Going into anesthesia for pain

[lost007]

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So I'm a MS4 who applied to internal medicine and anesthesiology and have just over a week to figure out my rank list. Honestly, I didn't love my anesthesia rotations but I did love my pain rotation (although it was run by a PMR doc). Then again, I didn't love my IM rotation either.

I guess my only hesitations with anesthesia is the amount of stress that they deal with on a daily basis. It kinda freaks me out the the patient's lives are in the hands of the anesthesiologist. I'm worried about burning out fast with this kind of constant pressure.

Did anyone go into anesthesia for the sole purpose to get to pain? And did anyone on here go into anesthesia without absolutely loving their rotations and having some of the same concerns as me?

 

[Per4mer8]

Rank IM. Seriously.

 

[excalibur]

I think I did 3 months of pain during my 4 year anesthesiology residency. If you didn't enjoy your basic anesthesiology rotations, you might be miserable during residency as the overwhelming majority of the residency is not pain.

 

[lobelsteve]

Go PMR if you want pain, anesthesia provides poor training for private practice in PM.

😛😛😛😛😛

 

[lost007]

Ya Pmr would have been a good route...but it's too late. I only applied to IM and anesthesia. I don't exactly love IM either though, which is the problem.

 

[michigangirl]

If you didn't love either (which begs the question why you applied to either-- did you not enjoy any of your rotations?), then I would definitely go with IM over anesthesia. Residency is going to be one big painful experience for you if you do anesthesia. IM may be the same, but you have a lot more options for specialization. And if you enjoyed pain then clearly you don't mind listening to folks talk about their chronic issues. Other than pain or ICU, there's no way out of the OR with anesthesia.

 

[lost007]

I enjoyed some aspects of all of my rotations (except maybe OB/GYN), but never had that "a-ha" moment where I had finally found the specialty that I wanted to do for the rest of my life. I liked aspects of anesthesia as well as IM. I am however more comfortable in the clinic setting as opposed to the OR. I loved my pain rotation and thought it was very rewarding (most of the patients had acute pain issues) and at the same time had a good lifestyle. So that's why I'm considering the anesthesia-->pain route.

 

[pie944]

I have two friends who wanted to go into pain medicine from the start of the application cycle, both had no intention of practicing anesthesia after residency. Both are practicing pain full time.

 

[Ronin786]

Im curious as to why you didn't apply to PM&R from the get go? Does PM&R require a prelim year? Because you could always do a prelim year and apply there next cycle or transfer out of your IM program.

 

[lost007]

I did an inner-city inpatient PMR rotation in the beginning of the year where I was on the spinal cord unit, and hated seeing the young paraplegics/quadraplegics due to GSW's who were now screwed for the rest of their lives. Seeing them struggle with incontinence, pressure ulcers, etc on a daily basis kinda depressed me. But now I realize that's only a small subsection of PMR, and some of the other stuff they do like sports medicine and pain is really cool. PMR does require a prelim but then i'd have to take a year off since all of their advanced positions for the following year would probably be filled.

I do like aspects of anesthesia - the physio and pharm as well as ability to do pain med. I am worried about the acute stress of daily anesthesia as well as long days and being in the OR all the time.

 

[Stellar Clouds]

I did an inner-city inpatient PMR rotation in the beginning of the year where I was on the spinal cord unit, and hated seeing the young paraplegics/quadraplegics due to GSW's who were now screwed for the rest of their lives. Seeing them struggle with incontinence, pressure ulcers, etc on a daily basis kinda depressed me. But now I realize that's only a small subsection of PMR, and some of the other stuff they do like sports medicine and pain is really cool. PMR does require a prelim but then i'd have to take a year off since all of their advanced positions for the following year would probably be filled.

I do like aspects of anesthesia - the physio and pharm as well as ability to do pain med. I am worried about the acute stress of daily anesthesia as well as long days and being in the OR all the time.

There are 12 PM&R spots in the match this year which start in July of 2013 as a PGY-2, so there is at least hope that you could switch without repeating your internship.

 

[lost007]

There are 12 PM&R spots in the match this year which start in July of 2013 as a PGY-2, so there is at least hope that you could switch without repeating your internship.

Where did you see that information?

 

[bronx43]

Do you like the procedures that you encounter in pain medicine, or do you like actually dealing with pain patients? I can't see how it would be the latter...

 

[Stellar Clouds]

Where did you see that information?

Search the NRMP program list. Under specialty pick Physical Medicine and Rehabilitation, under position type select Physician Only, and then hit search.

 

[lost007]

Do you like the procedures that you encounter in pain medicine, or do you like actually dealing with pain patients? I can't see how it would be the latter...

I like the procedures and dealing with acute pain patients. I agree that chronic pain patients are tough.

Search the NRMP program list. Under specialty pick Physical Medicine and Rehabilitation, under position type select Physician Only, and then hit search.

Oh nice, but when I did that it only showed 9 spots.

 

[Stellar Clouds]

Oh nice, but when I did that it only showed 9 spots.

9 programs, but some had more than 1 spot