Incoming MS1 interested in anesthesiology(Poll included)

[Clockdoc89]

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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.

I don't understand why Anesthesia is viewed this way...it's literally required for any surgeon to do their job and i'm sure surgeons want an expert doing it for when **** hits the fan!! How is there not value in that?

 

[Clockdoc89]

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

From my perspective this does sound like quite a bit of money and I imagine I could live a content life with it, but if you compare it to other specialties and careers and see that they're putting in less time for more money it could get extremely frustrating...but I don't think job satisfaction can be ignored in this equation..or does that start to erode over time too

 

[Strider_91]

If you are only considering earning potential I'd imagine it is tough to beat EM right now. You can do a 3 yr residency and come out making damn near 300k/ yr depending on where you are in the country. When you factor in the speed at which you can pay off your high interest debt I can't imagine an ortho guy who does a fellowship comes out ahead for at least A long while after medical school. Especially since they are not at max earning potential until they build their practice.

Plus I hear that their residency is brutal.

 

[yoyoni]

From my perspective this does sound like quite a bit of money and I imagine I could live a content life with it, but if you compare it to other specialties and careers and see that they're putting in less time for more money it could get extremely frustrating...but I don't think job satisfaction can be ignored in this equation..or does that start to erode over time too

I feel like you answered your own question—when you see other specialties or even the crnas and perceive it as they're making comparatively more for the amount of work they're doing, that frustration begins to erode your job satisfaction

 

[yoyoni]

If you are only considering earning potential I'd imagine it is tough to beat EM right now. You can do a 3 yr residency and come out making damn near 300k/ yr depending on where you are in the country. When you factor in the speed at which you can pay off your high interest debt I can't imagine an ortho guy who does a fellowship comes out ahead for at least A long while after medical school. Especially since they are not at max earning potential until they build their practice.

Plus I hear that their residency is brutal.

not worth it for the odd hours IMO

every specialty has their own issues

gotta find the one that sucks the least and/or willing to put up with the issue

*bemoans existence*

 

[Clockdoc89]

I feel like you answered your own question—when you see other specialties or even the crnas and perceive it as they're making comparatively more for the amount of work they're doing, that frustration begins to erode your job satisfaction

Right but my point is, if you derive your job satisfaction only through income then of course you will come to that conclusion. You can always find someone in a better position making more money putting in less time, you will never be satified with that mentality.

 

[Clockdoc89]

If you are only considering earning potential I'd imagine it is tough to beat EM right now. You can do a 3 yr residency and come out making damn near 300k/ yr depending on where you are in the country. When you factor in the speed at which you can pay off your high interest debt I can't imagine an ortho guy who does a fellowship comes out ahead for at least A long while after medical school. Especially since they are not at max earning potential until they build their practice.

Plus I hear that their residency is brutal.

I used to work as ER scribe and almost EVERY ER doc I talked to advised against going into it lol. This is further supported by recent surveys where EM always tops the burnout list. The schedule changes are just brutal

 

[mmag]

If you are only considering earning potential I'd imagine it is tough to beat EM right now. You can do a 3 yr residency and come out making damn near 300k/ yr depending on where you are in the country. When you factor in the speed at which you can pay off your high interest debt I can't imagine an ortho guy who does a fellowship comes out ahead for at least A long while after medical school. Especially since they are not at max earning potential until they build their practice.

Plus I hear that their residency is brutal.

Unfortunately EM is about 10 years ahead of anesthesia in terms of management entities (private equity, public companies, etc) taking over contracts from equitable physician owned groups. Check out the reviews of the House of God equivalent for EM The Rape of EM or google the title to read the actual book free in PDF.

 

[BLADEMDA]

Right but my point is, if you derive your job satisfaction only through income then of course you will come to that conclusion. You can always find someone in a better position making more money putting in less time, you will never be satified with that mentality.

When picking a specialty carefully consider all factors in your decision. Money/income is just one factor among a whole list of things that may matter to you. For example, maybe you hate Derm and would much rather do Neurosurgery assuming you have that 250+ Step 1 score plus AOA. ENT attracts some very talented medical students who value lifestyle as much as income.

For the vast majority of med students with a 210-230 Step 1 score the top specialties are pretty much out of reach leaving a lot fewer choices to pick from.

