Incoming MS1 interested in anesthesiology(Poll included)

[Clockdoc89]

Hello everyone! As the title says I am an incoming MS1 that is interested in Anesthesiology. I am going into medical school with an open mind and my interests are certainly subject to change but based on my research I think Anesthesiology would be a good specialty for me.

-I do not mind being unrecognized or not being thought of as the patient's doctor. (I actually hate being the center of attention).

-I think I would enjoy the limited but intense patient interaction. I have volunteered in community clinics for a while and cannot see myself working in a clinic for the rest of my career.

-I have always enjoyed Pharmacology and Physiology and I understand yall are the masters at that. I like the idea of understanding WHY something happens and being able to fix it at the moment, with my own hands, and be able to see the results without waiting for a 6 month follow up.

- I like working with my hands so the procedural aspect is a draw for me as well.

-I like that I would not be tied down by a clinic as I love to travel.

-I am an easy going person unless it comes to work, I tend to be very detail oriented and from what I understand people in this specialty are very relaxed(I need this lol).

-I am not ashamed to say the income and lifestyle(I understand this varies based on where you work and what you make of it) appeal to me as well. With that being said I am a hard worker and do not like to stand around and waste time.

While this is not set in stone, what would be the best way for me to gauge my interest? The reason I ask is if I do go into this specialty I would like to build a good application and try to compete for a top residency so I would like to start from 1st year pursuing research that would make me competitive. I don't wait to wait until M4 to do a rotation so is shadowing an Anesthesiologist a good way to move forward at this point?

I've read about the doom and gloom of mid-level creep which is a bit concerning, but would be interested in doing a fellowship for sure, not only for greater job security but greater income as well. How do yall feel about where the field is going in the next 10-15 years(I'm sure this is hard to predict)?

Is there anything you would tell your M1 self after all of the experience you've had?

Thank you so much for reading I know it's a bit long

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[nimbus]

Anesthesia was a good choice for me but in the current environment I'd tell my M1 self to do Ortho. Hardworking, detail oriented, like working with your hands is a perfect fit for ortho. And the field is MUCH healthier.

 

[AdmiralChz]

Do what you enjoy and keep an open mind. My friends making half the median of anesthesiologists in primary care are happy as larks, making a difference in their communities.

 

[Clockdoc89]

Anesthesia was a good choice for me but in the current environment I'd tell my M1 self to do Ortho. Hardworking, detail oriented, like working with your hands is a perfect fit for ortho. And the field is MUCH healthier.

Thanks for the input! What exactly about the current environment is bad? I'm assuming you're talking about mid-levels?

 

[Clockdoc89]

Do what you enjoy and keep an open mind. My friends making half the median of anesthesiologists in primary care are happy as larks, making a difference in their communities.

Yeah I am definitely going in with an open mind, and I would not prioritize money over my own happiness. Money is not everything and there's no point in making lots of it if you can never use it...or are miserable at for 60 hours a week to get it. Thank you for the edit of your original post..not trying to irk people here just want some input from those that have traveled this path before me.

 

[nimbus]

Thanks for the input! What exactly about the current environment is bad? I'm assuming you're talking about mid-levels?

Corporatization more than midlevels. Surgeons can distinguish themselves to the community as outstanding practitioners and patients will seek them out. Anesthesia is a nameless faceless commodity.

 

[Strider_91]

I'm in the same boat as you! All the doom and gloom has got me so worried I don't think I can go into it in good conscious unless I meet a bunch of anesthesiologists that are genuinely happy. Right now I only have a small sample size of a 3 person MD only group that owns a surgery center and are raking in cash hand over fist with Cush hours and then everyone on here who says the sky is falling.

 

[Clockdoc89]

Corporatization more than midlevels. Surgeons can distinguish themselves to the community as outstanding practitioners and patients will seek them out. Anesthesia is a nameless faceless commodity.

