match thoughts!?

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donkeykong1 said:
You can easliy get into FM/IM with just a passing Step 1, not the case with Anesthesia
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Agreed i think its a tad harder than FM/IM but still really easy. I mean 70% of US seniors with less than 200 step matched according to charting outcomes 2014. If you get a 200 you have an 80% chance. I don't consider that moderately competetive.
 
ERRES2288 said:
Agreed i think its a tad harder than FM/IM but still really easy. I mean 70% of US seniors with less than 200 step matched according to charting outcomes 2014. If you get a 200 you have an 80% chance. I don't consider that moderately competetive.
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Comparatively though the numbers who apply with those scores to Gas are much lower than primary care specialties. They self-select out. If you apply Anesthesia with a step 1 between 200-220, you are risking a whole lot more than applying FM/IM with the same score. Most programs have cut offs at 220 unlike FM/IM which have community programs willing to take on anyone with a pulse.

Secondly the vast majority of Anesthesia programs do not accept IMGs. They would rather go unmatched and pick up AMGs in SOAP, mainly those who didn't match derm or surgical specialties. This is another reason why EM has less unfilled slots, community EM programs certainly take IMGs.
 
donkeykong1 said:
Pain or Regional are what im considering. But I agree after having done a Pain rotation as a med student the pt population is difficult and procedure reimbursement is on decline, though doing the interventions can be rewarding.
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What would your plan be with regional?
 
Man o War said:
What would your plan be with regional?
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Well I really like the fast pace and how things are run at an ASC. Ideally I'd run the Regional service there. Perhaps buy in if that's possible. Spoke to a senior partner in the past who said regional is becoming hot in the market now.

Also us millennials love working those portable ultrasound machines. I literally had to teach my 60 yr old Anesthesia attending how to use it lol
 
donkeykong1 said:
Comparatively though the numbers who apply with those scores to Gas are much lower than primary care specialties. They self-select out. If you apply Anesthesia with a step 1 between 200-220, you are risking a whole lot more than applying FM/IM with the same score. Most programs have cut offs at 220 unlike FM/IM which have community programs willing to take on anyone with a pulse.

Secondly the vast majority of Anesthesia programs do not accept IMGs. They would rather go unmatched and pick up AMGs in SOAP, mainly those who didn't match derm or surgical specialties. This is another reason why EM has less unfilled slots, community EM programs certainly take IMGs.
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Agreed people self select once you get around 205. Also agree on the IMG thing. However it is not risky to apply between 200-220. The numbers show 246 matched, 17 didn't. That's equal to the overall match rate for US seniors.
 
ERRES2288 said:
Agreed people self select once you get around 205. Also agree on the IMG thing. However it is not risky to apply between 200-220. The numbers show 246 matched, 17 didn't. That's equal to the overall match rate for US seniors.
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Sure but still riskier than FM/IM especially the community ones. Charting outcomes doesn't separate university vs community primary care programs. Its a whole different beast
 
donkeykong1 said:
I agree. EM has become so protocol based. PA's and NP's can work the room easily. Plus insurance companies are doing everything possible to reduce annual ER visits and re-route patients to PCP. While the revers is true for surgery. This bodes well for anesthesia
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I only rotated for a month in the ed but I seriously doubt it. I've seen midlevels work. One patient I saw with cellulitis ended up with a huge gash in their arm from a midlevel that went looking for some pus to drain. No pus was found but the patient did benefit from some good old fashioned bloodletting. Guy with history of cancer came in with ha, d/ced with some po meds at outside hospital by midlevel a few days earlier, found to have a nice tumor in his head. Another guy with history of endovascular repair for infrarenal aaa comes in with abdominal and back pain over several days, midlevel is thinking kidney stone despite not colicky, no nausea, no fever, no hematuria, no dysuria, no frequency, found to have enteroaortic fistula. And so on.
 
