EM to Anesthesia?

[Throwaway12345771511]

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Long story short, I was going for EM and did an anesthesia rotation in March of fourth year, realized it was a better fit, but it was too late. Hoping it’s just pre-residency jitters but if it isn’t... How do I get into this field? The program I matched to doesn’t have an anesthesia residency so it seems like in this case I may have to finish my original residency and try to apply to anesthesia after (and hope there’s a program that will look past the funding issues). US MD, if that makes a difference. Is that the best course of action?

 

[IMGASMD]

Talk to your PD? Talk to your own med school? Even better if they have a anesthesia residency. You may find a pgy-2 spot (Ca-1)?

With some work and some luck, you’ll probably be fine.

Are you done with your first year EM? You’re going into the residency now?

 

[anbuitachi]

Not sure why you would go from EM to anesthesia... But it should be pretty easy if you decide to finish a few years of EM. You will be WAY ahead of other residents since you already will be proficient with lines/access/ some tubing experience/chest tubes and management in emergencies situstions. Program directors should love you .

 

[Apollyon]

A guy with whom I worked did EM, then an anesthesia critical care fellowship, then anesthesia residency. He was working in the ED after the fellowship, but before the anesthesia residency, for several years.

He did everything (med school, EM, fellowship, anesthesia) in California. Name places, too.

 

[Consigliere]

A guy with whom I worked did EM, then an anesthesia critical care fellowship, then anesthesia residency. He was working in the ED after the fellowship, but before the anesthesia residency, for several years.

He did everything (med school, EM, fellowship, anesthesia) in California. Name places, too.

Well I'm awfully proud of him

 

[Apollyon]

Well I'm awfully proud of him

Uh, OK? I gave an example for the OP. I haven't seen the guy in 8 years.

 

[2010houston]

If you really decide you want to do anesthesia, you would likely be competitive for one of the R (physician only) CA1 spots that would start in July 2020- that way you would not miss any time. I’m assuming you’d be competitive since you matched EM. HOWEVER, that means you have to submit ERAS in sept 2019- which doesn’t give you much time to give EM a chance!! Good luck w whatever you decide.

 

[Throwaway12345771511]

Thanks, everyone! I will consider my options and probably start speaking to PDs in August if I decide to make the jump. I just don’t want to end up leaving a residency and not getting a spot considering in that case, I would be pretty screwed...

 

[CidHighwind]

Just out of curiosity, what made you realize it was a better fit? Also, why not finish up the residency you’re already at and reapply as an attending?

 

[IMGASMD]

Just out of curiosity, what made you realize it was a better fit? Also, why not finish up the residency you’re already at and reapply as an attending?

EM is either 3 or 4 yrs. after that doing anesthesia is another 3. So six years of training..... opportunity cost for attending salary alone is at least half a mil.

Not a “whole lot” in the grand scheme of things, but makes a difference nonetheless.

 

[AdmiralChz]

EM is either 3 or 4 yrs. after that doing anesthesia is another 3. So six years of training..... opportunity cost for attending salary alone is at least half a mil.

Not a “whole lot” in the grand scheme of things, but makes a difference nonetheless.

I understand this “lost wage” argument, but if you are miserable in training and hate the field then really the cost is much more from a utilitarian point of view to stay in it and do all 6 or 7 years.

 

[IMGASMD]

I understand this “lost wage” argument, but if you are miserable in training and hate the field then really the cost is much more from a utilitarian point of view to stay in it and do all 6 or 7 years.

I totally agree.
I was answering the second part of that question. Why not switch after training? I should have preference it by “if the op had the opportunity to switch now, and knows that s/he won’t be happy in EM. Then they should do it now.”

 

[Groove]

Long story short, I was going for EM and did an anesthesia rotation in March of fourth year, realized it was a better fit, but it was too late. Hoping it’s just pre-residency jitters but if it isn’t... How do I get into this field? The program I matched to doesn’t have an anesthesia residency so it seems like in this case I may have to finish my original residency and try to apply to anesthesia after (and hope there’s a program that will look past the funding issues). US MD, if that makes a difference. Is that the best course of action?

Just be sure it's what you want to do... It can be really difficult as a med student/intern to have a solid, crystal idea about what life is like after residency in a chosen specialty. I'm convinced, that no matter what you choose...you'll inevitably start hating some days at work, especially around and after that 10 year mark. The grass is ALWAYS greener on the other side. For myself, I did a gas rotation during my 4th year, decided to apply to anesthesia, then switched back to EM. That was a long time ago. Some days I hate EM and wish I had chosen gas. Some days I hate the idea of both of them and wish I worked as an intensivist. Some days I wish I could win the lottery and just give up medicine altogether. Other days, I love EM and just think I need to work less. I guess my point is that hopefully you identified a few things about EM that you initially liked...enough to apply to the specialty. Chances are your initial gut instinct was not too far from the mark. Even if you don't get into anesthesia, I would bet you could enjoy a life of EM perfectly fine. Although the specialties are different, I feel there is more overlap than not. (i.e. Both are procedure heavy, have relatively short pt interactions, generally no continuity of care, instant gratification for relatively short "surgical" procedures, etc..) Just realize that nobody goes into a field and has a "****oo for coco puffs" level of excitement for the rest of their career...

There's no "magical specialty" that is imprinted on your DNA and that you were genetically engineered to be excellent at. Chances are I could have chosen several different specialties and been equally satisfied with my career in the long run. I just happened to choose EM. Whatever you choose, you'll be just fine. Good luck.

 

[deleted171991]

I understand this “lost wage” argument, but if you are miserable in training and hate the field then really the cost is much more from a utilitarian point of view to stay in it and do all 6 or 7 years.

If miserable in EM, one should do another 2 years of CCM, not anesthesia.

First, one should check if miserable in EM, at all, given the current state of anesthesia.