Cold Feet After Matching: Switching Specialties

[SimMic90]

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[cf817]

Would be extremely risky. Your program isn't going to save you a spot to explore switching out. Even with being transparent, getting a good LOR from your PD, you'd be at a disadvantage and high risk of not matching and being left with nothing. You'd also need a SLOR (assuming you don't have one) and have to prove yourself a more desirable candidate than others without any of the baggage. Anesthesia definitely isn't for everyone and considering you'll only be in your intern year, you'll have no idea if you really like it or not. I happen to love it and don't care much for the ED. But to each their own. Being an IMG US or not, makes it all the more risky. You'd have to ask yourself is it worth being left with nothing to not do Anesthesia and do EM? If the answers yes then go for it, but you'd have to decide pretty quickly considering you'd want your application in early and get the ball rolling on that end. EM match 99% this year and 2/3 where US grads. Odds are stacked against you. Take a deep breath and really think this through before you burn any bridges.

 

[Piebaldi]

I'm a US-IMG that recently matched into anesthesia. I'm going to spare everyone the sentimental regretfulness that usually comes with these types of posts. I'm grateful to have matched in a mid-tier program that rarely takes IMGs and is US-MD heavy with very well connected faculty. With that said, I can't help but feeling like I made a mistake in choosing a specialty. I've always been drawn to EM but was fearful of being non-competitive among other reasons, so I decided to pursue anesthesia. Looking back, I think I would have made a good candidate for some mid-low tier EM programs that I would not have minded.

I'm going to go into my PGY1 year with an open mind and work my tail off, but I'm seriously considering reapplying in the next application cycle. The only issue is the time constraint: I'd have to do an EM block, be transparent with my PD and redo the process all over again.

Assuming all goes well (PD approval, EM letters and good performance), would applying as a PGY1 put me at a disadvantage?

Don't do it. Anesthesia is a fine specialty. Going into EM can be risky. EM has become more competitive, there is no guarantee that you will match. You may lose your Anesthesia spot and end up with nothing. Proceed with caution. What's wrong with Anesthesia?

 

[evilbooyaa]

Very risky. I would not consider it. IMG of any type matching into EM is very very difficult with increased competitiveness of EM.

 

[SimMic90]

I think it would be worth it and as an IMG, the odds are always stacked against us. Again, I say this now but maybe it will change over intern year. I did not realize, as cf817 had mentioned, that the number of US grads to EM were so low (65%); it seemed a lot higher. It actually dropped by 14% over the last 4 years. I'm encouraged by small community programs that are IMG-friendly opening up around the country.

Looks like 98.4% of anesthesia programs were filled (compared to 98.8% EM, 98.9% psychiatry, and 99.8% OB-Gyn ). I'm not sure that fill rate is a function of competitiveness. What's more, it seems like anesthesia is more US-grad heavy than EM (67.8% v. 65%).

I do not want people to get the wrong impression, anesthesiology is a fine specialty, but I am better off unburdening myself of the guilt of trying to be happy with my career choice.

Thank you for the feedback.

 

[cf817]

I think it would be worth it and as an IMG, the odds are always stacked against us. Again, I say this now but maybe it will change over intern year. I did not realize, as cf817 had mentioned, that the number of US grads to EM were so low (65%); it seemed a lot higher. It actually dropped by 14% over the last 4 years. I'm encouraged by small community programs that are IMG-friendly opening up around the country.

Looks like 98.4% of anesthesia programs were filled (compared to 98.8% EM, 98.9% psychiatry, and 99.8% OB-Gyn ). I'm not sure that fill rate is a function of competitiveness. What's more, it seems like anesthesia is more US-grad heavy than EM (67.8% v. 65%).

I do not want people to get the wrong impression, anesthesiology is a fine specialty, but I am better off unburdening myself of the guilt of trying to be happy with my career choice.

Thank you for the feedback.

True, odds are stacked against IMGs in general but this is a scenario that has an even lower chance of success as everyone has mentioned. It's a bad idea but you seemed to have come into this looking for validation of a decision you've already made. If it's truly worth it knowing your chances of being left without a residency after the years of hard work are worth it to be an EM doc then good luck, you're gonna need it.

