Match Anesthesia To-Do

[cjmurph14]

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M2 here pretty sold so far on going for anesthesia from my interactions with the faculty and anesthesiologists outside academics. I have a buddy applying to anesthesiology this year and telling me that interviews are scarce across his class for the specialty. I'm wondering what I should be doing to give myself some good chances in case the field gets competitive by the time I apply. Not cornering myself, but I feel pretty strongly about anesthesiology at this point so I'd like to go down that road for now. I'm top quartile for pre-clinical grades (for now). I should have a publication in anesthesia within the next couple months and hopefully an abstract in urology published soon. Aside from that not much besides some creative writing pubs through our school and a chunk of volunteer ours at a free clinic. Thanks in advance for your advice.

 

[Dr. Anonymouss]

M3 here. I've spoken to a lot of anesthesiologists, upperclassmen, and the PD at our school. It's good that you've figured it out early that you want anesthesia. If you have a research department getting involved in that is one of the best things you can do just to show commitment to the field and it will help with networking. You can also reach out to the clerkship director/PD for anesthesia at your school and ask to come in on 1-2 weekends a month. Anesthesiologists are super cool and will likely let you get involved with procedures quickly. It's not really rocket science how to be a competitive applicant we just tend to over think it as students. You need to have good grades and you need to be likeable because applying to residency is a job interview. So first and most important ensure that you pass step I on your first attempt and try to do as well as possible on step II. Secondly get involved with the anesthesia department either through research or through weekend shadowing. Show your face around the department and get them to know you and like you. That's all.

 

[voxveritatisetlucis]

I feel like if MDs are having trouble matching specialties like anesthesiology, it’s time for the LCME to put a halt to all new school expansions and class size increases.

I thought MDs used to need only passing scores to match anesthesiology

 

[junky372]

I feel like if MDs are having trouble matching specialties like anesthesiology, it’s time for the LCME to put a halt to all new school expansions and class size increases.

I thought MDs used to need only passing scores to match anesthesiology

This has been a trend for the last few years and doesn't have much to do with expansion.

www.aamc.org/data-reports/interactive-data/eras-statistics-data

The number of MD applicants (and applicants overall) for anesthesia have gone up a lot over the last few years (1376 MD in 2018 -> 2089 MD this year) which is causing the increase in competitiveness. At my MD school, a lot of the folks who initially came in wanting EM switched over to anesthesia. Between this and the people drawn for the solid pay/lifestyle/variety, the number of anesthesia applicants almost doubled from previous years.

 

[Dr. Anonymouss]

This has been a trend for the last few years and doesn't have much to do with expansion.

www.aamc.org/data-reports/interactive-data/eras-statistics-data

The number of MD applicants (and applicants overall) for anesthesia have gone up a lot over the last few years (1376 MD in 2018 -> 2089 MD this year) which is causing the increase in competitiveness. At my MD school, a lot of the folks who initially came in wanting EM switched over to anesthesia. Between this and the people drawn for the solid pay/lifestyle/variety, the number of anesthesia applicants almost doubled from previous years.

It goes in phases, right now anesthesia is very hot. And for all the reasons you mentioned.

 

[cjmurph14]

It goes in phases, right now anesthesia is very hot. And for all the reasons you mentioned.

Any chance of it cooling off by 2025? Maybe the EM thing will fall away a bit? Thanks for the advice, I appreciate it.

 

[collegestud2013]

Any chance of it cooling off by 2025? Maybe the EM thing will fall away a bit? Thanks for the advice, I appreciate it.

Possibly, or it could be even more competitive. Hard to predict the future for certain. Part of specialty competitive involves relative interest (or lack thereof) in other specialties. For example, part of why anesthesiology and radiology was much more competitive this past cycle was due to a shift in medical student interest; due to the relative lack of interest in other specialties such as EM and rad onc, more instead applied to anesthesiology and radiology.

 

[collegestud2013]

I feel like if MDs are having trouble matching specialties like anesthesiology, it’s time for the LCME to put a halt to all new school expansions and class size increases.

I thought MDs used to need only passing scores to match anesthesiology

There's still way more residency spots than USMD grads. DOs and IMGs will fill many of the spots. It's always been more of a distribution problem; for example a lot more students every year want to go into dermatology than family medicine so one gets overfilled while the other has empty residency spots to fill.

 

[voxveritatisetlucis]

There's still way more residency spots than USMD grads. DOs and IMGs will fill many of the spots. It's always been more of a distribution problem; for example a lot more students every year want to go into dermatology than family medicine so one gets overfilled while the other has empty residency spots to fill.

Yes but many people hate the idea of doing primary care. Before at least USMDs could safely match anesthesiology, radiology, general surgery (to a lesser extent). Seems like that’s changing.

 

[collegestud2013]

Yes but many people hate the idea of doing primary care. Before at least USMDs could safely match anesthesiology, radiology, general surgery (to a lesser extent). Seems like that’s changing.

Maybe anesthesia was easy to get in, but Surgery and radiology have been pretty competitive the past few years. Surgery match rates for USMDs have always hovered in the low-mid 80s. Radiology wasn't very competitive from around 2011 to 2016 largely because of a poorer job market at that time, but since then has been competitive (though not as competitive as this past cycle). A lot of it has to do with relative lack of interest in other specialties, with EM being the big one this past cycle.