But if every surgery requires anesthesiology doesn't that indirectly tie a surgeon's ability to bring in patients to Anesthesiology job security? Whether you'd be doing the anesthesia yourself or supervising a CRNA. Is that any different with a fellowship? Say a Critical Care fellowship...I suppose you aren't bringing in any patients but you are a commodity in that you can treat any ICU admits as well as do anesthesia, no?

Also, what is the overall effect of Corporatization? Less autonomy in how your practice? I worked in the ER for a while and they had "patient satisfaction" surveys and all kinds of measures of quality of care. How is the corporate influence manifested in Anesthesiology?

 

[Clockdoc89]

I'm in the same boat as you! All the doom and gloom has got me so worried I don't think I can go into it in good conscious unless I meet a bunch of anesthesiologists that are genuinely happy. Right now I only have a small sample size of a 3 person MD only group that owns a surgery center and are raking in cash hand over fist with Cush hours and then everyone on here who says the sky is falling.

Haha what sucks is who knows what the landscape will be like by the time we graduate...Do you know if this is an established practice that has been around for a while or if it was recently started. From what Nimbus mentioned, corporatization seems to be growing making it more difficult to establish a private practice.

 

[Strider_91]

Not sure when it started exactly but it couldn't have been that long ago. None of the people in the group are that old but I guess they took a risk starting a surgery center which many physicians would be afraid to do. Paid off tho for sure. I know for a fact that owning around 5% of the center nets 225k/ yr and that's not even including what the physicians are billing for, that's just profit from surgery center fees.

 

[Clockdoc89]

Not sure when it started exactly but it couldn't have been that long ago. None of the people in the group are that old but I guess they took a risk starting a surgery center which many physicians would be afraid to do. Paid off tho for sure. I know for a fact that owning around 5% of the center nets 225k/ yr and that's not even including what the physicians are billing for, that's just profit from surgery center fees.

Well it's nice to see there are lucrative opportunities whether you have to find them or make them yourself. I wonder if any of them have a business background, something like that I imagine is not easy to do and as you said certainly risky. Financially speaking ownership in some practice/facility is always the way to go but the headache to get there is another story lol. What state is this in if you don't mind me asking

 

[anbuitachi]

I would not go into anesthesiology again if i were to not go to med school. But if i did do med, id likely do aneshtesiology again. Very interesting field

 

[Clockdoc89]

I would not go into anesthesiology again if i were to not go to med school. But if i did do med, id likely do aneshtesiology again. Very interesting field

So basically you'd do anesthesiology again?? lol If you don't go to med school you basically don't have a choice haha. What drew you to it?

 

[Strider_91]

Well it's nice to see there are lucrative opportunities whether you have to find them or make them yourself. I wonder if any of them have a business background, something like that I imagine is not easy to do and as you said certainly risky. Financially speaking ownership in some practice/facility is always the way to go but the headache to get there is another story lol. What state is this in if you don't mind me asking

The guy who runs it is actually a CPA (no MD)the guys a monster and handles most of the business aspect. This is tri-state area. I don't know the particulars of the surgery center day to day business, I work in the same building for a doctor who is part owner and operates there so I know a decent amount...but not everything.

 

[anbuitachi]

So basically you'd do anesthesiology again?? lol If you don't go to med school you basically don't have a choice haha. What drew you to it?

I guess i mean if i had a choice, id skip out on med and go into another field all together. medicine has way too many issues.
I like it cause it makes sense. When i did my medicine rotations, a lot of it is just memorization. if this, then this. memorize those algorithms, and tons of social work etc. surgery had it's own issues, bad environment, too little medicine and too much operating. they call cardiology consult for basic HTN. it's ridiculous.
Anesthesiology meanwhile is a mix of procedures and medicine. You do a lot of medicine/ICU stuff in the OR (of course not the chronic stuff). you manage their glucose, volume status, ventilation, etc. You learn why you do certain things instead of just being told you should do it. obviously the field has a lot of downsides too - very busy, unpredictable work hours, high stress since many sick patients, dealing with surgeons, CRNA turf issues, decreasing pay etc

 

[Wiscoblue]

You need to do well on your step 1. A score of 250, and you will have multiple options. A score of 210, and you might not be in a position to choose where you go. Study hard in med school. Get high pass or better in all your subjects. Then look at your options. It is good to 'think about' anesthesiology at this stage. But your scores might determine where you will end up. Good luck.


