lvspro

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Yo. I posted this in a different thread earlier, but it degenerated into a pissing contest. Please, unless you have something constructive to say, don't bother posting. The Umich part is a Q to current residents there, and whether or not they know of any IMG's there.

Hey everyone. I usually don't post, but my school just sent me my electives form, and they require it to be done by monday. The problem I'm having is that I'm only 5 mo's into my cores, and still don't know exactly what I want to do. I like medicine, but can see myself getting sick of tweaking medications for old ladies w/CHF. I like surgery, but sometimes I get the feeling that they are just glorified mechanics who lead the life of an indentured servant. ER sounds cool, but the heavy emphasis on being a primary care doc w/a touch of real emergent care defeats the purpose being an ER doc IMHO. Finally, I think I am leaning towards gas but I am still working on cores, and thus have not done an elective yet. For me, gas seems the ideal route. I get to do procedures, more so if I go pain, satisfying my desire for surgery. I get to tweak meds, and I get immediate results, satisfying my love for medicine while staying in the realm of acute care. Finally, an emergency in anaesthesia is usually a trouser-soiling emergency and allows me to flex my cool under pressure, satisfying my desire for emergent care. I also have a knack at making others feel comfy and assured. I get much personal satisfaction knowing I have put a Px's mind at ease.
My questions.
1. Have all of you had the same feelings I'm having right now?

2. I'm taking a gas elective in Sept. Any tips?

3. What electives should I stack in my MSIV yr, and pgy1 yr that will make me a strong gas doc? More focus on MSIV for now please.

4.This goes with the last one, should I do a g-surg/imed/or transit yr for my pgy1?

5. Does anyone know if US-IMG's are accepted @ UMich? S1:235/95, top 1/3 @ big 3 caribschool, don't mind working from the crack of dawn til' the middle of the night, english is my 1st... only language. I've heard many good things about UMich, plus I've always wanted to go there. I live in Mich, and would love to move to Ann Arbor. If not UMich, does anyone know of IMG's landing a spot at one of the commonly discussed "best" programs?

6. BTW, I read the book "Choosing a medical specialty" by Lange, and it states that there is a shortage of gas docs in 2004, and that this shortage is expected to carry on for at least ten years.furthermore, the statement is referenced: Am Soc Anaesthesiol Newsletter; 65(4):16-19. My Q is this. It seems with all the talk of CRNA's, oversupply of MDA's, and demand shrinking on this forum you would think the book is wrong, so does anyone know the real story?

7. For all the people concerned w/$$$, please don't choose a field on how much $ you make. I was making 6 figures b4 med school, and hated life. Sure, the Lexus was nice, and the Phat condo was cool, but it really isn't worth it. It would take 6 alarm clocks in the morning to get me out of bed, and I was always bored at work. When I acted on my goal of becoming a doc, I suddenly had no trouble in the AM, and I can't even think of the last time I had a bad day at work.... er, I guess it would be at rotations. I hate to beat a dead horse, but whatever you do better get you aroused too.

Thanks
Peace
Lo
 

VentdependenT

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1. Sort of. I didn't view surgeons as glorified mechanics however. Those folks work extremely hard and the bright ones are a sight to behold. God bless em. EM and Interventional Rads aren't bad routes either. If not gas then probably EM for myself.

2. Basics of Anesthesia by Miller and Dukes Secrets. Do a search on this forum as tips on how to succeed have already been addressed adequately. Basically just try and be like UTsouthwestern!

3. Anesthesia x2, SICU, Trauma surgery/Surgery sub-I, Medicine sub-I, Cards, Pulm.

4. Transition year.

5. Dunno. Apply. Goes for all institutions.

6. Bottom line, if you enjoy this field go into it.

7. Not a question. Sorry you dissed your 6 figure job that didn't include call and having peoples lives in your hands. Hehe :D

EDIT: Apologies about the wise crack in #7, just read that hijacked thread of yours which was closed. Ouch. Land a couple of letters, follow skips advice below, apply widely to cover yourself, and I'm positive you will match! ICU rotation will help greatly on interviews/application statement and during your intern year on unit months.

1 week o' unit left.
 

