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If the lifestyle and bank is as tops as people say, then why is it so easy to get in? What kind of lifestyle and what kind of bank are we talking about?
If Anesthesiology is so good, why so non-competitive?
- Thread starter Le_Donald
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Because the CRNAs are taking over the field, thats why
20 years from now MDA residency slots will be 10% of what they are now. CRNAs will be running 95% of surgeries, and MDAs will be relegated to the super specialized procedures and the new surgeries coming down the pipeline.
20 years from now MDA residency slots will be 10% of what they are now. CRNAs will be running 95% of surgeries, and MDAs will be relegated to the super specialized procedures and the new surgeries coming down the pipeline.
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first of all, i think most people prioritize finding what they're passionate about, as opposed to "lifestyle and bank". The gas lifestyle isn't THE best out there (check rads, derm, pmr), and no matter how much you earn, you won't be happy unless you love what you do.
As for why gas is relatively uncompetitive, i think it's because
--a lot of people don't like the OR or working with surgeons
--for some people, having a long term relationship with patients is very important in their career decisionmaking, as is having patients to call "their own"
--depends on what people had in mind as what medicine means to them, for some it's more about maintaining people's health, for others it's taking care of long-term illness, yet others--solving mechanical body issues by directly fixing them with their hands.
--large number of anesthesia positions
--many med schools don't offer much exposure to anesthesiology in time for career decision making and residency applications
I just think this board makes anesthesia sound like it's the best thing in the world b/c most of us on here have found that this is field that is the best fit for us and that's why we're going into it. If you go onto other specialties' forums, you'll have the same impression from them about their field of choice. Honestly, I personally also have trouble understandin why more people don't want to do gas but i think that is just because for me personally gas is the best field.
As for why gas is relatively uncompetitive, i think it's because
--a lot of people don't like the OR or working with surgeons
--for some people, having a long term relationship with patients is very important in their career decisionmaking, as is having patients to call "their own"
--depends on what people had in mind as what medicine means to them, for some it's more about maintaining people's health, for others it's taking care of long-term illness, yet others--solving mechanical body issues by directly fixing them with their hands.
--large number of anesthesia positions
--many med schools don't offer much exposure to anesthesiology in time for career decision making and residency applications
I just think this board makes anesthesia sound like it's the best thing in the world b/c most of us on here have found that this is field that is the best fit for us and that's why we're going into it. If you go onto other specialties' forums, you'll have the same impression from them about their field of choice. Honestly, I personally also have trouble understandin why more people don't want to do gas but i think that is just because for me personally gas is the best field.
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MacGyver said:
Look who's back!
-Skip
Le_Donald said:
first off, people are catching on and anesthesia has become more popular over the last few years. even so, it's not particularly competitive, and here's why...
1. limited exposure during medical school
2. you're working for surgeons: essentially playing 2nd banana for your entire career.
3. it has the potential to be incredibly boring (for the most part)
4. there are tons of spots.
5. CRNAs continue to do more routine surgeries, which means less need for MDA's. Those that remain will likely run multiple OR's, supervising a CRNA in each room.
6. you don't have your own patients
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MacGyver said:
By that time, midlevels will be seeing the majority of IM, FP, Ophtho, EM, and PM and R patients. The majority of film will be read in India by telerads, and the only hope for M.D.'s will be to scramble into general surg. residency, or quit and start selling real estate.
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Gas NON-competitive???
I dont know about that, I went down to #4 on my list in the match last year with a solid application. I know at least one person who didnt match at all. And CA-1 spots for this June are few and far between. So i think you are wrong to say gas is not competive. Its not as competitve as Rads or derm but its heating up. This week is going to be very interesting.......
I dont know about that, I went down to #4 on my list in the match last year with a solid application. I know at least one person who didnt match at all. And CA-1 spots for this June are few and far between. So i think you are wrong to say gas is not competive. Its not as competitve as Rads or derm but its heating up. This week is going to be very interesting.......
