Is this how you felt about choosing Anesthesia for a career ?

[BlitznFire]

Hi there, I'm a long time lurker, first time poster. I am finally at that stage of deciding on what I want to do for the rest of my life, and now I need some perspective on whether I am a good match for anesthesia and vice versa.

Ever since starting medical school, I have been drawn to field of Anesthesia because of the science behind it. I am an average student, but I consistently scored atleast 1 deviation higher than average on physiology and pharmacology. I feel like I am more competent with memorizing a few facts and combining those with logical thinking to solve a problem rather than memorizing a ton of information and being able to implement that knowledge by putting patterns together. I know that like most people, I really enjoy what I am good at.

During this 3rd year, I didn't get to do a rotation in Anesthesia, but on surgery I showed up to the OR early, and begged the anesthesiologist to let me start IVs and intubate whenever I could. I got the chance to observe some U/S guided regional blocks, epidurals and so on. I really enjoyed doing hands on work, being on my feet, using technology and talking to the patients even if it was very briefly. I also felt like most of the anesthesia people were laid back, hard working and showed great situational awareness.

My second option is ENT. I really enjoyed my ENT surgery rotation and liked the breadth of their surgeries from simple 30 mins surgeries to complex H&N dissections. I felt like it really took an artist to be able to perform these surgeries. Though I am not a great fan of clinics, I felt that the focussed clinics provided adequate patient contact with tremendous positive reward (which I felt was missing with anesthesia, but then again I only went as far as dropping the patient of at the PACU). However, I do know that the residency is harder, the residents are not exactly 'happy' and its atleast 5 years with an option to do plastics later. (for the artist in me)

All that being said, I feel like the ultimate decision that its going to come down to is 'lifestyle'. I know that neither of them are easy, but then again I don't really know what to do. I think ENT is really 'cool' but am worried that it might get old on me. Whereas anesthesia, I love the science with endless different permutations and combinations of situations. I also feel like becoming a surgeon will somehow make me a much more serious and intense person. I only say this because that is exactly how I felt during my surgery rotation and I dont know why. My step 1 score is competitive for both fields, so that is not an issue

I'm sorry if this seems more like a conversation that I am having in my head with myself. But I would really appreciate any thoughts on all this, especially since its the time of the year where we are supposed to talk to our program directors, deans etc about our decisions. Either way, I love the OR and that is where I want to be.

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[yasawa]

Blitz,
I was actually in your exact situation 3rd year. The only difference is that I did an anesthesia rotation. I knew that I liked being in the OR. I was torn between surgery and anesthesiology. To be honest, the only surgical specialties that I found remotely interesting were ENT, ortho and plastics. At the end of the day, no matter how cool the surgeries were I still wasnt in love with it. I did 4wks of ENT electives, 4wks of ortho and two weeks of additional plastics electives and still found myself coming back to anesthesiology. The best advice I got was from my ENT attending who told me that if I didnt like the bread and butter cases, then that specialty wasnt for me. I would much rather sit through 10 lap appys as the anesthesiologist rather than do an entire day of T&As, and ear tubes as an ENT doc. If you cant get an anesthesia rotation before you have to choose your schedule, ask to work a couple of 4pm-8 shifts or take a weekend call with your program. My only advice is that if you dont truly love anesthesiology, then dont do it. We dont need anymore people is this specialty who dont care enough to protect it. They are the ones who are selling the rest of us out. If you cant see yourself doing your own cases all day everyday for the rest of your then you should go into surgery. We need more people actually willing to sit the stool rather than just supervise.

 

[rsgillmd]

Try to get an anesthesia rotation, preferably 4 weeks but even 2 weeks. This way you can see if you like doing it day in and day out.

I was debating between ICU via medicine and Anesthesiology. I did 4 weeks of Burn ICU, more out of interest, which I really enjoyed. I then did 4 weeks of Medical ICU. A fair amount of the days in the MICU I just wanted to get out of there. When I next did 4 weeks of Anesthesiology, 2 weeks into it I knew this was the field for me.

The way the medical education system is set up is not ideal for helping decide on a specialty unfortunately, because people start getting applications ready by summer, and out by September. By the time you have to start getting your applications ready, you've usually only done the requisite cores. So don't worry, you are not alone.

However, given that you can't change the system, my best advice is to do an anesthesiology rotation (a minimum of 2 weeks, but preferably 4 weeks) and see what you think. Do the same for ENT. In the end go where you think you'll be happiest at the end of the day. Ask yourself where do you see yourself 20-30 years from now -- do you think you'll still be happy in different fields. That's a question you are going to have to answer for yourself.

 

[AnesFuture]

Hey There

I was also in a similar situation as you and have heard of many people that debated between the 2 fields. Both Anes and ENT deal heavily with the airway and the 2 specialties really get along very well.

I agree with the advice above. Try to do a rotation in each if you can.

For me, ENT was fun but I did not LOVE doing surgery and that's what it came down to. Personally, I think to be a surgeon you have to really love being in the OR, maybe more than anything else in life. For me, that just wasn't the case and that's what it came down to. Surgery has to do it for you and give you a high you enjoy.

