Making a last minute switch

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yanks26dmb

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Have been psych all along but anesthesia has been the only other thing I've liked. Everything in my app is geared towards psych.

Would it be silly to try and make a switch now? I could get one anesthesia letter by early October. Will not have completed any rotations however.

DO student, 24x step 1 < step 2, honors surgery and IM, top quarter of class.

Thanks
 
Have been psych all along but anesthesia has been the only other thing I've liked. Everything in my app is geared towards psych.

Would it be silly to try and make a switch now? I could get one anesthesia letter by early October. Will not have completed any rotations however.

DO student, 24x step 1 < step 2, honors surgery and IM, top quarter of class.

Thanks

How do you get a letter without doing a rotation? Stats wise. You should get interviews. But be sure this is what you want to do, it’ll look silly and you may be miserable to switch into something else later.
 
How do you get a letter without doing a rotation? Stats wise. You should get interviews. But be sure this is what you want to do, it’ll look silly and you may be miserable to switch into something else later.
Spent a few days with an anesthesiologist during my surgery rotation and we hit it off. He offered a letter.

How bad is it all my letters take about psych?
 
Have been psych all along but anesthesia has been the only other thing I've liked. Everything in my app is geared towards psych.

Would it be silly to try and make a switch now? I could get one anesthesia letter by early October. Will not have completed any rotations however.

DO student, 24x step 1 < step 2, honors surgery and IM, top quarter of class.

Thanks
You must be nuts to even consider this. Meaning... you're clearly made for psych.
 
I’ve been called back to my hospital twice tonight with the second probably having me stay all night....you still want to switch?
 
Spent a few days with an anesthesiologist during my surgery rotation and we hit it off. He offered a letter.

How bad is it all my letters take about psych?


Sounds like you met and worked with a cool doc. That's fun and all but probably not a good way to choose a career. You at least need 1-2 months of a rotation to see if it appeals to you before signing up for a residency.
 
Sounds like you met and worked with a cool doc. That's fun and all but probably not a good way to choose a career. You at least need 1-2 months of a rotation to see if it appeals to you before signing up for a residency.

Fair point. That aside...would I have trouble landing interviews w my current app?
 
With ALL the letters geared towards psych? I am going to walk back on what I said. Maybe you’ll get a few that may want to see why you applied.

I mean I'd have one anesthesia letter...the rest are psych. If I did an anesthesia rotation soon ish, would it be that inconceivable that one had a last minute change of heart?
 
Can't you get a psych letter writer or two to change their letters to be more generic / to speak to your ability as a clinician generally?
 
Fair point. That aside...would I have trouble landing interviews w my current app?

I have no idea if you'd get interviews or not, but I suspect your lack of ever having done an anesthesia rotation would be a massive red flag during an interview and may cause programs to not rank you.
 
Any idea the feasibility of switching in to anesthesia after a year of psych residency? Wondering if this may be a better shot at this point.
 
Any idea the feasibility of switching in to anesthesia after a year of psych residency? Wondering if this may be a better shot at this point.
You could theoretically (one year of psych still counts technically as an internship). Practically, zero chances, because I would expect the psych PGY-1 experience to be basically irrelevant for anesthesia, and you would be applying for the rare PGY-2 spot of a withdrawn matched applicant. The only realistic way, I think, would be to start from PGY-1 again.

Seriously, if you already know that psych is not for you, you have a big problem.
 
Any idea the feasibility of switching in to anesthesia after a year of psych residency? Wondering if this may be a better shot at this point.

I’m addition to what FFP said above, you might need to fulfill rotations as per ACGME requirements if you don’t get them in your internship - like inpatient IM, Peds, EM. Hopefully your program would be organized enough to recognize this and offer it during your CA-1 year.
 
You could theoretically (one year of psych still counts technically as an internship). Practically, zero chances, because I would expect the psych PGY-1 experience to be basically irrelevant for anesthesia, and you would be applying for the rare PGY-2 spot of a withdrawn matched applicant. The only realistic way, I think, would be to start from PGY-1 again.

Seriously, if you already know that psych is not for you, you have a big problem.

I love psych. I got a fair look at anesthesia during my surgery rotation and did a lot of reading about the field during third year. Gas was the only other field I seriously considered and I was split on the two for a long while. At the 11th hour, I'm just second guessing myself...
 
I love psych. I got a fair look at anesthesia during my surgery rotation and did a lot of reading about the field during third year. Gas was the only other field I seriously considered and I was split on the two for a long while. At the 11th hour, I'm just second guessing myself...

Are you just getting cold feet? Maybe you still want psych when the dust settles.
 
Are you just getting cold feet? Maybe you still want psych when the dust settles.