Back in my day almost all Allopathic Med Students in the top 1/3 of the class with good Board exam scores (70th percentile or higher) could match into any specialty (except perhaps Derm and plastics). Things have gotten more competitive over the decades and now only the top med students entering the most competitive specialties are likely to earn the kind of income which was common place just one generation ago.

 

[BLADEMDA]

Family Practice:

 

[BLADEMDA]

 

[BLADEMDA]

 

[BLADEMDA]

 

[BLADEMDA]

not worth it for the odd hours IMO

every specialty has their own issues

gotta find the one that sucks the least and/or willing to put up with the issue

*bemoans existence*

Let's hope you find a specialty that you actually enjoy doing for the next 30+ years.

 

[BLADEMDA]

 

[BLADEMDA]

 

[Psai]

Seriously? Our RNs make that much lol

 

[Man o War]

I'm going to tell you what I tell every med student: pick something you like, and do not do something you don't like because it has a high salary right now. Since ortho has been brought up here...talk about an elective heavy surgery based specialty. What if we get some iteration of single payer that limits these surgeries? The question you should ask is, if the salary went down to more average levels, would I still want to do it? if yes, go for it.

 

[BLADEMDA]

I'm going to tell you what I tell every med student: pick something you like, and do not do something you don't like because it has a high salary right now. Since ortho has been brought up here...talk about an elective heavy surgery based specialty. What if we get some iteration of single payer that limits these surgeries? The question you should ask is, if the salary went down to more average levels, would I still want to do it? if yes, go for it.

Here is what I tell every Med Student about salary:

If Medicare became the ONLY insurer for 100% of all your patients what would that mean to your income? Also, if Medicare cut back elective surgeries by 25% what would that mean to your bottom line?

Ortho and Neurosurgery do just fine by these metrics. Anesthesiology, on the other hand, gets crushed quite hard.

Risk vs Reward favors Ortho, ENT, Urology over EM and GAS by a wide margin.

 

[Man o War]

Here is what I tell every Med Student about salary:

If Medicare became the ONLY insurer for 100% of all your patients what would that mean to your income? Also, if Medicare cut back elective surgeries by 25% what would that mean to your bottom line?

Ortho and Neurosurgery do just fine by these metrics. Anesthesiology, on the other hand, gets crushed quite hard.

Risk vs Reward favors Ortho, ENT, Urology over EM and GAS by a wide margin.

This is true as well.
Reimbursement can change to a given specialty with a pen stroke, or rationing could wipe out a bunch of their case loads. No guarantees anywhere.
Or we could all become $250k per year employees working for the government....

 

[yoyoni]

Let's hope you find a specialty that you actually enjoy doing for the next 30+ years.

Tonalities don't transfer well over the internet, so I can't really tell what the point of your post was, but I hope so too.

 

[Strider_91]

Are you posting this to say that the sky is not actually falling or is this somehow sarcastic?

 

[anbuitachi]

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.

It's ridiculous how unbalanced it is. B/c ortho makes so much more money compared to other specialties, ortho is hugely catered by the hospital admins, there's entire floor named for Ortho. These days these ortho peeps do a few spines a day and they are way richer than anesthesiologists. Neurosurgery residents are even going into spines after their 7 yr residency b/c they know it pays.

Why does ortho even pay so much? Spines are som eof the most profitable procedures but I dont even think they work very well. The patients just keep coming back for more spine surgery until their entire spine is fused

 

[deleted87051]

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 surgical subspecialties have a better lifestyle than anesthesia and MUCH more control over your own schedule. At least in private practice.

 

[DrWhozits]

For those of us not looking at super competitive specialties...

Are the problems that face Anesthesia any worse than those facing EM, IM, Neuro, psych, etc.?

There's always so much doom and gloom around Anesthesia but it seems like for all of the specialities with similar or lesser competiveness, they all have issues just like Anesthesia.

 

[Man o War]

It's ridiculous how unbalanced it is. B/c ortho makes so much more money compared to other specialties, ortho is hugely catered by the hospital admins, there's entire floor named for Ortho. These days these ortho peeps do a few spines a day and they are way richer than anesthesiologists. Neurosurgery residents are even going into spines after their 7 yr residency b/c they know it pays.