Psai said:
I only rotated for a month in the ed but I seriously doubt it. I've seen midlevels work. One patient I saw with cellulitis ended up with a huge gash in their arm from a midlevel that went looking for some pus to drain. No pus was found but the patient did benefit from some good old fashioned bloodletting. Guy with history of cancer came in with ha, d/ced with some po meds at outside hospital by midlevel a few days earlier, found to have a nice tumor in his head. Another guy with history of endovascular repair for infrarenal aaa comes in with abdominal and back pain, midlevel is thinking kidney stone despite not colicky, no nausea, no fever, no hematuria, turns out to have enteroaortic fistula. And so on.
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Any of the above cases would be turfed off as a consult anyways, not much an ER doc can offer besides being there to intake a trauma/stemi/stroke etc. Go work a shift at a rural hospital. Its mostly PAs and NPs, the nect day the ER doc just signs off the charts
 
donkeykong1 said:
Sure but still riskier than FM/IM especially the community ones. Charting outcomes doesn't separate university vs community primary care programs. Its a whole different beast
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What are you talking about?
Community programs are (on average) more competitive (and better) than university based.
The value for FM programs is to go to a program where FM is the only residency program (unopposed).
 
Doctor4Life1769 said:
What are you talking about?
Community programs are (on average) more competitive (and better) than university based.
The value for FM programs is to go to a program where FM is the only residency program (unopposed).
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Meant to say community IM and those community FMG FM mills. I agree unopposed FM is definitively sought after. Bottom line the weaker FM/IM programs of which there are hundreds are significantly easier to get into than the weaker Gas programs of which ranger from 10-30
 
Psai said:
I only rotated for a month in the ed but I seriously doubt it. I've seen midlevels work. One patient I saw with cellulitis ended up with a huge gash in their arm from a midlevel that went looking for some pus to drain. No pus was found but the patient did benefit from some good old fashioned bloodletting. Guy with history of cancer came in with ha, d/ced with some po meds at outside hospital by midlevel a few days earlier, found to have a nice tumor in his head. Another guy with history of endovascular repair for infrarenal aaa comes in with abdominal and back pain over several days, midlevel is thinking kidney stone despite not colicky, no nausea, no fever, no hematuria, no dysuria, no frequency, found to have enteroaortic fistula. And so on.
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Love it.
Glad to see you back.
 
How is the job market bad for anesthesiology? There seem to be plenty of jobs on that Gaswork site and I know that's nowhere near all of them. Yeah the Management companies are taking over etc but starting salary for people in those is still around 350-375k. I was surprised though when the girl who is president of the anes interest meeting group here matched rads. Why was she kissing so much butt just to switch over to rads at the last minute i'll never understand. There will always be a need foe anesthesiologist, if a machine ever replaces anyone it will be CRNA, nurses are dumb and there needs to be a doctor around.
 
Please stop degrading peoples' accomplishments who just matched Anesthesia. Most of these posts seem to cheapen our future careers. To get into the top programs you still need 250+ AOA and great letters/grades. Anesthesia is still competitive regardless of your opinion of the "sinking ship." Congrats on matching everyone; I'm stoked for the future.
 
DrOwnage said:
Please stop degrading peoples' accomplishments who just matched Anesthesia. Most of these posts seem to cheapen our future careers. To get into the top programs you still need 250+ AOA and great letters/grades. Anesthesia is still competitive regardless of your opinion of the "sinking ship." Congrats on matching everyone; I'm stoked for the future.
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Congratulations on your match and same with your colleagues.
I suspect the intentions of those posts are more to forewarn, but nonetheless a lot of these guys would still do anesthesia if they had to do it all over again. All the junior medical students should consider every option before deciding on anesthesia (or some other specialty). I know I was told "if you love the OR, pick surgery. If you wanted a life, pick anesthesia." It's more complicated than that, especially with the way things are going.
 
DrOwnage said:
Please stop degrading peoples' accomplishments who just matched Anesthesia. Most of these posts seem to cheapen our future careers. To get into the top programs you still need 250+ AOA and great letters/grades. Anesthesia is still competitive regardless of your opinion of the "sinking ship." Congrats on matching everyone; I'm stoked for the future.
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If any of my posts came across that way, I sincerely apologize. I'm very happy in gas, have a great job, make great money, and I'd do it all over again. Yeah we have issues but what specialty doesn't? I know more miserable surgeons than I can even count, even though many here will say that's the ticket, not for me. As I stated the other day here, this apocalyptic talk has been going on since I was a med student a long, long time ago. Nothing much has changed for me since then that I didn't directly choose/cause.
 
This thread invariably pops up every year after the match. We get it, anesthesia sucks but can we move on now.
 
