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I think I hate it all!!!

Discussion in 'Anesthesiology' started by moha, Apr 28, 2004.

  1. moha

    moha Member
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    I'm a bit nervous saying this but here it goes guys....I can honestly say after doing all my 3rd year rotations that I hate everything. Granted I'm only an M3 and this is not what a real doctor does, blah, blah, blah....but I sincerely don't enjoy medicine. However, I did do a 2wk anethesia rotation, didn't particularly fall in love with it, but was able to see myself tolerating it. Now, I know some of you may say, "Why the hell are you in med school?" or "Who the hell let you in?", but I truly did enter med school with a passion that has seemed to have disappeared. It is nothing I envisioned either in my dreams or my nightmares! Anyways, I have a few questions:
    1. Does anyone else feel this way, or feel better now that they are in their anesthesia residency?
    2. I feel like anesthesia is different than some of the other fields (i.e. I don't like continuity of care and gas doesn't have much of this; $$$ without the endless hours of sitting on your ass writing notes about every f***ing aspect of a person's life; normal personalities w/out the outrageous cockiness of a surgeon or the uptight stick-up-their-ass internist; even though sitting on your ass in the OR is part of the job, at least you are doing SOMETHING instead of staring out the window waiting for an admission; finally, an actual punch-in punch-out schedule (for the most part) with much-needed breaks) -Is this true or am I living in a dream world????
    3. I don't want a career, I want a job - a part time job that's somewhat interesting and satisfying - I feel like there is so much more to life than just being in the hospital for most hours of the day....some might find this fulfilling, more power to ya, but I definitely want to see other things in this world. Is this feasible, or should I just quit now?
    4. I have to say the only thing I do get excited about in medicine is CV/Pulm physiology and procedures...good match for anesthesia, or do I actually have to like pharm too?

    To all of you, I'm sorry to sound so cynical, but really I'm just trying to find out where I could fit in. I don't mean to put down the field of medicine, and for those that love it I wish I was in your shoes...but I'm not and don't want to be miserable in my job. Please feel free to pour out the advice! Thanks!
     
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  3. UTSouthwestern

    UTSouthwestern 1K Member
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    Take a break and see if your enthusiasm re-emerges.

    Yes, you have to love pharmacology. Not every part of pharmacology, but a significant amount.
     
  4. 2ndyear

    2ndyear Senior Member
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    Moha,
    I'm just finishing up 4th year and I probably sounded similar to you for most of 3rd year. I hated writing notes, found most of the physical exam useless, and was generally not enthused to be in the hospital. Someone broke it down to me like this, instead of medicine vs. surgery yada yada yada, think acute vs. chronic. I get the sense that adjusting Lasix doses for little old ladies with CHF exacerbations just ain't gonna cut it for you, if so then pick an acute care specialty. Anesthesiology is a great one, and I'm glad I matched this year, I can't wait to start. I've had two attending surgeons this week tell me how smart I was for picking anesthesia.

    Take this summer and start doing some electives! Try out some things, just get some good letters along the way. You've got until September to submit ERAS and I know some people who waited until the last minute to decide. Look to what attendings live the lifestyle like you want someday. In my fourth year I would say that the ones who seemed to get out and play most were gas, ER and PM&R but there are more I'm sure. Realize that residency will be hard, you're going to have to like whatever field you choose, so pick wisely. Whatever you do, don't quit now. Third year is a drag. Fourth year rocks, it does get better. But July 1 will suck for me no matter what!
    Good luck
     
  5. frotteurism

    frotteurism Member
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    I felt exactly that way...and I still do...to the point that I feel I could have written your exact post word for word.

    I'm finishing up intern year and start anesthesia in july...i hope i like it, otherwise i'd better go find a job at a coffeeshop or something...
     
  6. Energon

    Energon Nobody Summons Megatron
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    Hmm... I feel for some of you guys and can relate upto a certain point. Its got to be really tough to be in that position. Anyways here is some advice I got:

    If you are M2+ do not quit now!!! Graduate. An MD/DO/DDS/DMD/PhD whatever are very versatile degrees. Even if you are not happy doing any clinical medicine including specialties like gas, rads, derm, optho, etc, dont be too down on yourself. Do a little bit of soul searching. Look into other things, do you like policy, law, business aspects etc. If any of the above are true, you can do an intership take step3 and pursue an MBA, your income will be comparable to that of a practicing physician the hours might be a little better and you will have the advantage of working in the corporate world: clean offices, business lunches, trips etc. as opposed to working in a run down county hospital with people constantly on your ass (patients and staff alike)... this is only one example, always remember there are a lot of different options, you just have to be a little creative. One thing you have to keep in mind: do not go into the self destruct mode no matter how much you hate it, just fake it, if you are an M3 just think of it as a few more months to go.
    Best of luck
     
  7. medique

    medique Junior Member

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    Sorry to coopt this post somewhat, but what instigated your disillusionment? I am curious because I am thinking of doing med school and am more interested in the discouraging aspects of the field (to weigh against my interest in pursuing a career in medicine). Thanks.
     