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[yoyoni]

What's the low down on CRNAs @anbuitachi and @nimbus by "healthy" what do you mean? I am also interested in anesthesia, but with all the talk of "turf wars" and the problems of one anesthesiologist with pain meds or whatever being generalized to a whole field it's hard to know what the situation is actually like.

Like OP I love the procedural aspect of it and the medical underpinnings but wonder if, nowadays with med-levels, being an anesthesiologist has become a little boring? Is the "baby sitter" troupe true? I also don't know how much I'd jive with a lack of sustained patient interaction (where "sustained" means just in a clinic setting, not FM per se). I do love the notion of being able to offer reassurance to a patient before he or she undergoes surgery etc. though.

I'd appreciate any thoughts! (I am also an incoming M1).

 

[BLADEMDA]

I'm in the same boat as you! All the doom and gloom has got me so worried I don't think I can go into it in good conscious unless I meet a bunch of anesthesiologists that are genuinely happy. Right now I only have a small sample size of a 3 person MD only group that owns a surgery center and are raking in cash hand over fist with Cush hours and then everyone on here who says the sky is falling.

Things have changed in Anesthesiology a great deal. The vast majority of new Anesthesia graduates circa 2021 will end up working for "the man" in the mid 300K range.
Hospital employed, Academic or AMC will represent 75% of the market by 2021. The other 25% will remain private practice but even then those practices may not offer you a real partnership track with ownership/equity in the practice.

The fact that you know 3 guys who are raking in cash by running/owning a surgicenter doesn't change the reality on the ground for the rest. For example, the CRNA who co-founded NorthStar made millions or the CRNA running LifeLinc is making a small fortune doesn't alter the reality for other 98% of CRNAs in the USA.

If a med student chooses Anesthesiology then a realistic expectation of salary/income vs work hours and type of employment opportunities are extremely important components of that decision.

 

[GA8314]

I would do it again and am very happy with my choice. Keep asking anes docs as you are, but find others too. I did that.

You need to be service oriented. All of the things discussed in many other threads. Yes, things are changing in this field. But, there will always be work for good people with skills. I'm more optimistic than others but I won't discredit their opinions.

 

[Strider_91]

Things have changed in Anesthesiology a great deal. The vast majority of new Anesthesia graduates circa 2021 will end up working for "the man" in the mid 300K range.
Hospital employed, Academic or AMC will represent 75% of the market by 2021. The other 25% will remain private practice but even then those practices may not offer you a real partnership track with ownership/equity in the practice.

The fact that you know 3 guys who are raking in cash by running/owning a surgicenter doesn't change the reality on the ground for the rest. For example, the CRNA who co-founded NorthStar made millions or the CRNA running LifeLinc is making a small fortune doesn't alter the reality for other 98% of CRNAs in the USA.

If a med student chooses Anesthesiology then a realistic expectation of salary/income vs work hours and type of employment opportunities are extremely important components of that decision.

I totally understand that. There are also some lawyers making millions but the reality of law grads today is that the job market is horrible. Earning in the mid 3's still sounds pretty good to me and more money than many specialties. No one I've ever known before meeting physicians made that type of money. The talk on here seems to be more like the low 200s which would be terrible considering the debt most med students graduating in 2021 will have.

 

[BLADEMDA]

What's the low down on CRNAs @anbuitachi and @nimbus by "healthy" what do you mean? I am also interested in anesthesia, but with all the talk of "turf wars" and the problems of one anesthesiologist with pain meds or whatever being generalized to a whole field it's hard to know what the situation is actually like.

Like OP I love the procedural aspect of it and the medical underpinnings but wonder if, nowadays with med-levels, being an anesthesiologist has become a little boring? Is the "baby sitter" troupe true? I also don't know how much I'd jive with a lack of sustained patient interaction (where "sustained" means just in a clinic setting, not FM per se). I do love the notion of being able to offer reassurance to a patient before he or she undergoes surgery etc. though.