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lvspro said:
Finally, I think I am leaning towards gas but I am still working on cores, and thus have not done an elective yet. For me, gas seems the ideal route. I get to do procedures, more so if I go pain, satisfying my desire for surgery. I get to tweak meds, and I get immediate results, satisfying my love for medicine while staying in the realm of acute care. Finally, an emergency in anaesthesia is usually a trouser-soiling emergency and allows me to flex my cool under pressure, satisfying my desire for emergent care. I also have a knack at making others feel comfy and assured. I get much personal satisfaction knowing I have put a Px's mind at ease.
My questions.
1. Have all of you had the same feelings I'm having right now?
I think most of us have. Personally, I like the OR setting but have no desire to be a surgeon. I am also attracted to the field for similar reasons you state above.

lvspro said:
2. I'm taking a gas elective in Sept. Any tips?
Show up on time, all the time. Get as much opportunity as you can to begin to master some of the basics like starting peripheral IVs, doing intubations, etc. Get to know as much as you can about the induction agents, the vapors, and the workings of the unit before you walk into the OR your first day. And, when you are ready to work on a patient, know the patient. Make sure you know their concomitant medical problems, their allergies, why they are having the procedure, etc. Know the Mallampati airway classification and the ASA risk classifications. Assess the patient for both of these, and see if your assessments match the attending's. Ask questions if not. MOST IMPORTANTLY, when you go into a room, plan to stay in for the whole case. Many attendings hate it when students flit around room-to-room looking just to do procedures. Stay in the room, ask questions, and get to know your attending's/resident's style. This will also offer you a huge opportunity to get some excellent one-on-one instruction and, if you show a high level of interest, will also segue nicely into a strong LoR. This is basic stuff, but is really important.

lvspro said:
3. What electives should I stack in my MSIV yr, and pgy1 yr that will make me a strong gas doc? More focus on MSIV for now please.
Do more than one gas elective at different hospital(s). Do a SICU or Critical Care elective. Try to do a 2-week pain elective. Get as much gas time as you can while a student, and try to do an elective at a program that has a residency program. I got offered a pre-match position (and turned it down) at one such place. I was invited to interview at the other. This creates a good opportunity to get letters as well, which are at least as important as your Step scores.

lvspro said:
4.This goes with the last one, should I do a g-surg/imed/or transit yr for my pgy1?
I'm only ranking highly University-based categorical programs. About 35-40% of the gas spots are categorical. By 2008, all programs will have to offer at least one categorical spot. If I don't match at one of these categorical programs, I'm planning on doing a Int Med preliminary year, and will do a one month anesthesiology elective. I want to have a year of medicine, as much as possible, to prepare me for Step 3.

lvspro said:
5. Does anyone know if US-IMG's are accepted @ UMich? S1:235/95, top 1/3 @ big 3 caribschool, don't mind working from the crack of dawn til' the middle of the night, english is my 1st... only language. I've heard many good things about UMich, plus I've always wanted to go there. I live in Mich, and would love to move to Ann Arbor. If not UMich, does anyone know of IMG's landing a spot at one of the commonly discussed "best" programs?
You have a very strong Step 1 score, but the reality is that some programs simply will not look at your application based on where you went to undergrad med. This also holds true, in a lot of instances, for soon-to-be graduates of some osteopathy schools and other "lower tier" U.S. medical schools. Some programs only care about pedigree, and unless you came from a top allo school, regardless of your Step scores, you won't even get looked at.

Still, your best opportunity of "cracking through the glass ceiling" would be to try to do a visiting rotation there. If this is possible, I'd try to set one up now for sometime in the summer. Otherwise, if you'd be just as happy in Detroit (which ain't Ann Arbor by a long shot, I'll grant you), I can almost guarantee you that you'll get invited to Wayne State and Henry Ford. I applied to both programs as a back-up, and since I got so many interviews at other places I just decided that I didn't need to go mostly because Detroit was not high on my list of places to live. But, I heard both programs (from other interviewees) are really solid and that, especially the Wayne State program, is a solid and very resident-friendly place.

