Did I make mistake picking anesthesia?

[Sparklesandstars]

Hi, I’m a CA1 at large academic hospital and quite frankly fairly unhappy with my residency experience and anesthesia in general. I’m writing to see if my feelings are typical or if I need to consider other options. My end game is likely not practicing general anesthesia but rather chronic pain (hospital employed) or hospital administration. I am not overly interested in the physiology of anesthesia and the leadership from my PD and chair is non-existent. IThe work environment is such that I dread going into work. I also am not feeling gratified or fulfilled by the work. I don’t feel like I’m helping people, though I recognize that occurs in many medical specialties. I look at what attendings do on a daily basis and recognize that it is different from what residents must do to a certain degree but the broad strokes are the same. I’m wondering if what I’m feeling is typical and common and if people recommend just sucking it up and do whatever I need to do to match into chronic pain, realizing that there is a possibility that the grass is not greener.

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[MirrorTodd]

Hi, I’m a CA1 at large academic hospital and quite frankly fairly unhappy with my residency experience and anesthesia in general. I’m writing to see if my feelings are typical or if I need to consider other options. My end game is likely not practicing general anesthesia but rather chronic pain (hospital employed) or hospital administration. I am not overly interested in the physiology of anesthesia and the leadership from my PD and chair is non-existent. IThe work environment is such that I dread going into work. I also am not feeling gratified or fulfilled by the work. I don’t feel like I’m helping people, though I recognize that occurs in many medical specialties. I look at what attendings do on a daily basis and recognize that it is different from what residents must do to a certain degree but the broad strokes are the same. I’m wondering if what I’m feeling is typical and common and if people recommend just sucking it up and do whatever I need to do to match into chronic pain, realizing that there is a possibility that the grass is not greener.

How much pain have you done? Personally, I think it's better to get out early, but one should still do tons of self reflection. To me, it's a bad sign that you don't feel like you are helping people. One of the great joys of anesthesia is seeing the direct results of your interventions. From my perspective, I loved anesthesia from my first anesthetic as an intern. Felt like I belonged there right away and that feeling never really went away completely. It certainly diminished during pgy4, especially near the tail end. I also couldn't stand clinic especially chronic pain clinic, so more power to you. What would you want to switch in to?

 

[ProwlerturnGas]

PP physician only anesthesia is the best job in medicine.

 

[coffeebythelake]

I would ask whether your feelings are due to your particular program and hospital, and less from thr actual specialty. Also, CA1 year can be pretty tedious when you are doing the same sort of cases everyday. Wait til you do your subspecialty rotations.

 

[vector2]

Pain plan or no pain plan I consider the fact that you don't like what you're doing or dread heading to work to be a big red flag. I can still remember 8 yrs ago when myself and everyone in my CA-1 class, including the folks who went on to do pain, were absolutely overjoyed to be living and breathing anesthesia and all things anesthesia-related after a long intern year out of the OR.

 

[dhb]

Did I make mistake picking anesthesia?​

Just read the title and the short answer is Yes

 

[nimbus]

Work environment aside, is any part of anesthesia fun for you? If not there is no shame in switching specialties. In my year, we had a guy switch to psych and another switch to urology. When I was a CA-3, one of our CA-1’s switched back to IM after 3 months of anesthesia. He eventually became a cardiologist.

 

[Sparklesandstars]

I’m a peds resident and would switch in a heartbeat. Wanna talk about feeling useless at the end of the day? Let me introduce you to endless notes, rounding for hours, and social crap that 100% doesn’t need a medical degree to do…

Yes, the grass isn’t greener

 

[Sparklesandstars]

I’m tempted to explore trying to transfer programs but that move would limit pain fellowship prospects as my current program has in house program with multiple spots

 

[Test Boy]

I’m tempted to explore trying to transfer programs but that move would limit pain fellowship prospects as my current program has in house program with multiple spots

Transfer to a PMR program if your goal is pain later. I bet their residency is much easier.