 

[res1cue]

I think it would be worth it and as an IMG, the odds are always stacked against us. Again, I say this now but maybe it will change over intern year. I did not realize, as cf817 had mentioned, that the number of US grads to EM were so low (65%); it seemed a lot higher. It actually dropped by 14% over the last 4 years. I'm encouraged by small community programs that are IMG-friendly opening up around the country.

Looks like 98.4% of anesthesia programs were filled (compared to 98.8% EM, 98.9% psychiatry, and 99.8% OB-Gyn ). I'm not sure that fill rate is a function of competitiveness. What's more, it seems like anesthesia is more US-grad heavy than EM (67.8% v. 65%).

I do not want people to get the wrong impression, anesthesiology is a fine specialty, but I am better off unburdening myself of the guilt of trying to be happy with my career choice.

Thank you for the feedback.

You realize that the other 35% are DOs right? Go for it if you want but just understand what you are doing:

You will be giving up an almost guaranteed shot at a good paying competitive career, for a (low) chance at getting a different one.

 

[Piebaldi]

You realize that the other 35% are DOs right? Go for it if you want but just understand what you are doing:

You will be giving up an almost guaranteed shot at a good paying competitive career, for a (low) chance at getting a different one.

This. I agree with your statements, a not so small percentage of people that match that are listed as non MD are DO so still US grads, rather than foreign grads. It's risky for sure. If OP was MD/DO US grad I would say maybe. But it's a big risk, and Anesthesia while still has a lot of challenges I would say is a better career move than EM.

 

[gutonc]

I think it would be worth it and as an IMG, the odds are always stacked against us. Again, I say this now but maybe it will change over intern year. I did not realize, as cf817 had mentioned, that the number of US grads to EM were so low (65%); it seemed a lot higher. It actually dropped by 14% over the last 4 years. I'm encouraged by small community programs that are IMG-friendly opening up around the country.

Looks like 98.4% of anesthesia programs were filled (compared to 98.8% EM, 98.9% psychiatry, and 99.8% OB-Gyn ). I'm not sure that fill rate is a function of competitiveness. What's more, it seems like anesthesia is more US-grad heavy than EM (67.8% v. 65%).

I do not want people to get the wrong impression, anesthesiology is a fine specialty, but I am better off unburdening myself of the guilt of trying to be happy with my career choice.

Thank you for the feedback.

To put some actual data on this:

In the 2018 Match, there were 72 US-IMGs that matched in EM and 76 who did not (basically a coin flip). Compare this to Anesthesia which had 114 US-IMGs match compared to 56 that did not (2:1).

Obviously, you do you, but understand that, if you decide to bail on Anesthesia this year and try for EM, your doing it for what amounts to a coin flip. You're also going to have to contend with the fact that your schedule is probably not going to be amenable to you going on 15-20 interviews which is going to make things harder for you.

 

[Piebaldi]

To put some actual data on this:

In the 2018 Match, there were 72 US-IMGs that matched in EM and 76 who did not (basically a coin flip). Compare this to Anesthesia which had 114 US-IMGs match compared to 56 that did not (2:1).

Obviously, you do you, but understand that, if you decide to bail on Anesthesia this year and try for EM, your doing it for what amounts to a coin flip. You're also going to have to contend with the fact that your schedule is probably not going to be amenable to you going on 15-20 interviews which is going to make things harder for you.

This is completely unrelated - but why "gutonc" - are you an oncologist that treats the GI tract? I frequently wonder this.

 

[SimMic90]

To put some actual data on this:

In the 2018 Match, there were 72 US-IMGs that matched in EM and 76 who did not (basically a coin flip). Compare this to Anesthesia which had 114 US-IMGs match compared to 56 that did not (2:1).

Obviously, you do you, but understand that, if you decide to bail on Anesthesia this year and try for EM, your doing it for what amounts to a coin flip. You're also going to have to contend with the fact that your schedule is probably not going to be amenable to you going on 15-20 interviews which is going to make things harder for you.

I'm looking at my score range and it looks like my chances of matching based on step 1 score are about 68.4% for EM and 66.6% for anesthesia. Apologies for coming off resistant - obviously there's some confirmation bias in my observations - I truly appreciate the feedback.

 

[Piebaldi]

I'm looking at my score range and it looks like my chances of matching based on step 1 score are about 68.4% for EM and 66.6% for anesthesia. Apologies for coming off resistant - obviously there's some confirmation bias in my observations - I truly appreciate the feedback.