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Capsaicin said:By that time, midlevels will be seeing the majority of IM, FP, Ophtho, EM, and PM and R patients. The majority of film will be read in India by telerads, and the only hope for M.D.'s will be to scramble into general surg. residency, or quit and start selling real estate.
Smart boy.
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You forgot to include that robots will be performing all but the least scriptable surgeries.Capsaicin said:By that time, midlevels will be seeing the majority of IM, FP, Ophtho, EM, and PM and R patients. The majority of film will be read in India by telerads, and the only hope for M.D.'s will be to scramble into general surg. residency, or quit and start selling real estate.
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I love how these troll-bait threads are often started by someone with a brand-new user ID. Le Donald seems to be establishing a pretty negative SDN persona. http://forums.studentdoctor.net/search.php?searchid=782304 I wonder who he was a month ago. Could he be an alter-ego of MacGuyver??
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i find the crna stuff laughable...one of the more recent anesthesiology issues had a paper with a cost analysis wherein they showed that MDAs save hospitals money because the cases are shorter on the front and back end when compared to crna-run cases (i would say this is true on an anecdotal basis in my experience as well)...food for thought
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fishtolive said:
Got a link?
-Skip
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impetigo said:
Thank you for not calling your username "infantigo" like EVERY PARENT OF EVERY 4-YEAR-OLD does.
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fishtolive said:
I don't find it laughable at all. In the end we'll see if all this "crna stuff" was much ado about nothing or if we really should have done something about it when we still had the chance.
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Skip Intro said:
Nevermind. I found it:
http://www.anesthesia-analgesia.org/cgi/content/abstract/98/3/750
However, it doesn't appear, upon (admittedly only) reviewing the abstract, that this study utilized the most rigorous of scientific methodologies to come to its conclusions. But, it's an interesting discussion point.
-Skip
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After all these ongoing state to state battles wtih CRNAs, and some of you are still sticking your head in the sand?
What the hell is it going to take to realize that they are a threat?
Look at the long term picture people. Good grief.
The CRNA lobby is very smart. They dont push for everything all at once, they push small steps at a time. People like Skip Intro look at those small steps and say "no big deal" but when you add up 25+ years of "small steps" that turns into one "giant leap" for CRNAs at the expense of MDAs.
This kind of attitude is what allowed the CRNAs to initially infiltrate the world of MDAs. Greedy MDAs started hiring/supervising 10+ CRNAs at a time and let them run the surgeries solo so they could make money off those CRNA-induced surgeries. Meanwhile, the MDA was giving ZERO SUPERVISION to the CRNAs and doing his own specialized surgeries in another surgical suite or hell even in another hospital period.
Right now Medicare/Medicaid and most insurance companies in general give direct reimbursement to CRNAs. The next step is that they are going to call the MDAs bluff and refuse to pay for MDA-supervision of CRNA procedures and instead just pay the CRNA direct. Uh oh spagettios, there goes a major source of MDA cash flow. Of course, the original greedy MDAs who started this problem wont care. They will have long since cashed out, retire, and enjoy sipping their margaritas on their yachts while the younger MDAs are getting screwed over.
The net result is you've got CRNAs COMPETING AGAINST MDAs for reimbursement. Of course, wage suppression is the inevitable result. The percentage of all health care costs paid by the federal government climbs every year. The bureaucrats in Washington are slowly gaining power towards a critical mass. When that critical mass is reached, their reimbursement decisions will affect so much of the MDA market that it becomes a de facto government installed wage scale across the whole industry. This is a problem for all doctors in general, but its particularly bad for MDAs because there is already a willing and able group of nurses who will work for substantially lower wages than MDAs and which the govt bureaucrats believe can efficiently replace 95% of the duties of a full blown MDA.
MDAs will always exist. The problem is they will be paid at suppressed CRNA wage levels. Think about it. Average nurse makes about 55k. Average NP makes about 70k. Average CRNA makes about 150k. If I'm a government bureaucrat, I cut reimbursement for all gas procedures such that the average for CRNAs is perhaps 100k. And then I pay MDAs the same scale as the CRNAs. What are the CRNAs going to do? Leave gas so they can take a pay cut working as a regular NP or nurse? Hell no, they are going to stay in gas. MDAs, on the other hand, will leave the profession in droves.