 

[GravelRider]

I’m a person who has never bought into the whole “you should love your job and be overjoyed to do it” philosophy. That sounds like a diagnosable psychiatric pathology to me. I could probably take or leave anesthesia and could be equally content in any number of specialties so long as the work life balance made sense to me. I find anesthesia interesting enough to not be miserable.

However, it sounds like you made a bad specialty decision. Either your expectations of what you were getting yourself into were wrong or you should have found a different path to what you wanted out of a career. Either adjust your expectations or find a new path.

 

[dabears505]

Oh you better believe you made a bad decision. Anesthesia and ob are easily the worst fields in medicine. Done transfer program, transfer to another specialty. Trust me, if you already hate it, you will grow to hate it even more.

 

[sevoflurane]

Anesthesia and ob are easily the worst fields in medicine. Done transfer program, transfer to another specialty. Trust me, if you already hate it, you will grow to hate it even more.

…

 

[nimbus]

Oh you better believe you made a bad decision. Anesthesia and ob are easily the worst fields in medicine. Done transfer program, transfer to another specialty. Trust me, if you already hate it, you will grow to hate it even more.

Imagine being an anesthesiologist married to an OB/gyn. Oh the horror 😱. Might as well yeet yourself.

 

[Silo004]

I hated residency. I still hate it and sometimes I wish I quit, but only after graduating I realized that anesthesia and residency were two different things. Currently at an MD only community practice where I do bread and butter cases with ASA 3/4s and a good amount of regional. Eight weeks vacation. Money is pretty decent.

I still deal with h** a** surgeons from time to time but the job is dope. Trust me just put your head down and pass the basic.

 

[DrOwnage]

Imagine being an anesthesiologist married to an OB/gyn. Oh the horror 😱. Might as well yeet yourself.

This is literally me.

 

[Status Sciaticus]

you can get into pain from EM, Neuro, Psych, and PMR. I personally hated CA-1 year. CA-2 year goes fast. and I stopped giving a f1ck CA-3 year. Im happier during CA-3 year.

 

[ERRES2288]

Were you considering anything else? Switching is not the end of the world but it does set you back some. There are lots of options in anesthesia and I think most people could be happy in either ccm, pain, or OR. Even within these practices vary considerably.

 

[D P356]

How are you sleeping, losing interest in normal activities, any feelings of guilt, lack of energy, difficulty concentrating, agitated, desire to hurt yourself?
If you feel like you’re depressed, it may not be anesthesiology that’s the problem.

Residency sucks, being depressed with high work expectations is worse. Make sure you’re doing okay.
Anesthesia is not for everyone. You don’t have to love the work to be good at it and take pride in your efforts. Find what suits you and take care of yourself.

An excerpt from my favorite book.
“A man can do no better than to eat, drink and find satisfaction in his work.”

 

[GassYous]

Residency gets worse as you lose sunlight since you come in before the suns up and leave after it sets.

I would power through and get those benjamins

 

[emergentmd]

Unless you love another field, just finish. I actually love my job and look forward to going to work. But I would guess maybe 20% of my partners or friends in other specialties love their jobs.

Make your $$$, enjoy stuff outside work, create a good home life. You will get great satisfaction if you do this.

 

[nimbus]

This is literally me.

Oh how I pity you. Your life must be terrible

 

[kidthor]

Hi, I’m a CA1 at large academic hospital and quite frankly fairly unhappy with my residency experience and anesthesia in general. I’m writing to see if my feelings are typical or if I need to consider other options. My end game is likely not practicing general anesthesia but rather chronic pain (hospital employed) or hospital administration. I am not overly interested in the physiology of anesthesia and the leadership from my PD and chair is non-existent. IThe work environment is such that I dread going into work. I also am not feeling gratified or fulfilled by the work. I don’t feel like I’m helping people, though I recognize that occurs in many medical specialties. I look at what attendings do on a daily basis and recognize that it is different from what residents must do to a certain degree but the broad strokes are the same. I’m wondering if what I’m feeling is typical and common and if people recommend just sucking it up and do whatever I need to do to match into chronic pain, realizing that there is a possibility that the grass is not greener.

