Changing careers to Anesthesia at age 36

[pazzer2]

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Hello,

I graduated from med school in 1995, afterwhich I completed 2 years of General Surgery. I realized that surgery wasn't for me and switched into a Family Medicine program which I completed in 2000, and successfully was board certified. I was thinking about going into Anesthesia after quitting General Surgery in 1997 but now felt like I made a dumb move and went into Family Medicine.

Since completing my residency in 2000, I've worked as a locums ER physician for a year in rural Texas, followed by a 4 year stint as a medical monitor for a drug company (during the entire time I moonlighted in the ER). Also during this time I went back to school and got a masters in clinical research from Duke (focused on biostatistics and epidemiology).

I'm now considering going back and doing a residency in Anesthesia. I presume that my Family Medicine residency would count for the Clinical Base Year. During my 2 years of General Surgery, I completed 5 months of SICU. I assume that I'd get credit for at least 14-17 months (12 months Base year plus 2-5 months SICU).

I graduated from a well respected state medical school with grades in the top 30% of my class. USMLE Step 1 Score was 215, USMLE Step 2 score was 205. I can't even remember my Step 3 score. It will be hard for me to go back and get letters of recommendation now (my Family Practice residency was 5 years ago, My dean's letter is a decade old).
I have two kids and a wife who works, so I'm not able to move. Fortunately I live in the NY/NJ metro area and am willing to drive up to 1 hour each way (this would include all the NYC programs, as well as NJ, and most of Philly).

Would I be a competitive applicant for a CA-1 position to begin in July 2006? If so how do I go about finding open spots?

 

[docrjay]

Just curious, what made you change your mind on Family Practice?

 

[pazzer2]

Just curious, what made you change your mind on Family Practice?

Family practice reimbursement rates are horrible, coupled with long hours, P4P, demanding patients and the most important reason is the lousy pay.

 

[lvspro]

Hi there
I wish I had the answers, but I don't. Actually, I'm curious as to whether you've worked with/shadowed/rotated with an anesthesiologist. The reason I ask is that gas is so much different than FP, and not much like surg except the emphasis on procedures, so I'm wondering as to how you've come to the conclusion that you'd like to do anesthesiology.

Anyway, welcome to anesthesiology, and I hope you're able to find a way to secure a position. Keep us posted on how things go for ya.

 

[VolatileAgent]

we have a guy in our program who is in just about the same shoes as you. he was an FP attending and hated it. so, at least i know that in theory it can be done. you'll may have to go through the whole rigamarole about applying through ERAS (etc) and may be too late for this year, but you will get credit for your previous training and will be able to step into a CA-1 (pgy-2) position. still you should try contacting some programs in your area now and see if they have any open positions for next year. a lot of the drop-out spots for the july '06 starting CA-1 class can sometimes be filled by side deals (as someone just did in our program). best bet is to contact some programs directly. go to the acgme website to get the most recent contact information and fire away! good luck.

 

[pazzer2]

Thanks everyone for the responses so far.

I've been in touch with a few residency programs and so far have only heard back from one. There is one open CA-1 spot at this program (which would begin July 2006). The bad part is that I'd have to go thru ERAS to apply for this CA-1 spot. The residency coordinator also mentioned that they have a "graduation date cutoff of 5 years"? Is this common in gas residencies nowadays?

When I applied for the match in 1995, everything was done by paper. So I have no idea how to do any of this. I contacted my dean's office yesterday, but is it already too late to start doing this? Would it be better to just use my old LORs and Dean's letter (from 1995) and supplement with 2 recent letters 1) Anesthesiologist from my pharma job and 2) Masters program?

Can anyone else please give me some advice on how credit for prior rotations done in other residencies would count? Of the 5 years of residency that I've already done I assume PGY-I from Family Practice would count for the Base Year. Then from the 2 years of General Surgery, I did mostly surgical rotations, but of which 18 weeks of SICU, which I assume will count for something towards Anesthesia boards. Does this all get negotiated up front or am I going to get screwed and have to repeat everything?

 

[seattledoc]

Hi,
I think I am the one Volatile Agent mentioned...Yes, I hated FP. And yes you can switch, I did last year at age 34. I'm not saying it's easy to go from the one calling the shots to the one occasionally being shot at, but it's a living...

