IM to Anesthesia? HELP!

[ConfusedIM]

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I am just about done with my first year of internal medicine. It was always my dream to do cardiology, however, since I started residency I am just not satisfied with IM. I am not quite sure what it is but I think I just don't enjoy the patient interaction. I am really tired of psych patients and social admits. I am also tired of how IM is just a dumping service. I feel like I just can't put up with these patients anymore. I always wanted to do cardiology but just thinking of going through 5 more years of being unhappy is making me depressed. A friend encouraged me to consider going into Anesthesiology, but I am not sure if this is the best decision for me. My concerns about it are does it have enough medicine? Does it have a lot of physics (not my best subject)? Also, I don't really like the critical care setting. I am doing a rotation in it to help me figure things out. However, I need to act fast if I want to join it because July is around the corner & there probably aren't even any vacancies left. So far what I like about anesthesiology is that everything is so fast. It's just case after case and you don't have to worry about seeing the same patients everyday. There is little patient interaction and you don't have to worry about social admits. I also really like doing procedures. I am very confused about whether I should stay in IM or switch to anesthesiology. I don't want to make a mistake. Also, I think I might be too late to make the switch for this July. I am fearing leaving something like IM that is comfortable to me (in terms of knowledge) and leaving it for something I know so little about. Please give me advice/suggestions. I could use all the help I can get! Thanks!

 

[Gern Blansten]

I am just about done with my first year of internal medicine. It was always my dream to do cardiology, however, since I started residency I am just not satisfied with IM. I am not quite sure what it is but I think I just don't enjoy the patient interaction. I am really tired of psych patients and social admits. I am also tired of how IM is just a dumping service.Substitute getting dumped on and treated as a technician. Few patients will know you went to med school I feel like I just can't put up with these patients anymore. I always wanted to do cardiology but just thinking of going through 5 more years of being unhappy is making me depressed. A friend encouraged me to consider going into Anesthesiology, but I am not sure if this is the best decision for me. My concerns about it are does it have enough medicineYes, more than you expect? Does it have a lot of physics won't be an issue(not my best subject)? Also, I don't really like the critical care settingmay be an issue for you. Often the OR is like an extension of the ICU with critically ill patients. I am doing a rotation in it to help me figure things outgreat idea. However, I need to act fast if I want to join it because July is around the corner & there probably aren't even any vacancies leftTrue, will be difficult to find on such short notice, but you might get lucky. So far what I like about anesthesiology is that everything is so fastOnly sometimes...other times long and boring. It's just case after case and you don't have to worry about seeing the same patients everyday. There is little patient interactionNot true, actually quite a bit of interaction...some good, some bad. Often you have more control over the interactions because you wield the syringe and you don't have to worry about social admits. I also really like doing procedures. I am very confused about whether I should stay in IM or switch to anesthesiology. I don't want to make a mistake. Also, I think I might be too late to make the switch for this July. I am fearing leaving something like IM that is comfortable to me (in terms of knowledge) and leaving it for something I know so little aboutThe learning curve will be steep to learn the anesth and surgical aspects, but it will come quickly if you apply yourself. A good base in medicine will be helpful. Please give me advice/suggestions. I could use all the help I can get! Thanks!

One other option is to finish what you started and get boarded in IM as you are doing anesthesiology. You would certainly be a more competitive candidate to get a good spot. I know that doesn't sound appealing, but it is another option.

 

[CambieMD]

I am just about done with my first year of internal medicine. It was always my dream to do cardiology, however, since I started residency I am just not satisfied with IM. I am not quite sure what it is but I think I just don't enjoy the patient interaction. I am really tired of psych patients and social admits. I am also tired of how IM is just a dumping service. I feel like I just can't put up with these patients anymore. I always wanted to do cardiology but just thinking of going through 5 more years of being unhappy is making me depressed. A friend encouraged me to consider going into Anesthesiology, but I am not sure if this is the best decision for me. My concerns about it are does it have enough medicine? Does it have a lot of physics (not my best subject)? Also, I don't really like the critical care setting. I am doing a rotation in it to help me figure things out. However, I need to act fast if I want to join it because July is around the corner & there probably aren't even any vacancies left. So far what I like about anesthesiology is that everything is so fast. It's just case after case and you don't have to worry about seeing the same patients everyday. There is little patient interaction and you don't have to worry about social admits. I also really like doing procedures. I am very confused about whether I should stay in IM or switch to anesthesiology. I don't want to make a mistake. Also, I think I might be too late to make the switch for this July. I am fearing leaving something like IM that is comfortable to me (in terms of knowledge) and leaving it for something I know so little about. Please give me advice/suggestions. I could use all the help I can get! Thanks!

I left family practice to become an anesthesiologist. I am not sure if you really know what you want to do. anesthesiologists often take care of patients with complicated medical and social histories.

How could anesthesia not ,"have enough medicine," for you. We see physiology in action every day. Anesthesiologists must make critical decisions quickly.

