I like Anesthesiology, but I'm nervous about going into it. Should I be?

[medstudent87]

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I enjoy being in the OR, I like pharm and physio, and I love how you can immediately see the effects of whatever you're doing to the pt (as opposed to waiting it out in medicine and then trying another med). Furthermore, I feel like I really meshed well with the attendings and residents in this specialty and would enjoy pursuing it as a career. Thing is, then I read threads like this:

http://forums.studentdoctor.net/showthread.php?t=353603

...and I start having second thoughts. Will I even have a job in the future? I really don't want to become an ICU doc if that's where the profession seems to be heading....

Thing is, I really haven't enjoyed anything else. My surgery clerkship was a living hell, and I'm not really digging medicine right now either. Rads seems boring to me, as does psych. EM is like working at a walk-in clinic...no thanks.

Thoughts? Ideas?

 

[bcat85]

I think you could make this thread about literally any specialty in medicine. The future of everything is never 100% certain, though there are some that are probably a bit closer (say... neurosurgery). Go into what you want to go into.

 

[Creed Bratton]

You know, no one has ever made this thread before. My crystal ball is in storage so the only response I can give is "try again later"

 

[PMPMD]

I enjoy being in the OR, I like pharm and physio, and I love how you can immediately see the effects of whatever you're doing to the pt (as opposed to waiting it out in medicine and then trying another med). Furthermore, I feel like I really meshed well with the attendings and residents in this specialty and would enjoy pursuing it as a career.

So what's the problem?

Thing is, then I read threads like this:
...

Ohh, that's the problem. I think you should stop reading SDN.

Seriously, there are doom & gloom threads for every specialty.

 

[BLADEMDA]

I enjoy being in the OR, I like pharm and physio, and I love how you can immediately see the effects of whatever you're doing to the pt (as opposed to waiting it out in medicine and then trying another med). Furthermore, I feel like I really meshed well with the attendings and residents in this specialty and would enjoy pursuing it as a career. Thing is, then I read threads like this:

http://forums.studentdoctor.net/showthread.php?t=353603

...and I start having second thoughts. Will I even have a job in the future? I really don't want to become an ICU doc if that's where the profession seems to be heading....

Thing is, I really haven't enjoyed anything else. My surgery clerkship was a living hell, and I'm not really digging medicine right now either. Rads seems boring to me, as does psych. EM is like working at a walk-in clinic...no thanks.

Thoughts? Ideas?

That EtherMD person seems like a he/she is on the money.😀 I like the writing style.

 

[medstudent87]

Seriously, there are doom & gloom threads for every specialty.

Yea, but it seems like anesthesiology is closest to being overtaken by its midlevels..no?

 

[scudrunner]

Yea, but it seems like anesthesiology is closest to being overtaken by its midlevels..no?

I think you should talk with some attendings at your home institution about this issue and see what they have to say.

 

[Cathyran]

Yea, but it seems like anesthesiology is closest to being overtaken by its midlevels..no?

No. Virtually every specialty has a midlevel provider to fight with. In ophtho, its optometrists. In family, its NP's. Radiology has that overseas thing they worry about. Derm has NP's, and on and on and on. The only specialties that are somewhat exempt are the surgical specialties. "Hi, I'm (insert name), I'll be the nurse removing your brain tumor" just doesn't have the same ring to it. Admittedly, "I'm the nurse that will keep you neurologically intact while the surgeons fart around in your abdomen" doesn't feel very good either, but its the way that anesthesia has evolved... we just can't make enough docs to provide all the anesthetics in the country. Anyway, this is not a problem unique to anesthesiology, by a very long shot.

 

[urge]

"Fear is the path to the dark side. Fear leads to anger. Anger leads to hate. Hate leads to suffering."

Use the Force... Let go...

 

[Doctor4Life1769]

If you're scared of nursing, go into IM... they seem to have the routine down pat.

 

[yappy]

I'm confused by the persons comments above about IM..?

Anyways, to me nursing is out of control. They should be techs and techs only. There is nothing an RN does that an EMT-paramedic cannot do with a little extra OJT and they would work for much less (Many paramedics do RSI, IV, urinary cath, drug admin, ACLS, and manage IV pumps in the pre-hospital enviroment. They also have the same prereqs as nursing. Yet RN's earn on average 30-40 dollars per hour and bring in all the baggage that goes along with dealing with unions.

It seems to me if you really want to bring down the cost of health care, optimize the financial cut that goes to physicians, it's to give the 1000's of worker bees a pay cut while leaving all the professional duties to the professionals (read: MD/DO). In most dental offices I've shadowed the Dr. is in charge of everyones wages. They pay people based off of their production (collections) or an hourly wage.

Why cant physician groups hire their own help and pay them based on collections? If reimbersement goes down then the physician would lay people off and perform more duties or hire cheaper labor to increase their case load - which ever resulted in better pay.

