IM has thousands of spots but anesthesia.....

[LoudBark]

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Internal medicine has thousands and thousands of spots in residency in this country. Something like 4800 spots, by far the most in the country of any residency.

Anesthesia by comparison has hundreds if not thousands of less spots.

WHY, then oh why.......

does the anesthesia board on SDN always, always have more people viewing than IM?

As I type this anesthesia has 99 viewing it's board and IM has 49 viewing it's board.......yet there are thousands of more IM residents.

What it the reason? Are anesthesia gas nuts just more into internet boards and don't have as many hobbies as IM people? Are anesthesia people more internet savvy than their IM comrades? Is there just not much interesting IM stuff to talk about and gas topics like femoral nerve blocks and epidurals are so much more intriguing so they attract more people on their board? Is IM more of an intense residency while we are slaving away on call, the gas people are home everyday by 3pm logging onto the internet? Are the anesthesia people sneaking iphones into the surgeries and logging on to SDN during a boring case while the IM folks are working up the cause of chest pain in a 42 year old obese female or going over the differential for hyponatremia in an 85 year old nursing home resident?

I can't be the only one who notices that the anesthesia board trumps the IM board on SDN when it comes to people on the board.

What is your opinion on why this is so?

 

[jdh71]

I think different personalities tend to be drawn to different specialties. The EM forum is always pretty damn active too. It's hard to say or pin down. I do think my IM colleagues as a group tend to be more lame - not only on the interwubz, but also in real life. The gas guys seem to appreciate the profession more as a job, not one that they take lightly or anything, but just something they do so they can make some money and do other things that they really want to do. And it's a way to not be a real doctor - and before I get a bunch of flamey responses from some gas peeps - what they do requires a doctor level education and training, it's not time to be ****ing around with patients given their job description, but if you're not spending your time diagnosing, treating, and following disease, I have a hard time seeing anyone as a "real" doctor who doesn't do that. And so you have the personality that is drawn to that kind of thing versus the type that is drawn to IM. And there is something about that personality that makes them more chatty on internet web forums. It seems to me most IM people are kind of lame and see this place as a means to an end - get info - and have no real desire to give anything back to anyone else, not really. It's kind of a d-bag thing about IM, no real sense of community, and you'll see this in the hospital. One medicine guy will not generally hesitate to throw another medicine under the bus if he thinks it's necessary. We don't stand together. Interestingly enough, you generally will see the gas folks at any institution in a united front no matter what.

So what gives?? I don't know. I think I made things more muddy than clear.

 

[Khanal007]

It could also be that we have to be less neurotic in IM during the residency match process. If you're someone with average board scores and HP's in most clerkships, there is a chance you won't match in EM or Anesthesia, while in IM you'll always be able to find some sort of safety program, while it may not necessarily be the case with EM or Anesthesia.

Also, JDH, I don't like your negative view of the IM personality type! Granted, you've been through an IM residency and I'm about to enter one, but I personally found IM people to be the perfect mix of chill and caring about patients, compared to Anesthesia (checked out, always planning their next golf outing) and EM (talking about extreme kayaking or skiing ad nauseum)!

 

[EPADHA]

I think different personalities tend to be drawn to different specialties. The EM forum is always pretty damn active too. It's hard to say or pin down. I do think my IM colleagues as a group tend to be more lame - not only on the interwubz, but also in real life. The gas guys seem to appreciate the profession more as a job, not one that they take lightly or anything, but just something they do so they can make some money and do other things that they really want to do. And it's a way to not be a real doctor - and before I get a bunch of flamey responses from some gas peeps - what they do requires a doctor level education and training, it's not time to be ****ing around with patients given their job description, but if you're not spending your time diagnosing, treating, and following disease, I have a hard time seeing anyone as a "real" doctor who doesn't do that. And so you have the personality that is drawn to that kind of thing versus the type that is drawn to IM. And there is something about that personality that makes them more chatty on internet web forums. It seems to me most IM people are kind of lame and see this place as a means to an end - get info - and have no real desire to give anything back to anyone else, not really. It's kind of a d-bag thing about IM, no real sense of community, and you'll see this in the hospital. One medicine guy will not generally hesitate to throw another medicine under the bus if he thinks it's necessary. We don't stand together. Interestingly enough, you generally will see the gas folks at any institution in a united front no matter what.