  8. ALTorGT

    ALTorGT Senior Member
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    hey
    read your post about how u hate it all
    i feel your pain
    i went through the same things and have recently developed a liking / toleration for anesthetics.....just like for you, I too found understanding physiology much more interesting than sitting around asking about a patients ****ing history and examination (i.e chronic care). But just like you, pharm seems a bit dreary (rote learning telephone books again..hhehe)..

    BTW, have you done the Meyers Brigss Personality Test. If so whats your profile? if you havent, i highly recommend you do it....will help decide what you might be suited for........Mines E or I and NTP for sure...my ideal career as it turns out is one that is analytical with a strong problem solving and creative focus.....yours might be too...anesthetics is the closest match I have found in medicine for that....treats the body like one giant chemical reaction with you being the person controlling the various taps and levers.....kinda cool when you put in perspective like that...AND YEAH...the lifestyle aint bad either...
     
  9. 2ndyear

    2ndyear Senior Member
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    Just remember here everybody, no matter what you need a good application by September. You will really need to find something interesting by then or elect to take a prelim or TY year. If you go into an anesthesia or any other interview with the attitude that its tolerable your chances of matching are pretty much zero, no matter what the paper app looks like. If you are not genuinely enthusiastic about a specialty it will show. I'm not trying to sound discouraging here, but this is the truth.

    To Medique,
    Med school is tough, not as hard as residency I'm sure, but it's still difficult. Not necessarily academically difficult but third year is a lot of hours compared to what most of us were previously used to. What the original poster and some others of us refer to is pretty common in talking to classmates. Different things excite us and spending two months learning about things that we find not exciting can be a drag. There are discouraging aspects of any field, but if you find your niche then nothing else really matters. If the idea of having a job where you directly impact people's lives every single day appeals to you, then medicine is a good choice.
     
  10. joshmir

    joshmir Senior Member
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    I disagree with the statement that you will not match if you don't have the right attitde. I certainly was pretty disattached during the process, because I had "other plans", and I was very happy where I matched. It's all about whether you're "on" that day, who you get to interview with and if your personalities are compatible.

    I do agree with the OP's sentiments. Have you had the whole ER vs Gas debate within yourself?

    Also, I have been doing a lot of looking into how likely a good part-time gig is. We all assume they are out there (also the "8-5, M-F no call outpatient surgery center" scenario seems to be what everyone is looking for), and from the attendings and residnets I've talked to, nobody has a good handle on how easy these are to get in non-rural areas...the attendings I've spoken with say these spots go to people who were part of things from the beginning when the surgicenter was being created, and the graduating residnts say they and their colleaugues have found it difficult to find part-time gigs outside of doing locums.

    I am worried, b/c this is what I want to do.

    Anybody have any insights? Has anybody spoken with headhunters to see how available these no-call or part time positions are outside of areas that are realtively short on physicians?
     
  11. joshmir

    joshmir Senior Member
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    Apologize to the OP for alomost co-opting the thread in my previous post. I started a new thread about part time/no-call concerns.

    The OP said:

    1. Does anyone else feel this way, or feel better now that they are in their anesthesia residency?

    I would be very interested to hear any residents take on this.

    Also a shout out to UTSouthwestern and all the other residents who post on hear...thanks so much for the knowledge and your time, I wanna have yalls' collective baby. :thumbup:

    Hook up their karmas...show your LOVE! :love:

    (and buy beer at meetings)
     
  12. moha

    moha Member
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    The first two years of med school are books, books, books. Actually, that doesn't sound too bad nowadays. Then the infamous Step 1 comes, in which you study your ass off for knowledge that will disappear about one month later because on the wards you use hardly any of it (with the exception of your medicine rotation....all other rotations are just specialties with their own set of knowledge). As a third year you have no role other than to kiss ass, follow your residents around like a puppy dog, micromanage stupid **** on your pts that you could care less about (I DID NOT GO TO SCHOOL FOR UMPTEEN YEARS JUST SO I COULD LOOK ON THE COMPUTER TO SEE IF SO-AND-SO'S DIET WAS CHANGED FROM NPO TO CLEARS), and learn the f***ing computer systems/acronyms/note formats. Then you go home tired, not from working your ass off but from getting up before dawn and being totally bored for 12hrs/day. You are then expected to read up on ****, look up some articles of the new tx for Chron's dz that hasn't even been approved yet, and then go to bed early enough so that you can get up in time to drag your ass back to the hospital. And in the end nothing that you have potentially done or learned matters because your grade depends on a stupid shelf exam that tests you on nothing you ever did during that rotation, and how much the attending liked you after spending a whole 1hr that whole month with you.

    So, to answer your question, I never thought this was what med school was like, but in fact this is only the tip of the iceberg. Medicine is full of beaurocratic bull**** and a hierarchy that makes you realize that you are and will always be smaller than somebody....all MDs are not equal, and at some institutions even the RNs overpower you.