Man o War said:
If any of my posts came across that way, I sincerely apologize. I'm very happy in gas, have a great job, make great money, and I'd do it all over again. Yeah we have issues but what specialty doesn't? I know more miserable surgeons than I can even count, even though many here will say that's the ticket. Not for me. As I stated the other day here, this apocalyptic talk has been going on since I was a med student a long, long time ago. Nothing has changed for me since then.
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You hit the nail on the head right there. The bolded part of your post above is exactly why I chose anesthesia.

When I rotated through the OR on several different clerkships (Surg, Anesthesia, Ob/Gyn), I got a first-hand glimpse at how happy the surgeons seemed vs. the anesthesiologists. Let's just say the surgeons didn't come out on top.

Many people on the anesthesia sub-forums will tell medical students to go for surgery, but I definitely think there is some aspect of "grass is greener" syndrome at play here.
 
amLOLdipine said:
You hit the nail on the head right there. The bolded part of your post above is exactly why I chose anesthesia.

When I rotated through the OR on several different clerkships (Surg, Anesthesia, Ob/Gyn), I got a first-hand glimpse at how happy the surgeons seemed vs. the anesthesiologists. Let's just say the surgeons didn't come out on top.

Many people on the anesthesia sub-forums will tell medical students to go for surgery, but I definitely think there is some aspect of "grass is greener" syndrome at play here.
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I'd rather take all the crap I took from the Techs, CRNAs, Surgeons in med school as a resident/attending anesthesiologist than have to scrub in each day, deal with unhappy patients, clinic, call and nurses in any surgical field.
 
amLOLdipine said:
You hit the nail on the head right there. The bolded part of your post above is exactly why I chose anesthesia.

When I rotated through the OR on several different clerkships (Surg, Anesthesia, Ob/Gyn), I got a first-hand glimpse at how happy the surgeons seemed vs. the anesthesiologists. Let's just say the surgeons didn't come out on top.

Many people on the anesthesia sub-forums will tell medical students to go for surgery, but I definitely think there is some aspect of "grass is greener" syndrome at play here.
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Money and "pull" are not worth my happiness. I chose correctly despite the issues we face.
 
| March 17, 2016 9:05 AM ET

"B.C. hospital threatening to fire all 28 anesthesiologists if they don’t agree to round-the-clock care"

http://news.nationalpost.com/health...der-fire-as-some-women-in-labour-left-in-pain

“Frankly, the doctors are asking for far too much money,” he said, without disclosing the amount.

Laura Heinze, spokeswoman for the minister added: “Fraser Health has told the anesthesiology group it will be looking for another group to take on the service, and has given the current group a full year’s notice as required."
 
Would the above EVER be happening to Surgeons?
 
Carbocation1 said:
Would the above EVER be happening to Surgeons?
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Eh, thats kind of failing to see the forest for the trees. one groups problems shouldn't nail an entire profession. PP groups across all specialties have to deal with hospital administration. Its just the nature of the game

Secondly 24 hr OB anesthesia coverage is the norm at most urban hospitals
 
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Carbocation1 said:
| March 17, 2016 9:05 AM ET

"B.C. hospital threatening to fire all 28 anesthesiologists if they don’t agree to round-the-clock care"
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It doesn't seem that unreasonable to have at least 1 anesthesiologist on call at all hours of the day, does it? For a decently sized hospital, more than 1 seems reasonable.
 
amLOLdipine said:
It doesn't seem that unreasonable to have at least 1 anesthesiologist on call at all hours of the day, does it? For a decently sized hospital, more than 1 seems reasonable.
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Ill ask you this? If you worked at mcdonalds and the manager said.... Hey I need you to stay on for 16 more hours but i can only pay you 2 bucks an hour for those 16 hours.. would you do it or would you say I need my current hourly wage plus a surcharge for being away from family, the nature of the work, and off peak surcharge?
 
criticalelement said:
Ill ask you this? If you worked at mcdonalds and the manager said.... Hey I need you to stay on for 16 more hours but i can only pay you 2 bucks an hour for those 16 hours.. would you do it or would you say I need my current hourly wage plus a surcharge for being away from family, the nature of the work, and off peak surcharge?
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You do realize the hospital in question is in Canada..where CRNAs are non-existant, and Gas salaries hit 500k easily
 
criticalelement said:
Ill ask you this? If you worked at mcdonalds and the manager said.... Hey I need you to stay on for 16 more hours but i can only pay you 2 bucks an hour for those 16 hours.. would you do it or would you say I need my current hourly wage plus a surcharge for being away from family, the nature of the work, and off peak surcharge?
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They are working in an environment where there are no CRNAs. They are also getting paid 500k/year, per the article.