Why does ortho even pay so much? Spines are som eof the most profitable procedures but I dont even think they work very well. The patients just keep coming back for more spine surgery until their entire spine is fused

If we ever go to single payer, I predict a lot of these surgeries aren't done anymore or only in extreme cases. I read an article recently about how restrictive Medicaid is in some states on back/ortho surgeries. They don't pay for many of these surgeries as state budgets get crunched and they eliminate the low hanging fruit.
The rules mentioned in the same article also affect our friends in chronic pain since that's another area that states seem to view as non essential.

 

[repititionition]

For those of us not looking at super competitive specialties...

Are the problems that face Anesthesia any worse than those facing EM, IM, Neuro, psych, etc.?

There's always so much doom and gloom around Anesthesia but it seems like for all of the specialities with similar or lesser competiveness, they all have issues just like Anesthesia.

Much to my surprise, I liked my neuro rotation enough that I actually entertained the specialty for a few (perhaps fleeting) moments. Pay is rising fast, new interventions coming up... but then I realized that it just wasn't a fit for me.

As others have said, pick something you like.

 

[anbuitachi]

Much to my surprise, I liked my neuro rotation enough that I actually entertained the specialty for a few (perhaps fleeting) moments. Pay is rising fast, new interventions coming up... but then I realized that it just wasn't a fit for me.

As others have said, pick something you like.

why is pay rising fast? what changed?

 

[GoPelicans]

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[Babou the Ocelot]

Great thread. I'm a soon-to-be third year considering anesthesia as well. I was always interested in anesthesia since shadowing as a pre-med, but I kept my distance because of all the doom and gloom on these forums. The more I read though, it doesn't seem like the threat to the field is as imminent as many seem to contend.

I'm excited to start rotations so that I can explore the actual clinical practice of a few specialties instead of just reading about them online. The most important factor for me is obviously having a job that I enjoy on a daily basis. I love the medicine and physiology that anesthesia seems to offer, and I'd also prefer acute, hands-on care over long-term care. Surgery doesn't really strike a cord with me, but who knows if that'll change once I get out onto rotations.

The next most important factor is having a career that allows me to cut back once I pay off my loans and get into my 40s. I want to be there to hang out with my kids and enjoy life outside of work. It seems like anesthesia is one of those fields where, if you get into the right group/employment opportunity, you can cut back on shifts/month and actually have a life. Money is of little concern (beyond paying back loans). I have no desire to make 500k/yr for the sake of making 500k/yr. I'd much rather have the time to spend with my family.

I'm really looking forward to rotations in a couple months. Any suggestions on getting exposure during third year? Can you ask to follow anesthesia while on surgery rotation? What are the "rules" for exploring a subspecialty when you're supposed to be on a "core" rotation?

 

[vector2]

Can you ask to follow anesthesia while on surgery rotation? What are the "rules" for exploring a subspecialty when you're supposed to be on a "core" rotation?

Good god, do not do that when you're on surgery. They're called core rotations for a reason, and your surgical residents and attendings will likely notice if you're spending most of your time on the wrong side of the curtain. Beyond just the optics, learning about surgical procedures and the medical care of surgical patients is important for the practice of anesthesia- the best anesthesiologists are acutely aware of the steps/progress of a particular procedure and are ready for any contingencies which may arise. Spend your time on surgery learning about surgery.

As for how to get exposure, most schools are moving towards allowing some elective time during third year. If your school isn't one of them, you may be SOL.

 

[Babou the Ocelot]

Good god, do not do that when you're on surgery. They're called core rotations for a reason, and your surgical residents and attendings will likely notice if you're spending most of your time on the wrong side of the curtain. Beyond just the optics, learning about surgical procedures and the medical care of surgical patients is important for the practice of anesthesia- the best anesthesiologists are acutely aware of the steps/progress of a particular procedure and are ready for any contingencies which may arise. Spend your time on surgery learning about surgery.

As for how to get exposure, most schools are moving towards allowing some elective time during third-year. If your school isn't one of them, you may be SOL.

Right on, thanks for the tip. I had heard from some upper classmen that you could get away with exploring subspecialties when on medicine, for example, so I wasn't sure if similar rules applied to surgery (although I can see how anesthesia is different). That being said, I'm still looking forward to surgery rotation since, like you said, it's all relevant.