Like we say to patients "These are the recommendations" What people end up doing is up to them. But again you don't want to be one of those people that come back in a few months and are like "what are the suggestions to improve my application because now I don't have a spot" type of thing

 

[cf817]

I'm looking at my score range and it looks like my chances of matching based on step 1 score are about 68.4% for EM and 66.6% for anesthesia. Apologies for coming off resistant - obviously there's some confirmation bias in my observations - I truly appreciate the feedback.

Those odds are not including the fact that you are switching out being an IMG. It's a coin flip at best. What is even more bleak is trying to get into something when you lose your residency spot now and then don't match in EM.

 

[SimMic90]

Like we say to patients "These are the recommendations" What people end up doing is up to them. But again you don't want to be one of those people that come back in a few months and are like "what are the suggestions to improve my application because now I don't have a spot" type of thing

Let's hope it doesn't get to that point. I'm counting on the doctor to make a clinical mistake . But these recommendations matter - I appreciate everyone's feedback.

 

[Piebaldi]

Let's hope it doesn't get to that point. I'm counting on the doctor to make a clinical mistake . But these recommendations matter - I appreciate everyone's feedback.

Haha, that was actually funny. Good luck.

 

[res1cue]

I'm looking at my score range and it looks like my chances of matching based on step 1 score are about 68.4% for EM and 66.6% for anesthesia. Apologies for coming off resistant - obviously there's some confirmation bias in my observations - I truly appreciate the feedback.

Have you done much research on EM? Scores are pretty far down on what EM PDs look for. SLOE, away rotations, and interviews are much higher weighted. Judging your competitiveness based on board scores will give you a false sense of security

 

[SimMic90]

Have you done much research on EM? Scores are pretty far down on what EM PDs look for. SLOE, away rotations, and interviews are much higher weighted. Judging your competitiveness based on board scores will give you a false sense of security

Good to know. I will keep that in mind as I go into PGY1 - maybe do and ED block earlier.
Thank you.

 

[gutonc]

Good to know. I will keep that in mind as I go into PGY1 - maybe do and ED block earlier.
Thank you.

You should have 2 SLOEs from at least 2 rotations. Get one now, before you graduate, and one next year, because that's the best option you'll have.

 

[cf817]

Good to know. I will keep that in mind as I go into PGY1 - maybe do and ED block earlier.
Thank you.

You're thinking as if you have control of your schedule. Does your the institution you're going to have an EM residency? You're going to have to basically walk in in July and immediately say I have had a change of heart and hope that they are cool with it. You'll need them to accommodate request for schedule changes, interview dates and hope they are willing to give you a strong LOR having not really been able to assess you beyond being someone who said one thing when being interviewed and now given a spot changes his mind.

 

[Piebaldi]

You're thinking as if you have control of your schedule. Does your the institution you're going to have an EM residency? You're going to have to basically walk in in July and immediately say I have had a change of heart and hope that they are cool with it. You'll need them to accommodate request for schedule changes, interview dates and hope they are willing to give you a strong LOR having not really been able to assess you beyond being someone who said one thing when being interviewed and now given a spot changes his mind.

I think it's clear that OP has made his/her mind up. It is up to them what they will do.

 

[cf817]

I think it's clear that OP has made his/her mind up. It is up to them what they will do.

Yeah it certainly seems so. Will tag this thread for the future "what do I now" post come next March.

 

[DokterMom]

It would be much, much safer to begin the swap process after you have completed the training necessary to become fully licensed.

 

[SimMic90]

You should have 2 SLOEs from at least 2 rotations. Get one now, before you graduate, and one next year, because that's the best option you'll have.

Thank you for the tip, will get on it.
It looks like I've ruffled some feathers with the other responders. Not my intention.
Glad I can get some feedback.

 

[ThoracicGuy]

I'm a US-IMG that recently matched into anesthesia. I'm going to spare everyone the sentimental regretfulness that usually comes with these types of posts. I'm grateful to have matched in a mid-tier program that rarely takes IMGs and is US-MD heavy with very well connected faculty. With that said, I can't help but feeling like I made a mistake in choosing a specialty. I've always been drawn to EM but was fearful of being non-competitive among other reasons, so I decided to pursue anesthesia. Looking back, I think I would have made a good candidate for some mid-low tier EM programs that I would not have minded.