I'd appreciate any thoughts! (I am also an incoming M1).

Being an Anesthesiologist is typically anything but "boring" as patients are getting older, fatter and sicker while still demanding even more elective procedures than ever before.

A small "error" in Anesthesiology can have catastrophic consequences for both patient and Physician.

 

[BLADEMDA]

I totally understand that. There are also some lawyers making millions but the reality of law grads today is that the job market is horrible. Earning in the mid 3's still sounds pretty good to me and more money than many specialties. No one I've ever known before meeting physicians made that type of money. The talk on here seems to be more like the low 200s which would be terrible considering the debt most med students graduating in 2021 will have.

Well, the job market shows the vast majority of positions (employed) pay in the 300's. Typically, the AMC may start you out in the low 300's with pay raises over time (2-3 years) until you eventually max out at around $350-$375K. Those will fellowships may be able to command slightly higher pay but even more importantly, pick their location and perhaps, reduced work hours vs their non-fellowed colleagues.

If you are willing to be an employee the job market is wide open.

 

[Consigliere]

Yeah I am definitely going in with an open mind, and I would not prioritize money over my own happiness. Money is not everything and there's no point in making lots of it if you can never use it...or are miserable at for 60 hours a week to get it. Thank you for the edit of your original post..not trying to irk people here just want some input from those that have traveled this path before me.

Those are the "easy" gigs in anesthesia my man.

 

[BLADEMDA]

 

[yoyoni]

Being an Anesthesiologist is typically anything but "boring" as patients are getting older, fatter and sicker while still demanding even more elective procedures than ever before.

A small "error" in Anesthesiology can have catastrophic consequences for both patient and Physician.

Very true, but I was asking more if, due to the presence of CRNAs, anesthesiologists have less to do while in an OR? I'll give this anecdote so it hopefully helps with what I'm asking: When I shadowed a surgeon this past year the anesthesiologist would (after the patient was intubated, etc.) just pop in and out of the OR, ask the CRNA how it's going, tell him or her to change the glucose levels or whatever, and only acted once it seemed like **** was about to hit the fan so to speak. I love working with others, coordinating tasks,
etc. but I would rather be the person actually doing the work rather than telling someone else what to do. Other than my singular experience in the OR I don't have any idea of what it's actually like to be an Anes. at an academic center though, so please forgive me if my understanding is all wrong!

 

[BLADEMDA]

Very true, but I was asking more if, due to the presence of CRNAs, anesthesiologists have less to do while in an OR? I'll give this anecdote so it hopefully helps with what I'm asking: When I shadowed a surgeon this past year the anesthesiologist would (after the patient was intubated, etc.) just pop in and out of the OR, ask the CRNA how it's going, tell him or her to change the glucose levels or whatever, and only acted once it seemed like **** was about to hit the fan so to speak. I love working with others, coordinating tasks,
etc. but I would rather be the person actually doing the work rather than telling someone else what to do. Other than my singular experience in the OR I don't have any idea of what it's actually like to be an Anes. at an academic center though, so please forgive me if my understanding is all wrong!

On the West Coast of the USA many non academic practices are staffed with Anesthesiologists only. This means that there are no CRNAs/AAs and the Anesthesiologists do all their own cases. While this is a great model of care and the one used in Australia, Canada, United Kingdom, etc it is also the most expensive model vs the ACT (anesthesia care team) so employers are shifting the model accordingly to maximize profits.

That said, I expect MD solo practices to continue on the West Coast for at least the next 10 years if not longer.

There is a misconception about supervising CRNAs; if the Anesthesiologist is responsible for 4 CRNAs that is more work than doing your own room. The Anesthesiologist is legally responsible for the care of 4 rooms with many cases scheduled per room. He/She should preop each patient, decide on the anesthetic plan and implement that plan with the CRNA. In addition, some patients will require peripheral nerve blocks and/or neuraxial anesthesia.