IM has always been a good back up choice for many USMDs and for now continues to be. Still easy to get into overall, and there's the opportunity to pursue all of the IM subspecialities like GI, cards, heme/onc down the line. And even if you don't get into one of those or decide not to, there's also options besides traditional primary care such as hospitalist, or urgent care work or telemedicine.

 

[Gilakend]

Any chance of it cooling off by 2025? Maybe the EM thing will fall away a bit? Thanks for the advice, I appreciate it.

I don't think it is going to be uber-competitive, but I see it staying the same as this year or increasing. Part of the reason is EM, but also as stated above it is pretty cyclical and currently on an upswing. Applications had a heavy upward trajectory before the big EM drop in apps. In addition to EM there was a drop in many surgical subspecialties, who very likely switched to anesthesia. The job market is hot right now and the anesthesia shortage is expected to get worse. So, seemingly many things point to it staying as it is now or getting more competitive. But again, I do not think it will be anywhere remotely close to plastics or something like that. Likely similar to what it will be this year if I had to guess.

 

[Angus Avagadro]

I feel like if MDs are having trouble matching specialties like anesthesiology, it’s time for the LCME to put a halt to all new school expansions and class size increases.

I thought MDs used to need only passing scores to match anesthesiology

You only need to have passing score to match many specialties, IM, Peds,FM, etc.. If you don't want to train in a community hospital in the middle of nowhere, you need a better app. For Gas, step 2, class rank, and deans letter are most important. Research not so much except for top programs. Ideally, if you know you want anesthesiology, then do an elective 3rd yr somewhere to get some baseline experience. Auditions are important. If you can audition and shine, then that is a big help. The OR is a small community and you want to be personable and capable.Nobody wants to hear surgeons and OR personal complaining about their resident.

 

[AnonymousPD]

cjmurph14,

It's good to see that you are thinking about things early and are trying to get a jump on the next few years. Proactive self-starting applicants are highly coveted by PD's when it comes time for recruitment season.

Something I think you should do is to devote a good amount of your energy on activities that will get you noticed by outside programs. Getting on the radar of your home program is easy, you can do a rotation, do a second rotation, come in and shadow, get involved in department functions, always have an inexhaustible supply of your Chair's favorite candy, etc. But given the changing competitive landscape of many specialties (not just anesthesiology), don't sell yourself short by neglecting to do things that will get you noticed by programs that don't know you personally.

Remember this...most of the time the only thing an outside program will know about you is what is in your ERAS application. For the class of 2025, its Step 2, your school's grades and transcript, research, extracurricular activities, your Dean's Letter, your personal statement, possibly some supplemental questions, and letters of recommendation. Find things you enjoy (its its easy to invest yourself) that will show up in domains that you and will catch the attention of someone who will be reviewing upwards of a thousand applications a year. Doing a bunch of one-off activities that let you check a few boxes is better than nothing, but is not very compelling.

Will you be able to match if you just do a good job in school without doing all of this? Probably. But you're asking about this now in the middle of an M2 year which is going well. I'm guessing you did that because you'd rather pick where you match rather than just match anywhere.

 

[cjmurph14]

M3 here. I've spoken to a lot of anesthesiologists, upperclassmen, and the PD at our school. It's good that you've figured it out early that you want anesthesia. If you have a research department getting involved in that is one of the best things you can do just to show commitment to the field and it will help with networking. You can also reach out to the clerkship director/PD for anesthesia at your school and ask to come in on 1-2 weekends a month. Anesthesiologists are super cool and will likely let you get involved with procedures quickly. It's not really rocket science how to be a competitive applicant we just tend to over think it as students. You need to have good grades and you need to be likeable because applying to residency is a job interview. So first and most important ensure that you pass step I on your first attempt and try to do as well as possible on step II. Secondly get involved with the anesthesia department either through research or through weekend shadowing. Show your face around the department and get them to know you and like you. That's all.

Got some time set up in December to shadow an attending and I think it'll turn into an ongoing gig. I got your same exact advice from a preceptor of mine in chronic pain via anesthesiology. Thanks for your help!

 

[cjmurph14]

I have heard that going to a national conference may be a good way to get facetime with programs in the era of zoom interviews. Is this something you'd recommend during 3rd or 4th year if I have the time/money to go? I'm sure it would be enjoyable regardless, but just wanted to know how useful it may actually be.

 

[Dr. Anonymouss]

I have heard that going to a national conference may be a good way to get facetime with programs in the era of zoom interviews. Is this something you'd recommend during 3rd or 4th year if I have the time/money to go? I'm sure it would be enjoyable regardless, but just wanted to know how useful it may actually be.

I've heard this is not a good use of time mostly because you won't be able to determine who is a program director and who isn't. It's not like they walk around wearing this around their neck. Along with this you likely won't be remembered anyway. It's just hard to make such an impact at a meeting where they are going for different reasons.

 

[njtrimed]

I've heard this is not a good use of time mostly because you won't be able to determine who is a program director and who isn't. It's not like they walk around wearing this around their neck. Along with this you likely won't be remembered anyway. It's just hard to make such an impact at a meeting where they are going for different reasons.

Actually I went to the Anesthesiology national meeting in med school because I was presenting research, and they had a huge residency fair for med students (as well as a *ton* of cool workshops with residents teaching us central lines, intubation, etc. in a sim lab). We had the opportunity to network and chat with leadership from dozens of programs; there were so many there, I just focused on my preferred geographical region. Granted, this was 5+ years ago. I’m sure someone here could speak to whether this is still done at national meetings.