So what gives?? I don't know. I think I made things more muddy than clear.

well said... I wonder if burn out is more prevalent among IM residents than gas doctors.
One of my colleagues calls it the pathos of internal medicine.. sick and complex patients with burnt out/digruntled physicians who believe in the futility of interventions.

 

[flipmd]

Eh, they're all probably in the OR surfing the webz on their ipads between induction and the end of the case.

 

[Blitz2006]

IM guys are all too busy gunning for cards/GI fellowship 😛

 

[Deferoxamine]

I think different personalities tend to be drawn to different specialties. The EM forum is always pretty damn active too. It's hard to say or pin down. I do think my IM colleagues as a group tend to be more lame - not only on the interwubz, but also in real life. The gas guys seem to appreciate the profession more as a job, not one that they take lightly or anything, but just something they do so they can make some money and do other things that they really want to do. And it's a way to not be a real doctor - and before I get a bunch of flamey responses from some gas peeps - what they do requires a doctor level education and training, it's not time to be ****ing around with patients given their job description, but if you're not spending your time diagnosing, treating, and following disease, I have a hard time seeing anyone as a "real" doctor who doesn't do that. And so you have the personality that is drawn to that kind of thing versus the type that is drawn to IM. And there is something about that personality that makes them more chatty on internet web forums. It seems to me most IM people are kind of lame and see this place as a means to an end - get info - and have no real desire to give anything back to anyone else, not really. It's kind of a d-bag thing about IM, no real sense of community, and you'll see this in the hospital. One medicine guy will not generally hesitate to throw another medicine under the bus if he thinks it's necessary. We don't stand together. Interestingly enough, you generally will see the gas folks at any institution in a united front no matter what.

So what gives?? I don't know. I think I made things more muddy than clear.

Most emo response ever?

Nah, but JDH is right. The lameness of this place scared me away. I only swing by the IM boards about qmonthly now, basically to tell the residency applicants and interviewees to refill their albuterol / xanax and chill the f*&% out over not hearing from one of the Big 15 or whatever the hell they call it now.

IM as a specialty pwns if you are ADHD, OCD, and/or down wit' OPP.

Show me 25 more posters here who can throw it down and not get their panties in a twist, and I might stop by here more often.

 

[jdh71]

It could also be that we have to be less neurotic in IM during the residency match process. If you're someone with average board scores and HP's in most clerkships, there is a chance you won't match in EM or Anesthesia, while in IM you'll always be able to find some sort of safety program, while it may not necessarily be the case with EM or Anesthesia.

Also, JDH, I don't like your negative view of the IM personality type! Granted, you've been through an IM residency and I'm about to enter one, but I personally found IM people to be the perfect mix of chill and caring about patients, compared to Anesthesia (checked out, always planning their next golf outing) and EM (talking about extreme kayaking or skiing ad nauseum)!

I'm not being negative per se, just kind of calling it the way I see it.

It's not like the gas peeps and their attitudes don't drive me crazy too.

I was just shooting from the hip.

But as a group, IM peeps just aren't tons of fun. I wouldn't take any of you with me to a cocaine and hookers party.

 

[jdh71]

well said... I wonder if burn out is more prevalent among IM residents than gas doctors.
One of my colleagues calls it the pathos of internal medicine.. sick and complex patients with burnt out/digruntled physicians who believe in the futility of interventions.

Well. I guess I don't know, but I'd guess based on the jobs, burn out would be higher. I kind of don't see how outside of call, gas could get your burned out unless you got bored of it. Being on call sucks . . . well being on REAL call anyway. I know everyone takes "call" for their respective sub-specialties but you can't punt the kind of work that requires anesthesia, if it needs doing at 3AM, it needs you there. THAT might get old, but if you're practice was structured so it wasn't so bad . . . I don't know.