First of all, OP, I‘m sorry to hear you feel this way. It is very tough to be in a situation where you dread going to work (and I’ve been there).

I and many (most?) others found residency tough and often disheartening. The system of residency education (in all fields) is rotten and exploits trainees. Mesh that with COVID-induced global malaise and you’ve got a recipe for wellbeing disaster. It’s hard to know if you are suffering from trainee beat-down vs a true specific dislike for anesthesiology.

As an attending many days truly are a joy and I know I’m making a positive difference for people. Sure, there are monotonous BS days too. But overall it’s pretty good. I am VERY positive as an attending compared to when I was a trainee. Really it’s a good setup as an attending... Show up, do some good, have fun, go home, get paid…. And people really do value you.

So in sum I think you’re depressed. And it’ll get better - but you ought to get some help now. Talk to a psychologist or an attending you trust or something... You need to take care of yourself above all else.

 

[Leinie]

PP physician only anesthesia is the best job in medicine.

This statement is worth repeating.

 

[dhb]

This statement is worth repeating.

Not by a long shot.

 

[Twiggidy]

Oh you better believe you made a bad decision. Anesthesia and ob are easily the worst fields in medicine. Done transfer program, transfer to another specialty. Trust me, if you already hate it, you will grow to hate it even more.

I kind of agree with this

If @Sparklesandstars your endgame is hospital administrator, your path may be easier doing IM and a specialty and getting an MBA rather than anesthesia. If that were my legit goals that’s absolutely the route I would take.

 

[Status Sciaticus]

I kind of agree with this

If @Sparklesandstars your endgame is hospital administrator, your path may be easier doing IM and a specialty and getting an MBA rather than anesthesia. If that were my legit goals that’s absolutely the route I would take.

why not anesthesia ? Its one of the prime specialties that allows you to do this... most places you get post-call day off, pre-call day you leave early. and most weekends are free. You're not wasting time doing notes, clinic, prior-auths. All that time can be spent on those physician MBAs.

 

[sevoflurane]

I don't know man. Worst in medicine? That is a bit too gloomy for me.
When I think worst in medicine I think Gen. surg and most of their subspecialties, FP, peds, vascular, OB/GYN... IM and most of subspecialties outside of cards and GI. Anesthesia is far from the worst. No clinic, no patient phone calls, you are "off" when you are off. You are not doing the same boring procedure every day and in fact anesthesia can be pretty interesting from day to day. Hearts, transplants, peds, acute and chronic pain, trauma, ortho all sorts of cancer, plastics/reconstructive, critical care and a billion different procedures to boot. Not being stuck in clinic is a big feather in our hats.

It definitely caters to a certain personality type no doubt. The worst part of anesthesia is the call. Some centers have OR's going 24/7- mine included. The key is to get a big enough group that you can spread the call around or a small enough group where call backs are rare. Been in both those group types. But you can also tailor your call system. For our group, you don't have to take 24 hr call. You can just drop off of it. You'll make less, but you won't suffer any long nights but with that, you also don't get the post call day off.

My week so far: Monday 4th call, Tuesday off, Wednesday 1st call (shifts starts at 3pm), today off. Was home at 8:30 pm last night and slept all through the night . I am a regular 7-3pm dude tomorrow.

Pay is above average for medical specialties. We do make a huge difference and are able to handle a lot of situations.

Can be a lifestyle choice as you get close to retirement... cutting back is easy to as we don't have any overhead. Took 16 weeks last year, more this year. A lot of specialties don't have this option. Either you are in or you are out.

It isn't the worst job in medicine even w/ all the BS that is out there. Just remember, every subspecialty is under attack from consolidation.

Give it some time, my wife is super chill and was a bit shy to the specialty when she started. Fast forward 15 years, and she has done it all. Hearts, peds, regional, trauma, etc. She's 5'4" and deals with all the surgical personalities- she is well respected in our community. Things change after residency 100%. Also, keep in mind we are in historical demand right now. Good luck OP, it isn't a perfect specialty... but it is FAR from the worst.