I'm going to go into my PGY1 year with an open mind and work my tail off, but I'm seriously considering reapplying in the next application cycle. The only issue is the time constraint: I'd have to do an EM block, be transparent with my PD and redo the process all over again.

Assuming all goes well (PD approval, EM letters and good performance), would applying as a PGY1 put me at a disadvantage?

If you decide to forgo your anesthesia training program, there is a strong chance of never finishing training.

I wouldn't do it.

 

[Piebaldi]

If you decide to forgo your anesthesia training program, there is a strong chance of never finishing training.

I wouldn't do it.

I think OP is set on doing what he/she wants. It is up to them what they do. I think they have received good advice. Each person is free to do as they wish. Maybe we are all wrong and they will match EM. Otherwise they will be back asking what to do.

 

[AdmiralChz]

Bad idea!! You have a current training spot in a competitive specialty, that’s a big accomplishment and there are many US-IMGs that are left out entirely each year (check out the SOAP 2019 thread for some gut wrenching stories). It’s going to be hard to jump ship without some internal support from your new program - definitely give the field a shot and see if you can enjoy it.

 

[ThoracicGuy]

I think OP is set on doing what he/she wants. It is up to them what they do. I think they have received good advice. Each person is free to do as they wish. Maybe we are all wrong and they will match EM. Otherwise they will be back asking what to do.

They may be set on it, but I'm not sure they truly realize there is a significant chance that they will give up their anesthesia spot to try for an EM spot and end up with nothing after their first year. They must get a waiver for the advanced program before they can even reapply on ERAS. Plus, they don't have SLOEs available which is a requirement. If they can get one or two this late in the game, I wonder how good that will end up being.

If he gives up his spot in anesthesia to try for EM, he can count on never getting an anesthesia spot again. If he doesn't match in EM, then he has at least a year without ongoing training before he reapplies to try for an IM or FM spot. And then he's further and further out from graduation and his odds get harder and harder. Right now he won. He got a spot, particularly as an IMG.

But sure, he can do as he wishes. We'll see him coming back saying he never matched and wondering what everyone's opinion is on getting back in anesthesia. He shouldn't be that guy.

 

[Troyzle]

I'm a US-IMG that recently matched into anesthesia. I'm going to spare everyone the sentimental regretfulness that usually comes with these types of posts. I'm grateful to have matched in a mid-tier program that rarely takes IMGs and is US-MD heavy with very well connected faculty. With that said, I can't help but feeling like I made a mistake in choosing a specialty. I've always been drawn to EM but was fearful of being non-competitive among other reasons, so I decided to pursue anesthesia. Looking back, I think I would have made a good candidate for some mid-low tier EM programs that I would not have minded.

I'm going to go into my PGY1 year with an open mind and work my tail off, but I'm seriously considering reapplying in the next application cycle. The only issue is the time constraint: I'd have to do an EM block, be transparent with my PD and redo the process all over again.

Assuming all goes well (PD approval, EM letters and good performance), would applying as a PGY1 put me at a disadvantage?

DON'T DO IT

 

[Piebaldi]

They may be set on it, but I'm not sure they truly realize there is a significant chance that they will give up their anesthesia spot to try for an EM spot and end up with nothing after their first year. They must get a waiver for the advanced program before they can even reapply on ERAS. Plus, they don't have SLOEs available which is a requirement. If they can get one or two this late in the game, I wonder how good that will end up being.

If he gives up his spot in anesthesia to try for EM, he can count on never getting an anesthesia spot again. If he doesn't match in EM, then he has at least a year without ongoing training before he reapplies to try for an IM or FM spot. And then he's further and further out from graduation and his odds get harder and harder. Right now he won. He got a spot, particularly as an IMG.

But sure, he can do as he wishes. We'll see him coming back saying he never matched and wondering what everyone's opinion is on getting back in anesthesia. He shouldn't be that guy.

Yes, but just about everyone has adviced him/her of the poor decision this is, and they continue trying to insist that's what they want to do. They are an adult, I'm sure they are aware that getting an anesthesia spot is a good thing particularly for an IMG, and they have been warned about being that "guy" that comes back next year asking for recs as to what to do when they don't have a spot. But hey we are all adults and we do as we see fit. Kind of like our patients!
Me: "Ma'm you need to be on thickener because you might aspirate, leading to pneumonia, which can lead to death."
Patient: "You can't refuse me water. I have a right to water. You all are going to get it."
Me: "Ma'm at home you are free to do as you wish, but while you are here you are under my care and it's my job to keep you alive."
Patient: Referring to me, therapist and nurse "I don't know how, but you all are going to get it." Lol.
this OP reminds me of this patient! Awesome.