It's hard dealing with sick people and having to be the go to person shot-caller for everything. Get a CT of the chest back and there is a new small sub-centimeter nodule? ****. Why the hell did I even order that (?) - put that in your pile of bull**** that I have to take care of . . . Oh hey! Look! Little sickler lady has non-TB mycobacteria in that sputum culture you never should have gotten in the first place, that grew out after 8 weeks (could be contaminant! ) - put that on the pile of bull**** you now have to deal with . . . Awesome here's a creatinine that bumped after starting lisinopril . . .

rinse repeat

and it's different for the hospitalist, but still just as infuriating because you have to arrange for everything to get them out of your hospital - social situations, meds they can't afford, consultant clinic visits that are booked out three months and you need the patient seen in one . . .

it's easy to see how the burn-out occurs

 

[jdh71]

Most emo response ever?

Nah, but JDH is right. The lameness of this place scared me away. I only swing by the IM boards about qmonthly now, basically to tell the residency applicants and interviewees to refill their albuterol / xanax and chill the f*&% out over not hearing from one of the Big 15 or whatever the hell they call it now.

IM as a specialty pwns if you are ADHD, OCD, and/or down wit' OPP.

Show me 25 more posters here who can throw it down and not get their panties in a twist, and I might stop by here more often.

It can only get better when cool people stick around.

Drive by commentary isn't super helpful.

There have been a few years where me and gutonc literally kept this place alive by ourselves. I honestly don't know why this forum is way more lame than some of the others.

All I can say, if the people that don't like this forum, should try and mix it up a little more in here. I know I've tried. More than once.

 

[dragonfly99]

Maybe IM people are working (when at work) and busy living life in the real (not virtual) world when not working. Anesthesia folks are probably logging on between cases...at least I hope it is BETWEEN cases...LOL.

 

[tallash]

I don't know, anesthesia definitely attracts a different crowd from IM as evidenced by the posts in their forum. Some of my favorites: 1) "What's the best first gun to own?" 2) "New campaign slogan has ties to Socialism/Marxism" 3) Any number of their CRNA posts

"Based on my experience", the folks at my med school who opted for gas tended to be those emphasizing lifestyle and income over the actual nature of the work (which is fine). But they also tended to be people who were very aware of the 'turf wars' in medicine and who were already concerned about the future of gas. That's reflected in the posts on their forum, for better or worse.

 

[powermd]

Seeing a lot of misconceptions about anesthesiology here, thought I'd chime in.

I've been posting on SDN since 2003, before even picking a residency. I wrote the first FAQ for the anesthesia forum. During my anesthesiology residency the forum was alive with a number of outstanding 'fighter pilot' personality anesthesiologists who created a strong clinical backbone for discussions. It is my belief that their strong presence is what attracted a large number of very solid residents to become forum regulars. There were endless case discussions, discussions of technique, and the business of the field. That seems to have given way a good bit to political discussion regarding CRNAs, the government, and, of course, the obligatory threads about guns, metal, bikes, video games, etc. Most (if not all) anesthesiology residents I know have no interest in participating in online discussions about medicine, but SDN has attracted a substantial number who are. There is a solid core who participate in the pain medicine forum as well, and have been for years.

The big misconception I'd heavily dispute is any suggestion that we as anesthesiologists do not see ourselves as "real" doctors, viewing the field merely as a job providing us with the time and cash to pursue other interests. On the contrary, most of us are consummate professionals about what we do and take great pride in our capabilities. Most people will never see or understand what we do for patients, but the satisfaction of a job well done is tremendous. Doctors in every specialty can coast through life doing mediocre work, and anesthesiologists are no exception. But there are a lot of truly great people doing anesthesia right now, and quite a few are active members of the anesthesiology forum. If the IM forum is hurting for participants, maybe what's lacking is leadership.

 

[jdh71]

There are no attendings posting in the IM forum, outside of the occasional post by aPD, which is usually good stuff. The forum lacks direction. I give it time, which is why I stick around.

 

[LoudBark]

This forum is extremely dry and moves very slow. It seems to be just the typical, "What are my chances of the top 10....."

"Is it alright to email a PD after my interview and let them know it is my first choice?"

"How do I let my home program know I don't want to go there after they have been so nice to me as a student without hurting their feelings?"

Besides various versions of these same questions, not much going on here.

 

[gutonc]

Besides various versions of these same questions, not much going on here.

So...instead of just b****ing about it, why don't you start an interesting thread?

 

[jdh71]

So...instead of just b****ing about it, why don't you start an interesting thread?

word

everyone goes around bitching about how much it sucks in here but isn't interested in doing anything to change or help