Just Curious?

[AnesFuture]

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I'm applying into Anes, but was wondering (incase things look bad this upcoming year in regards to legislation)

Is a Categorical 1st year in Anes = to a Prelim medicine year or would you have to do a prelim medicine year in order to switch into Medicine?

Can you do your prelim medicine year at one institution and if you decide not go into Anes, not do your advanced Anes program years wherever that may be (ofcourse asking them first and going through the proper channels)?

Thanks for your help. I'm just trying to keep my bases covered just incase worst case scenarios happen.

 

[DO4lifer]

you're kidding me....

anesthesiology requires commitment. if you let lawmakers decide whether or not to do it, then you shouldn't even apply.

sounds like you are more interested in the money. apply to derm. its better than medicine and anesthesiology.

 

[BLADEMDA]

I'm applying into Anes, but was wondering (incase things look bad this upcoming year in regards to legislation)

Is a Categorical 1st year in Anes = to a Prelim medicine year or would you have to do a prelim medicine year in order to switch into Medicine?

Can you do your prelim medicine year at one institution and if you decide not go into Anes, not do your advanced Anes program years wherever that may be (ofcourse asking them first and going through the proper channels)?

Thanks for your help. I'm just trying to keep my bases covered just incase worst case scenarios happen.

There are some Anesthesia Programs which allow you to match as a CA-1.
You would also match as a PGY-1 at a Transitional or Internal Medicine program. If you choose I.M. as a PGY-1 you could "cancel" anesthesia midway through your PGY-1 and remain on as a Internal Medicine Resident assuming that you have done a good job and there is room for you.

That said, I am not advocating "screwing over" your Anesthesia Program which you made a committment to through the match.

 

[AnesFuture]

As I tried to indicate before this would be the absolute last case scenario. I just see many people switching around so much (eg obgyn to anes, or surg to anes or rads, etc so I was wondering if it was possible the other way...just in case)

By worst case scenario I don't refer to medicare payments. I'm referring to difficulty finding a job because of all the CRNA issues that I constantly read about on this forum. As a MS4 it's a real deterrant when you're excited about Anes and then you come on here and see all these threads about impending doom (unless most people on here are just exagerrating the situation so much that it isnt' true). I know plenty of my classmates that were interested, came on here, and immediately became dissuaded by the talks that go on here.

You see threads about "well if I was applying now in this climate I wouldn't choose Anes, but then you say Anes requires real committment and you cannot waver or you should go into something else" You can't have it both ways.

 

[Masseter Spasm]

Pursue the field that you enjoy the most. I think your question about the future of anesthesia is really a smaller version of a larger question: What is the future of medicine?
I think physicians in any field are concerned about threats to their individuals specialties. Anesthesia may seem particularly vulnerable but is by no means alone. Other specialities have issues with expanding scope of practice by mid-level providers.
I do not believe that the proposed health care reforms will have "winners and losers." (i.e. Internists will get paid substantially more at the expense of specialists.) I think all physicians will lose. Do not make a specialty decision based on how proposed legislation aims to "value" certain types of care.

 

[Southpaw]

Is a Categorical 1st year in Anes = to a Prelim medicine year or would you have to do a prelim medicine year in order to switch into Medicine?

Can you do your prelim medicine year at one institution and if you decide not go into Anes, not do your advanced Anes program years wherever that may be (ofcourse asking them first and going through the proper channels)?

For the first part, most categorical programs include a first year of general medicine. If that's the case, and the year is run by the department of medicine in your hospital, then I'm sure you wouldn't have to redo the year if you switched. I think there are a few categorical programs where the PGY-1 is run by the department of surgery. If you matched to that program it wouldn't count towards a year of medicine, and you'd have to do another intern year if you switched to medicine.

For the second part, you could spend your prelim year in one program and not advance to your anesthesiology program if your medicine program would take you on for the next two years and your anesthesiology program wouldn't give you a hard time about getting out of your contract.

Just for general overall advice, I think Masseter Spasm's post was superb and you should really take their words to heart.