If you gave me those conditions and asked me to take overnight call once a week, I would be asking where to sign.

There are 28 anesthesiologists in that group. Even if each of them only took call once every 2 weeks, that would be enough to have 2 anesthesiologists on-site 24/7.
 
Can US-trained anesthesiologists practice in Canada? Looks like it's time to move. :laugh:
 
amLOLdipine said:
They are working in an environment where there are no CRNAs. They are also getting paid 500k/year, per the article.

If you gave me those conditions and asked me to take overnight call once a week, I would be asking where to sign.

There are 28 anesthesiologists in that group. Even if each of them only took call once every 2 weeks, that would be enough to have 2 anesthesiologists on-site 24/7.
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I'm sure these folks were getting 500k without call.
They probably felt entitled to make more if required to take call.
I'm not saying these anesthesiologists were right to demand more, but they should have. I don't think they should have walked away or negotiated their way out of the underlying contract offer.
 
amLOLdipine said:
Can US-trained anesthesiologists practice in Canada? Looks like it's time to move. :laugh:
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Unless you want to get taxed to death, stick with 'Murica, still the greatest country on the planet and has a decent chance of getting even greater.
 
Carbocation1 said:
| March 17, 2016 9:05 AM ET

"B.C. hospital threatening to fire all 28 anesthesiologists if they don’t agree to round-the-clock care"

http://news.nationalpost.com/health...der-fire-as-some-women-in-labour-left-in-pain

“Frankly, the doctors are asking for far too much money,” he said, without disclosing the amount.

Laura Heinze, spokeswoman for the minister added: “Fraser Health has told the anesthesiology group it will be looking for another group to take on the service, and has given the current group a full year’s notice as required."
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A few thoughts.

1) There are plenty of anesthesiologists on this very forum who think OB is beneath them. Seems a perilous attitude when contracted to hospitals that do OB.

2) Some Canadians' contract dispute doesn't seem to have a lot of relevance to the US job market.

3) I put even odds on the hospital shooting itself in the foot by going through with its threat to change groups.
 
DrOwnage said:
Please stop degrading peoples' accomplishments who just matched Anesthesia. Most of these posts seem to cheapen our future careers. To get into the top programs you still need 250+ AOA and great letters/grades. Anesthesia is still competitive regardless of your opinion of the "sinking ship." Congrats on matching everyone; I'm stoked for the future.
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Congrats on your match. The intent of my posts was not to degrade your choice for a career but to explain/expose issues with the specialty. Anesthesiology could be great again if and only if 2 main issues could be solved: Reduction in the number of Anesthesiology positions and a solution to the CRNA/AANA issue. Specialty leaders could fix both of them by reducing the positions available by 300 and boosting the AA training programs by 500%.
 
BLADEMDA said:
Congrats on your match. The intent of my posts was not to degrade your choice for a career but to explain/expose issues with the specialty. Anesthesiology could be great again if and only if 2 main issues could be solved: Reduction in the number of Anesthesiology positions and a solution to the CRNA/AANA issue. Specialty leaders could fix both of them by reducing the positions available by 300 and boosting the AA training programs by 500%.
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What will happen instead is that salaries will come down to the point that Anesthesiologists and CRNAs will cost approximately the same on an hourly basis. There will be an oversupply of CRNAs. Anesthesiologists will all find jobs but will have to live on salaries comparable to a hospitalist, not to an orthopedic surgeon.
 
skypilot said:
What will happen instead is that salaries will come down to the point that Anesthesiologists and CRNAs will cost approximately the same on an hourly basis. There will be an oversupply of CRNAs. Anesthesiologists will all find jobs but will have to live on salaries comparable to a hospitalist, not to an orthopedic surgeon.
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Or CRNAs take a salary hit to $100k along with Anesthesiologists who get cut to $250k. We can't win by seeing who is the cheapest provider because they win that scenario every time.
 
