Matched to anesthesia - now what?

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Wertt

Wertt

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Hi all - I succesfully matched to anesthesia today (in Canada) despite only having a couple of short electives and an ICU stint.
So, while I'm excited I feel my exposure is lacking - have done little to no neuraxial stuff for instance, etc. Can anyone comment on whether it's worth trying to get some more informal exposure in the next few months during off hours? Or am I not going to be the only incoming R1 with deficiencies...

Thanks !
 
Wertt said:
Hi all - I succesfully matched to anesthesia today (in Canada) despite only having a couple of short electives and an ICU stint.
So, while I'm excited I feel my exposure is lacking - have done little to no neuraxial stuff for instance, etc. Can anyone comment on whether it's worth trying to get some more informal exposure in the next few months during off hours? Or am I not going to be the only incoming R1 with deficiencies...

Thanks !
Click to expand...

Congrads! Anesthesiology is a great field in Canada. You will be doing your own cases and avoid the AANA/CRNA problem...for now.
 
Watch us silly Americans have panic attacks for two more weeks while we wait for our match while enjoying tasty adult beverages?
 
BLADEMDA said:
Congrads! Anesthesiology is a great field in Canada. You will be doing your own cases and avoid the AANA/CRNA problem...for now.
Click to expand...

It's true - Anesthesiology is not going through the same things here as in the states and can be very much a lifestyle specialty. We do have AA's but they are RTs and a great help rather than being competition in the system. I hope it stays that way...

Finally did a spinal today!
 
The Canadian residency is 5 years total though right? Can you work icu or is that still a fellowship like in the US
 
secants said:
The Canadian residency is 5 years total though right? Can you work icu or is that still a fellowship like in the US
Click to expand...

Yes it is five years - however the Royal College of Physicians and Surgeons here is introducing new curriculum design for many specialties that will make it possible to complete in 4 years. ICU does require a critical care fellowship; though I know of one R4 anesthesia resident who did moonlighting ICU attending shifts.
 
LaMarcusAldridge said:
You have a career in anesthesiology? What has stopped you from taking your own advice? Just curious..
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He was lacking foresight. If I knew 10 years ago what I know now, I might have taken a different path. But maybe you can contradict both of us about the future... Tell us, Pythia!

It would be so much simpler to just smile the American way, and say that everything is just GREAT in anesthesia, that working with CRNAs is just a PLEASURE, that decreasing reimbursements and a soon to come really crappy job market (except maybe for cardiac or pediatric anesthesiologists) are just something temporary which don't apply to us, that the future is bright, the sun is shining, life is beautiful...
 
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FFP said:
He was lacking foresight. If I knew 10 years ago what I know now, I might have taken a different path.

But maybe you can contradict us about the future... Tell us, Pythia!
Click to expand...

Unless he's retired, he still has a career in anesthesiology. What's the motive of convincing others to put a bullet through their head and not one through his own? Or maybe he just has nothing of value to add to these forums..
 
LaMarcusAldridge said:
Unless he's retired, he still has a career in anesthesiology. What's the motive of convincing others to put a bullet through their head and not one through his own? Or maybe he just has nothing of value to add to these forums..
Click to expand...
I already like you so much that I can only wish you a long career as an anesthesiologist!

I don't know why Consigliere is mostly trolling. He might be bitter, or just fed up giving explanations to wide-eyed medical students. I still remember the day I matched into an anesthesia program with a nice big name. I was as happy as a puppy for my internship year, waiting for my trip to the world of Oz, my upcoming anesthesia residency. Three years later, I woke up.

When you walk a mile in our attending shoes, you will understand, but by then it will be too late.

I personally don't care as much anymore, as I chose to concentrate on the aspects I like (learning, taking care of my patients personally, being the best doctor I can be). But there is almost no week when I am not reminded that I am just OR staff, just a "body", in the eyes of the hospital and the departmental bean counters, an assembly lane worker. If you are a truly intelligent and talented person (like many physicians), this will eat away at your soul sooner or later.
 