I dunno...I think about the physiology, the hands on aspect, the procedures...and I feel like I'll miss it a lot. On the other hand, I like long term relationships, I love discussing human emotions/behavior, and I have the most empathy for those patients suffering from bipolar/depression/anxiety. I'm still very much at a toss up here...
 
I love psych. I got a fair look at anesthesia during my surgery rotation and did a lot of reading about the field during third year. Gas was the only other field I seriously considered and I was split on the two for a long while. At the 11th hour, I'm just second guessing myself...

there's your answer
 
I dunno...I think about the physiology, the hands on aspect, the procedures...and I feel like I'll miss it a lot. On the other hand, I like long term relationships, I love discussing human emotions/behavior, and I have the most empathy for those patients suffering from bipolar/depression/anxiety. I'm still very much at a toss up here...

Anesthesia can be a gift and a curse because for all the interesting physiology, "hands on", and procedures, some of my best days are where I get paid to do as little as possible to a patient. The procedure aspect can be really jading. People hate having things "done to them".
 
Anesthesia can be a gift and a curse because for all the interesting physiology, "hands on", and procedures, some of my best days are where I get paid to do as little as possible to a patient. The procedure aspect can be really jading. People hate having things "done to them".

I also feel like gas lets me feel like more of a doctor. Often times in psych, I'm mistaken for a psychologist, therapist, whatever...people are often surprised I can rx meds... I don't know if this is a legit reason to not go into the field though.

If I wasn't solid on anesthesia too, I wouldn't consider, but I was so torn between these two fields all through med school.
 
I also feel like gas lets me feel like more of a doctor. Often times in psych, I'm mistaken for a psychologist, therapist, whatever...people are often surprised I can rx meds... I don't know if this is a legit reason to not go into the field though.

If I wasn't solid on anesthesia too, I wouldn't consider, but I was so torn between these two fields all through med school.

Buddy, if one of your professional goals is not being misrecognized as a midlevel provider then anesthesia is definitely not for you.
 
I also feel like gas lets me feel like more of a doctor. Often times in psych, I'm mistaken for a psychologist, therapist, whatever...people are often surprised I can rx meds... I don't know if this is a legit reason to not go into the field though.

If I wasn't solid on anesthesia too, I wouldn't consider, but I was so torn between these two fields all through med school.

Then why didn't you do an anaesthesia rotation earlier in the year?

I mean...ERAS opened today and despite your good grades you've got maybe one letter from an anaesthesia attending and no real clinical exposure to the field. Switching based on a cool attending you worked with would be pretty stupid and you might not match in anything as a result.
 
Then why didn't you do an anaesthesia rotation earlier in the year?

I mean...ERAS opened today and despite your good grades you've got maybe one letter from an anaesthesia attending and no real clinical exposure to the field. Switching based on a cool attending you worked with would be pretty stupid and you might not match in anything as a result.

Unfortunately we didnt get elective time third year...and I had a copule psych sub is set up early in the year. I thought my mind was made up when I went through vsas for rotations..obviously I could have planned this better.
 
Unfortunately we didnt get elective time third year...and I had a copule psych sub is set up early in the year. I thought my mind was made up when I went through vsas for rotations..obviously I could have planned this better.

Do your rotations now, find a way to spend time in anesthesia, dump your sub psych rotation. Go talk to the chairman at your institution/hospitals, I am not sure what else to say. Maybe apply a few prelim medicine/surg? Talk to your advisors and or deans to see if they can help you out?
Or you can match at a good psy program, and hoping they can find you a spot within their hospital.
You have the grades that may open doors for you. They (your school) don’t want a good candidate go on unmatched either. Be content with a lower tier program, or do a prelim year, without a final destination.

Good luck.
 
OP- you have anesthesia followed by pain management fellowship written all over you.
Checks every single box for you.
 
OP- you have anesthesia followed by pain management fellowship written all over you.
Checks every single box for you.

Can’t believe this wasn’t mentioned earlier - co-sign. You can even work some brief therapy into your clinic, if you want.
 
OP- you have anesthesia followed by pain management fellowship written all over you.
Checks every single box for you.

Definitely have considered this as well.

Is there any real chance of going this route through psych?
 
Definitely have considered this as well.

Is there any real chance of going this route through psych?

It’s possible but a long shot - you’d be competing against anesthesiology grads along with PM&R, Neurology and the rare EM grad. It’s pretty difficult to break into (interventional) chronic pain through other specialties (and it’s competitive even within anesthesia).

More common are psych grads doing a more medical action focused approach.
 
Have been psych all along but anesthesia has been the only other thing I've liked. Everything in my app is geared towards psych.

Would it be silly to try and make a switch now? I could get one anesthesia letter by early October. Will not have completed any rotations however.

DO student, 24x step 1 < step 2, honors surgery and IM, top quarter of class.