 

[We'llBeDoneIn15Minutes]

Hi, I’m a CA1 at large academic hospital and quite frankly fairly unhappy with my residency experience and anesthesia in general. I’m writing to see if my feelings are typical or if I need to consider other options. My end game is likely not practicing general anesthesia but rather chronic pain (hospital employed) or hospital administration. I am not overly interested in the physiology of anesthesia and the leadership from my PD and chair is non-existent. IThe work environment is such that I dread going into work. I also am not feeling gratified or fulfilled by the work. I don’t feel like I’m helping people, though I recognize that occurs in many medical specialties. I look at what attendings do on a daily basis and recognize that it is different from what residents must do to a certain degree but the broad strokes are the same. I’m wondering if what I’m feeling is typical and common and if people recommend just sucking it up and do whatever I need to do to match into chronic pain, realizing that there is a possibility that the grass is not greener.

A few thoughts:

I think I was going to hate CA1 year anywhere. Too many people ahead of you at every turn are into power trips. Everyone from attendings, residents, surgeons, and nurses may treat you like ****. It does get better with every passing year.

If you're sure about going into pain, who GAF if you don't like anesthesia? It's a means to an end. Why transfer to another specialty to get into the pain track when you are already in a pathway to pain. That would be a lot of unnecessary transfer work, major upheaval, and possibly loss of any credit for this year.

You are already past the worst months of residency when you are stupid and paired up. Ride it out unless, of course, it's just so unbearable you can't stand it and are not doing a good quality job.

 

[emergentmd]

Young people tend to be bright eye, lots of ambitions, lots of goals, and lots of energy so even if they are not happy with 25% of the job. As you get older, life changes and priority changes. You eyes are able to focus on what is important, your ambition is to be left along in a peaceful existence, your goal is to watch your kids grow up happy, and your energy is focused on your family/friends.

If you read the EM board, you would think that is the worse field known to man. Trust me it is not.

IMO most of the time you are either a happy person or not. If you want to spend another 2-5 yrs in residency hell to find out, then good luck to you.

 

[nimbus]

Young people tend to be bright eye, lots of ambitions, lots of goals, and lots of energy so even if they are not happy with 25% of the job. As you get older, life changes and priority changes. You eyes are able to focus on what is important, your ambition is to be left along in a peaceful existence, your goal is to watch your kids grow up happy, and your energy is focused on your family/friends.

If you read the EM board, you would think that is the worse field known to man. Trust me it is not.

IMO most of the time you are either a happy person or not. If you want to spend another 2-5 yrs in residency hell to find out, then good luck to you.

Yeah even within the same department with people doing exactly the same job, some people are very satisfied with their job and others are not.

 

[Volatile]

I’m biased but I do think being an anesthesiologist is the best job in medicine. Maybe stick it out for a year and see if your opinion changes?

 

[Twiggidy]

why not anesthesia ? Its one of the prime specialties that allows you to do this... most places you get post-call day off, pre-call day you leave early. and most weekends are free. You're not wasting time doing notes, clinic, prior-auths. All that time can be spent on those physician MBAs.

From a "in hospital networkings" aspect, you'll find yourself in the right room with the right people more often. At least where I am, the candidates, for President, CMO, "Regional Director of Sales" will be from a multitude of specialties before an anesthesiologist. The exception could be a critical care anesthesiologist. This is just observation

 

[Twiggidy]

I’m biased but I do think being an anesthesiologist is the best job in medicine. Maybe stick it out for a year and see if your opinion changes?

I agree. I think the Pros of anesthesiology outweight the Cons so long as what Sevo said.....find the right practice. The wrong practice can quickly make this field a crap show (as I'm sure is the same with most fields)

 

[shepardsun]

At least where I am, the candidates, for President, CMO, "Regional Director of Sales" will be from a multitude of specialties before an anesthesiologist. The exception could be a critical care anesthesiologist. This is just observation

I dunno, I trained at a major academic medical center where the CEO of the entire hospital system was an anesthesiologist.

