-doc? Are you pre-diem rate doctor? Are you a crna and gets paid overtime when you’re over 40 hours?

I’d like to challenge YOU, young grasshopper, to find me an anesthesiologist who is true “part-time” whatever your definition is, make consistently over $200/hr. With no call, 6 weeks of vacation.

Location, money, lifestyle. Pick two. When you’re little older with a family, you’d understand “idiotic” thinking of not want to move for the nth time to find a better job.

Sure I use mgma to judge a job too. I am only saying use it as a tool and with a grain of salt. Not the holy book it may be. There’s a lot of things mgma don’t account for. Are you supervising 1:4, 1:8? Do you get your post call day off? Do you get your pre-call day off? What’s their definition of working full time? Do you weight someone who work 80hrs the same as someone who work 45hrs? Do you pay for your insurance? Do they match your 401k? Do they pay you as 1099?

You’re right. Most anesthesiologists make on average $200/hr.

 

[deleted162650]

is that once you’re an attending “you can pretty much set up your schedule however you want.”

That’s still very true, just realize that you are going to take a big income hit to do it.

The other aspect with Anes is that my daily schedule is very much at the mercy of the OR schedule. I can’t just decide to come in at 1000 every Wednesday like a surgeon or PCP could. On the flip side, I don’t have an office with its associated staffing and overhead to worry about.

Although, my daily schedule isn’t that flexible, my vacation time is. I can take off just about whenever I want so long as my requests are in well in advance.

 

[IMGASMD]

Wow that is horrible.

Dude. It’ll be okay. It’s not the yesteryear of anesthesia boom. it’s certainly a much better field than some.

There are good democratic equal groups out there. Just have to find them. But now I’ve set your expectations so low, maybe Napa/Mednax/Envision/Death Star(I mean the other one)/usap don’t sound so bad anymore?

 

[YCAGA]

Who are you working for? A private group? Hospital? AMC?

What’s your definition of part time?
Are you salaried full time? Are you a day-doc? Are you pre-diem rate doctor? Are you a crna and gets paid overtime when you’re over 40 hours?

I’d like to challenge YOU, young grasshopper, to find me an anesthesiologist who is true “part-time” whatever your definition is, make consistently over $200/hr. With no call, 6 weeks of vacation.

Location, money, lifestyle. Pick two. When you’re little older with a family, you’d understand “idiotic” thinking of not want to move for the nth time to find a better job.

Sure I use mgma to judge a job too. I am only saying use it as a tool and with a grain of salt. Not the holy book it may be. There’s a lot of things mgma don’t account for. Are you supervising 1:4, 1:8? Do you get your post call day off? Do you get your pre-call day off? What’s their definition of working full time? Do you weight someone who work 80hrs the same as someone who work 45hrs? Do you pay for your insurance? Do they match your 401k? Do they pay you as 1099?

You’re right. Most anesthesiologists make on average $200/hr.

I will happily admit that I am a naive young grasshopper. But with that being said, I don’t think anyone’s definition of part-time is 45hrs/week. The most conservative definition of part-time is under 40hrs/week. When most people say part time (in my experience) they are thinking of 20-30hrs/week and/or 2-4 days a week.

Also I didn’t say I could find an anesthesiologist working part time with no call who makes $200/hr. That’s a straw man argument. I said $130/hr for part-time work, especially if you still are willing to take call, seems like hyperbole* since FT with call makes about $200/hr.

*seems like hyperbole to someone who knows much less about the field than you all do. That’s why I was curious if there is some mysterious reason for such a huge pay cut.

 

[YCAGA]

That’s still very true, just realize that you are going to take a big income hit to do it.

The other aspect with Anes is that my daily schedule is very much at the mercy of the OR schedule. I can’t just decide to come in at 1000 every Wednesday like a surgeon or PCP could. On the flip side, I don’t have an office with its associated staffing and overhead to worry about.

Although, my daily schedule isn’t that flexible, my vacation time is. I can take off just about whenever I want so long as my requests are in well in advance.

Fair point, but the counter point is would any practice/hospital want to hire a surgeon who comes in at 10am on once a week or only works 35hrs/week? Seems like a hard sell if your partners are working much more than that a week. Maybe if they are desperate and you promise to take a big pay-cut like you said.

 

[deleted126335]

I will happily admit that I am a naive young grasshopper. But with that being said, I don’t think anyone’s definition of part-time is 45hrs/week. The most conservative definition of part-time is under 40hrs/week. When most people say part time (in my experience) they are thinking of 20-30hrs/week and/or 2-4 days a week.