I enjoy patient contact. I did not switch to anesthesia in order to have less patient contact. The body of knowledge encompassed by anesthesia is what attracted me to anesthesia.

Anesthesia has many pluses but there are minuses, also.

Think long and hard before you decide to leave IM.

The question that you should ask is will you be happy in cardiology. Forget the time involved in the training process.

Cambie

 

[kaioukenx]

It sounds like you are mostly unhappy with IM wards. Doesn't your required time in wards decrease significantly after intern year? Most R2 schedules I've seen for IM have only 2-3 months of wards and lots of elective time. I also don't know why you consider going through a cardiology fellowship a source of unhappiness when cardiology is (supposedly) what you want to do. I would have to imagine that there is much less social/dumping stuff on a specialty service.

 

[PMPMD]

Agree with above. Intern year sucks for everyone. Anesthesia has its own share of problems, make sure you're not just seeing the grass as greener on our side. Don't know about your program, but at my institution, IM seems to get exponentially better after PGY1 year.

 

[lord_jeebus]

Be sure that you make your decision on the basis of the life of a practicing internist, and not that of an internal medicine resident. For instance, what seems like a "bogus dump" or "social admission" in residency may be an easy and lucrative consultation or admission as a private practice attending.

 

[ConfusedIM]

Thanks everyone for replying! I don't think it is just the wards during intern year that bothered me. I didn't really enjoy the electives or other rotations like the MICU or CCU that much either. I somehow seem to have lost the motivation and drive I once had for IM and cards. It is not the time involved in fellowship for cardiology that is making me like it less. I just don't feel the same about IM anymore. Again I am not quite sure what happened this year to drastically change my mind about IM. When I think about what I would like to do after IM I can't really imagine myself being a hospitalist or seeing patients OP. However, I am not sure if anesthesiology is the best fit for me since it has a lot of pharmacology, physics and it is all about making fast decisions on the spot. But with experience I am sure the decision making process will get easier. I like procedures and I like anesthesia because I feel they really deal with the medicine or anesthesia aspect of it rather than deal with patient crap.
I am not sure how to decide what is the best course of action for me. Maybe only time will tell.
PMPMD, you mentioned that anesthesia has it's own share of problems. What problems?
If you guys have any other piece of advice I will appreciate it.
Thanks again!

 

[hoyden]

Your anesthesia rotation may help but do not count too much on it - you may not see at all the perks and what the problems are.

If you do not like ICU/CCU setting that might be a red flag in your mind that you might not like anesthesia either.

Actually I think that you are just very tired IM intern who needs to get to the easier year ( PGY-2 ) to sort the things out. Since it is very close to July and finding the spot in Anesthesia might be really tough that PGY-2 in IM might be a deal breaker for your future.
Just do not look at it as a wasted time. Try to get as many cardiology related electives as possible - to test your previous dream in a new setting. Not being an intern anymore will help a lot 😉

Good luck!

 

[RussianJoo]

how could you hate the ICU but love the fast pace of anesthesia and the procedures that an anesthesiologist does? seems contradictory to me.

 

[211498]

You can apply this September for a CA-1 postion beginning 2013. If during the first 4 or 5 months your PGY2 year turns out to be the thing you were always waiting for, you still can cancel the interviews.

 

[ConfusedIM]

Thank you everyone for your help!

 

[jetproppilot]

Thank you everyone for your help!

Think psychiatry.

 

[themont0]

If i were you I wouldn't worry so much about how the critical care setting makes you feel or how much physics there is in daily anesthesia. I would recommend that you focus first on deciding if the IM path your on is for you or not. If not, then you should defin start shopping other options but you'll have to be patient and work a little harder now that the main match is history. Whatever you do now is 'out-of-the-match' and inherently will take more energy to make happen. But, like anything else, you can do it. You wouldn't be where you are now if that wasn't the case.

I knew by the 4th month of my medicine intern year that I didn't want to stay on the IM path. I went to the anes program and made it very clear that I wanted to switch, and would wait as long as it took to get a spot. I finished my second year of Medicine before snagging an out-of-match spot. Now, almost a year in as an attending at the same institution, I do not regret my path at all. That extra year in medicine made a big difference in my comfort level and still serves me well in OR/Pacu problem solving and evaluating preop patients on-the-fly.

If your interested in Anes then find out if it IS for you by spending some more time in the OR. Its as simple as dropping by your main OR ready room, no need to make it complicated, just show an interest, ask some residents if you can shadow them, they can tell you who the right Admin are to talk to when/if you want to go all-in.

Good luck with your decision

 

[CambieMD]

If i were you I wouldn't worry so much about how the critical care setting makes you feel or how much physics there is in daily anesthesia. I would recommend that you focus first on deciding if the IM path your on is for you or not. If not, then you should defin start shopping other options but you'll have to be patient and work a little harder now that the main match is history. Whatever you do now is 'out-of-the-match' and inherently will take more energy to make happen. But, like anything else, you can do it. You wouldn't be where you are now if that wasn't the case.

