Career flexibility in anesthesia

[IMGASMD]

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?

I routinely assess patient saturation by looking at the color of their lips.
Red=good. Purple=probably good. Purplish blue=probably not so good. Blue... you get the idea.

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[Twiggidy]

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.

This is the correct answer. Do a prelim in either surgery or IM and just reapply. If you had your heart set on ophtho so much that you put yourself through the entire process you know you have somewhat of a feeling that it was the correct choice. Dual apply is also a good idea if you're worried. I dual applied many ages ago simply because I was undecided all the way up until Rank listing so I just let fate decide......and I was still a little undecided as an intern. Hell, when I'm stuck in a c-section at 3am after 10 years of practice, I still somewhat question my decision (Did I talk you out of anesthesia with that last sentence?)

 

[GassYous]

This is the correct answer. Do a prelim in either surgery or IM and just reapply. If you had your heart set on ophtho so much that you put yourself through the entire process you know you have somewhat of a feeling that it was the correct choice. Dual apply is also a good idea if you're worried. I dual applied many ages ago simply because I was undecided all the way up until Rank listing so I just let fate decide......and I was still a little undecided as an intern. Hell, when I'm stuck in a c-section at 3am after 10 years of practice, I still somewhat question my decision (Did I talk you out of anesthesia with that last sentence?)

Just find a job with no ob

 

[Twiggidy]

Just find a job with no ob

I think we could have a good discussion thread on that subject. OB coverage has its pros (mostly financial) and cons (mostly psychological). And then there’s the topic of “good” non OB covering jobs which most of us know don’t grow on trees

 

[IMGASMD]

I think we could have a good discussion thread on that subject. OB coverage has its pros (mostly financial) and cons (mostly psychological). And then there’s the topic of “good” non OB covering jobs which most of us know don’t grow on trees

I think there’s also some correlation between people who do cardiac and people who hate OB. I think you’d be hard pressed to find someone who “loves” OB.

 

[Twiggidy]

I think there’s also some correlation between people who do cardiac and people who hate OB. I think you’d be hard pressed to find someone who “loves” OB.

Agree....and if they claim the love OB the translation is they love the paycheck

 

[abolt18]

I think there’s also some correlation between people who do cardiac and people who hate OB. I think you’d be hard pressed to find someone who “loves” OB.

As a resident, I love OB. Who knows what it'll be like later on in my life. Can't lie, I just love sticking needles in people.

 

[YCAGA]

Agree....and if they claim the love OB the translation is they love the paycheck

Would you guys be able to put a number on jobs with OB vs non-OB coverage?

 

[deleted171991]

Would you guys be able to put a number on jobs with OB vs non-OB coverage?

Outside of academia, taking call means OB coverage, most of the time. In academia, it varies based on the local culture and volume.

And not taking call means loss of income everywhere. I would guess around 70% of the call-taking positions come with some OB. It's much more likely not to have trauma in a hospital than not to have OB.

The only non-academic place where you're guaranteed not to have OB coverage is a hospital with no OB floor. How many of those do you know?

 

[abolt18]

I know back home, the hospital by my house had 4 docs in the group that exclusively did OB, 24hr shifts. Same thing with the private hospital next to my training program. So there definitely places and groups where OB is almost a totally separate entity and you have to try hard to get into it.

 

[YCAGA]

Outside of academia, taking call means OB coverage, most of the time. And not taking call means loss of income everywhere. I would guess 70-80% of the call-taking positions come with some OB.

The only place where you're guaranteed not to have OB call is a hospital with no OB floor.

Gotcha, thanks for explaining. So most call is not going to be any other type of surgery besides OB c-sections and epidurals? Is call normally in-house for OB? I would imagine so considering the time sensitive nature of OB emergencies.

 

[YCAGA]

I know back home, the hospital by my house had 4 docs in the group that exclusively did OB, 24hr shifts. Same thing with the private hospital next to my training program. So there definitely places and groups where OB is almost a totally separate entity and you have to try hard to get into it.

Any idea what their schedule was like? I can't remember if it was in anesthesia but I saw a job posting recently for 24 on 24 off for 2 weeks and then 1 week off. Sounds brutal but maybe some people are down.

 

[IMGASMD]

I know back home, the hospital by my house had 4 docs in the group that exclusively did OB, 24hr shifts. Same thing with the private hospital next to my training program. So there definitely places and groups where OB is almost a totally separate entity and you have to try hard to get into it.

Where is home? I am sort of intrigued. Never seen a group with “exclusive” ob coverage where I am.
I am in the NE, tristate area.

 

[Twiggidy]

Gotcha, thanks for explaining. So most call is not going to be any other type of surgery besides OB c-sections and epidurals? Is call normally in-house for OB? I would imagine so considering the time sensitive nature of OB emergencies.

Depends on the practice. The are a handful of places that cover hospitals and only cover the OB. I know of one definitely where a separate group covers OB. Again, there's always money involved. As FFP stated, there are definitely a handful of practices where people make a good amount of money not taking any call but for the most part taking some sort of call (whether trauma, OB, etc) is where the salary bump occurs. As FFP also stated, in academics is where you can maybe find a way out of OB call coverage because departments are so big that you can sell off call or you specialize and take only cardiac call. As a side note, I'm finding it harder and harder to join an academic departments cardiac team.

