Chances--conservative advice

[md11]

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At least one person from my school did not match in anesthesiology last year. Now, our dean is meeting with us all to make sure we have a safe strategy for the match. I am still deciding between medicine and anesthesia, and because I'm a very average applicant, she suggested that I seriously consider applying in both to make sure I end up matching. I hate the thought of applying in two specialties, especially if I end up deciding anesthesia's what I want to do (will decide this by August at latest, when I have my first elective). Should I suck it up and do it anyway?

Background:
Top 15 med school
Bottom half of class (HP--medicine, surgery, psychiatry; Pass--peds, ob/gyn)
232 Step 1
1 full year research (between MS3/4) in onc; numerous other research experiences
One basic science publication (published 2010, but experience was from before med school)

I have strong geographic preferences--California (any program) and then New York. Would probably be happy with either medicine or anesthesia.

 

[Gimlet]

At least one person from my school did not match in anesthesiology last year. Now, our dean is meeting with us all to make sure we have a safe strategy for the match. I am still deciding between medicine and anesthesia, and because I'm a very average applicant, she suggested that I seriously consider applying in both to make sure I end up matching. I hate the thought of applying in two specialties, especially if I end up deciding anesthesia's what I want to do (will decide this by August at latest, when I have my first elective). Should I suck it up and do it anyway?

Background:
Top 15 med school
Bottom half of class (HP--medicine, surgery, psychiatry; Pass--peds, ob/gyn)
232 Step 1
1 full year research (between MS3/4) in onc; numerous other research experiences
One basic science publication (published 2010, but experience was from before med school)

I have strong geographic preferences--California (any program) and then New York. Would probably be happy with either medicine or anesthesia.

You should probably have a backup of some sort with your geographic restrictions alone. Whether that's a backup specialty (medicine) or a backup location (anesthesia apps in a less competitive region) is up to you. Otherwise I think your stats make you competitive for anesthesiology.

[insert standard disclaimer that stats aren't the only thing that matter].

 

[Arch Guillotti]

At least one person from my school did not match in anesthesiology last year. Now, our dean is meeting with us all to make sure we have a safe strategy for the match. I am still deciding between medicine and anesthesia, and because I'm a very average applicant, she suggested that I seriously consider applying in both to make sure I end up matching. I hate the thought of applying in two specialties, especially if I end up deciding anesthesia's what I want to do (will decide this by August at latest, when I have my first elective). Should I suck it up and do it anyway?

Background:
Top 15 med school
Bottom half of class (HP--medicine, surgery, psychiatry; Pass--peds, ob/gyn)
232 Step 1
1 full year research (between MS3/4) in onc; numerous other research experiences
One basic science publication (published 2010, but experience was from before med school)

I have strong geographic preferences--California (any program) and then New York. Would probably be happy with either medicine or anesthesia.

I think first of all you need to decide on anesth or medicine. They are 2 very different fields. Most of us on this board would go nuts doing medicine. A few people can get along well in either specialty but they are 2 very different specialties.

I don't know much about california but it is reportedly a tough match for a lot of people. NY has tons of programs and I am sure you could match a pretty good place there as long as you don't do something dumb (interview poorly, red flag on LOR, etc.).

Personally I think your dean is being an alarmist, he probably doesn't want anyone to go unmatched because then it makes your schools list look bad. Of course I am opining here.

A 232 coming from your school is a very good start towards matching where you want to.

 

[gaspasser2004]

First thing you need to do is decide between medicine and anesthesia. I had a similar dilemma as a third year medical student and knew anesthesia was for me after my medicine clerkship.

If you decide to do anesthesia, you should want to do it badly enough that you would train anywhere. Somewhere in California shouldn't be a problem with your credentials, but there are no guarantees. If I was your dean, instead of advising you to apply simultaneously to internal medicine, I would advise you to apply to about 20 anesthesia programs in hopes of going on about 10 interviews. If you go on 10 interviews, it would be highly unlikely for you not to match unless all of those interviews were at extremely competitive programs.

Not all programs are categorical so you will have to interview at preliminary programs (transitional, prelim medicine or surgery). You can always rank these one-year programs at the back end of your list so that even if you don't get an anesthesia residency, you have a year of employment to figure the next year out.

 

[lord_jeebus]

I think your chances at a CA or NY program are excellent. I would not apply to a back-up specialty.

 

[md11]

I know I came on here looking for encouragement, and that's what I got. Not sure yet if I'll end up heeding the alarmist's advice, but I thank you all for the realistic insights-

Ok now back to square one for a second, and I apologize in advance for the quasi-rant:
When I was on my medicine rotation, I rarely wanted to go home early. I loved admitting patients from the ED, working them up, chatting with them during follow-up, even some of the random BS drama/psycho pts and even writing notes.
That being said, I typically zoned out and occasionally fell asleep during rounds (except when presenting), and I was frustrated by treatment efficacy (or lack thereof). And outpatient medicine is of no interest to me.

In the OR, I tire easily and get fidgety. Perhaps I just don't sleep enough, but I would fall asleep during operations (while holding the camera) my third year, and today, I came to the conclusion that wearing the mask makes me sleepy (maybe I tie it too tightly?) after dozing off while watching a central line placement. I think my point is that I don't feel as engaged in the OR--as a beginning observer in anesthesia, I feel like there are a bunch of monitors and numbers to look at, drugs to push, and, on the other side of the curtain, there is someone suturing and cutting away for hours and hours. I get bored, and I want to LEAVE. I probably just need to be doing something or actively thinking so that I can get more into it (after all, the medicine rotation was, in a way, just a long series of little assignments), but having little tolerance for long cases concerns me. Are these initial reactions typical, or should I proceed cautiously in my attempts to learn more about/pursue anesthesia?

I have never fallen asleep watching medicine residents do procedures, even when it takes them hours. Not that I remember. I am usually running around trying to help them. Something about being in the OR makes me especially tired.

I'm not really pleading for help in making my decision here--I know that's my job--but I really do wonder if the fatigue is normal.

 

[pseudoknot]

When I was on my medicine rotation, I rarely wanted to go home early. I loved admitting patients from the ED, working them up, chatting with them during follow-up, even some of the random BS drama/psycho pts and even writing notes.
That being said, I typically zoned out and occasionally fell asleep during rounds (except when presenting), and I was frustrated by treatment efficacy (or lack thereof). And outpatient medicine is of no interest to me.

If you love the initial workup of patients, but don't like rounds or clinic, have you considered emergency medicine? I was just curious; it seems like that's a more common choice vs. anesthesia than IM.

EDIT: also, (and this is secondhand so maybe I shouldn't post it) many, many people have told me that doing anesthesia is far more interesting than watching it. Kind of like the difference between reading a good book and watching someone else read the same book. This is probably why it's hard to get a good sense for anesthesia as a student and so it ends up being a leap of faith for most.