Going from anesthesiology to surgery

[Gasintern]

I'm a current pgy1 anesthesiology resident at a pretty decent program. Ive always loved the OR, and basically went into anesthesiology after deciding against surgery (mainly because of the lifestyle) with the goal of becoming an interventional pain management doc. I finished a few months of anesthesia and to be honest, I hate going into work. I worked hard to be successful in medical school because I wanted to be a doctor. Now that I am, I don't really feel like one. I hate "taking orders" from my surgical colleagues (raise/lower table) I hate that I do a lot of things that nurses do (set up rooms, chart drugs/vitals/transfer patients from one bed to another). On my internal medicine rotations, I'm finding I love talking to patients, explaining a diagnosis to a concerned family member is usually the highlight of my day. I know that once I start pgy2 year, I'll never get that again as an anesthesiologist. I thought I wanted money and lifestyle, but I'm starting to feel like I've made a huge mistake. I love being in the hospital, and feel like I have what it takes to get through GS residency.
Basically, how easy would it be to switch from anesthesiology to general surgery? I haven't spoken with my PD yet, and am in the initial stages of researching the process. Do any of you have any advice as to how to make a more informed decision?

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[mostwanted]

As a practicing anesthesiologist, I would strongly advise against it. Wait at least until you are doing more advanced cases. PGY1 is learning a lot of basics, but private practice is a different environment. I think easing/comforting someone in a difficult time can be very rewarding. In my residency, I knew at least six people who had switched from surgery to anesthesia.

 

[Libertas]

Fellow in anesthesiology.
-If you didn't want to go into surgery because of lifestyle, you're still not going to like the surgery lifestyle.
-I don't take orders from surgeons and neither do my attendings. We have a colleague/team relationship. Maybe you and your attendings need to step up and be worthy of respect? If we're talking about raising the bed, honestly, that doesn't bother me.
-I do some things that nurses traditionally do (emptying a foley). But a lot of the traditional 'nursing tasks,' like transporting patients or placing IVs I have to do because frankly we're the best at it. A lot of my transports are way too unstable to be done by nurses alone. For routine cases the nurses/techs bring my patients to my OR for me at my hospital.
-I talk to tons of patients and families.

 

[bannie22]

Er yeah. You are gonna be taking a lot more orders from your surgical seniors and attendings.

Dont throw away a fantastic career.

 

[The Anhedonia]

yeah man, i'm an OMFS resident on my 5-month anesthesia rotation, and honestly it's so awesome I'm wondering what I'm doing continuing my surgical training. Anesthesia is the best. You'd be making a yuuugggggeee mistake.

 

[Psai]

yeah man, i'm an OMFS resident on my 5-month anesthesia rotation, and honestly it's so awesome I'm wondering what I'm doing continuing my surgical training. Anesthesia is the best. You'd be making a yuuugggggeee mistake.

Anesthesia is awesome

 

[Carbocation1]

yeah man, i'm an OMFS resident on my 5-month anesthesia rotation, and honestly it's so awesome I'm wondering what I'm doing continuing my surgical training. Anesthesia is the best. You'd be making a yuuugggggeee mistake.

Can't tell if sarcasm. Can you elaborate?

 

[doc05]

stick with anesthesiology. switching into surgery would be an unfortunate mistake.

 

[Winged Scapula]

1) you didn't ask for advice about whether to switch
2) it seems a bunch of non-surgeons and anesthesiologists have decided that they are going to give you advice any way
3) while residency can be difficult, you can make good money and have a good lifestyle in surgery; you're playing the medical student/resident game (its ok, we all did) that surgery = long hours and no lifestyle
4) there are generally open spots in GS after PGY-1 so while it isn't easy, if you are a good candidate you've as good a shot as any
5) your best shot is likely to be at your current program (assuming a GS residency exists)
6) depending on rotations, assume that you will have to repeat the majority of your PGY-1 year; its likely only SICU and/or Trauma (if done) will count. The majority of a surgical PGY-1 must be surgical or critical care rotations
7)only you can answer whether you should switch; anesthesiologists and non-surgeons are going to be biased, surgeons are going to be biased as well
8) your tale only goes to show that picking a specialty based on false assumptions often doesn't work out well

Best of luck to you

 

[bannie22]

I agree with most of the other posters. Do yourself the biggest favor and dont even THINK about it anymore.

Even the OMFS resident thinks you are cray cray.

All the best!

 

[dienekes88]

I'm a current pgy1 anesthesiology resident at a pretty decent program. Ive always loved the OR, and basically went into anesthesiology after deciding against surgery (mainly because of the lifestyle) with the goal of becoming an interventional pain management doc. I finished a few months of anesthesia and to be honest, I hate going into work. I worked hard to be successful in medical school because I wanted to be a doctor. Now that I am, I don't really feel like one. I hate "taking orders" from my surgical colleagues (raise/lower table) I hate that I do a lot of things that nurses do (set up rooms, chart drugs/vitals/transfer patients from one bed to another). On my internal medicine rotations, I'm finding I love talking to patients, explaining a diagnosis to a concerned family member is usually the highlight of my day. I know that once I start pgy2 year, I'll never get that again as an anesthesiologist. I thought I wanted money and lifestyle, but I'm starting to feel like I've made a huge mistake. I love being in the hospital, and feel like I have what it takes to get through GS residency.
Basically, how easy would it be to switch from anesthesiology to general surgery? I haven't spoken with my PD yet, and am in the initial stages of researching the process. Do any of you have any advice as to how to make a more informed decision?

Since the question is not "should I switch" but "how do I make an informed decision," I can only recommend the following:

1) Talk to some of the senior anesthesia residents about your concerns about anesthesia. I definitely would NOT mention possibly switching fields in any conversation.
2) Talk to some of the young attendings who do slightly more longitudinal care than periop stuff. I'm thinking about Anesthesia/Critical Care and Pain.

I think that in a position of stress, everyone experiences a bit of the "grass is greener" phenomenon. For some, they like to think that other programs in the same field are way better. For others, they start thinking about how much better it would be in another field. In some respects, this is you trying to find a way out (any way out) of the discontent you feel not entirely about anesthesiology but the pain of being an intern: "April is the cruelest month." Growth and change is never easy. At least that's what I saw a lot in my early years of residency. There is a lot of pain in surgical residency, but there are some really great moments as you point out: the connection you feel with a patient and family when you tell them the diagnosis, the plan, and explain the operation. The exhiliration of conducting an elegant operation. Watching a transplanted heart start beating when the clamp comes off. These are some of the most beautiful moments. There is a flip side, though: you have to be there at the bedside with the family when things go bad. That can be really tough.

 

[The Anhedonia]

Can't tell if sarcasm. Can you elaborate?

No sarcasm. Anesthesia is an amazing profession. I find the scut level as a resident is way lower compared to surgery. It's also very gratifying to follow a patient the entire way through the surgical process. And the residency is only 3 years after intern year.

 

[Dr.LeoSpaceman]

No sarcasm. Anesthesia is an amazing profession. I find the scut level as a resident is way lower compared to surgery. It's also very gratifying to follow a patient the entire way through the surgical process. And the residency is only 3 years after intern year.

Selecting a profession which you will practice for 30+ years based on the amount of scut you do in residency (or an extra 1-2 years of training) seems a bit short-sighted. And I also take issue when I hear things like "following patients through the surgical process". The surgical "process" begins before they show up in the pre-op area and extends beyond the time they leave the PACU. People who choose surgery generally enjoy those elements of treating patients in addition to what happens in the OR.