Thanks
DO NOT DO IT!! Stick to psych. Your posts sound exactly like mine did more than 10 years ago and I regret my decision to switch.
A lot more freedom to do what you want in psych, be your own boss and make some good money. These days, psych is hot.
 
OP- you have anesthesia followed by pain management fellowship written all over you.
Checks every single box for you.

I am sorry, but as much as everyone says pain patients are all psychiatric patients, well the opposite is not true. Personally, working with pain patients daily would make me want to scream.

OP as someone who made the switch last minute because I wanted more of a challenge as far as physiology and doing cool procedures, who now regrets it and is finally doing that CCM fellowship that got her interested in anesthesia in the first place, I tell you, DO NOT SWITCH.

I have friends who have their own outpatient practices and come and go as they please, don't work nights or weekends, supplement their income if they want doing consult services, making good money and are in demand. These people are happy. I wanted to be a shrink because the docs seemed happy and have psych issues in my family as well.

As an anesthesiologist, you will be at the beck and call of a surgeon, some of whom do not respect you and think they are better than you, who may order you around and be rude to you, topped off with the CRNA hell that is the thorn in the side of Anesthesia. Your life will be full of night and weekend call unless you get a mommy track position. That mommy track position will pay less than what you could make as a shrink currently unless you are in certain markets. And then there's administration who see you as an expense and not an asset, never mind the little fact the surgeons or the ORs cannot work without you, and of course the ever present AMCs and greedy partners trying to take your money.

The demand and pay for psych is hot right now. If you want a normal life, and good pay, psych is as close as you can get.
 
To answer your question, I am sure that you could end up getting enough interviews to match into an anesthesia program somewhere if you apply broadly.
With that said, there's not much to add to the discussion above, i.e. I recommend having a meeting with your coordinator/whatever person tomorrow and get them to switch you into an anesthesia elective immediately following whatever rotation you're currently completing. You'll of course have to explain everything in your personal statement if you do apply to anesthesia. You can always apply to both specialties and decline or cancel interviews as things pan out. But also relax and remember that despite being a big decision, this is a good problem to have in the grand scheme of things. There's a good chance you will end up enjoying either field and enjoy what you want in life. You're almost finished with medical school, something you have only dreamed of for a long time now. Take a step back, re-evaluate your priorities and what made you interested in psychiatry in the first place. You'll figure out what's right for you.

PS I kinda wish I fell in love with psych bc even their residency work/life balance is awesome (speaking as a tired CA-3 who was on call all weekend)
 
To answer your question, I am sure that you could end up getting enough interviews to match into an anesthesia program somewhere if you apply broadly.
With that said, there's not much to add to the discussion above, i.e. I recommend having a meeting with your coordinator/whatever person tomorrow and get them to switch you into an anesthesia elective immediately following whatever rotation you're currently completing. You'll of course have to explain everything in your personal statement if you do apply to anesthesia. You can always apply to both specialties and decline or cancel interviews as things pan out. But also relax and remember that despite being a big decision, this is a good problem to have in the grand scheme of things. There's a good chance you will end up enjoying either field and enjoy what you want in life. You're almost finished with medical school, something you have only dreamed of for a long time now. Take a step back, re-evaluate your priorities and what made you interested in psychiatry in the first place. You'll figure out what's right for you.

PS I kinda wish I fell in love with psych bc even their residency work/life balance is awesome (speaking as a tired CA-3 who was on call all weekend)

I am a new attending. Am on all weekend too. Just saying it doesn’t end there....

Good luck, op
 
I am a new attending. Am on all weekend too. Just saying it doesn’t end there....

Good luck, op

Any chance there are high paying doggy father positions out there? ;-)

Kidding aside, I know it doesn't end with residency. But hopefully call as an attending is a bit less miserable than as a resident?
 
Any chance there are high paying doggy father positions out there? ;-)

Kidding aside, I know it doesn't end with residency. But hopefully call as an attending is a bit less miserable than as a resident?

Look through recent posts. Location, money and life style are your three parameters. You can usually only choose two....

I am lucky, found a nice short partnership. But my classmates who work for AMCs probably make at least 30% more the first few years.

So far this call isn’t bad, but I was told could be much worse.
 
Any chance there are high paying doggy father positions out there? ;-)

Kidding aside, I know it doesn't end with residency. But hopefully call as an attending is a bit less miserable than as a resident?


Sometimes it’s worse as an attending. Up all night and you’re the only one in house....no pee breaks. But it’s the luck of the draw.
 
Landing a psych PGY2 spot out of anesthesia won't be a problem. Go for anesthesia - fully explore the other side of the grass to discover what's greener for you. You can PM me about Psych if ye wish.
 
Sometimes it’s worse as an attending. Up all night and you’re the only one in house....no pee breaks. But it’s the luck of the draw.
This right here. Anesthesiology is one of those few fields were attending life might actually be harder than resident life.
 
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