IM categorical or EM for applying to Anesthesia

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whatsthepoint

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For someone who has no Prelim Med or Surg options, if applying to anesthesia during PGY-1, does doing so from from IM categorical or EM residency make a difference? Would one be better than the other in terms of odds of matching?

I know it's non-conventional, but I would like to try to apply anesthesia next year and need to decide between these two options. Thanks

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I was trying to follow your thread...did you end up attempting to match ortho after reconsidering and deciding on optho? Now youre focusing on Anesthesia?
 
I'm confused about your question. Just do IM categorical and call it a day. Send us a thank you check later.
 
Anesthesia is NOT the one to enter into now. It will be different in 3-4 years. Don’t look at it for what it is now. Care about stability and also flexibility. I wouldn’t do EM even now.
 
I'm confused about your question. Just do IM categorical and call it a day. Send us a thank you check later.
Can you sell me on it? I never ever considered IM (hated it as an MS3) but I interviewed at a program today and was surprised it kinda excited me
 
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IM equals flexibility with its many fellowship options. You’ll also be awake at 3am dealing with bad smells much less often than EM.

If that’s not enough, I have no further help for you.
 
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For someone who has no Prelim Med or Surg options, if applying to anesthesia during PGY-1, does doing so from from IM categorical or EM residency make a difference? Would one be better than the other in terms of odds of matching?

I know it's non-conventional, but I would like to try to apply anesthesia next year and need to decide between these two options. Thanks
Consider IM and a GI fellowship. I was told by my locums recruiter that finding GI docs is a lot harder than finding anesthesiologists. When you have completed that GI fellowship and set up your own shop, I'll come work for you. Anesthesia market will have flamed out by then.
 
Consider IM and a GI fellowship. I was told by my locums recruiter that finding GI docs is a lot harder than finding anesthesiologists. When you have completed that GI fellowship and set up your own shop, I'll come work for you. Anesthesia market will have flamed out by then.
I am on the same boat as OP. Cannot do fellowship for various reasons but wanting to go from IM to anesthesia for this upcoming year. I am board certified in IM and wanting to do a second residency in anesthesia. Why do you think the anesthesia market will flame out?
 
I am on the same boat as OP. Cannot do fellowship for various reasons but wanting to go from IM to anesthesia for this upcoming year. I am board certified in IM and wanting to do a second residency in anesthesia. Why do you think the anesthesia market will flame out?
Reimbursement is way down, hospital stipends are way up, Crnas are flooding the market. At some point (in the near future / whenever they can) the hospitals will cheap out and squeeze us.

If we have to survive just on case based reimbursement then we get decimated and everyone will eject.

Basically we will be EM 2.0 soon.
 
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I am on the same boat as OP. Cannot do fellowship for various reasons but wanting to go from IM to anesthesia for this upcoming year. I am board certified in IM and wanting to do a second residency in anesthesia. Why do you think the anesthesia market will flame out?
I am sorry I dont understand this. "Cannot do fellowship" - cannot or do not want to?
Why not cardiology or oncology? Highly respected subspecialties and can have an outpatient practice. If you wish, you never have to step foot in the hospital.

You are seeking a demotion in another residency as opposed to promotion and moving your career forward with a fellowship.
Anesthesia may seem nice to you as an outsider, but it comes with its set of issues also. At the end of the day, work is work. Its all the same after a while.
 
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Reimbursement is way down, hospital stipends are way up, Crnas are flooding the market. At some point (in the near future / whenever they can) the hospitals will cheap out and squeeze us.

If we have to survive just on case based reimbursement then we get decimated and everyone will eject.

Basically we will be EM 2.0 soon.
It sounds like some smart one is trying to time the market
 
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Personally if I had the will or desire to go back and do another residency as opposed to a fellowship after internal medicine, I'd do opthalmology or radiation oncology. I would not do anesthesia. There is a risk. Yes, there is demand, but at the same time, demand is being met by hordes of CRNAs entering the market. Hospitals and surgeons do not care about quality, efficiency or outcomes. They care mostly about $$$$.

Just to give you some reference. These are the working hours of an opthalmologist I know:

Monday9:00 am - 5:00 pm
Tuesday9:00 am - 5:00 pm
Wednesday 9:00 am to 1 pm
Thursday9:00 am to 5:00 pm
Friday9:00 am - 12 pm
Saturday - off
Sunday - off

Total hours: 31 hours with 5 hours of lunch.

He definitely earns more than I. And I earn above average for my market with a pretty decent lifestyle. His Exercise/sleep/family life all intact. No 6 am starts. No late afternoon cases or waiting on surgeons etc etc.

No way in anesthesia you can have that schedule and make the income you're looking for. You wont have any census of patients which has inherent value. Hard for anesthesiologists to own equity in buildings or ASCs (unless you do Pain).

Do not be blinded by current locums rates. No one does locums long term. Its not sustainable. The higher per hour pay comes with compromise on stability.

Things will change a lot by the time you finish residency. I feel that a lot of anesthesia departments would be in-house for fixed pay with no or very little further re-imbursement for production. Thats the ultimate goal of CMS. To reduce surgeries.