 

[Eta Carinae]

Ever since starting medical school, I have been drawn to field of Anesthesia because of the science behind it. I am an average student, but I consistently scored atleast 1 deviation higher than average on physiology and pharmacology. I feel like I am more competent with memorizing a few facts and combining those with logical thinking to solve a problem rather than memorizing a ton of information and being able to implement that knowledge by putting patterns together. I know that like most people, I really enjoy what I am good at.

The science behind it is ultimately, IMHO, the foremost reason anyone should choose Anesthesiology. So I would say you are on the right track. If you are not committed to the specialty, it reflects in your level of fulfilment and satisfaction, your general demeanor at work, your overall work ethic and your ability to work well in a group.

.. Granted, not everyone thinks phys and pharm are absolutely awesome. But if you do, welcome! You are among friends.

During this 3rd year, I didn't get to do a rotation in Anesthesia, but on surgery I showed up to the OR early, and begged the anesthesiologist to let me start IVs and intubate whenever I could. I got the chance to observe some U/S guided regional blocks, epidurals and so on. I really enjoyed doing hands on work, being on my feet, using technology and talking to the patients even if it was very briefly. I also felt like most of the anesthesia people were laid back, hard working and showed great situational awareness.

you sound like one of my classmates from med school. He and I were paired together on a medicine team during our medicine rotation. One night on call, the rest of the team was doing admits and John was nowhere to be found. He was with an Anesthesiology attg starting an IV on a trauma pt! Although the team felt somewhat betrayed, at least he convinced us of his passion for the field. (He matched to his #1). And I think you are displaying a commensurate level of interest.

My second option is ENT. I really enjoyed my ENT surgery rotation and liked the breadth of their surgeries from simple 30 mins surgeries to complex H&N dissections. I felt like it really took an artist to be able to perform these surgeries. Though I am not a great fan of clinics, I felt that the focussed clinics provided adequate patient contact with tremendous positive reward (which I felt was missing with anesthesia, but then again I only went as far as dropping the patient of at the PACU). However, I do know that the residency is harder, the residents are not exactly 'happy' and its atleast 5 years with an option to do plastics later. (for the artist in me)

Whatever specialty you decide to pursue, do not be completely dissuaded by the length of residency training as this is just a snapshot in the course of a possibly 30yr practice. In general, I don’t know that I’ve met a surgery resident who is “happy”. But most will tell you they could never ever dream of doing anything else. Surgery residency is grueling and most surgery residents are overworked and frequently physically exhausted. However the level of fulfilment they experience from the nature of the work they do is unparalleled. And what you perceive as unhappy may not necessarily reflect the emotional state of the person. Pedi residents for instance tend to be sanguine, hence appear to be “happy”. A lot of surgery residents may be slightly more reticent, reserved or militant, that may not necessarily denote unhappiness.

Perhaps you will come to a choice between ENT and Anesthesia after an anesthesia rotation.

All that being said, I feel like the ultimate decision that its going to come down to is 'lifestyle'. I know that neither of them are easy, but then again I don't really know what to do. I think ENT is really 'cool' but am worried that it might get old on me. Whereas anesthesia, I love the science with endless different permutations and combinations of situations. I also feel like becoming a surgeon will somehow make me a much more serious and intense person. I only say this because that is exactly how I felt during my surgery rotation and I dont know why. My step 1 score is competitive for both fields, so that is not an issue

Again, your level of intellectual and other fulfilment during an anesthesia rotation may be the deciding factor. Bear in mind that Anesthesia is not a lifestyle specialty.

I'm sorry if this seems more like a conversation that I am having in my head with myself. But I would really appreciate any thoughts on all this, especially since its the time of the year where we are supposed to talk to our program directors, deans etc about our decisions. Either way, I love the OR and that is where I want to be.

FWIW, you sound like the kind of person I would love to work with and a great candidate for Anesthesia. Why? Because your approach is from the right perspective. It should be about the nature of the work and the science behind it, like you’ve rightly said.

Good luck with your decision and I hope you seriously consider anesthesiology. I am embarking on intern year in June so I don’t have the experience that an attg or senior resident would. However, I’m not so far away from where you currently stand as to be unable to relate to your thought process. You are welcome to interpret my little bit of advice accordingly.

 

[Eta Carinae]

Here are some links to some older threads related to your question that might help you along:

Why did you choose Anesthesiology?

If you could choose a specialty again, would you choose Anesthesia?

Why Anesthesiology?

 

[BlitznFire]

Firstly, thanks for taking the time to share your perspectives. I really appreciate it.Secondly, I am going to be doing a month of gas in September, and I am hoping I will be atleast 95% sure by then. I plan on continuing to shadow as much as I can in the meanwhile and scheduling an ENT elective for the next year as well.

 

[stargirl50]

I would guess that a fair number of people who chose anesthesiology were in your shoes at one time or another, trying to decide between a surgical specialty vs anes. For me, on my surgery months, I would find my attention wandering to the other side of the curtain. And, like others have said, if you don't live for the next opportunity to operate, it'd be pretty tough to be happy in surgery.