 

[Man o War]

Very true, but I was asking more if, due to the presence of CRNAs, anesthesiologists have less to do while in an OR? I'll give this anecdote so it hopefully helps with what I'm asking: When I shadowed a surgeon this past year the anesthesiologist would (after the patient was intubated, etc.) just pop in and out of the OR, ask the CRNA how it's going, tell him or her to change the glucose levels or whatever, and only acted once it seemed like **** was about to hit the fan so to speak. I love working with others, coordinating tasks,
etc. but I would rather be the person actually doing the work rather than telling someone else what to do. Other than my singular experience in the OR I don't have any idea of what it's actually like to be an Anes. at an academic center though, so please forgive me if my understanding is all wrong!

Sounds like you'd be a good fit for cardiac anesthesia based on what you're saying. You will need to tack on an extra year for fellowship after residency if that's the route you want to take.

 

[Consigliere]

There is a misconception about supervising CRNAs; if the Anesthesiologist is responsible for 4 CRNAs that is more work than doing your own room. The Anesthesiologist is legally responsible for the care of 4 rooms with many cases scheduled per room. He/She should preop each patient, decide on the anesthetic plan and implement that plan with the CRNA. In addition, some patients will require peripheral nerve blocks and/or neuraxial anesthesia.

So true and so very, very, true. I will probably be transitioning to doing my own cases soon because I'm tired of working so hard.

 

[yoyoni]

On the West Coast of the USA many non academic practices are staffed with Anesthesiologists only. This means that there are no CRNAs/AAs and the Anesthesiologists do all their own cases. While this is a great model of care and the one used in Australia, Canada, United Kingdom, etc it is also the most expensive model vs the ACT (anesthesia care team) so employers are shifting the model accordingly to maximize profits.

That said, I expect MD solo practices to continue on the West Coast for at least the next 10 years if not longer.

There is a misconception about supervising CRNAs; if the Anesthesiologist is responsible for 4 CRNAs that is more work than doing your own room. The Anesthesiologist is legally responsible for the care of 4 rooms with many cases scheduled per room. He/She should preop each patient, decide on the anesthetic plan and implement that plan with the CRNA. In addition, some patients will require peripheral nerve blocks and/or neuraxial anesthesia.

Do you feel like you're spreading yourself too thin? I feel like I'd rather spend all my time in one or two rooms doing cases from start to finish than overseeing the management of four rooms. Idk

 

[yoyoni]

Sounds like you'd be a good fit for cardiac anesthesia based on what you're saying. You will need to tack on an extra year for fellowship after residency if that's the route you want to take.

Could I ask why cardiac anesthesia? I do think if I end up choose anesthesiology I'll do a fellowship, but unsure of which one I would end up choosing.

 

[Man o War]

Could I ask why cardiac anesthesia? I do think if I end up choose anesthesiology I'll do a fellowship, but unsure of which one I would end up choosing.

Doing your own cases or minimal supervision ratios is the norm in cardiac anesthesia. I think you'd enjoy TEE based on your comments here, and it's a lot of multitasking so you won't have a lot of idle time, which it sounds like you'd like to avoid.

 

[waterbottle10]

I totally understand that. There are also some lawyers making millions but the reality of law grads today is that the job market is horrible. Earning in the mid 3's still sounds pretty good to me and more money than many specialties. No one I've ever known before meeting physicians made that type of money. The talk on here seems to be more like the low 200s which would be terrible considering the debt most med students graduating in 2021 will have.

