IM vs ANS

[purple pearl]

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I cant decide between internal medicine and anesthesiology. I also recently blow step 2 ck. Step 1: 225 Step 2: 205 I go to a subpar medical school.
I need to decide today for LOR and I am too poor to apply for both. Adviser told me to make a pro/con list so I am posting it here out of desperation for additions/ advice. All my friends are too busy in rotations (and sick of me)! So here goes…

Internal Medicine: / Anesthesiology:
Procedures, can seek / Many required, troubleshoot, excellence
- Take work home / Take preps home
Out patient setting / Unlikely out patient
Easy to keep up/ read / less continuing education
Lifestyle past residency / Bad hours always
Independent work / Work as a team with crna
Low pressure/academic / High pressure/angry surgeon
Know: adult medicine +rads / Know: everyone + surgery+ rad
Can do womens health/ obesity / Can do ob/gyn
Pulm/ critical care+ 3yr /
Floor work / Rare floor work, more holding/or time
Less pt time / Stare at pt for hours☺
Easier to match for me / Chance of no match.

I will work hard for either… I am worried that I am too dumb for anesthesia as it is one of those- seize the moment/ risk taking professions and i never want to ever be a bad doctor... Thanks in advance for any advice.

 

[J ROD]

From reading between the lines, I think you are wanting to go IM.

Seems like you know the fields, now just make a decision. We cant tell you what to do. Only you know where you can see yourself. I always try to envision myself doing that job for yrs.

If you see yourself on the floors, being a generalist...there ya go.....IM

down in the OR, knocking folks out and managing CRNAs in a stressful environment...........Anes.

Where ya want to be? The CHOICE is yours. Make and be done with.

 

[BeardedRunner]

I disagree with some of your assumptions in comparing IM and Anes.
As for teamwork - I'd say IM involved more teamwork - especially when doing consults, working with residents, and seeking help from more seasoned colleagues on complicated cases.
In Anes. - I feel that you pretty much fly solo - of course you're there with surgery team, but from what I've seen in the OR, surgery is mainly concerned with each other and the operation, while the Anes. sits on his/her iPad behind the curtain. If something goes wrong in the OR, you have to act fast and often time do not have time to consult anyone else.
As for hours - I'd argue that IM may have worse hours that Anes - if you have patients admitted at a hospital, you obligated to round on them everyday and you can't leave until they're stable. Anes often work for private groups that contract out to hospitals - they have clear cut shifts - once they become more senior they can pick and choose when they want to work. I know a middle aged female Anes that works 3 10-hour days a week doing light sedation at an endoscopy center and makes 350k.
As for stress levels, IM can be pretty chill, but it can get stressful very fast when you have patients that argue with you and disagree with everything that you advise them to do. One of my mentors described being an internist as being a "life coach". In anesthesia - you do procedures for patients, but you don't have to coax or convince them to take their Metformin or Statin drugs ?!
-Some people may disagree with my views, but I was also considering Anesthesia and IM, and those were some of my opinions.