You will without a doubt get credit for one year, i.e. you'll only have to do three years of anesthesia training. Your additional SICU training will most likely get you very little. You'll probably have to repeat it. But you never know...

Yes, go through your old med school. All they do is get you a number or password , i forget, to get onto the ERAS site. Then the rest is for you to do. I think you also need to get your old transcripts sent from your school. I used a combination of ancient med school LOR and some newer letters and it worked fine.

Your scores are fine, now you need to get on the phone and contact the programs, send your ERAS crap ASAP.

BTW, with FP, Epidemiology plus drug company experience you sound like you could do well in many places...industry, NIH. Any thoughts of not doing clinical medicine?

 

[Atropine]

"Are you considering anesthesia because you're truly interested or is it because you didn't like surgery/fp/er/biostatistics?" "Is being a medical doctor what you really want to be?"
If I was an interviewer I'd openly question your motives for changing your mind--not just once--but multiple times. Not meant to disrespect but it sounds like you're a bit confused. Definitely apply if you're truly interested but be prepared for the third degree during your interviews.

 

[DrDre']

I have to echo Atropine. Being older and having had many jobs, I respect your path. If I was looking at a bunch of applicants, I would be extremely interested in your responses about why gas and why not the others. You have been in what i would consider diametrically opposed specialties, surg and biostats?
also, funding- they may consider someone who has funding remaining. You will not get credit for SICU.

All the best, I hope it works out for you!

 

[Monitor]

I'm not working past 35, how could you think about another residency? Bet you thought you were pretty smart, one of those high and mighty PC types back in the day. Then reality smacked you in the teeth with a 4 x 4 hickory stick and when you came to, you thought boy this sucks. I say suck it up little man and sick with your chosen field!

 

[VolatileAgent]

Hi,
I think I am the one Volatile Agent mentioned...Yes, I hated FP.

yes, you are the one i was talking about. didn't realize you were you, though. now i'll look at all your old posts with a new perspective. (haha)

 

[CambieMD]

I'm not working past 35, how could you think about another residency? Bet you thought you were pretty smart, one of those high and mighty PC types back in the day. Then reality smacked you in the teeth with a 4 x 4 hickory stick and when you came to, you thought boy this sucks. I say suck it up little man and sick with your chosen field!

Life is too short to spend your time doing something that you hate. I swithched and I am glad that I did. I have work in some many different fields.
Medicine in the only profession that looks down on someone who changes mid stream. In other areas it is not uncommon for individuals to change careers a few times. Physicians pay big $$$$ and end up doing something that they hate.

I look forward to going to work. I know that I did the right thing for me and my family.

CambieMD

p.s.
Hi seattledoc

 

[pazzer2]

Thought I'd clear something up. I have no intention of going back to practice clinical medicine full-time.

The pharma world is filled at the top with a bunch of specialists who look down upon generalists like me. I've been working on the development of CNS drugs for the last 5 years. The only thing holding me back from getting top management positions in pharma is lack of speciality training. An anesthesia/neuro/psych residency is almost a requirement nowadays for the best top management jobs.

Just an FYI within the next decade there will be dozens and dozens of new drugs on the market to treat a variety of chronic pain syndromes (neuropathic pain, post-herpetic neuralgia, diabetic neuropathy, deep somatic cancer pain, etc). This is novel stuff, not just new opioids.

I suppose that I'd still work part time as a moonlighter just to keep my anesthesia and ER skills intact, but my main intention is to then go back to Pharma and work my way up the ladder. Of course in case the pharma world crashes, anesthesia will always be around and job security will be nice. But the main reason I want to do this is to shatter the glass ceiling in the pharma world that has been imposed over me.

I know a lot of program directors would probably freak if they heard I wanted to go back to pharma, but its the truth.

 

[docrjay]

The only thing holding me back from getting top management positions in pharma is lack of speciality training. An anesthesia/neuro/psych residency is almost a requirement nowadays for the best top management jobs.


I know a lot of program directors would probably freak if they heard I wanted to go back to pharma, but its the truth.

Wow! Talk about a different kind of motive.....But it if makes you happy, it cant be that bad..... 😀

 

[aredoubleyou]

Thought I'd clear something up. I have no intention of going back to practice clinical medicine full-time.