Also I didn’t say I could find an anesthesiologist working part time with no call who makes $200/hr. That’s a straw man argument. I said $130/hr for part-time work, especially if you still are willing to take call, seems like hyperbole* since FT with call makes about $200/hr.

*seems like hyperbole to someone who knows much less about the field than you all do. That’s why I was curious if there is some mysterious reason for such a huge pay cut.

"Part time" in anesthesia often means long hour weeks (40-50+), but fewer weeks working.

the 2-4 days/week or fewer hours per day is often a burden for the group to accommodate, so is uncommon.

 

[YCAGA]

"Part time" in anesthesia often means long hour weeks (40-50+), but fewer weeks working.

the 2-4 days/week or fewer hours per day is often a burden for the group to accommodate, so is uncommon.

That makes a lot of sense. So basically FT hours for your “on” weeks but more vacation so over the course of a year your total hours worked averages out to be part-time?

For many hobbies that honestly works out better to have full days off, instead of an extra few hours each day. Stuff like aviation, overnight backpacking, travel.

 

[deleted697127]

Hello all,

I'm an MS4 who was hoping to go into ophtho until our match kicked me on my ass this week and it was suggested to me that I consider another field. As such, I'm considering trying to SOAP into another field if I can get my **** together in time and figure out what else I would want to do with my life with enough certainty to take the plunge. I never really considered anesthesia all that much previously, to be completely honest. I always loved the OR, and always assumed I would be a surgeon of some sort, but found the more that I looked into different surgical subspecialties that I wasn't going to want to make a career in such brutal fields, in terms of either lifestyle or the other crap they have to deal with as an integral part of the job (not a big fan of rounding, managing your own inpatients, etc). Now that ophtho, the one surgical specialty which really clicked with me, may be completely out of the picture, I find myself wondering about anesthesia.

However, there is one thing that concerns me: the ability to have flexibility in where and how I might want to practice. Obviously in gas, you're practicing only when and where someone else is in need of your services, and there's no such thing (to my knowledge) as hanging up your own shingle, which is what I was planning to do in ophtho. I'm from a pretty rural background, and would want to go back there to be closer to family. There are a few hospitals out there, but not many, and who knows how those few jobs would be. I guess what I'm getting at is that I don't know what other options are out there for you guys. I'd imagine it's feasible to make a good living working at an ASC, but could something like dental anesthesia be a full time gig? Are there any good office/clinic-based jobs available through anesthesia, either as a primary provider (I think pain is an option here, if I'm not mistaken?) or doing quick sedations or procedures for another primary provider? I'm just hesitant to enter a field that typically is so inextricably linked with the hospital, when I'm trying to get back to a specific, rural area.

What other issues do you think are important to consider before entering the field? How much do things like the rise of CRNAs threaten job security - or on the flipside, do they allow you to hire and manage midlevels and make some profit off of them? Are there any other issues specific to anesthesia that could really threaten its future (huge, imminent reimbursement cuts; PE taking over all the PP jobs, etc)? I know you have to be humble as an anesthesiologist, as a lot of surgeons can be ***holes to anesthesia, and I think a lot of patients don't understand your value as a physician either - are there any other interpersonal things inherent to the job that I should be thinking about?

I know this is an extremely broad question, but if anyone can speak to these issues, and any other thoughts on the field that you think I should be thinking about, I would greatly appreciate it! I have been looking around on the forums a bit, but haven't gotten a great sense for a lot of these issues. Unfortunately there's limited time before the SOAP, and I'm scrambling in 15 different directions trying to figure out what I'm doing with my life, so I'm trying to gather as much information as I can as quickly as I can.

If you went straight from undergrad to med school, realize many people did not, myself included. Feel free to slow the F down and figure out exactly what you want to do. People get so caught up in the opportunity cost of delaying one year like it’s the end of the world.

I have friends that knew they wanted ortho, derm, urology, and even plastics, that found a way to make it happen. Some did prelim medicine and some research gap years. If you do prelim medicine and reapply, at least for anesthesia you will be applying for advanced, categorical, or R (reserved) positions. Advanced would have a gap year before anesthesia training, categorical would repeat intern year, and R would be from prelim directly into anesthesia training. There are very few R positions. If you applied optho, you are likely competitive for most categorical programs. R may be more difficult by the sheer low number of slots available.

It is likely much easier to have time to interview if you do a gap year. Time off from intern year to interview at 10 places can be challenging. Maybe not being an intern during COVID wouldnt be the worst?