    All in all, if you get through med school and still have a positive attitude you are one lucky SOB!!!
     
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  13. medique

    medique Junior Member

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    YIKES! That sounds horrible!
     
  14. apma77

    apma77 Senior Member
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    we all feel (well maybe not all) burnt out at some point and start hating this shi# after a while when all u see is that esp in things like int med you essentailly become a pill pusher or a social worker or deal with insurance BS all day.

    i cose anesthesia becuz i like the study of medicine and hate all the BS of being a primary dr
    im not out to solve the worlds problems or find the cure to cancer..i just want a job which i like and which will give me the tiem to spend with my family
     
  15. TofuBalls

    TofuBalls Bring the Pain!
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    These posts sound a lot like me in my third year. I sorta liked everything but hated the idea of rounding, listening to whinny patients, and putting up with the everyday drudgery of being a doctor. This turned into a general dislike of being a doctor and questioning why I chose to do this to myself.

    I am now almost finished with my CA-1 year and must say I am much happier than I was in medschool and definitely happier than my intern year (Prelim-IM). Don't get me wrong, the begining of the CA-1 year was stressful for me and I was questioning my choice constantly. Actually doing anesthesia is a whole lot different than anything they teach in med school and very different from your elective rotations. I felt run down by some of the personalities in the OR, the constant busy work of preops, etc., all on top of learning new procedures and consistently perfoming "flawlessly" in front of my attendings and surgeons.

    Before I ask for any cheese with my whine, I'll say this, I have finally gotten to the point where I enjoy most of what I do, esp regional anesthesia. I love epidurals... there I said it! Having said this, I realize that there are parts of anesthesia that don't really get me excited like generals for ortho. I still try to make the most of it by learning how to make my anesthetic smoother i.e. emergence, etc.

    Long story short, having been on both sides of the fence, there are no easy answers and ultimately the choice remains. Here is one bit of advice I can offer that I wish I had taken during my clinical years or pre clinical for that matter: Go and spend some time with a private practice doc in whatever specialty you are considering. You will be surprised how different academic medicine is from private practice, even in Internal Medicine. This was something that may have changed my mind last year when I was being seduced by Nephrology (I loved the vascular access and kidney biopsies) :idea:

    Regardless, good luck and don't let the bastards grind you down! :D
     
  16. medstudent2005

    medstudent2005 Welcome to the Jungle
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    oh my gosh, i thought i was the only one who had become disillusioned with all the nitpicky idiotic things we have to do as medical professionals...moha, your posts seem to have come right out of my mind, WORD FOR WORD!!! it seems like i'm the only one in my group who feels that way man, everyone is like all ok with writing those blastd histories, they drive me NUTS! such a waste of time...and out patient clinic is a nightmare...may be it's just me, but why can't everyone's LDL be less than 100???

    anyway, it's just cathartic to know that there are others out there like me :)
     
  17. Leukocyte

    Leukocyte Senior Member
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    :laugh:

    I love you, Moha. I love you man. :love:

    In fact when I did my FP core, the unit nurses used to call us "the KGB."
     
  18. white daisy

    white daisy Member
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    my god moha. it's like you really read my mind. I mean, i just cannot stand one more second of following my resident around all day and being pitched all the admissions or consults that nobody wants to do. holy smokes, there was this one resident who asked me if I could go do a presentation for her cuz she couldn't be there the day of her presentation!! what the f***? Now i have to swallow your personal **** too? It's enough being bossed around!!

    anyhow, I will be starting residency in july. very scared but also very excited to finally think that I am waking up in the morning for a purpose, which is to learn and not just stand around all day writing meaningless notes that nobody will ever read.

    so way to go Moha. it's good to vent a little.
     
  19. VentdependenT

    VentdependenT You didnt build thaT
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    Ahh, we have all gone through what you are experiencing, disenchantment. If I were you I'd consider landing a anesthesiology rotation at Harborview Hospital, through U Washington, in the summer. Seattle is friggen beautiful that time of year. Make sure to bring a friend with you too. You do as many procedures as you can handle. No being forced to hang out in one room. They boot you out as soon as you slap in your piv, artline, induction, and intubation so you can get as much clinical experience as possible.

    If you want to stick around and learn after that, then you will be taught. Once you've gotten the basics of the case down, you move on and learn about another one. I really loved this rotation and it revealed to me what I was longing for in medicine. Although it doesn't show you what life will be like as an anesthesia resident, who the hell cares. You will have a blast. Jet at 10:30 am if you'd like and run around in the pacific northwest sunshine and get loaded. However if you like what you see stick around, learn, and land great letters from guys who have been around forever in this field (Dr. Cullen from the ubiquitous Barash book is there, chill as hell).


    Vent
     
  20. Nilf

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    hey Moha, I can feel your pain. Everything you said is true. That's why I'm in pathology :D
     
  21. moha

    moha Member
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    Thanks for all the advice people! I'm glad to know it's not just me...I haven't made a decision yet, but I definitely want to graduate and see where life takes me after that. Good luck to all of you!