 

[enalli]

OP, please don't do this.

There are plenty of competitive AMG EM applicants each year that fall to their 8th, 9th, 10th ranks or fail to match completely. You will not get 8 interviews. Even if you do, you won't have the time to go.

Do you hate anesthesia that much? Clearly there are things about it that you like since you applied in the first place. Stick with anesthesia and after finishing residency you can apply again. If EM really is your passion, it will still be there in 4 years and you will have a sweet back up specialty if it doesn't work out.

 

[Apollyon]

There was a guy with whom I worked, 10 years ago, who had done an EM residency, then an anesthesia CCM fellowship. This guy is SHARP. He went back, after 3 or 4 years, and did an anesthesia residency.

US FMG (I am one, so, I can say it) that got an anesthesiology spot? Stop right there. There is plenty of great advice here.

1. Keep the anesthesia spot. If you don't take it, you'll NEVER get another one.
2. It is HIGHLY unlikely you'll get any EM hits.

If you want EM, wait until the end of your anesthesia residency. Bird in hand. Devil you know. All that.

 

[Keona]

Yes, but just about everyone has adviced him/her of the poor decision this is, and they continue trying to insist that's what they want to do. They are an adult, I'm sure they are aware that getting an anesthesia spot is a good thing particularly for an IMG, and they have been warned about being that "guy" that comes back next year asking for recs as to what to do when they don't have a spot. But hey we are all adults and we do as we see fit. Kind of like our patients!
Me: "Ma'm you need to be on thickener because you might aspirate, leading to pneumonia, which can lead to death."
Patient: "You can't refuse me water. I have a right to water. You all are going to get it."
Me: "Ma'm at home you are free to do as you wish, but while you are here you are under my care and it's my job to keep you alive."
Patient: Referring to me, therapist and nurse "I don't know how, but you all are going to get it." Lol.
this OP reminds me of this patient! Awesome.

Frazier water protocol for those patients. After a few days of serious oral hygiene.

 

[AlvinKamara]

I'm looking at my score range and it looks like my chances of matching based on step 1 score are about 68.4% for EM and 66.6% for anesthesia. Apologies for coming off resistant - obviously there's some confirmation bias in my observations - I truly appreciate the feedback.

This is flawed. You’ll be at a much lower success rate because you won’t be coming straight out of Med school. I’m an EM resident. We love DOs. We don’t take on IMGs for whatever reason. If doing EM is that important to you, finish your Anesthesia residency and then do an EM residency.

The lifestyles are pretty similar as is the pay.

You are not making a good decision. You will be in poor standing with your PD and you’ll end up with neither EM nor Anesthesia. The moment you tell your PD you want out of anesthesia, you’re dead to him/her. They’ll help you get out of the program. They won’t help you stay if you fail.

 

[NotAProgDirector]

As others have mentioned, this is a tough decision. If your PD is supportive, they might allow you to apply and see how it goes. If by December you have a decent number of interviews, you'd have to resign your spot and they would fill it in the match as an R position. If you matched into a prelim/adv combination, then you'd have to ask for a match waiver by mid december, and that would prevent you from matching in anesthesia again. If you get nothing in the match for EM, you'll be scrambling for a new position and it will now be unlikely to be in EM or Anesthesia.

As mentioned, getting time for interviews is going to be very difficult. This is a paid position, you have a job to do. You can't just take as much time as you want, as you could when a student.

If your PD is REALLY nice, and you matched to a Categorical position, they could put your spot back into the match as an R psition AND then rank you for it -- if you didn't match to EM, you would match back to the same program you're in for the same spot. Honestly, I'm not sure I'd be that nice, and I'm the nicest person I know. Other than my wife, of course.

Best option, honestly: Do a Critical Care fellowship after anesthesia.

 

[Piebaldi]

As others have mentioned, this is a tough decision. If your PD is supportive, they might allow you to apply and see how it goes. If by December you have a decent number of interviews, you'd have to resign your spot and they would fill it in the match as an R position. If you matched into a prelim/adv combination, then you'd have to ask for a match waiver by mid december, and that would prevent you from matching in anesthesia again. If you get nothing in the match for EM, you'll be scrambling for a new position and it will now be unlikely to be in EM or Anesthesia.