 

[zebalong]

I'm confused by the persons comments above about IM..?

Anyways, to me nursing is out of control. They should be techs and techs only. There is nothing an RN does that an EMT-paramedic cannot do with a little extra OJT and they would work for much less (Many paramedics do RSI, IV, urinary cath, drug admin, ACLS, and manage IV pumps in the pre-hospital enviroment. They also have the same prereqs as nursing. Yet RN's earn on average 30-40 dollars per hour and bring in all the baggage that goes along with dealing with unions.

Uh your arguement for nurses to be techs bc paramedics can do the same job is an arguement you could use for crna's to take jobs from physicians. You can teach a nurse to do all the physical tasks an anesthesiologist does but the difference is the level of understanding when things go wrong. The difference between rn's and medics is their training and understanding, a good icu nurse is worth their weight in gold- their critical thinking allows for you to not be called for every little thing as a critical care doctor. A medics is taught how to stabilize and transport... Ask them to titrate drips and you'll have yourself a problem. and perhaps more importantly a well trained RN knows when to notify a doc when things start going bad. This allows doctors to budget their time for matters that actually need their attention.

Before med school I was a critical care rn so I am baised but I've trained other nurses and medics through their Er rotations and I can say their training is different enough that you can't group them into one.profession- the same way I would believe crnas will never be a replacement for anesthesiologist. The knowledge base that anesthesiologist have can't be fully replaced by crna's - yes care team models will persist and perhaps for certain institutions will be the right choice for financial reasons. But as someone who used to be a nurse I see the knowledge and training difference between the two professions and I beleive anesthesia will always be the leader of the care teams bc general public in the us always demands the best care available. For instance, if anyone is being sued for a million dollars I doubt they'd take a paralegal over an attorney if given the choice.

 

[yappy]

That's not what I'm saying at all.

Uh your arguement for nurses to be techs bc paramedics can do the same job is an arguement you could use for crna's to take jobs from physicians.

The prereqs between RN and EMTP are the exact same. They have the same basic science understanding. Alot of what you're describing comes after years on the ICU floor. They both have the same tools to begin with and the rest is developed through experience. The same could not be said for an RN with anesthesia training and an MD anesthesiologist. In both cases the RN and EMTP are not DX, RX, or PRACTICING MEDICNE. They are trained to fulfull orders that are based off of the physicians professional opinion and understanding of medicine.

 

[The right Path]

That's not what I'm saying at all.



The prereqs between RN and EMTP are the exact same. They have the same basic science understanding. Alot of what you're describing comes after years on the ICU floor. They both have the same tools to begin with and the rest is developed through experience. The same could not be said for an RN with anesthesia training and an MD anesthesiologist. In both cases the RN and EMTP are not DX, RX, or PRACTICING MEDICNE. They are trained to fulfull orders that are based off of the physicians professional opinion and understanding of medicine.

Uh, so are you saying that you may as well take a student that's finished their pre-reqs and just throw 'em into the hospital for OTJ training? Just skip the whole nursing school thing altogether. And call that person a licensed professional nurse?

I don't know why some people persist in spouting off about nursing when clearly they don't know jack about it. 🙄

You want bottom of the barrel, warm body with a pulse minimal requirement, lowest pay bidder type of nursing care when YOU or YOUR MAMA are in the hospital? After all, everything the nurse needs to know has been spelled out by physician orders and protocols, amirite?



There is a reason that there are standards in nursing and medicine.

 

[yappy]

lol. What's that I smell? An ex-union-RN?

No need to strawman my arguement to support your position.

Uh, so are you saying that you may as well take a student that's finished their pre-reqs and just throw 'em into the hospital for OTJ training? Just skip the whole nursing school thing altogether. And call that person a licensed professional nurse?

 

[The right Path]

lol. What's that I smell? An ex-union-RN?

No need to strawman my arguement to support your position.

I am currently not. Nor have I ever been in a union. *****. Your username is apt.

Oh, and I don't need a strawman to support my position that a person who has the responsibility of being a nurse should be well-educated in strict accordance with well-defined standards. If you think that any boob off the street would suffice as a nurse- well, I bet you wouldn't hope that you get what you wished for.

 

[zebalong]

I am currently not. Nor have I ever been in a union. *****. Your username is apt.

Oh, and I don't need a strawman to support my position that a person who has the responsibility of being a nurse should be well-educated in strict accordance with well-defined standards. If you think that any boob off the street would suffice as a nurse- well, I bet you wouldn't hope that you get what you wished for.

This was my overall point (although in a more... Mild manner) that we can't assume that just cause jobs look similar on the outside that people should be able to jump back and forth between them if the training is different.