    P.S. Path kinda looks good too, but all that reading dude is not my cup of tea...yeah, yeah, I AM LAZY!!
     
  22. Lonestar

    Lonestar Senior Member
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    Moha,
    you seem to be in the path to enlightenment my friend. You can't go wrong with any decision with a rational thought process like that. YOU are entering a critical period in your medical school career. I would shadow as many people in those fields as I can. In a field like anesthesiology a mentor can be very helpful and can provide valuabe insight in the decision making process. I never did a path rotation so I don't know about that (no intern year, little call, just did not want to cut dead people open). As for anesthesiology: good lifestyle, excellent benefits, procedure based specialty, get to work in OR environment. The happiest docs I saw at my hospital were definitely the anesthesiologists. And relatively normal personalities for being doctors. In fact one of them helped me scramble into this field. As long as you can tolerate it, I would go for it. Anything you do will have good days and bad days. Might as well go for lifestyle and money. You have spent way too much time and effort into medicine. Prestige and honor never appealed to me as much either, and even less after I saw the medicine and surgery folks parade around the hospital like they were God's gift to man. I hope you find happiness in your choice, and wish you best of luck.
     
  23. apma77

    apma77 Senior Member
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    honestly, no one outside the hospital environment really cares if you are a surgeon or dermatologist or whatever. People see the big home or the S500 benz ..they could care less what your specialty is!

    surgeons' "i am a GOD " mentality is restricted to their little OR environment where the nurses are scared by them and many people are intimidated by them including their residents outside of that little world no one gives 2 shi#ts about em.

    The outside world only cares how much money you make and how nice of a person you are...so the choice of specialty shouldnt lie on who gets most respect in the hospital,,it should rest in what YOU like the most!!

    if tommorow doctors salary went down to $50k, all the peoples love for medicine would go out the window and medical schools would be desperate for applicants....that is REALITY!
     
  24. Lonestar

    Lonestar Senior Member
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    Moha,
    I forgot to answer part of your question. My experiences in anesthesiology were in a private practice environment (our med school doesn't have a residency in anesthesiology). I never had experience in a place where residents were involved in the administration of anesthesia. At our hospital, we had 16 anesthesiologists, 14 CRNAs, and 10 Anesthesiology Assistants. It would be helpful to do rotations at both private practice and academic places. Of course, I would not overdo it by doing more than two rotations. Just my 2 cents.
     
  25. gaslady

    gaslady Senior Member
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    There is some truth to this, but I think it's pretty simplistic to say that this is because people want the big house and the benz. With the burden of student loan debt being so high and widespread, anyone with the average debt or greater is naive and frankly stupid if they don't consider salary and the ability to pay back their loans. When I look at my peers who have chosen fields other than medicine, I see them having more free time to enjoy their lives and not having to make as many sacrifices (or if they do make those sacrifices they get reimbursed more accordingly for it). In business and law it is acceptable and even expected to make 6 figures and there's no negativity towards that. It's only in medicine that this is looked down upon so much. I don't think there's anything wrong with wanting to have a high salary given the path that we haven to take to get here. With that said, though, money clearly isn't a reason to chose medicine or a specialty within medicine, because there are many better choices than medicine if money is the motivation.
     
  26. truly9

    truly9 Junior Member
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    Moha and everyone,

    Your words truly resonate. I'm finishing the third year of medical school now, and it is truly very hard to stomach the cold realization that a lot of medicine is really not that enticing. I think there is really no real way to know what it will be like before actually experiencing it first-hand. There have been countless times during this year (usually around 3am on-call) when I feel so isolated and cut off from the rest of the world in the sense that our job really is full of managing a never-ending laundry list of little tasks that heap one on top of the other in an endless stream.

    The stark reality is that at the end of third year, at the apex of dispair and burn-out, we are supposed to choose a specialty that will color our future lives in ways that we don't fully realize. Clearly, life is always dynamic and we can always change the course, but applying to residency is really a time when we have to put our money down and say, ok, I am going to devote X number of years to training myself fully in this specialty. It has been so hard for me to come up with a decision, largely because I really didn't like very much of what I have seen. Let me qualify that statement by saying that I realized this year that I love patients for their own sake, but often the work that is involved is very taxing that caring for patients is only one part of the token. For example, during my surgery rotation, I was in the OR all day and then again until the wee hours of the night, then did several consults that my intern had delegated to me, then paperwork, notes... then didn't go home until about 7pm post-call... clearly, there are many people who can tolerate this without problem, but for me, the very long hours are really difficult. I lose my ability to care about things when I am so tired that I can't see straight.

    So, somehow we are supposed to choose our specialty. The problem is I feel like I am choosing internal medicine by default. I did not like surgery, don't want to do peds, radiology, ER. I haven't done anesthesia yet, but I don't like the OR too much and am not sure that I want to interact with surgeons all the time and also deal with the 1% of terror that is involved in anesthesia when patients crash. (though it is not fair of me to comment on this yet since I haven't done the rotation yet, but I think I know myself well enough to know that this might be true).