The pharma world is filled at the top with a bunch of specialists who look down upon generalists like me. I've been working on the development of CNS drugs for the last 5 years. The only thing holding me back from getting top management positions in pharma is lack of speciality training. An anesthesia/neuro/psych residency is almost a requirement nowadays for the best top management jobs.

Just an FYI within the next decade there will be dozens and dozens of new drugs on the market to treat a variety of chronic pain syndromes (neuropathic pain, post-herpetic neuralgia, diabetic neuropathy, deep somatic cancer pain, etc). This is novel stuff, not just new opioids.

I suppose that I'd still work part time as a moonlighter just to keep my anesthesia and ER skills intact, but my main intention is to then go back to Pharma and work my way up the ladder. Of course in case the pharma world crashes, anesthesia will always be around and job security will be nice. But the main reason I want to do this is to shatter the glass ceiling in the pharma world that has been imposed over me.

I know a lot of program directors would probably freak if they heard I wanted to go back to pharma, but its the truth.

R U sure you really thought through these things? R U sure its just not your company. When I was in the pharma world (not that long ago), the glass ceilings to top management was the same as most other big business - what business school you went to, who were your friends back at prep school ,etc. The emphasis was always who you know and how good you sound on paper (in that order). My boss used to literally laugh at and through away resumes from MBAs that werent from Ivy, or at minimum UofC or NWU business schools. MDs had less requirement to go to a big private school, but still Harvard MD, regardless of specialty trumped University of Whatever State.

I think you'd be way better served to go get an MBA at a top program, make the connections you need (tons of ceos would come and lecture and recruit at NWU - so I would imagine it would be even more so at a good Ivy). Get a job at BCG or McKinsey, or comparable - and get back into pharma if the goal is really working up the corporate ladder. Most of your resume potential, in my humble opinion, has already been determined by what undergrad you went to and what medical school you went to - residency is almost irrelevant - all the *****s at the top wanna see is Harvard, Yale, or similar. Also now that I'm thinking of it theres a ton of corporate MDs who never completed residency (internship at most) - who are near medical ******s now but are getting paid huge bucks for their input.

Ok, think I'll take a chill-pill now. Good luck.

 

[pazzer2]

There are two diametrically opposite ends of the spectrum in Pharma:

1) Business: Sales/Marketing/Finance MBA types
2) R&D: Science/PhD/MD/MS

I work predominantly in R&D. The rule of thumb in R&D is that the more degrees you have (MD > PhD > MS > BS) the better off you are. MBA is practically useless here (Although not so in #1 above). Many of the top-top jobs in Pharma are MDs. Within the MD world in R&D pharma, there is a pecking order of those who have advanced speciality training, and those who do not.

In the business side of pharma, you are correct, a pedigreed education with MBA from top 10 school will be very very useful. But in R&D it doesn't mean squat.

 

[aredoubleyou]

There are two diametrically opposite ends of the spectrum in Pharma:

1) Business: Sales/Marketing/Finance MBA types
2) R&D: Science/PhD/MD/MS

I work predominantly in R&D. The rule of thumb in R&D is that the more degrees you have (MD > PhD > MS > BS) the better off you are. MBA is practically useless here (Although not so in #1 above). Many of the top-top jobs in Pharma are MDs. Within the MD world in R&D pharma, there is a pecking order of those who have advanced speciality training, and those who do not.

In the business side of pharma, you are correct, a pedigreed education with MBA from top 10 school will be very very useful. But in R&D it doesn't mean squat.

You're absolutely right - i was under the impression you were heading (or already entrenched) in the business side. I'm still very suprised that specialty would make any difference - but the pettiness and things valued in corporate america never cease to amaze me. Good luck.

 

[CambieMD]

Thought I'd clear something up. I have no intention of going back to practice clinical medicine full-time.
I suppose that I'd still work part time as a moonlighter just to keep my anesthesia and ER skills intact.
I know a lot of program directors would probably freak if they heard I wanted to go back to pharma, but its the truth.

As much as think that anesthesia is great, I do not think that someone who is not interested in practicing clinical medicine should complete a gas residency to work in research. A phd would serve you better. That is my opinion.

A program director would freak out if they knew that you weren't interested in gas per say and plan to use it as a vehicle to making inroads in the pharma world. They would be worried that you would bail out of the program when the going got tough.