That will probably start to change for you soon. Most residents in my program went to good colleges and you quickly start seeing how much money others make compared to doctors. At such an early stage of your career 300k sounds like a lot but it's not. Esp not w laods of debt and starting work at 30s. If you went to good school you prob have smart friends comparable to yourself. The lawyers you know probably won't be the unemployed ones. The lawyer friends I know all have high paying jobs. Corporate law starts at 180k these days before bonus.. Senior associates easily make more than docs and then there's bonus. Partner is hard but make millions. Other popular fields make a lot too like business/cs

 

[deleted162650]

That will probably start to change for you soon. Most residents in my program went to good colleges and you quickly start seeing how much money others make compared to doctors. At such an early stage of your career 300k sounds like a lot but it's not. Esp not w laods of debt and starting work at 30s. If you went to good school you prob have smart friends comparable to yourself. The lawyers you know probably won't be the unemployed ones. The lawyer friends I know all have high paying jobs. Corporate law starts at 180k these days before bonus.. Senior associates easily make more than docs and then there's bonus. Partner is hard but make millions. Other popular fields make a lot too like business/cs

Don't forget iBanking

 

[Strider_91]

To be honest I went to my local small no name state college. I am confident I will do better financially as a physician than most of my friends except for the ones who start their own businesses and they take off. As for Ibanking, I never would have gotten a chance for that coming from my school. But I do think my income priorities will change when I'm older. Maybe I'll try to bag a finance chick...key to success.

 

[Arch Guillotti]

There is a misconception about supervising CRNAs; if the Anesthesiologist is responsible for 4 CRNAs that is more work than doing your own room. The Anesthesiologist is legally responsible for the care of 4 rooms with many cases scheduled per room. He/She should preop each patient, decide on the anesthetic plan and implement that plan with the CRNA. In addition, some patients will require peripheral nerve blocks and/or neuraxial anesthesia.

Sitting a case is a cakewalk compared to supervising 4 at a time.

 

[nimbus]

Well, the job market shows the vast majority of positions (employed) pay in the 300's. Typically, the AMC may start you out in the low 300's with pay raises over time (2-3 years) until you eventually max out at around $350-$375K. Those will fellowships may be able to command slightly higher pay but even more importantly, pick their location and perhaps, reduced work hours vs their non-fellowed colleagues.

If you are willing to be an employee the job market is wide open.

But if you do Ortho, you can double or triple this with a better lifestyle. It makes no sense as an M1 to shoot for anesthesia in this day and age.

And in my practice, fellowship doesn't matter except cardiac and sometimes peds. We now have half a dozen each of CCM fellows and Peds fellows who will never practice their subspecialty. Regional is neither plus or minus. Everybody is expected to be decent at blocks.

 

[repititionition]

But if you do Ortho, you can double or triple this with a better lifestyle. It makes no sense as an M1 to shoot for anesthesia in this day and age.

And in my practice, fellowship doesn't matter except cardiac and sometimes peds. We now have half a dozen each of CCM fellows and Peds fellows who will never practice their subspecialty. Regional is neither plus or minus. Everybody is expected to be decent at blocks.

I hate hearing this. It depresses me.

That said, still applying to anesthesiology as an ortho-competitive applicant.... because **** surgery.

 

[BLADEMDA]

But if you do Ortho, you can double or triple this with a better lifestyle. It makes no sense as an M1 to shoot for anesthesia in this day and age.

And in my practice, fellowship doesn't matter except cardiac and sometimes peds. We now have half a dozen each of CCM fellows and Peds fellows who will never practice their subspecialty. Regional is neither plus or minus. Everybody is expected to be decent at blocks.

1. I agree with you about Ortho but ENT and Urology are excellent as well.

2. Non surgical specialties- Cards, Gi, Pulmonary, Radiology (interventional) and Derm.

3. Fellowship- We have had this debate many times and in general, a fellowship is helpful in this job market especially Cardiac. CCM is a great fellowship for academia and I recommend it as well. Anesthesiologists who choose Pain will still out earn the vast majority of new grads circa 2021.

 

[yoyoni]

But if you do Ortho, you can double or triple this with a better lifestyle. It makes no sense as an M1 to shoot for anesthesia in this day and age.

And in my practice, fellowship doesn't matter except cardiac and sometimes peds. We now have half a dozen each of CCM fellows and Peds fellows who will never practice their subspecialty. Regional is neither plus or minus. Everybody is expected to be decent at blocks.