 

[AnesFuture]

Thanks for the post. For some reason I thought that the Department of Anesthesia always ran the first year of categorical. Thanks for clearing that up.

I def am listening to that advice. The thing is there's a lot of specialties I enjoyed. I was one of those that liked a lot of my rotations. I feel like I like Anes the best, but it's not like I would be unhappy if I had to do Cards or something. But I'm committing to Anes now and that's why I'm applying to Anesthesia and not dual applying.

From 3rd year and the beginning of 4th year I liked Anes the best, but I don't think it betrays my loyalty to Anesthesia to wonder about worst case scenarios especially if I start hearing things like CA3's are having trouble finding jobs in major cities. All I'm looking for is to be able to find a solid job in a location that I would like. If for some reason I can't find that with Anes, it's not as if Anes is the only specialty for me and anything else would be terrible. I came out of 3rd year liking a lot of different specialties.

Thanks for your post, clearing up the fact a Categorical yr may be run by medicine dept (and in that case acts like a prelim med yr) or can be run by a surg dept(and in that caes may act like a prelim surg yr?) but they are usually not run by the Anes dept? Did I get that correct or no?

 

[BLADEMDA]

Thanks for the post. For some reason I thought that the Department of Anesthesia always ran the first year of categorical. Thanks for clearing that up.

I def am listening to that advice. The thing is there's a lot of specialties I enjoyed. I was one of those that liked a lot of my rotations. I feel like I like Anes the best, but it's not like I would be unhappy if I had to do Cards or something. But I'm committing to Anes now and that's why I'm applying to Anesthesia and not dual applying.

From 3rd year and the beginning of 4th year I liked Anes the best, but I don't think it betrays my loyalty to Anesthesia to wonder about worst case scenarios especially if I start hearing things like CA3's are having trouble finding jobs in major cities. All I'm looking for is to be able to find a solid job in a location that I would like. If for some reason I can't find that with Anes, it's not as if Anes is the only specialty for me and anything else would be terrible. I came out of 3rd year liking a lot of different specialties.

Thanks for your post, clearing up the fact a Categorical yr may be run by medicine dept (and in that case acts like a prelim med yr) or can be run by a surg dept(and in that caes may act like a prelim surg yr?) but they are usually not run by the Anes dept? Did I get that correct or no?

Yes. You need to get a PGY-1 year in a I.M. program run by I.M. Your Anesthesia Program needs to be a CA-1 (PGY-2) match. No Anesthesia programs will force you to matriculate for your PGY-2 year. You can "bail" midway through your PGY-1 year if you so choose.

 

[Southpaw]

Thanks for your post, clearing up the fact a Categorical yr may be run by medicine dept (and in that case acts like a prelim med yr) or can be run by a surg dept(and in that caes may act like a prelim surg yr?) but they are usually not run by the Anes dept? Did I get that correct or no?

They can be run by the anesthesiology department as well. It's just something to ask and consider while interviewing. If the year as run by anesthesiology, much of your time could count towards IM if you wanted to switch and the IM department would accept you, but you additionally may do a month of ED and a month or two of SICU/Neuro ICU, etc., which may not be counted towards IM. Still, I'd think most of your year would count towards IM if it were run by the anesthesiology department. That's something you should consider and look at closely while interviewing.

I wouldn't sweat being concerned about the future. People who've worked for so hard for so long towards a set goal (treating patients) should expect to be able to pay off loans and provide for their family. If reimbursement for ortho dropped 50% you'd see a lot of would-be ortho dudes finding something else to do with their lives.

 

[DO4lifer]

I'm referring to difficulty finding a job because of all the CRNA issues that I constantly read about on this forum. As a MS4 it's a real deterrant when you're excited about Anes and then you come on here and see all these threads about impending doom (unless most people on here are just exagerrating the situation so much that it isnt' true). I know plenty of my classmates that were interested, came on here, and immediately became dissuaded by the talks that go on here.

spend some time reading the forums...you will find out that this impending doom stuff has been going on for quite some time. you gotta do what you love, whether you get paid peanuts or not. transfer is always possible, but its not cool to leave a program that turned down hundreds of others for that spot. thats my only issue with transfers.