    I am hoping to perhaps choose a sub-specialty within medicine that is interesting and which affords a tolerable lifestyle.

    It is just very hard to go through this process since i think that we are not fully exposed to all of the areas of medicine through medical school, and our view is very academic and not neccessarily representative of the real world of private practice where most of us will end up.

    Just know that you are not alone. It would be interesting to see how many third year medical students feel this way at the end of the 3rd year process. I think that medical school changes you in clear and hidden ways... I think that I have managed to maintain my inner self throughout the process largely because I have felt rather detached from all of the things that went on that were so negative. I think you have to have a Zen like mentality that allows you to find inner peace and happiness somehow when it is 2am and you are eating your third bag of cookies from the nurse's station in order to stay away to write the handwritten H+P.....
     
  27. banner

    banner Senior Member
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    Moha,

    You are lucky you hate everything. Or at least you realize it. Others will come to the same conclusions that you have, only too late.

    Don't quit now because you'll close too many doors for yourself outside of clinical medicine. Instead, do the easiest and shortest tolerable residency where you'll make the most $$$ at the end. Anesthesia is definately one of those. Go for it.

    Forget all that passion stuff and all that save the world nonsense. Maybe that works in other things like if you're a pro baseball player or president of the USA. But, there's no passion in medicine because it's a crappy job and only a very delusional person (and there's plenty of them) could be passionate about sticking their fingers up gomes butts all day and being paid peanuts for it.

    There's some saying which is very applicable to this characteristic of medicine which goes something like this "Don't pee on my leg and tell me that it's raining."
     
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  28. alcmd

    alcmd Member
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    Where are the people like you guys at my hospital? I am a resident in the most unpleasant specialty itself and I've echoed your sentiments exactly- many times.

    I was mildly disillusioned as a student but it has skyrocketed during residency. I honestly don't care about prestige or making a ton of money- I just want to pay off my loans and have enough for a nice trip from time to time. I would not have entered medicine if I could do it over but am trying to figure out the best solution for the situation I am currently in (I'm thinking about a switch into path, gas, or rads.)

    Don't worry; you're not the only one that has these ideas. I don't get the huge ego kick, I can't stand the fact that we practice medicine for the lawyers, sitting around arguing about the intricies of documentation bores me out of my mind, I hate playing social worker, wasting time waiting for tests... need I go on? Just wanted to say good for you for figuring it out now and not have wasted time like myself.
     
  29. Gator05

    Gator05 Resident
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    I'll be the first to admit it; I hated my medicine rotation, with a huge freaking passion. Not a big fan of chasing down papers on the wards, either. And I thought surgery was simply cutting and sewing with special tools on special material. GYN was disgusting. Peds, well, nothing was more frustrating than parents who just don't care.

    But I also remember my chagrin when, upon asking an anesthesiology resident what he liked about anesthesiology, he replied, "Well, I hated everything else, and the hours here are supposed to be shorter..." I read this as, "I hate what I'm doing, but I do it 12 hours a day just to get a paycheck".

    The program director mentioned that every residency is going to have its good and bad days; as "no-brainer" as this sounds, it meant more coming from this person. I also wonder if it has wider implications for specialties as a whole. The practice of medicine as a 3rd year student is not the same as it is for an attending; it is probably both better and worse, as is everything in life.

    After 24 years of education, I sure as heck better ENJOY what I'm doing when I'm done with training! There aren't too many valid excuses, as we've had plenty of time to change our minds.

    I think this shows in the OR. The residents who seemed genuinely interested to be there received more respect from the surgeons, and even requests to work with said residents on upcoming cases.

    Is there anyone else here who has enjoyed (at least parts of) rotations in most of the specialties they've rotated through?
     
  30. UTSouthwestern

    UTSouthwestern 1K Member
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    Echoing Gator05's comments, you have to know that every specialty has its pluses and minuses. As an anesthesiologist, you may not enjoy sitting in the OR for a 9 hour belly case to get done. You may not like not having sunlight in your work space. Whatever the pluses and minuses are for you, just make sure you are going for the positives and not just for the least amount of negatives.

    The worst thing that you could do is become a half-hearted anesthesiologist. You are responsible for every factor that could kill a patient in a matter of seconds and if your interest level and motivation are suboptimal, you WILL kill a patient during residency and probably several more out in private practice.
     
  31. DOMD

    DOMD Member
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    Before you guys out there started med school, how many docs that you had precepted gave the advice: "Don't go into medicine" or "If I had to do it all over again I wouldn't go into medicine" ? I'm still debating whether I wish I had listened to them. Medicine has changed to the point where we're not seeing patients...they're really customers. Unfortunately, it's a business now. If it wasn't for the money (which is dwindling), many docs would be quitting. I'm hoping anesthesiology is different because this is my second residency that I will be starting soon. Just my two cents...
     