How does ortho have a better lifestyle? I would think none of the surgical sub specialties have a better lifestyle than anesthesia

 

[BLADEMDA]

How does ortho have a better lifestyle? I would think none of the surgical sub specialties have a better lifestyle than anesthesia

It depends on your job. At my hospital anesthesia has one of the worst lifestyles out of any of the specialties. Ortho makes double the money and enjoys a far better lifestyle.

Worst Lifestyle:

1. OB- can be mitigated by less call and working in a large group
2. Trauma surgery- Can be mitigated by working in a large group or just not doing trauma after age 50
3. Cardiology- Can be mitigated by avoiding MIs, stents in the middle of the night (choose a smaller community hospital)
4. ER/EM- join a large group and just do a 12 hour shift but weekends/holidays likely required
5. Ortho- avoid trauma and then you can control your own schedule.
6. Neurosurgery- Big $$$ but lifestyle depends on avoiding trauma hospitals

Happy to discuss any of the specialties.

 

[Man o War]

How does ortho have a better lifestyle? I would think none of the surgical sub specialties have a better lifestyle than anesthesia

Most of the orthos I know work 6-7 days a week, rounds, clinic, etc. Not for me. I make plenty of money without dealing with any of that

 

[yoyoni]

1. I agree with you about Ortho but ENT and Urology are excellent as well.

2. Non surgical specialties- Cards, Gi, Pulmonary, Radiology (interventional) and Derm.

3. Fellowship- We have had this debate many times and in general, a fellowship is helpful in this job market especially Cardiac. CCM is a great fellowship for academia and I recommend it as well. Anesthesiologists who choose Pain will still out earn the vast majority of new grads circa 2021.

I agree with 1. and 2. but regarding 1. From my understanding ENT's and Urologists can customize their practices/ratio of clinic to surgeries if in PP so they have a better work/life balance, but how does this pan out in ortho? My understanding of ortho is that it's equal in intensity as neurosurg or CT is (maybe a little less so). And this is going to sound naive but I'm serious: doesn't popping bones back in place/screwing things into bones become boring after a while in ortho? With Cardiology you're dealing with (most of the time) non compliant patients whose problems could (most of the time) easily be fixed with cutting our drinking, smoking, a healthier diet, and exercise. Wouldn't that become tiresome? With Dermatology the medical underpinning isn't that compelling to me, and with GI you're looking at butts all day! Apparently anesthesia is doomed, so that leaves all of us with what, IR?

Also I've been doing specialty quizzes for fun and GI has been #1 for me on almost all of them...what does that say about me?

 

[BLADEMDA]

Most of the orthos I know work 6-7 days a week, rounds, clinic, etc. Not for me. I make plenty of money without dealing with any of that

Sure, if the Ortho MD wants to earn $800K then they work 6 days per week. I know a few earning $500K but work less than 40 hours per week. If you want the big $$$ then the sacrifices must be made

At age 50 quite a few Ortho docs can cut back on the hours,cases,call etc and focus on earning $$$ at their surgi-centers doing well insured patients. Many gradually figure out where the money is and adjust their practice accordingly.

 

[yoyoni]

It depends on your job. At my hospital anesthesia has one of the worst lifestyles out of any of the specialties. Ortho makes double the money and enjoys a far better lifestyle.

Worst Lifestyle:

1. OB- can be mitigated by less call and working in a large group
2. Trauma surgery- Can be mitigated by working in a large group or just not doing trauma after age 50
3. Cardiology- Can be mitigated by avoiding MIs, stents in the middle of the night (choose a smaller community hospital)
4. ER/EM- join a large group and just do a 12 hour shift but weekends/holidays likely required
5. Ortho- avoid trauma and then you can control your own schedule.
6. Neurosurgery- Big $$$ but lifestyle depends on avoiding trauma hospitals

Happy to discuss any of the specialties.