As that happens over time, watch the slow death of the MDA residency system.
What the hell is it going to take to realize that they are a threat?
Look at the long term picture people. Good grief.
The CRNA lobby is very smart. They dont push for everything all at once, they push small steps at a time. People like Skip Intro look at those small steps and say "no big deal" but when you add up 25+ years of "small steps" that turns into one "giant leap" for CRNAs at the expense of MDAs.
This kind of attitude is what allowed the CRNAs to initially infiltrate the world of MDAs. Greedy MDAs started hiring/supervising 10+ CRNAs at a time and let them run the surgeries solo so they could make money off those CRNA-induced surgeries. Meanwhile, the MDA was giving ZERO SUPERVISION to the CRNAs and doing his own specialized surgeries in another surgical suite or hell even in another hospital period.
Right now Medicare/Medicaid and most insurance companies in general give direct reimbursement to CRNAs. The next step is that they are going to call the MDAs bluff and refuse to pay for MDA-supervision of CRNA procedures and instead just pay the CRNA direct. Uh oh spagettios, there goes a major source of MDA cash flow. Of course, the original greedy MDAs who started this problem wont care. They will have long since cashed out, retire, and enjoy sipping their margaritas on their yachts while the younger MDAs are getting screwed over.
The net result is you've got CRNAs COMPETING AGAINST MDAs for reimbursement. Of course, wage suppression is the inevitable result. The percentage of all health care costs paid by the federal government climbs every year. The bureaucrats in Washington are slowly gaining power towards a critical mass. When that critical mass is reached, their reimbursement decisions will affect so much of the MDA market that it becomes a de facto government installed wage scale across the whole industry. This is a problem for all doctors in general, but its particularly bad for MDAs because there is already a willing and able group of nurses who will work for substantially lower wages than MDAs and which the govt bureaucrats believe can efficiently replace 95% of the duties of a full blown MDA.
MDAs will always exist. The problem is they will be paid at suppressed CRNA wage levels. Think about it. Average nurse makes about 55k. Average NP makes about 70k. Average CRNA makes about 150k. If I'm a government bureaucrat, I cut reimbursement for all gas procedures such that the average for CRNAs is perhaps 100k. And then I pay MDAs the same scale as the CRNAs. What are the CRNAs going to do? Leave gas so they can take a pay cut working as a regular NP or nurse? Hell no, they are going to stay in gas. MDAs, on the other hand, will leave the profession in droves.
As that happens over time, watch the slow death of the MDA residency system.
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Can that be said about just any specialty except Surgery? I mean, a path lab tech can read the gross slides, a Rads tech can read CT/MRI/etc, EM PA can do the same job as EMMD, .... Heck, I bet a scrub-in nurse can do appy also if given the training and opportunity... Why do we even need to have medical schools?
MacGyver said:
Smash you macgyver, SMASH YOU I say, you little troll.
Didn't think I could find you, so you disappeared, eh you little chicken.
Off with you. Nobody wants to listen to your idiotic rants.
I dare you to reply, biotch.
____________
"The question is, 'Do I have an as$munch complex?' Which makes me wonder if this...person has any idea as to the kind of abuse one has to indure in college and beyond to keep on venting their frustrations on an internet forum. If you have the vaguest clue as to how untalented someone has to be to lead a pointless discussion. I got my Master's@Bates. I am board certified in idiocy and general lack of tact. I have been awarded citations from seven different forums moderators for general toolishness. So I ask you: When someone goes in to that thread and they type on their keyboard and they pray to God that I don't spoil a hint of reason with my pointless rants, who do you think they're praying to? Now, you go ahead and read your TOS... and you go to your church, and with any luck you might get some useful information, but if you're looking for bull, my posts are filled with it and I don't like to be second guessed. You ask me if I have a problem? You're god darn right I DO!" - macgyer from any thread he's ever been in.