As mentioned, getting time for interviews is going to be very difficult. This is a paid position, you have a job to do. You can't just take as much time as you want, as you could when a student.

If your PD is REALLY nice, and you matched to a Categorical position, they could put your spot back into the match as an R psition AND then rank you for it -- if you didn't match to EM, you would match back to the same program you're in for the same spot. Honestly, I'm not sure I'd be that nice, and I'm the nicest person I know. Other than my wife, of course.

Best option, honestly: Do a Critical Care fellowship after anesthesia.

I agree that you are quite nice!

 

[Crayola227]

OK, but seriously, I really really want any resident alive, to seriously consider what their life would be like tomorrow if they didn't get another training slot, didn't get a medical license, or didn't get board certified.

Like, go read all the threads of people without a slot.

Having a slot is like having the Golden Ticket in the movie Willy Wonka's Chocolate Factory.

Honestly, and I hope I don't get in trouble with SDN saying this, I do NOT encourage anyone to hurt themselves and anyone at risk of doing so should seek professional help immediately, but the pain of not completing your training, being deported and never getting to come back to a country you wanted a life in, the debt, the lack of job opportunities, the lost potential income, living in the proverbial gutter, what you end up finding yourself doing, like, so many people who ended up there can tell you, people that aren't even the depressive types, how low it brought them. It's frankly dangerous for people with the traits and hopes we have (ambition, perfectionism, self esteem/identity wrapped up in career/performance, etc etc) to lose it all. The stakes are really, really high. Others have different feelings, but I literally worry about the very well-being and continued survival of the un-Matched.

Throw away your sure thing, your slot, your Golden Ticket. Think that because you matched as well as you did the first time that it surely can't be that bad the second time. Ignore the people that will tell you it's a completely different ballgame after your first go-round.

I wish you luck. The odds are against you, and I hope in the likely worst case scenario, which is that you have no slot, that you are able to remain safe, keep the value of your life in proper perspective, continue to live, and persevere. There is life after not completing training, but it's hard. I would say that I hope that you are able to pull this off, but that would be like telling someone you hope someone lands on their feet after jumping from an airplane without a parachute.

Personally, I think you should just finish your program, and then go back for EM. Yes, I knew a resident that did this, they were IM, but they didn't figure out they wanted the switch until 2nd yr. At that point, it just made the most amount of sense to finish the program, be BC/E, and then they had a year off in between programs, before matching to EM. This was an AMG, and before EM was nearly so competitive. I don't know what they did abut SLORs. I bet if you get through your anesthesia program doing well, with no one knowing your intentions, that you could gain enough support from your program to help you make the switch after finishing.

 

[AdmiralChz]

Best option, honestly: Do a Critical Care fellowship after anesthesia.

I second this. CCM is also probably the least competitive out of the specialties in Anesthesia with several brand-name programs having open spots each year after the Match. It is really something to consider.

 

[anonperson]

I'm a US-IMG that recently matched into anesthesia. I'm going to spare everyone the sentimental regretfulness that usually comes with these types of posts. I'm grateful to have matched in a mid-tier program that rarely takes IMGs and is US-MD heavy with very well connected faculty. With that said, I can't help but feeling like I made a mistake in choosing a specialty. I've always been drawn to EM but was fearful of being non-competitive among other reasons, so I decided to pursue anesthesia. Looking back, I think I would have made a good candidate for some mid-low tier EM programs that I would not have minded.

I'm going to go into my PGY1 year with an open mind and work my tail off, but I'm seriously considering reapplying in the next application cycle. The only issue is the time constraint: I'd have to do an EM block, be transparent with my PD and redo the process all over again.

Assuming all goes well (PD approval, EM letters and good performance), would applying as a PGY1 put me at a disadvantage?

I will echo what everyone else has essentially said. Stay put. Do well in residency and live a good life. Even though people in the anesthesia forum complain, salaries are very high compared to other specialties.

Things working against you:
Being a US-IMG
Once you have graduated, every year you are out is kind of a negative against you. The further out you are from residency, the more "damaged goods" you are perceived to be.

Also think about the possible outcomes:
1. You match into EM and are happy. This is low probability based on your situation unless you have an inside track somewhere.