No approach is right or wrong. Go see your dean of students and discuss options. No matter what route you take, if you work hard, you will likely be able to find people to help you get where you want to be.

 

[Eye-eye]

If you went straight from undergrad to med school, realize many people did not, myself included. Feel free to slow the F down and figure out exactly what you want to do. People get so caught up in the opportunity cost of delaying one year like it’s the end of the world.

I have friends that knew they wanted ortho, derm, urology, and even plastics, that found a way to make it happen. Some did prelim medicine and some research gap years. If you do prelim medicine and reapply, at least for anesthesia you will be applying for advanced, categorical, or R (reserved) positions. Advanced would have a gap year before anesthesia training, categorical would repeat intern year, and R would be from prelim directly into anesthesia training. There are very few R positions. If you applied optho, you are likely competitive for most categorical programs. R may be more difficult by the sheer low number of slots available.

It is likely much easier to have time to interview if you do a gap year. Time off from intern year to interview at 10 places can be challenging. Maybe not being an intern during COVID wouldnt be the worst?

No approach is right or wrong. Go see your dean of students and discuss options. No matter what route you take, if you work hard, you will likely be able to find people to help you get where you want to be.

Yeah, I go back and forth on a near-daily basis. Low chance to get into the specialty I want for the rest of my life, or decent chance to SOAP into something else reasonable, but basically no chance of ever getting into what I really love if that happens? If I went straight through, I'd sure as hell retry next year, and maybe for another couple of cycles after that, until I got it. And while I'd love to say that I should do that no matter how old I am (and I'm not THAT old), it's hard to pull myself, my wife, and my kid through that when there are also real jobs out there that I could be using my degree for.

I dunno. I still have a little bit of time to decide. Just a terrifying decision.

 

[deleted697127]

How far are you in your training?

Don’t matter.
Anesthesiologist “historically” is paid by cases they do, and only generate money when they’re working. They are being paid by “units”. So an abdominal surgery can be 4 units then you also get time units at 15 min increments.
So a “simple” hernia repair for an hour is worth 8 units.
You get to negotiate your unit value with insurance company. Range from $60-120/unit roughly.

Great I just established my rate at $500/hr!
What if that’s the only case for you that day?
What if your next patient doesn’t have insurance.... and under going a ex-lap for the next 4 hours? How would you establish your rate or how much did you get paid for your 5 hour day?

You have overheads that day too, don’t forget. Your billing company takes 3-10% of what they collect.

So here comes the partnership/pooled units model. 5 of us work in the same area, covering the same hospital. We will take turns to take calls/vacations. We will share the overhead, hits from Medicaid/Medicare. In this model, still more you work, more you get. Higher risk cases come with higher rewards.

So how do I arrived at $130/hr part time/day doc position? You’re a salaried doctor in my practice. I pay you 275K a year, nah, I like you. 300K a year. But since you’re part time/associate/day doc, I don’t really pay you for your lunch. So you’re actually in the hospital for 45hr/week. You’re also not a full partner, you only get 4 weeks vacation to start. You earn one week per two years of service. With 7 as maximum. Lastly, since my company only pay for your health insurance, you have family? Sure I will deduct some for providing your family health insurance. Oh, since you’re salaried, can’t you just stay to finish this case? The other partner have a dental appointment and have to leave.

Sure a lot of these things may not happen to you, if the group is good/equal/democratic, but those qualities aren’t a “right” when you’re looking for a job.

Don’t get me started on AMCs.

MGMA is also a survey, that’s filled out by different people who may or may not have their own agenda when they present you “data”.

Disagree with bolded.

 

[Drwine]

I didn't match in ophthamology as a MS4 and I went to medical school with that goal in mind. Back in the day we could work in the ER after 1 year of post graduate training. I started working in the ER and reapplied unsuccessfully a second time. I had enjoyed anesthesia during my rotation and even did a second 4th year rotation in anesthesia. I then applied to anesthesiology and threw all of my energy in that direction and have no regrets as I near retirement. If I had a private practice in ophthamology it would be unlikely that I could go on 3 week ski trips. 😉

When it comes to residencies, there is no Carribbean or Guadalajara residencies so options are not quite the same as if you were rejected by American medical schools.

Eye-eye, If you want to discuss further please reach out to me. I feel your pain.

 

[IMGASMD]

Disagree with bolded.

Hahaha. Need to at least give the student something to look forward to, right? He’s already basically calling me out.

Also it sort of depends, if your pay is dependent on units. Crani does worth a few more base units than appy. And cardiac does generate more units.