 

[abolt18]

Any idea what their schedule was like? I can't remember if it was in anesthesia but I saw a job posting recently for 24 on 24 off for 2 weeks and then 1 week off. Sounds brutal but maybe some people are down.

That one was something like a Q4 24hr shift. So 3 days off, work a day, 3 days off, work a day. With the occasional moving around of shifts or coverage from the main group when someone took a day off.

 

[YCAGA]

That one was something like a Q4 24hr shift. So 3 days off, work a day, 3 days off, work a day. With the occasional moving around of shifts or coverage from the main group when someone took a day off.

That sounds pretty sweet if the pay and benefits were for full-time, since that is still about 2190 hours a year or 47hrs/week with 6 weeks vacation for a normal jobs. I would hope the rest of the group is willing to pay a premium for that service.

 

[abolt18]

That sounds pretty sweet if the pay and benefits were for full-time, since that is still about 2190 hours a year or 47hrs/week with 6 weeks vacation for a normal jobs. I would hope the rest of the group is willing to pay a premium for that service.

My (limited) understanding was that this was a very lucrative thing, as their billing was kept separate from the rest of the group and the hospital was relatively high volume OB with a lot of well-insured women.

 

[GassYous]

As a resident, I love OB. Who knows what it'll be like later on in my life. Can't lie, I just love sticking needles in people.

Yes but I don't want to be responsible for the baby's outcome for 18 years. Also these patients are relatively young and healthy so any bad outcome is horrible. Dealing with all the anti epidural and the doulas is a pain as well. Don't tell me that you won't accept an epidural under any circumstance and then call me at 3 am begging for pain relief with the father staring daggers at me right behind you. Hey dingus, you called me, I didn't call you.

 

[deleted162650]

As a side note, I'm finding it harder and harder to join an academic departments cardiac team.

Maybe stop providing references??

 

[Twiggidy]

Maybe stop providing references??

Or stop sending a photo with my CV 😎

 

[Twiggidy]

I will say OB is at it's best when there are 4 stable and satisfied blocks running and you can watch the entire Lord of the Rings trilogy during a shift. If it were ALWAYS like that you'd have people fighting to cover OB.....like literal fist fights.

 

[deleted171991]

I will say OB is at it's best when there are 4 stable and satisfied blocks running and you can watch the entire Lord of the Rings trilogy during a shift. If it were ALWAYS like that you'd have people fighting to cover OB.....like literal fist fights.

Let's not forget of the 30+% (more and more, every year) of deliveries that are C-sections. It's ridiculous.

 

[deleted171991]

Or stop sending a photo with my CV 😎

And change your name, like Ibram Henry Rogers did. Now he's a university professor. Who the heck would hire a Henry Rogers? 😛

 

[Twiggidy]

And change your name, like Ibram Henry Rogers did. Now he's a university professor. Who the heck would hire a Henry Rogers? 😛

Kendi X probably barely makes it past security for the interview lol

 

[GassYous]

Or stop sending a photo with my CV 😎

Have you tried being handsome

 

[pgg]

I think there’s also some correlation between people who do cardiac and people who hate OB. I think you’d be hard pressed to find someone who “loves” OB.

It's all about the practice environment.

OB in a military hospital is great. Everyone has insurance, everyone had prenatal care, almost everyone has a husband with a stable job that provides benefits, practically zero teenage pregnancies, practically zero drug use, and an incredibly favorable malpractice environment on top of all that. Most of them are happy to be having a baby. The worst I can say about it is there's some obesity ... but it's typically BMI 35 or 40 obesity.

Contrast with the 200 kilo uninsured never-saw-an-OB-before-presenting-to-the-ER meth-scabbed entitled PITA with an entourage of KFC-stained nicotine cloud low-tooth-to-tattoo-ratio relatives that was typically every third or fourth patient at my last moonlighting gig out in rural 'Merica. I'd hate OB too if that was my day job.

 

[deleted162650]

The worst I can say about it is there's some obesity ... but it's typically BMI 35 or 40 obesity.

Ah yes, the Military Dependapotamus.

 

[Twiggidy]

Have you tried being handsome

I look EXACTLY like Idris Elba, at least that's what they tell me at the 'Rhino

 

[Twiggidy]

Contrast with the 200 kilo uninsured never-saw-an-OB-before-presenting-to-the-ER meth-scabbed entitled PITA with an entourage of KFC-stained nicotine cloud low-tooth-to-tattoo-ratio relatives that was typically every third or fourth patient at my last moonlighting gig out in rural 'Merica. I'd hate OB too if that was my day job.

Or if you're in certain zip codes there's the "I've read everything about OB anesthesia on Mommy dot com and my dula from Yoga class helped me type out this 40 page birth plan and if we don't follow it to the letter I'm Yelping the shyte out of this place......by the way here's my insurance card"

Granted, my scenario is likely the easier block to place.

 

[GassYous]

by the way here's my insurance card"

That's all I heard

 

[IMGASMD]

.. it's typically BMI 35 or 40 obesity.

That’s obese?! Not the 350lb that I just wet tapped, because she shimmied my partners catheter out, and now moaning in pain with “edematous” tissue that I am not sure where the fuk I am?!

I’d rather do the, just skip your birth plan Karen’s, epidurals.

 

[IMGASMD]

I saw what you did there.


If that floats your fancy, you aren’t as bad as some people make you out to be.....