How do you balance what you're interested in (taking into account patient population, medical underpinning, personal skills and personality, and finances--I'm going to be in serious debt) with lifestyle and fulfillment? As I read more and more I'm starting to think it might be naive of me to think of medicine as my "calling" and treat it as such with the future of healthcare and current state of the system being the way it is

 

[BLADEMDA]

I agree with 1. and 2. but regarding 1. From my understanding ENT's and Urologists can customize their practices/ratio of clinic to surgeries if in PP so they have a better work/life balance, but how does this pan out in ortho? My understanding of ortho is that it's equal in intensity as neurosurg or CT is (maybe a little less so). And this is going to sound naive but I'm serious: doesn't popping bones back in place/screwing things into bones become boring after a while in ortho? With Cardiology you're dealing with (most of the time) non compliant patients whose problems could (most of the time) easily be fixed with cutting our drinking, smoking, a healthier diet, and exercise. Wouldn't that become tiresome? With Dermatology the medical underpinning isn't that compelling to me, and with GI you're looking at butts all day! Apparently anesthesia is doomed, so that leaves all of us with what, IR?

Also I've been doing specialty quizzes for fun and GI has been #1 for me on almost all of them...what does that say about me?

It all depends on how much money you want to earn and how hard you want to work for it. An Ortho Doc can work 1/2 as much as an anesthesia MD and still earn more money. Ortho is a huge money maker for hospitals and ASCs. They are the MDs to be catered to by hospital administrators vs Anesthesia which is viewed as an expense.

 

[BLADEMDA]

How do you balance what you're interested in (taking into account patient population, medical underpinning, personal skills and personality, and finances--I'm going to be in serious debt) with lifestyle and fulfillment? As I read more and more I'm starting to think it might be naive of me to think of medicine as my "calling" and treat it as such with the future of healthcare and current state of the system being the way it is

First things first. You need to crush Step-1 to have a shot at Ortho, ENT or Urology. Top 1/3 of your class with Step scores over 245. Sure, you MAY be able to match into one of those specialties with lower scores but a back-up plan is recommended.

Matching into Orthopaedic Surgery: Clerkships, USMLE Scores, 4th Year, Subinternships & More

 

[yoyoni]

It all depends on how much money you want to earn and how hard you want to work for it. An Ortho Doc can work 1/2 as much as an anesthesia MD and still earn more money. Ortho is a huge money maker for hospitals and ASCs. They are the MDs to be catered to by hospital administrators vs Anesthesia which is viewed as an expense.

Ah. I had no idea that's how anesthesia was viewed. Well, I want to work really hard, but I do want to be compensated fairly for it. I don't want to work myself to death though. A month ago I thought I would go into neurosurgery, but I don't know how sustainable that would be for me, and then I thought anesthesia so I could have all the OR time and none of the retracting, but then all of the things on this thread were said so I think I'm just gonna go into Derm and call it a day

jk

 

[yoyoni]

First things first. You need to crush Step-1 to have a shot at Ortho, ENT or Urology. Top 1/3 of your class with Step scores over 245. Sure, you MAY be able to match into one of those specialties with lower scores but a back-up plan is recommended.

Matching into Orthopaedic Surgery: Clerkships, USMLE Scores, 4th Year, Subinternships & More

Crushing Step, achieving AOA, etc is the plan, the only reason I want to know (or have some idea) of what speciality I want to pursue is so I can shadow and conduct research early on so I'm not stressed later if I do decide to go into a competitive specialty

 

[BLADEMDA]

Ah. I had no idea that's how anesthesia was viewed. Well, I want to work really hard, but I do want to be compensated fairly for it. I don't want to work myself to death though. A month ago I thought I would go into neurosurgery, but I don't know how sustainable that would be for me, and then I thought anesthesia so I could have all the OR time and none of the retracting, but then all of the things on this thread were said so I think I'm just gonna go into Derm and call it a day

jk

You will need a 250+ Step-1 for Derm or Neurosurgery.

 

[BLADEMDA]

Crushing Step, achieving AOA, etc is the plan, the only reason I want to know (or have some idea) of what speciality I want to pursue is so I can shadow and conduct research early on so I'm not stressed later if I do decide to go into a competitive specialty

Well with a 250+ Step 1 score the options should be wide open for you. Like it or not, Med Students are a smart bunch and the better the specialty (perceived to be better anyway) the higher the Step-1 score.