 

[GassYous]

Dude. It’ll be okay. It’s not the yesteryear of anesthesia boom. it’s certainly a much better field than some.

There are good democratic equal groups out there. Just have to find them. But now I’ve set your expectations so low, maybe Napa/Mednax/Envision/Death Star(I mean the other one)/usap don’t sound so bad anymore?

My group is fine. PP MD only, relatively fair partnership. We can accommodate the part time person with basically any amount of vacation. And plenty of people willing to take all your call if you'd like.

 

[IMGASMD]

My group is fine. PP MD only, relatively fair partnership. We can accommodate the part time person with basically any amount of vacation. And plenty of people willing to take all your call if you'd like.

Where are you? I am welling to move...

 

[Splenda88]

I did not read the whole thread... Someone else might have mentioned it. Why isn't radiology an option?

 

[IMGASMD]

I did not read the whole thread... Someone else might have mentioned it. Why isn't radiology an option?

No one mentioned it. Because I think op, is still in love with his/her first love.

 

[Splenda88]

No one mentioned it. Because I think op, is still in love with his/her first love.

Well, sometimes you have to go with your 2nd best option.

 

[BLADEMDA]

Being a senior level attending my advice is to give your dream job/specialty one more chance. Unlike some of the others I think you should soap into a basic PGY-1 year like FP or IM. If you excel during your intern year you may have a lot more options. Then, go ahead and try for Optho or Anesthesia the following year.

Realistically, you need a job and a specialty even one that is your second or third choice. In the end, you need to put food on the table and use that medical degree. If you were single I could understand wasting a year or two. But, if you need to support your family then my advice is to be practical about things.

I get your desire to pursue the field of your choice but when life gives you lemons make lemonade. There are many excellent IM sub specialties to pick from if you decide to go that route instead.

 

[deleted697127]

Being a senior level attending my advice is to give your dream job/specialty one more chance. Unlike some of the others I think you should soap into a basic PGY-1 year like FP or IM. If you excel during your intern year you may have a lot more options. Then, go ahead and try for Optho or Anesthesia the following year.

Realistically, you need a job and a specialty even one that is your second or third choice. In the end, you need to put food on the table and use that medical degree. If you were single I could understand wasting a year or two. But, if you need to support your family then my advice is to be practical about things.

I get your desire to pursue the field of your choice but when life gives you lemons make lemonade. There are many excellent IM sub specialties to pick from if you decide to go that route instead.

Counter point: some of us graduate with 500k in loans at 7% interest. If you happen to be at half of this, then you’re already way ahead of us. Whatever decision will be fine. I’m not sure what sort of family support you have available to you. You were likely a competitive applicant in a weird application cycle. If you can land a transitional year or internal medicine prelim, that is probably your best option, but personally I probably wouldn’t sign up for a malignant surgery program. I’d rather sign up for military than do surgery...which is not a terrible idea.

 

[agolden1]

Hello all,

I'm an MS4 who was hoping to go into ophtho until our match kicked me on my ass this week and it was suggested to me that I consider another field. As such, I'm considering trying to SOAP into another field if I can get my **** together in time and figure out what else I would want to do with my life with enough certainty to take the plunge. I never really considered anesthesia all that much previously, to be completely honest. I always loved the OR, and always assumed I would be a surgeon of some sort, but found the more that I looked into different surgical subspecialties that I wasn't going to want to make a career in such brutal fields, in terms of either lifestyle or the other crap they have to deal with as an integral part of the job (not a big fan of rounding, managing your own inpatients, etc). Now that ophtho, the one surgical specialty which really clicked with me, may be completely out of the picture, I find myself wondering about anesthesia.

However, there is one thing that concerns me: the ability to have flexibility in where and how I might want to practice. Obviously in gas, you're practicing only when and where someone else is in need of your services, and there's no such thing (to my knowledge) as hanging up your own shingle, which is what I was planning to do in ophtho. I'm from a pretty rural background, and would want to go back there to be closer to family. There are a few hospitals out there, but not many, and who knows how those few jobs would be. I guess what I'm getting at is that I don't know what other options are out there for you guys. I'd imagine it's feasible to make a good living working at an ASC, but could something like dental anesthesia be a full time gig? Are there any good office/clinic-based jobs available through anesthesia, either as a primary provider (I think pain is an option here, if I'm not mistaken?) or doing quick sedations or procedures for another primary provider? I'm just hesitant to enter a field that typically is so inextricably linked with the hospital, when I'm trying to get back to a specific, rural area.