 

[epidural man]

Hi, I’m a CA1 at large academic hospital and quite frankly fairly unhappy with my residency experience and anesthesia in general. I’m writing to see if my feelings are typical or if I need to consider other options. My end game is likely not practicing general anesthesia but rather chronic pain (hospital employed) or hospital administration. I am not overly interested in the physiology of anesthesia and the leadership from my PD and chair is non-existent. IThe work environment is such that I dread going into work. I also am not feeling gratified or fulfilled by the work. I don’t feel like I’m helping people, though I recognize that occurs in many medical specialties. I look at what attendings do on a daily basis and recognize that it is different from what residents must do to a certain degree but the broad strokes are the same. I’m wondering if what I’m feeling is typical and common and if people recommend just sucking it up and do whatever I need to do to match into chronic pain, realizing that there is a possibility that the grass is not greener.

Did you make a mistake?

Absolutely 100%.

You should have been a hedge fund manager, or robotic engineer, or built houses as a construction company owner, or real estate mogul, or even electrician or plumber is probably a better choice.

But since you are now stuck in this cesspool of health care, Anesthesia is a VERY wise choice.

 

[epidural man]

Actually, you should have become a pilot for an airline company or UPS. What a cool job that would be.

 

[epidural man]

But I would like to give a more serious answer.

Mine is the best answer so pay attention.

Every resident wants to quit at some point. Every single one. This is an important point.

I have met many anesthesia residents (I train residents daily) that are miserable.

I can’t think of any working Anesthesiologists that regret their decision.

Please think about those two statements before making a decision.

Finally, I think pain is a dying field. It won’t die of course, but it is a falling star. I do more pain than anesthesia and this is a much longer conversation that can’t get justice on SDN. My point is, you should spend a lot of time thinking about that specialty and where it is headed.

But you should know my bias.

I talked both my brother and sister (who was dead set on IM) into doing anesthesia. My sister thanks me every time I talk to her for saving her.

 

[Barleycorn]

Did you make a mistake?

Absolutely 100%.

You should have been a hedge fund manager, or robotic engineer, or built houses as a construction company owner, or real estate mogul, or even electrician or plumber is probably a better choice.

But since you are now stuck in this cesspool of health care, Anesthesia is a VERY wise choice.

The reason medicine may be preferable to the fields you listed (especially for immigrants and first generation immigrants) is that you dont really need any business savvy, innovation, creativity, foresight, family background, seed money, network or corporate ladder climbing skills to make an income greater than 90% of the world. You really just have to pass exams and meet some basic level of competence.

That being said, anesthesia can be horrible or a really chill job. In my experience, it is less fruiful to search for the perfect option in lieu of making the best of a good one.

 

[We'llBeDoneIn15Minutes]

Where were you when I stupidly picked peds over anesthesia. I regret that decision not only every day but multiple times a day

In my small anesthesia class were board certified physicians in ER, ObGyn, and Peds. Yes, it's 3 more sucky years, but your decision can be corrected.

 

[We'llBeDoneIn15Minutes]

The reason medicine may be preferable to the fields you listed (especially for immigrants and first generation immigrants) is that you dont really need any business savvy, innovation, creativity, foresight, family background, seed money, network or corporate ladder climbing skills to make an income greater than 90% of the world.

If you're throwing the world in this conversation it's well over 99%.

 

[Planktonmd]

So you think you will be "helping people" more doing pain? Pain doctors are everywhere from all specialties, even nurses are doing pain. The reason why they all want to do pain is not to help people, but it's more about billing for procedures that have to be repeated endlessly with no permanent results and no real cure. Then when you run out of procedures you give them opiates and other questionable medications that mainly turn them into loyal customers to the pharmaceutical companies. Sometimes you may also be inclined to place expensive devices (pumps and stimulators) that may delay the inevitable escalating opiates destiny for a few months at best.
I know many pain guys might find my statement offensive but it is the reality of pain medicine in this country.