  32. shahenshah

    shahenshah Junior Member

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    DOMD - which is the residency you r quitting..what was it that bugged u about the program..I'm just curious as I am trying to figure out things myself and trying to evaluate cons and pros of everything..and lastly what drew u to anesthesia
     
  33. SlopinMunkyDude

    SlopinMunkyDude Senior Member
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    Quitting to go into what? The oh-so-stable world of business? Or even law? Yeah, lawyers get canned all the time. And the average starting salary for a lawyer is about 55k. Plenty of them never clear six figures and are working 55 hours per week. When they go on vacation, they have to bring their cell phones, talk to partners and clients, and get updated on the progress in a case. Emergencies will pop up, and people will need to speak with them.

    Perspective goes a long way...
     
  34. Energon

    Energon Nobody Summons Megatron
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    Cosmetic dentistry :D
     
  35. DOMD

    DOMD Member
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    shahenshah,

    i finished my peds residency in 2001. i've been doing locums since then to be sure if peds was the right thing for me. the advantage of locums is you get to work at different settings (private, govt, indian health so far). i realize there were days where i loved what i was doing but it wasn't quite satisfying all the time. you can say that about any job but i couldn't see myself do peds day in and day out for the next 20-30 years. no regrets. i had several buds from med school in anesthes who seemed very, very happy. i think it's a combo of their jobs and lifestyles. so, in 2 weeks i will be starting my 2nd residency in Rochester. :)
     
  36. powermd

    Physician Lifetime Donor Classifieds Approved 15+ Year Member

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    I always cringe when reading posts like this one, and many others in this thread. This post makes you sound like you hate medicine, and will be miserable regardless of what field you go into. I sincerely hope I DO NOT work with colleagues who had such a lousy experience with medical school. I tend to be very skeptical of med students who claim to hate everything, but LOVE one field that happens to also offer very high income and a good lifestyle. People like this probably don't belong in medicine and would be happier in another career, as long as they didn't have to be poor.

    Here is a description of my mostly very positive experience in clerkships:

    ANESTHESIOLOGY (4th year)

    I did outside rotations in anesthesiology at NYU and Sinai, and the biggest difference between the residents at these two hospitals was the enthusiasm for medicine. The residents at NYU were mostly unenthusiastic, and a few, who were transfers from other residencies, or just didn't match in more competitive lifestyle fields (rads/derm), were downright miserable. One told me the best I could hope for is to not hate what I do. In contrast, the residents at Sinai loved anesthesiology, and seemed to love being doctors. Attendings at both hospitals were terrific.

    MEDICINE - COOK COUNTY HOSPITAL

    I did medicine at (the old) Cook County Hospital, arguably one of the worst physical environments in the country. Everyone I worked with was, at a minimum, a dedicated professional who liked being a doctor. The attendings are extaordinarily dedicated, since most could work elsewhere for more money, but choose to serve the patient population at County. At least once or twice a week I would have an experience caring for a patient that was truly rewarding. I remember one patient, who I took care of for two weeks, asked me if I could be his doctor after he left the hospital. I had to remind him I was still just a student, but to receive that kind of encouragement in my second month of clerkships felt amazing.

    SURGERY - MOUNT SINAI HOPITAL (CHICAGO)

    Surgery was a mixed bag. The first two weeks I did trauma, where students were basically note-writers, and x-ray fetchers. We would be in the OR all night with cases typically. The patients were mostly jerks, and likely gun/knife perps themselves, so I didn't find those patient interactions rewarding. Next I did two weeks of neurosurgery, which, at Mount Sinai Hospital (of Chicago), left a lot to be desired. I didn't see much surgery, and what I saw was pretty boring (a six-hour laminectomy, and a craniotomy). Finally I did four weeks of general. That was much more rewarding because I finally got to experience some of the bonding that takes place between surgeon and patient. From the moment you arrive at the patient's bedside and confidently announce "I'm from Surgery", you establish a partnership and trust I didn't feel on any other rotation. Although I didn't like scrubbing, standing for hours, holding retractors, and not being able to scratch my nose during cases, I did love being in the OR. What I liked best about it was the camraderie of the surgical team. I would imagine it's something like what happens between people who go to war together. Surgery challenges you to be your best in situations where you can not afford not to be. Rising to meet those challenges, even the little ones that students get to take on, produces a wonderful sense of achievement. Being good in the OR also seems to lead to greater respect on the wards and all around. I also loved the acuteness of some of the cases we did. After working on a guy with a 12 cm ruptured AAA, I was pretty much sold on surgery. It was only after the rotation ended that I discovered how much I did treasure my time outside the hospital.

    FAMILY MEDICINE - MADISON HEALTH CLINIC (INNER CITY)

    Family medicine was pleasant, and I enjoyed talking to the patients about low-stress problems, in a low-stress environment. I liked taking care of little kids. The bigger ones are fun to talk to, and the little ones are fun to hold. Of course, ear, eye, and nose exams are tough, and it's not fun forcing a kid to submit to these. I found the field intellectually dull, but socially very rewarding.