I think that you should do what you have to do to obtain that level of professional satisfaction that we all seek. Just understand that you anesthesia is cool but you work hard. My idea of sleeping in at this point is getting up at 0600 hr.

I have done my share of changing specialties. I know what it like to do something that you think sucks. I also know the flip side. I am having a ball learning procedures and caring for patients.

Good luck,

CambieMD

 

[Danger Man]

Hello,

I graduated from med school in 1995, afterwhich I completed 2 years of General Surgery. I realized that surgery wasn't for me and switched into a Family Medicine program which I completed in 2000, and successfully was board certified. I was thinking about going into Anesthesia after quitting General Surgery in 1997 but now felt like I made a dumb move and went into Family Medicine.

Since completing my residency in 2000, I've worked as a locums ER physician for a year in rural Texas, followed by a 4 year stint as a medical monitor for a drug company (during the entire time I moonlighted in the ER). Also during this time I went back to school and got a masters in clinical research from Duke (focused on biostatistics and epidemiology).

I'm now considering going back and doing a residency in Anesthesia. I presume that my Family Medicine residency would count for the Clinical Base Year. During my 2 years of General Surgery, I completed 5 months of SICU. I assume that I'd get credit for at least 14-17 months (12 months Base year plus 2-5 months SICU).

I graduated from a well respected state medical school with grades in the top 30% of my class. USMLE Step 1 Score was 215, USMLE Step 2 score was 205. I can't even remember my Step 3 score. It will be hard for me to go back and get letters of recommendation now (my Family Practice residency was 5 years ago, My dean's letter is a decade old).
I have two kids and a wife who works, so I'm not able to move. Fortunately I live in the NY/NJ metro area and am willing to drive up to 1 hour each way (this would include all the NYC programs, as well as NJ, and most of Philly).

Would I be a competitive applicant for a CA-1 position to begin in July 2006? If so how do I go about finding open spots?

Pazzer2, at best you will be treated on equal ground with those of us who have/are in the process of changing specialties. At worst, you have exhausted your career mulligans. To quote a PD from a gas program in New England, "Switching once is allowed, twice and we (programs) start to question your place in medicine." Best wishes and remember to put forth the effort towards the goal that you wish to obtain.

 

[joncmarkley]

If you live in NJ, St Josephs may be a nice match. It is a 900 bed trauma center with a childrens hospital. if you have any questions email me

jon

 

[Rainbowdoc]

I just ran accross this thread a little late.

If you want to get into anesthesia at this stage in your career, consider doing a combined residency / PhD program ( some places have this) and also consider trying to get into a program outside the match, out of season - I believe there are places on ERAS or elsewhere which can tell you when a program has an openings midseason.

As a word of encouragement, I graduated from med school in 1985 in South Africa (RSA). I then did general practice medicine and then internal medicine in both RSA and in America. I am board certified - (1996) and have done mainly locums since 1996. In RSA, during my time as a GP, I did some anesthesia and I liked it. When I came to America in 1993 I basically had to start my training over. I seriously considered doing anesthesia but because I like IM a lot, I repeated that instead. In 1992 I married for the 1st time. This made me reassess my long term goals- ie lifestyle ,finances, etc.. I considered doing anesthesia and in the process of inquiring about programs in early Sept, I learned that one program lost some Ca1s. I was coincidentally ending a locums stint then and I told them I was available. Well - less than one month later,at the age of 43, I was an anesthesia resident in a respected institution.

To top it off, my cv is far from stellar in the sense that I am a FMG and that I did "locums" pretty much full time since being boarded. Simultaneously,but after getting my anestesia spot, I went through eras for radiology just to see what would happen. Well, I didn't even get 1 invitation for an interview .Overall, I truly believe devine intervention had opened a spot for me.

Using my program ( located in SE America) for comparison - I would think your background would be a big plus. We have an active research division with many pharmaceutical PhDs around, and we have a combined residency/PhD program. Also, many of our attendings are double or triple boarded in IM, pediatrics, FP. Several of my fellow residents started off doing a surgery program and deciding it was not for them.

So far, I am happy with the choice I made. Anesthesia has been far more challenging, (in a nice way), than I expected and my fear that doing long cases would be boring has not yet materialized. I look forward to being done soon.

Good luck in your quest.