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BLADEMDA said:
Canadian Anesthesiology is like Anesthesia in the USA in the 1980s. The field is wide open and the job market is outstanding. I highly recommend the specialty in Canada.
Click to expand...
Likewise other UK/Commonwealth nations (e.g. Australia, New Zealand).
 
FFP said:
I already like you so much that I can only wish you a long career as an anesthesiologist!

I don't know why Consigliere is mostly trolling. He might be bitter, or just fed up giving explanations to wide-eyed medical students. I still remember the day I matched into an anesthesia program with a nice big name. I was as happy as a puppy for my internship year, waiting for my trip to the world of Oz, my upcoming anesthesia residency. Three years later, I woke up.

When you walk a mile in our attending shoes, you will understand, but by then it will be too late.

I personally don't care as much anymore, as I chose to concentrate on the aspects I like (learning, taking care of my patients personally, being the best doctor I can be). But there is almost no week when I am not reminded that I am just OR staff, just a "body", in the eyes of the hospital and the departmental bean counters, an assembly lane worker. If you are a truly intelligent and talented person (like many physicians), this will eat away at your soul sooner or later.
Click to expand...
That is very profound and true.
 
Can any other current attendings counter these claims?

FFP, I believe you work in academia, which pays less. I wonder if you worked in PP, if the increased reimbursement would ameliorate your issues. (I don't mean that in a condescending way)

Consigliere... I don't know your situation, but you don't sound happy... ever.

It's hard to believe you two are in such dissatisfaction with your fields/careers/situations/whatever. But I guess that's the way it is.
 
I can offer every perspective since I've worked in each environment (academics 3 years, AMC for 3 months, PP employed for 2 years, and switched to a diff PP as a partner (2 years) and now a "figurehead" if you will. The biggest shift in momentum is entirely due to market forces. The exponential increase in providers with expansion of scopes of practice has resulted in force multipliers that are killing the field. Unless you are one of the lucky few partners that might benefit from these forces, you are subject to them. Partnerships are drying up every day and, like myself, you may have to move somewhere to chase that opportunity, assuming any are left. It unfortunately comes down to timing in this environment. Most partners realize the ominous future and are trying to squeeze a little more out of their position before these same forces result in their own demise.
Failure to protect our field from the AANA by the ASA is largely to blame, but the horse is out of the barn. The ASA needs to find facilities that are using CRNA's without docs while skimming a profit and file a class action kickback suit. Setting a precedent here would be a start at opening back up some opportunities.
 
projectpat said:
Can any other current attendings counter these claims?

FFP, I believe you work in academia, which pays less. I wonder if you worked in PP, if the increased reimbursement would ameliorate your issues. (I don't mean that in a condescending way)

Consigliere... I don't know your situation, but you don't sound happy... ever.

It's hard to believe you two are in such dissatisfaction with your fields/careers/situations/whatever. But I guess that's the way it is.
Click to expand...

Please re read this post when you've been doing anesthesia for over 10 years and let's see how you feel.
 
Mad Jack said:
Yeah, but for how much money?
Click to expand...
If it's long-term, s/he's probably making way too little.

People don't realize that time is limited. That's why people are rarely happier if they make more money at the expense of a large amount of extra work-hours. Hence one should be paid more than proportionally, as the number of hours worked increases. Every extra hour over 40-50 should be paid better than the previous one.

The average hourly income means nothing without the total number of hours worked. 80 hours/week should pay much more than double of 40 hours/week. Why? Because one has less than 120 awake hours/week (if we assume just 48 hours for sleeping), out of which another 10-15 are spent with work-related grooming, dressing and travel, plus a few hours for work-related reading etc. There are less than 100 hours in total for both work and play.

The point is that when one works 80 hours/weekly, one has less than 20 hours of spare time. With 40 hours worked, it's 60 hours of personal time. See the difference? And the more one works, the more rest one will need, so those 100 work+play hours to start with will actually be even fewer.

Be very-very skeptical of any job that requires one to work a high number of hours as an employee. It's probably not worth it. Each of us knows our own limit of working hours/week where we can still be happy, and I would bet it's way under 96 for most.
 
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