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Well, it seems that gas has gotten more competitive. With only 53 open spots this year, that makes a 95.8% fill rate for 2005's Match.
Based on what I saw this year on the interview trail and my interactions with residents at programs, it seems like there are a lot of bright minds and really impressive people going into anesthesia over the past few years. This trend will, hopefully, make up for the huge slump that hit gas in the mid-90's. As I sit here reeling in the fact that I now know definitively that I will become an anesthesiologist, I can only hope that, like myself, all of these bright minds entering the discipline at the physician level will continue to support outcomes research as well as make a strong effort to advocate for the field at the physician level, ultimately doing what (will demonstrably be shown, I'm confident) is best for the patient.
Actually, that goes for anyone and everyone involved in peri-operative medicine, regardless of their exact role or level of training. Please remember that - and advocate strongly for that - as you advance through your residency and ultimately become attendings.
Best of luck to everyone who has chosen this field as their career.
-Skip
Based on what I saw this year on the interview trail and my interactions with residents at programs, it seems like there are a lot of bright minds and really impressive people going into anesthesia over the past few years. This trend will, hopefully, make up for the huge slump that hit gas in the mid-90's. As I sit here reeling in the fact that I now know definitively that I will become an anesthesiologist, I can only hope that, like myself, all of these bright minds entering the discipline at the physician level will continue to support outcomes research as well as make a strong effort to advocate for the field at the physician level, ultimately doing what (will demonstrably be shown, I'm confident) is best for the patient.
Actually, that goes for anyone and everyone involved in peri-operative medicine, regardless of their exact role or level of training. Please remember that - and advocate strongly for that - as you advance through your residency and ultimately become attendings.
Best of luck to everyone who has chosen this field as their career.
-Skip
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powermd said:
Um, how is it troll bait to ask why anesthesia isn't competitive? I don't have a negative SDN persona. Read my previous posts. Go back to getting high, oh prince of percocet, and leave decent people alone.
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belle007 said:
IIRC, 88 (or so) for 2004. And, about 81 (or so) for 2003. Don't have the time to look right now, but the stats are on the NRMP website.
-TT
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It's troll-bait because your assumption that anesthesia is NON-COMPETITIVE is baseless. If you have data that would persuade me to believe otherwise, please share. There were 53 unfilled positions this year, and while it's not very difficult to match somewhere, it is certainly difficult to match the best programs. I think Chicamedica summed up very well why anesthesia is not as competitive as the lifestyle/income reputation would suggest. It's all about supply and demand. The ratio of applicants to spots is much better for anesthesia than the truly competitive fields- derm, rads, plastics, ortho, etc. There ARE a lot of applicants for anesthesia. The numbers are particularly impressive when you consider how specialized the field is, and that it basically thumbs it's nose at the mode of practice most people associate with physicians. There just happen to be a lot of spots to accomodate people.
I'm not sure if anyone specifically answered your question about how good the lifestyle is, but try $350K for 50 hrs/week. One forum reader mentioned an offer for ~700K for a 70hrs/wk. There are many different modes of practice. You can do academics and take lots of call, you can work in an outpatient Surgi-center doing bread and butter cases from 9-3pm weekdays with no call. You can work as 1/2 and anesthesiologist making $200K/yr with 6 months off. At BID a resident told my group a member of last year's graduating class was making $1M/year in Las Vegas and is needs help. Not all jobs are this good, but the average offers I hear from CA-3s in NYC are pretty damn high.
I'm not sure if anyone specifically answered your question about how good the lifestyle is, but try $350K for 50 hrs/week. One forum reader mentioned an offer for ~700K for a 70hrs/wk. There are many different modes of practice. You can do academics and take lots of call, you can work in an outpatient Surgi-center doing bread and butter cases from 9-3pm weekdays with no call. You can work as 1/2 and anesthesiologist making $200K/yr with 6 months off. At BID a resident told my group a member of last year's graduating class was making $1M/year in Las Vegas and is needs help. Not all jobs are this good, but the average offers I hear from CA-3s in NYC are pretty damn high.