Keep in mind that salaries and income guarantees in general give a sense of false security to physicians and it comes with a ceiling. AMCs will typically give you a nice package and then run lean and over work you. Thats the only way they can make a margin. Its no different that hospitalist gigs you're used to. The 7 on 7 off gigs seemed nice, but I know so many of my friends that could not hack it after 2-3 years due to burn out and working half the year weekends.

The best and fairest way to earn is via production. Those opportunities may not be available if we all become hospital employed.

Consider all of that before making a decision. Life decisions need to be nuanced and financially viable. There is an opportunity cost (time plus money) to doing a 3 year residency also. And no, it will not be possible to do moonlighting as an internist while doing anesthesia. Its usually frowned upon by the programs, and secondly, it will be nearly impossible to find the time and motivation to do it and keep up with residency schedule and commitments.
 
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It sounds like some smart one is trying to time the market
If by timing the market you mean that I'm saving and investing while I can so that I can peace out when/if the anesthesia market eventually devolves, then yes. It may very well be a number of years (6-7?), but we're not on a sustainable path.

But also it's worth letting the up and coming crop know that they shouldn't pick anesthesiology because the job market is good currently, because it could all change quickly - EM style. But more power to them if they truly love the field otherwise.
 
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Personally if I had the will or desire to go back and do another residency as opposed to a fellowship after internal medicine, I'd do opthalmology or radiation oncology. I would not do anesthesia. There is a risk. Yes, there is demand, but at the same time, demand is being met by hordes of CRNAs entering the market. Hospitals and surgeons do not care about quality, efficiency or outcomes. They care mostly about $$$$.

Just to give you some reference. These are the working hours of an opthalmologist I know:

Monday9:00 am - 5:00 pm
Tuesday9:00 am - 5:00 pm
Wednesday 9:00 am to 1 pm
Thursday9:00 am to 5:00 pm
Friday9:00 am - 12 pm
Saturday - off
Sunday - off

Total hours: 31 hours with 5 hours of lunch.

He definitely earns more than I. And I earn above average for my market with a pretty decent lifestyle. His Exercise/sleep/family life all intact. No 6 am starts. No late afternoon cases or waiting on surgeons etc etc.

No way in anesthesia you can have that schedule and make the income you're looking for. You wont have any census of patients which has inherent value. Hard for anesthesiologists to own equity in buildings or ASCs (unless you do Pain).

Do not be blinded by current locums rates. No one does locums long term. Its not sustainable. The higher per hour pay comes with compromise on stability.

Things will change a lot by the time you finish residency. I feel that a lot of anesthesia departments would be in-house for fixed pay with no or very little further re-imbursement for production. Thats the ultimate goal of CMS. To reduce surgeries.

Keep in mind that salaries and income guarantees in general give a sense of false security to physicians and it comes with a ceiling. AMCs will typically give you a nice package and then run lean and over work you. Thats the only way they can make a margin. Its no different that hospitalist gigs you're used to. The 7 on 7 off gigs seemed nice, but I know so many of my friends that could not hack it after 2-3 years due to burn out and working half the year weekends.

The best and fairest way to earn is via production. Those opportunities may not be available if we all become hospital employed.

Consider all of that before making a decision. Life decisions need to be nuanced and financially viable. There is an opportunity cost (time plus money) to doing a 3 year residency also. And no, it will not be possible to do moonlighting as an internist while doing anesthesia. Its usually frowned upon by the programs, and secondly, it will be nearly impossible to find the time and motivation to do it and keep up with residency schedule and commitments.
Optho seems like a fantastic field lifestyle-wise and intellectually. Plus they have true innovations and research going on, which would be exciting to be a part of. Some of their surgeries are immediately life-changing too (e.g. cataracts and the like).

Plus you can even parlay your optho-ness into hookers and crystal meth while still being the dean of a major medical school, which counts for something.
 
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30/20/10years ago, all these sentiments was plentiful , pick a field you enjoy and can tolerate even if anesthesia.
All of medicine is going downhill so one field is not going to be significantly better than the other
 
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The average optho salary is actually below the average anesthesia salary. But obviously on here we only like to compare the 90th percentile of other specialties to own own average. To hell with actual data and statistics
 
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This is not true. Salary does not take into consideration ownership is real estate, practice, asset building and ancillary service revenue etc. that’s a big part of private practice compensation and net worth.
 
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Tricky situation here… I soaped into an EM spot and then right after I took the offer, I got a paid research position offer at a super well-respected Ophthalmology program. They historically match all their research fellows, but it would delay my residency graduation 2-3 years. I’ve always loved ophthalmology and wish I would’ve pursued it years ago. What would y’all do…
Do you like EM?
 
Personally if I had the will or desire to go back and do another residency as opposed to a fellowship after internal medicine, I'd do opthalmology or radiation oncology.

Have you read about the rad onc job market on the rad onc forums? Not good.
 
Most of our ophthos will not step foot in an ED or a hospital for that matter.
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