I knew by the 4th month of my medicine intern year that I didn't want to stay on the IM path. I went to the anes program and made it very clear that I wanted to switch, and would wait as long as it took to get a spot. I finished my second year of Medicine before snagging an out-of-match spot. Now, almost a year in as an attending at the same institution, I do not regret my path at all. That extra year in medicine made a big difference in my comfort level and still serves me well in OR/Pacu problem solving and evaluating preop patients on-the-fly.

If your interested in Anes then find out if it IS for you by spending some more time in the OR. Its as simple as dropping by your main OR ready room, no need to make it complicated, just show an interest, ask some residents if you can shadow them, they can tell you who the right Admin are to talk to when/if you want to go all-in.

Good luck with your decision

I left FP after practicing for four years. I think that the time that I spent as an FP has made me a better anesthesiologist.

I have never regretted leaving family practice. I had no doubts that anesthesia was the specialty for me.

Cambie

 

[ConfusedIM]

I have done a rotation at the OR in my institution.. and have liked anesthesiology.. but have not fallen in love with it. I tried to look through some of the anesthesiology textbooks but felt a bit overwhelmed by it probably because it was all so new to me. My mindset has always been IM so it's really hard for me to imagine doing something else. However, I do know that I am not happy doing IM. I don't know if switching to anesthesiology is right for me at this point then because I don't love anesthesiology.. I think it's ok so far. However, just shadowing someone doesn't give you the best perspective on it either b/c you are not doing much but just watching your attendings doing stuff. So maybe I will like it more? I think it might be unwise to change to anesthesiology at this point if I am not loving it. Any advice?

 

[Tedebear]

PM Ventdependant on this board.

He will be able to help you sort things out.

 

[UTSouthwestern]

I have done a rotation at the OR in my institution.. and have liked anesthesiology.. but have not fallen in love with it. I tried to look through some of the anesthesiology textbooks but felt a bit overwhelmed by it probably because it was all so new to me. My mindset has always been IM so it's really hard for me to imagine doing something else. However, I do know that I am not happy doing IM. I don't know if switching to anesthesiology is right for me at this point then because I don't love anesthesiology.. I think it's ok so far. However, just shadowing someone doesn't give you the best perspective on it either b/c you are not doing much but just watching your attendings doing stuff. So maybe I will like it more? I think it might be unwise to change to anesthesiology at this point if I am not loving it. Any advice?

I also left IM for anesthesiology, however, I did enjoy anesthesiology in med school on rotation. At this point, you are pretty much going to have to a PGY-2 year in IM and I would advise that you use the time to evaluate your like/dislike of IM. At the same time, you can apply for positions in other fields but since you will have 2 years of IM completed, I would complete the third year, THEN enter another field if you still feel compelled to leave IM and IM subspecialties. Having board certification in IM, plus having certification in another specialty definitely adds value to your CV and your future candidacy for academic or private practice situations.

 

[ConfusedIM]

Thank you everyone for your help!

 

[jetproppilot]

I am just about done with my first year of internal medicine. It was always my dream to do cardiology, however, since I started residency I am just not satisfied with IM. I am not quite sure what it is but I think I just don't enjoy the patient interaction. I am really tired of psych patients and social admits. I am also tired of how IM is just a dumping service. I feel like I just can't put up with these patients anymore. I always wanted to do cardiology but just thinking of going through 5 more years of being unhappy is making me depressed. A friend encouraged me to consider going into Anesthesiology, but I am not sure if this is the best decision for me. My concerns about it are does it have enough medicine? Does it have a lot of physics (not my best subject)? Also, I don't really like the critical care setting. I am doing a rotation in it to help me figure things out. However, I need to act fast if I want to join it because July is around the corner & there probably aren't even any vacancies left. So far what I like about anesthesiology is that everything is so fast. It's just case after case and you don't have to worry about seeing the same patients everyday. There is little patient interaction and you don't have to worry about social admits. I also really like doing procedures. I am very confused about whether I should stay in IM or switch to anesthesiology. I don't want to make a mistake. Also, I think I might be too late to make the switch for this July. I am fearing leaving something like IM that is comfortable to me (in terms of knowledge) and leaving it for something I know so little about. Please give me advice/suggestions. I could use all the help I can get! Thanks!

How did you find this forum?

Why do you feel comfortable posting to the entire Internet world that you potentially made the wrong decision, here, on SDN Anesthesia?

 

[CambieMD]

How did you find this forum?

Why do you feel comfortable posting to the entire Internet world that you potentially made the wrong decision, here, on SDN Anesthesia?

A lot of us have admitted that we made poor/wrong decisions, on this forum. I think that the op's concerns are valid. The most reasonable thing for him/her to do would be to complete the IM residency and assess the situation at that time.

Cambie