    EMERGENCY MEDICINE - COOK COUNTY HOSPITAL

    Emergency was okay. I did this at Cook County as well. It was like a giant primary care clinic. Very much like family medicine, but with lots of chest/abdominal pain cases. Trauma is separate from the ED at County, so I didn't see the really major cases. I loved the people I worked with there- the residents and attendings were all excellent doctors, very dedicated, and interesting people with lives outiside medicine. What I didn't like about EM was the primary care with no followup, and the shift work. If I'm not going to follow up on a patient, I would rather be doing something more acute with them, like you do in anesthesiology.

    NEUROLOGY - PRIVATE OFFICE

    Neurology was at a private doctor's office. Intellectually it was interesting, and it was socially rewarding as well. I did get to see a few patients more than once in my three weeks there. The office environment was quiet and nothing exciting ever happened, so I began to realize hospital-based acute care medicine was probably closer to my interests.

    Same deal with Rheumatology- intellectually interesting, and socially rewarding, but the office environment was dull.

    PEDIATRICS - COOK COUNTY HOSPITAL

    Pediatrics was wonderful. I loved working with kids, especially the neglected ones. It broke my heart to see so many kids with "child protective service" issues, so the parents may have been ***holes, but I loved having a chance to play some kind of positive role in these children's lives. Maybe one day some will remember that at least one person seemed to care about them. I had a very malignant attending on the inpatient portion of this rotation, and I got tired of all the conferences, reports, teaching rounds, and lectures we had, but the actual 'medicine' part of the rotation was fantastic.

    OB/GYN - MOUNT SINAI HOSPITAL (CHICAGO)

    OB/GYN was a mixed bag. GYN was great, like surgery (cool), only much lower stress. I got to give a talk on ethics (HIV patients desiring assisted reproduction services) at departmental grand rounds, which was fun. I didn't like the OB floor very much, mainly because there was so much work to do, and I didn't know exactly what my role was. Watching women give birth is kinda gross, and the smell of blood in c-sections eventually got to me. I liked the patients, however, and liked the limited role played by the anesthesiologist.

    PSYCHIATRY - HIGHLAND PARK HOSPITAL

    Psychiatry was cool. I did three weeks of child psych, and three weeks of adult inpatient psych. I enjoy talking to patients, so the whole rotation was a lot of fun, and it was neat not needing my stethescope to evaluate a patient. I talked to some truly manic, and some depressed kids who were suicidal, it was challenging but very interesting. I would seriously consider psych if I didn't want something more hands-on and 'medical'.

    MEDICINE SUB-I - ADVOCATE ILLINOIS MASONIC HOSPITAL

    My medicine sub-I was amazing and capped off the whole clerkship experience. I had full responsibility on my patients, no one on the team wrote orders on my patients but me (of course, I had to get co-signs). I communicated directly with consultants, and outside private attendings to discuss treatment plans, and felt very rewarded when I did my job well. My teammates were very supportive and fun to work with, despite it being a very busy month.

    Wow. That was long. I figured with all the bitching and negativity in this thread, some readers may desire a boost.
     
  37. Gator05

    Gator05 Resident
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    Whoa there!!!

    PowerMD, my post was designed to emphasize your point! Yes, there are things I didn't like about most of my rotations. But I also found plenty of wonderful aspects in each rotation, enough so that if I had been told I would be forced to do a specialty other than anesthesiology, I'd be just fine with it!!!!

    I simply didn't want to preface my point by claiming to be a perfect idealist who saw nothing wrong with any specialty.

    There is no perfect specialty, but each does have its own silver lining. My point was yours exactly; I too cringe when I hear people say they hate "everything else"!!!!
     
  38. powermd

    Physician Lifetime Donor Classifieds Approved 15+ Year Member

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    Thanks for clarifying your position. I didn't think that came through clearly in your post. My response was directed mainly at this entire thread, no so much your post individually. Lots of things about medical work suck, but a lot of it you can avoid as an attending. I've never seen an IM attending fighting on the phone over patient placement issues, or scheduling a test or consult with a difficult department. There are so many positives to what we do, particularly compared to what people do all day in other careers, if you can't see it, you must be choosing to only see the negatives.
     
  39. Lonestar

    Lonestar Senior Member
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    That brings up a good point. We should really look at the field from an attending point of view. I tried very hard to do this during my 3rd year rotations. However, in our hospital there were tons of medicine docs who were VERY unhappy about what they were doing. In fact, I have recalled 6 instances where I was told that going into general internal medicine would be downright stupid. The chairman of the IM department was one of them. He made 110K/yr with tons of call and scheduling conflicts with tests (trust me I noticed them when I did my ICU rotation with him). He told me people loose their passion for their field and it eventually boils down to lifestyle and money (AND I believe him because I think he genuinely cares about my happiness). In all honesty, there were a minority who enjoyed what they did, but they had that all positive aura behind them. I think they just had that very helpful/friendly personality no matter how hard life treated them.