 

[deleted875186]

But I would like to give a more serious answer.

Mine is the best answer so pay attention.

Every resident wants to quit at some point. Every single one. This is an important point.

I have met many anesthesia residents (I train residents daily) that are miserable.

I can’t think of any working Anesthesiologists that regret their decision.

Please think about those two statements before making a decision.

Finally, I think pain is a dying field. It won’t die of course, but it is a falling star. I do more pain than anesthesia and this is a much longer conversation that can’t get justice on SDN. My point is, you should spend a lot of time thinking about that specialty and where it is headed.

But you should know my bias.

I talked both my brother and sister (who was dead set on IM) into doing anesthesia. My sister thanks me every time I talk to her for saving her.

I disagree with the outlook for pain. I think the outlook is good, only thing that limits it is insurrance coverage for procedures.

Obviously the opioids are the main draw back to the specialty, but some people just prescribe no medications, probablem solved. Perhaps in the future we will have even stricter opioid guidelines for chronic pain, this would be the best thing for the specialty in my opinion.

 

[studentofsdn]

Fwiw, my ca-1 year i really thought I made a mistake and would be miserable in anesthesia forever. This was concerning bc i couldnt tolerate any other field in medicine. I was considering pain or leaving medicine all together. Now as a ca-2 i find anesthesia so fun, the way i thought i would as a med student, and am even strongly considering a cardiac fellowship. Give it some time if you truly liked the field at all as a med student. It will come back

 

[sevoflurane]

I disagree with the outlook for pain. I think the outlook is good, only thing that limits it is insurrance coverage for procedures.

Obviously the opioids are the main draw back to the specialty, but some people just prescribe no medications, probablem solved. Perhaps in the future we will have even stricter opioid guidelines for chronic pain, this would be the best thing for the specialty in my opinion.

I am highly suspicious of MILD and Vertiflex. Probably good for those who own their own centers.

 

[sevoflurane]

Fairly certain their reimbursements went down recently.

 

[sevoflurane]

To be fair, I am also suspicious of all the spine surgery we do in this country.

 

[We'llBeDoneIn15Minutes]

I plan to apply the next cycle. Will have a year off to get boarded in peds and work to pay off loans. Any tips to how I can be competitive?

I am DO who did well on boards but didn’t take the usmle. Debating studying for steps after getting boarded in peds. Worth it?

Obviously can't change your past academics and references, but definitely get boarded. That's a leg up. You did well on boards so I don't know if steps is adding much. If you are confident you smoke those types of exams then sure, fire away.

 

[nimbus]

To be fair, I am also suspicious of all the spine surgery we do in this country.

The Puzzling Popularity of Back Surgery in Certain Regions (Published 2017)

Health care innovations and procedures spread unevenly across geographic regions, seemingly because of physician preferences, research suggests.

www.nytimes.com

 

[Lidolover]

I think you should rule out a few things before you make a decision about changing specialty:
1. Make sure you don’t have depression; that would make everything look dark and worthless
2. Make sure you have fixed your personal life; active personal issues can ruin easily the outlook of our life, job, career etc; if single, go out, enjoy life, date normal ppl etc; if married, troubleshoot what appears to be broken
3. Take a trip somewhere nice, relax, turn off everything and appreciate how lucky and blessed you are for what u have achieved so far
4. Set goals and make your brain eliminate the noise till you reach that goal. I hated cholecystectomies, ortho cases and almost all the bread and butter cases but 4 yrs flied and luckily I ended up doing what I loved the most: cardiac critical care, cardiac anesthesia, echo and so forth
5. Sometimes we experience what is called obsession compulsion when experiencing an unexpected stress; figure out what it is (your performance? your attendings? your PD? you comparing yourself with you peers? Etc) because that might be the reason why you are obsessing about not being in the right field
6. After you check all of the above, and if you still feel strongly about it, change specialty. You will forget this year and how you felt very quickly 100000%

Good luck!

Ps. I do psychiatry as a side job lol