Carbocation1 said:
There just really aren't that many specialties from which to select. You guys need to keep in mind the perspective of the med stud:

Surgery specialties comprise too much manual labor and studying anatomy all day is very boring. I also refuse to sacrifice 5-8 yrs of my prime years in residency to appease the fatcat, grey-hair surgeons. Can't stand in 1 spot for 8 hours.

FM/IM specialties involve dealing with fat, non-compliant smokers in clinic. Keep in mind the good patients who care about their health are in fact healthy and don't come to see you. You are left with nothing but Gomers. Endless rounds. IM subs make LESS than Hospitalist for MORE work, with the exception of GI, which is a disgusting field and will tank once scopes are cut.

Rads is being outsourced to India and IBM Watson. Path is boring and literally 0 jobs.

EM is gloried triage, don't need physicians for shotgun ordering/calling consults. Also have to deal with the very worst of society.

PMR - what do they actually do? People think you're a physical therapist.

Derm - did not go into med school for this. Also, very low barrier of entry for nurses, as the work is not difficult.

Neurology and OBGYN - don't think I need to explain these.

Peds - crazy parents, very low pay.

Psych - Crazy pts.

Rad onc - must have family connection and/or PhD to match. Must be willing to move cross country for residency or job. Will be replaced by med onc eventually.

Please tell me if I am missing anything. With GAS, I can expect to pull in 400K, interesting phys/pharm/pathophys, ACLS skills, fun to be facile with procedures, privacy, no pt follow up. Americans will always demand high quality anesthesia care.
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I REALLY REALLY like your enthusiasm. Having said that, this way of thinking is what you normally have when you are fresh out of residency or living in a fantasy world. I'm not trying to shoot you down because I REALLY REALLY like your post but most anesthesiologist who have experience will not agree with this. From what I see..

1. The rest of the physicians on your list are still for the most part their own boss and are treated differently than us.
2. All of those non-compliant smokers/crazy patients/worse of society are the ones we are putting to sleep for surgery.
3. Expect to pull 400k on a consistent basis? Maybe in some parts of the U.S. This is not the case consistently in desirable areas. Yes, some will find that Job especially with connections but its not easy and not consistent. Things change with anesthesia job market and quickly.
4. Americans will demand high quality anesthesia? LOL. Most patients are STUPID (for lack of a better word). Some don't even know what type of surgery they are getting. Some don't even need surgery but the surgeon says they do. Some don't know the difference between doctors and nurses. This again will depend on where you practice but no one cares about quality. What they do care about is MONEY. Low cost is always better than better quality in the eyes of hospital administration and in the eyes of surgeons who just want patients to make it through in the cheapest possible way. Are there exceptions?? of course but I am talking in general terms and for the most part.

Not saying we should all give up on the field. I still enjoy what I do because its a unique field but its nice to live in reality.. But more power to you if your beliefs and experiences have been great..
 
Random Resident said:
Where did he go?


Sent from my iPhone using SDN mobile
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Post hold for 2 weeks because when someone brags about their top 5 us news ivy league undergraduate university in cambridge, other people aren't allowed to mention that they go to harvard
 
BLADEMDA said:
Specialty leaders could fix both of them by reducing the positions available by 300 and boosting the AA training programs by 500%.
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I agree with this statement 100 percent. Until we get AA legislation in every state, the CRNA issue will never be under control. NEVER. The devalueing of anesthesia services by even our own leaders plays(ed) a huge part as to where we are right now.
 
psychMDhopefully said:
How is the job market bad for anesthesiology? There seem to be plenty of jobs on that Gaswork site and I know that's nowhere near all of them. Yeah the Management companies are taking over etc but starting salary for people in those is still around 350-375k. I was surprised though when the girl who is president of the anes interest meeting group here matched rads. Why was she kissing so much butt just to switch over to rads at the last minute i'll never understand. There will always be a need foe anesthesiologist, if a machine ever replaces anyone it will be CRNA, nurses are dumb and there needs to be a doctor around.
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1) No it isn't. You have no idea what you are talking about
2) She saw the light. Perhaps she got a good dose of reality by reading this forum
 
Consigliere said:
1) No it isn't. You have no idea what you are talking about
2) She saw the light. Perhaps she got a good dose of reality by reading this forum
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Then what is starting salary nowadays? Most jobs on that gas work site list at least 320k.
 
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