    Now, I am not saying go into something simply because its lucrative. Certainly, interest has much to do with decision making. There are fields that I would not even consider such as dermatology, ortho, ENT, etc. But thats just me. I enjoyed my medicine and surgery rotations, but I reasoned that it was just a rotation AND not real life. Even the program director of surgery at our institution was excited and very happy that anesthesia was one of the fields that I was considering. He told me that he finally understood why the anesthesiologists were so happy after he met with a few of them outside of the hospital.

    Moral of the story: If you enjoy OR environment and can tolerate the field, GO FOR IT. :D
     
  40. coop528

    coop528 Member
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    This is a great thread...as I searched through the archives, I noticed it.

    I just flat out do not understand the appeal of primary care or anything with continuity of care. I don't know if some students (or the majority of students at my school) are just blinded to the real world...or maybe I am missing something.

    I am just so so so happy that anesthesiology is not ultra-competitive right now, or I would be screwed.

    Anyway, just thought I would bring up an oldie but goodie.
     
  41. CambieMD

    CambieMD cambiemd
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    Coop,

    I think that med students go into primary care for a few reasons.

    1. Someone told them that they would have a better quality of life in primary care.
    2. They failed to explore what really turned them on during their first three years of medical school and they had to go into something. This was me.
    3. Did not heed the warnings from posters on scutwork.
    4. Believed the lies of attendings who told them that they loved taking care of the whole patient.
    5. Thought,"how bad could it be."
    6. Wanted an easy residency.

    Primary care is for special people. Most of us just run of the mill. Crap doesn't just run off of our backs. Most people cannot tolerate a Crap Index (CI) that is higher than 5.0. Primary care is at least an 8.5. Gas is about 1.0-1.5.

    CambieMD
     
  42. GeddyLee

    GeddyLee Bad-ass Guitarist
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    A lot of people probably end up in primary care after being rejected from a high power fellowship. Cardiology and GI come to mind. Practically every resident in our IM program want to do one of these. If they don't make it, primary care it is. Personally, I'd quit if PC was the only option available to me.
     
  43. powermd

    Physician Lifetime Donor Classifieds Approved 15+ Year Member

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    I meet so many third and fourth year med students rotating through my hospital who have their sights set on IM. I try to dissuade them, but they are mesmerized by the "care for the whole patient" thing. I can understand this to some degree. From the perspective of a med student, you have learned all this great stuff and you're dying to apply it as a doctor. Some fields, such as anesthesia, don't appeal to this basic need med students have to apply what they have learned. A med student who just busted his butt to learn anatomy, pathology, micro, neuro, MCB, and rotations in IM and surgery doesn't want to go into a field where most of that is irrelevant! I suffered from this illusion for a while, but trusted that I would get over it. GOD AM I OVER IT NOW!!! I try to bring my message of caution to the med students, but they are skeptical of the satisfaction people find in the lifestyle fields.
     
  44. GAZZMAN

    GAZZMAN Junior Member

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    Moha,
    Holy Shytz, that was an awesome post. Thought I was the only one thinking those thoughts and as stated by many others, those words could have easily come out of my mind..word for freakin word.

    Refreshing to know there are others that also think all is not, exactly what we thought before entering medicine. And whoever wrote that phrase, "dont pee on my leg and tell me its raining"... absolutely priceless, nothing describes medicine better than that!

    But one question that Moha brought up that hasnt yet been answered, and which I am wondering is, is it possible to work part time as an anesthesiologist? I mean I think gas is great, but it would be even better if I could work it part time or even PRN. I really see medicine now as a job, and having so much outside interest, I would really like to be able to work part time if possible. And if that is not possible what field of medicine would be best for this? Right now the best I can come up with is doing ER/IM/FP and working a few shifts at urgent care clinincs and small ER's.

    Any idea's anyone? I havent checked gaswork.com to see if there are any part time positions posted but I was wondering if anyone has heard of this?

    I'm curious to see what others know about this.
     
  45. Brass_Monkey

    Brass_Monkey Membership Revoked
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    There are about 30 or so postings on Gaswork for part time/PRN positions. Go over there and check it out.
     
  46. joshmir

    joshmir Senior Member
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    I have posted/postulated extensively (but not authoritattively) on this...BUMP like you mean it.

    gas attending, MGH alum, told me that of the many groups here in the norfolk/south of richmond area (VA) only 1 of the five groups would take on part timers with a proportional partner salary.

    2 graduating ca-3s say it is getting harder and harder to find part time work where you are payed appropriatley as a partner.

    this flies in the face of most traditional perceptions about a wide open job market...my suspicion is that in not-so-desirable areas, it is not a problem, however, but in desirable areas it is.

    btw, scutwork does not post the best jobs...those are filled via woprd of mouth, and not advertised.

    being payed less than a partner for proportional part-time work is likely to be grating, the reference anxiety would be legion. that's why most don't do it.

    locums is always there though. the reason people do that less is when you have a settled life you will want a settled job.

    undeniably rads is the best for part time....there is so much infrastructure set up to make it easy.

    please post with what you have heard first-hand about the part-time making proportional partner pay prospects from senior residents and attendings.




     

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