What other issues do you think are important to consider before entering the field? How much do things like the rise of CRNAs threaten job security - or on the flipside, do they allow you to hire and manage midlevels and make some profit off of them? Are there any other issues specific to anesthesia that could really threaten its future (huge, imminent reimbursement cuts; PE taking over all the PP jobs, etc)? I know you have to be humble as an anesthesiologist, as a lot of surgeons can be ***holes to anesthesia, and I think a lot of patients don't understand your value as a physician either - are there any other interpersonal things inherent to the job that I should be thinking about?

I know this is an extremely broad question, but if anyone can speak to these issues, and any other thoughts on the field that you think I should be thinking about, I would greatly appreciate it! I have been looking around on the forums a bit, but haven't gotten a great sense for a lot of these issues. Unfortunately there's limited time before the SOAP, and I'm scrambling in 15 different directions trying to figure out what I'm doing with my life, so I'm trying to gather as much information as I can as quickly as I can.

I PM'd you eye-eye

 

[YCAGA]

FYI to everyone telling OP to just take a year off and reapply ophtho, it is worth a shot but it is not great odds. The match rates for US allo grads (not seniors so people who took 1+ gap years) was 52%, 51%, and 63% the last 3 cycles. This includes people who did not apply as M4's, took a research year, then applied as first time applicants. This gives many in that 50/50 cohort an edge over OP. Not saying it is impossible for OP, but the whole "don't look at anesthesia when you still like ophtho" is a little unfair considering his/her chances at ophtho.

Source: https://059987482848-shared-prod.s3...thalmology+Residency+Match+Summary+Report.pdf

 

[GassYous]

Well 50% is better than 0% by going into a field you had no interest in.

 

[YCAGA]

Well 50% is better than 0% by going into a field you had no interest in.

Right...but not matching to something isn't really an option...so it is appropriate and, honestly, required to start looking into other fields if you don't match on your first try. You can't be picky when a medical degree without residency is pretty useless.

 

[abolt18]

FYI to everyone telling OP to just take a year off and reapply ophtho, it is worth a shot but it is not great odds. The match rates for US allo grads (not seniors so people who took 1+ gap years) was 52%, 51%, and 63% the last 3 cycles. This includes people who did not apply as M4's, took a research year, then applied as first time applicants. This gives many in that 50/50 cohort an edge over OP. Not saying it is impossible for OP, but the whole "don't look at anesthesia when you still like ophtho" is a little unfair considering his/her chances at ophtho.

Source: https://059987482848-shared-prod.s3...thalmology+Residency+Match+Summary+Report.pdf

Very important. I'll tell you that my program doesn't look too kindly upon people taking a year off.

 

[IMGASMD]

Very important. I'll tell you that my program doesn't look too kindly upon people taking a year off.

Right...but not matching to something isn't really an option...so it is appropriate and, honestly, required to start looking into other fields if you don't match on your first try. You can't be picky when a medical degree without residency is pretty useless.

To both of your points. Op did not have a back up until 2/5 and asked the possibility of scramble/soap into anesthesia.

@memdoctobe I don’t think he thought this through. I agree with @GassYous, he can be totally miserable if he didn’t try again, I don’t know. And certainly I will say I don’t like the feeling that my field is only someone’s second love.

Which leads to my second point @abolt18. I trained at a little community program, I never knew someone who has step scores of 250+ soap into one of the spots. I will not pretend to know how an academic program PD thinks. Will they be worried accepting someone who was all in for another field, now have to settle for anestheia, jump **** at some point?

Can only speculate.

As usual, good luck op. If only you bought GME at 10.... I kid I kid.

 

[Eye-eye]

Thank you all for your advice. I think I would hate myself if I didn't reapply ophtho next year. I'll very likely dual apply, but it'll give me time to make sure that I apply into the right thing, and to prepare myself better for the application. I appreciate all your candor.

 

[BLADEMDA]

Thank you all for your advice. I think I would hate myself if I didn't reapply ophtho next year. I'll very likely dual apply, but it'll give me time to make sure that I apply into the right thing, and to prepare myself better for the application. I appreciate all your candor.

You should try for a PGY-1 spot in the SOAP and dual apply next year. That means OPTHO plus Anesthesia or IM or EM. I am sorry if you can't have your dream job but sometimes that's the way it is. Realistically, you won't Match Optho and will Match one of those others. I highly encourage you to make use of your medical degree and complete a Residency even if that residency is Anesthesiology.

 

[Status Sciaticus]

looking at these posts..... who the hell is putting up shingles in the 21st century? Do yall also keep your patient contact in a Rolodex?