confused fourth yr med student

[mdconfused]

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So i am a 4th year med student applying categorical medicine. I really have doubts about my career choice and always liked anesthesia. Going through the interview process, I keep thinking to myself....do I really want to do medicine? I chose medicine because there are so many options after you finish, but I think I like anesthesia more now (i just did a 1 week rotation in pain and saw some anesthesia there too, and really like the critical care part of medicine)? Is it too late to apply transitional or preliminary? Should I just get out of the match and try to scramble for a prelim/transitional and then try to get an anesthesia spot? Should I just match into medicine and then try to find a pgy-2 spot in anesthesia? At this point in the process what do you think the best plan of action would be?

PS. I did search this topic but it was mostly people who had already matched into medicien who wanted to do anesthesia. I would like to prevent that from happening in the first place unless thats the better way to do it!

 

[cchoukal]

Since an internal medicine internship qualifies as a clinical base year for anesthesiology residency, you don't really lose anything by continuing on your path. One safe option would be to continue to try to match into the best IM program you can, schedule an additional elective in anesthesia while you finish your fourth year, and then start your IM residency as planned. One of two things will happen:

Either you'll fall into your IM residency and decide you like it, or you'll hate it and start looking around for CA1 slots, which frequently become available. Many programs at all levels of "prestige, quality, etc." hold CA1 spots for highly qualified applicants defecting from other specialties.

 

[maceo]

the options are vast for internal medicine grads. Seriously you should not abandon that. the anesthesia options are limited especially right now in terms of employment and opportunities. Be warned about the dire future of anesthesia for physicians

 

[Jcm800]

having gone into General surgery before leaving for anesthesia, and eventually pain, i can tell you that you will find an anesthesia spot if you look even inf you go directly to medicine, the only caution is that some will not have a CA-1 spot for the NEXT year, ie lots of places are offereing "4 year" programs, regardless if the internship is done elsewhere...but then you loose a year, not the end of the world... and likely this WILL NOT happen, but if it does, worst case, you do PGy2 medicine, which isnt that terrible, and will help you in the long run...or you sit out and do insurance work, or some kind of non-clinical work.

I agree Anesthesia is about to hit is downturn, like it does every 11 years...

quit em both, and find an ortho spot, their lobby is so strong they can weather anything

 

[mdconfused]

thanks for the advice,
I will definitely continue with internal med for now and will try to do an anesthesia elective before I finish to see if I really like it. I'm not a primary care type of person and would want to sub-specialize if I continued but not sure in what.

Why is everyone so down on anesthesia's future? I was thinking pain is the future and with shiftwork and all that anesthesia is going to become uber competetive! Do you think compensation will be decreasing for anesthsia or pain? I met a pain doc who started a private practice and is doing beyond well. He loves his job since there are so many procedures, no call, and the procedures pay great! I hope his success continues and government reform doesnt take it away from him.