I wouldn't trust a nurse in a rig unless they gained critical care transport training anymore then I would trust a medic on an icu floor. The training is much different- nurses have courses in med surg and experience on the floors - medics get trained for the rig. If medics want to work the floors like nurses then they should gain floor education, which is basically nursing school.

This is the same for crnas vs. Anesthesiologist. The crnas aren't trained to be physicians so to assume just cause they can do the same physical tasks that they can now assume the physician role once they gain extra experience or education (piece of crap dnp degree) is absolutely crazy. My friends who are crnas keep saying no matter what the national organizations might be spouting off they don't want the liability.that.would come with the extra responsibility because they are aware of their limitations due to their training. If crnas want to lead care teams then they should go.to medical school - I talked to a lot of crnas before I chose to invest the time and cost of medical school and they all felt this way.

 

[WholeLottaGame7]

I would be wary of judging experiences that you haven't had (for instance EMT vs RN), particularly educational ones. It's similar to what CRNAs do with anesthesiologists ("oh, we all read the same textbooks and learn the same things").

Unless you've actually been to medical school, I'm not really interested in what you THINK my education was like. Likewise, I'm not going to opine on others' educational experiences, either.

 

[pgg]

Uh, so are you saying that you may as well take a student that's finished their pre-reqs and just throw 'em into the hospital for OTJ training? Just skip the whole nursing school thing altogether. And call that person a licensed professional nurse?

Perhaps not in the ICU.

But sometimes I think you could grab the guy with the cardboard sign and scraggly dog by the traffic light next to Wal-Mart, scribble a checklist on the back of his cardboard sign, and he'd have a fair shot at outperforming some of the loungers at the nursing station. 🙂

 

[The right Path]

I would be wary of judging experiences that you haven't had (for instance EMT vs RN), particularly educational ones. It's similar to what CRNAs do with anesthesiologists ("oh, we all read the same textbooks and learn the same things").

Unless you've actually been to medical school, I'm not really interested in what you THINK my education was like. Likewise, I'm not going to opine on others' educational experiences, either.

Exactly.

Perhaps not in the ICU.

But sometimes I think you could grab the guy with the cardboard sign and scraggly dog by the traffic light next to Wal-Mart, scribble a checklist on the back of his cardboard sign, and he'd have a fair shot at outperforming some of the loungers at the nursing station. 🙂

Yikes! Well that's not where we should be setting the bar. (In nursing, anesthesiology, etc.) That's the main concern, yeah?

 

[medstudent87]

I'd love to discuss this with my anesthesia attendings but I'm currently at a site where I can't speak with them in person...and I'm trying to figure out what I wanna do with my life since I need to make my 4th year schedule pretty soon.

What's the general consensus amongst residents and young attendings? Will the AANA eventually win, CRNAs will practice independently everywhere...and anesthesiologists won't really be "needed"?
I've been asking around, and I always get different answers. I'm so lost. 🙁

I know this issue has been beaten over the head in numerous other threads, but most are a few years old. Any new thoughts?

 

[GoodmanBrown]

Blade had a solid post a few weeks back, and the heavy hitters on this forum chimed in with where they thought the specialty was headed. I would guess this is the best you're gonna get. No one here can actually see into the future.

I'd love to discuss this with my anesthesia attendings but I'm currently at a site where I can't speak with them in person...and I'm trying to figure out what I wanna do with my life since I need to make my 4th year schedule pretty soon.

What's the general consensus amongst residents and young attendings? Will the AANA eventually win, CRNAs will practice independently everywhere...and anesthesiologists won't really be "needed"?
I've been asking around, and I always get different answers. I'm so lost. 🙁

I know this issue has been beaten over the head in numerous other threads, but most are a few years old. Any new thoughts?

 

[drsiriaoom]

Anesthesiology is an awesome speciality. Alot of physiology and pharmacology and a lot of OR activity as you said- which eventually becomes routine in any speciality one goes into.

Every speciality under goes a change and has phases in the the market. I would say to pursue anesthesiology only if you love doing it. There is certainly a push towards critical care and taking care of more sicker patients. And that is what distinguishes us and makes us a better anesthesiologist. In the ICU also just like the operating room patients are very unstable and things change in the matter of minutes.

Anesthesiologist will take care of the whole perioperative care in the future. We have the advantage of knowing pharmacology well, medicine and knowing the surgical procedure also. No other speciality teaches that kind of mix. A lot of students rotating with us feel that we anesthesiologist are relaxed and happy. I do not deny that, but we are relaxed and happy because we have been rigorously trained and kind of know what to expect. and we always have plan B planned out in detail if things do not go the way they are planned. Anesthesiology is not a place for the lazy. It is physically and mentally demanding. and there is still alot of research work that can be done.

So if you feel that you are detail oriented, hard working, love new challenges, and can be a captain of the ship when necessary- anesthesiology is the speciality you want to do.