2. You don't match and you no longer have a residency. Are you prepared to have an essentially useless degree and no ability to work in any meaningful way related to your medical training? I am not being hyperbolic when I say that this is a likely outcome and is a disaster for any medical student/resident. The lifetime earnings for a physician are a couple of million dollars. Are you willing to throw that away for a chance at a different specialty? I think being pragmatic in this setting and just sucking it up is the way to go to be honest. This is just a job. It does not define you. Work, earn a paycheck and go enjoy life. Most people would be fine doing multiple specialties to be honest.

 

[Blanky]

Anesthesia --> CCM

 

[Realgasman135]

I’m curious how EM PDs will look at your application. A PGY1 who matched into Anesthesia has a change of heart before starting anesthesia training. If I’m a PD, I would be concerned about your decision going into EM. What if you change your mind again and change to some other specialty? Just something to think to think about.

 

[Arch Guillotti]

You are nuts if you switch😵

 

[AdmiralChz]

This might be the typical SDN advice thread:

OP: “Y’all are smart, should I do fairy outlandish thing X”
SDN (unaninmous): “Don’t do it for such and such”
OP: “What do you all know, I’m doing it anyway!”

OP hasn’t been directly defiant in the replies, but has only engaged with those indulging him or her in considering a switch rather than keeping what he/she has.

 

[Piebaldi]

This might be the typical SDN advice thread:

OP: “Y’all are smart, should I do fairy outlandish thing X”
SDN (unaninmous): “Don’t do it for such and such”
OP: “What do you all know, I’m doing it anyway!”

OP hasn’t been directly defiant in the replies, but has only engaged with those indulging him or her in considering a switch rather than keeping what he/she has.

Haha I like the "fairy outlandish thing X”
I think it probably is time to close the thread. There is a circular back and forth - with "don't do it" and OP "I'll do it" type of thing.
OP is an adult and can do as they see best, they have gotten appropriate feedback at this time.

 

[Apollyon]

Haha I like the "fairy outlandish thing X”
I think it probably is time to close the thread. There is a circular back and forth - with "don't do it" and OP "I'll do it" type of thing.
OP is an adult and can do as they see best, they have gotten appropriate feedback at this time.

There has been nothing in this thread to warrant closure.

 

[Piebaldi]

There has been nothing in this thread to warrant closure.

Just my 2 cents. Nothing wrong I agree, just pointless back and forth.

 

[skypilot]

Anesthesia --> CCM

I think this is a great plan. Gets you out of the OR if you don't like it. Gets you back to managing patients medically.

There is a lot of overlap between the day to day responsibilities of these specialties. You might be surprised and like the Operating Room. You also might like managing a group of patient in the ICU just as much as you would managing a group of patients in the ER.

 

[hmockingbird]

I don’t know if this is a thing with adult CCM but we often have PICU docs as the second attending in the Peds ER at my program.

I also know someone who did IM then did EM. They got some credit from residency since EM has to do some ICU shifts etc. So that may also be an option. You’d be airway king/queen haha.

I would not do it. Given the obvious risks... honestly I enjoy my specialty but I also enjoy time off, hobbies and my social life/family. Sometimes I feel like the dream specialty thing is a wash, you have to find happiness outside of your job too. Anaesthesia is a GREAT match, good option for lifestyle, good salary, potential for procedures, opportunities to be nerdy about the physiology, can be either chill or you’re the one saving the patient... like as much as I dislike treating adults I’d probably be happy in anaesthesiology (and other fields) too. I think with the odds stacked so against you re-matching, it may be time to adapt a different mentality outside of “it’s not my dream”.

 

[rokshana]

Haha I like the "fairy outlandish thing X”
I think it probably is time to close the thread. There is a circular back and forth - with "don't do it" and OP "I'll do it" type of thing.
OP is an adult and can do as they see best, they have gotten appropriate feedback at this time.

Threads aren’t closed because someone seems them not needed...they are closed if they go seriously off topic, become abusive or is a redundant thread.

The usual way a thread goes away is people stop posting in it and it drifts down the list...until of course someone necrobumps it.

 

[res1cue]

I also know someone who did IM then did EM. They got some credit from residency since EM has to do some ICU shifts etc. So that may also be an option. You’d be airway king/queen haha.

Nope because in the <5% chance this does work, OP would have completed prelim year only, wouldnt have done CA1 year yet