lvspro said:
6. BTW, I read the book "Choosing a medical specialty" by Lange, and it states that there is a shortage of gas docs in 2004, and that this shortage is expected to carry on for at least ten years.furthermore, the statement is referenced: Am Soc Anaesthesiol Newsletter; 65(4):16-19. My Q is this. It seems with all the talk of CRNA's, oversupply of MDA's, and demand shrinking on this forum you would think the book is wrong, so does anyone know the real story?
The fact is that there have been and always will be CRNAs. CRNAs are a valuable and extremely important member of the healthcare team. I think that's the key. Numerous studies have demonstrated that the team approach is the best way to deliver anesthesia care. This counts from getting accurate history from the PAT service (which is often run by Nurse Practitioners) all the way to the care given in the PACU. The CRNA issue is not a new one, and certainly does not diminish, replace, or take away from the need and importance of having a medically trained anesthesiologist in the room or within earshot. This issue, though, has been addressed at length in other threads. Try a search for more info.

lvspro said:
7. For all the people concerned w/$$$, please don't choose a field on how much $ you make. I was making 6 figures b4 med school, and hated life. Sure, the Lexus was nice, and the Phat condo was cool, but it really isn't worth it. It would take 6 alarm clocks in the morning to get me out of bed, and I was always bored at work. When I acted on my goal of becoming a doc, I suddenly had no trouble in the AM, and I can't even think of the last time I had a bad day at work.... er, I guess it would be at rotations. I hate to beat a dead horse, but whatever you do better get you aroused too.
I agree completely. I was in a similar situation as you were, and now I'm a year ahead of you with about the same thoughts. If you don't get into UMich, don't worry. I'm sure you'll get into a great University-based gas program in another great location. As I'm finalizing my rank-order list for next month's Match, I can tel you that I'm sitting pretty with a lot of great (perhaps TOO many great) choices of places to go. As I do a little more shuffling at the top, I know that if I end-up anywhere of my top five programs I'll get into a great program that offers great training. That's a good feeling. Just remember next year to apply far and wide and send your app out early.

Good luck. Gas is a great field. I'm really looking forward to graduation and getting started.

-Skip
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lvspro

lvspro

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Yo vent n skip
Thanks. I'll keep this info in mind when I finish scheduling my electives on Mon. btw, after I talk to the PD, I'll let you know what the real deal is at Umich.
Peace
Lo
 

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lvspro said:
Yo vent n skip
Thanks. I'll keep this info in mind when I finish scheduling my electives on Mon. btw, after I talk to the PD, I'll let you know what the real deal is at Umich.
Peace
Lo
Hey Ivspro,

Sorry about your thread getting high-jacked. I think I added to the fire when I responded to dkny's response to your post. My apologies. I didn't stick around to see the onslaught begin. But there is enough information thats been previously posted to more than answer your questions. Let me just add, that I didn't mean to discourage you, I just wanted you to be aware that there is a slight disadvantage coming from a carib school.(you probably aleady knew that), But with your stats you will be fine. You sound like you have the whole package. The better you do on your steps, the more doors will open to you. And yes, you can break into great programs. Someone from my school signed outside with UPENN this year. So there you go.

Good luck to you.

Dr. J
 
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lvspro

lvspro

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jenjas said:
Hey Ivspro,

Sorry about your thread getting high-jacked. I think I added to the fire when I responded to dkny's response to your post. My apologies. I didn't stick around to see the onslaught begin. But there is enough information thats been previously posted to more than answer your questions. Let me just add, that I didn't mean to discourage you, I just wanted you to be aware that there is a slight disadvantage coming from a carib school.(you probably aleady knew that), But with your stats you will be fine. You sound like you have the whole package. The better you do on your steps, the more doors will open to you. And yes, you can break into great programs. Someone from my school signed outside with UPENN this year. So there you go.

Good luck to you.

Dr. J

Hey J
Don't worry about what happened on the last thread. Sometimes it's hard to resist the temptation of revenge. I also am, and was, painfully aware of the disadvantages of being a carib grad.
I do appreciate the input from you, and the others who have had constuctive comments. Sometimes it seems a little overwhelming negotiating the maze to becoming a doc, so a little advice can go a long way.
Peace
Lo
 

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lvspro said:
Sometimes it seems a little overwhelming negotiating the maze to becoming a doc, so a little advice can go a long way.
Yeah, that's why I always try to help, which admittedly can take many forms. Often it's hard to pick out the good advice amidst the steaming piles of dog crap that certain other posters seem to want to drop on this forum. Also sorry about what happened on the other thread, but I think I needed to make a point... and a strong one at that.

Again, good luck dude.

-Skip