Medical Student Choosing Anesthesia

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JPSmyth

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I spoke with an attending last week about anesthesia, and asked if the rumors are bad as people make it seem. He said that the field isn't in such bad shape, and the job market is still pretty decent. People are blowing it out of proportion.

I go to a mid-tier MD school, and I really like the idea of going into anesthesia. I originally took it off my radar because of what I've read on SDN, but maybe it can be a viable option after all?

I feel like my personality type meshes well with the field, and I like the OR but don't necessarily love it enough to go into surgery. Also anesthesia is not very competitive residency wise so I think I'll be able to set myself up to do residency in a great hospital/location.

How difficult is it to secure a job in academic medicine as an anesthesiologist? Freshly out of residency+fellowship, I've heard that anesthesiologists can expect to make roughly 300?

I don't need 400-500, I will be able to pay down my loans and live comfortable with 300, even 275. So even if salaries in the field are taking a hit, coming down from 350+, I'm fine with a job paying around 300.

According to Medscape 2018 report, it seems that the field is up 6% in terms of compensation, anesthesiologists still make good money, and they seem to have pretty good job satisfaction.

I get the CRNA issue, and supervising CRNAs might not be for everyone, but aside from that, am I missing anything major here? The AMCs also are an issue I've also heard about.

(Would consider doing pain fellowship to get a mix of OR time and interventional pain clinic)

Thank you!

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You like the OR but don't love it enough to go into surgery?

Nobody spends as much time in the OR as anesthesiologists. Surgeons don't come close.
 
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I spoke with an attending last week about anesthesia, and asked if the rumors are bad as people make it seem. He said that the field isn't in such bad shape, and the job market is still pretty decent. People are blowing it out of proportion.

I go to a mid-tier MD school, and I really like the idea of going into anesthesia. I originally took it off my radar because of what I've read on SDN, but maybe it can be a viable option after all?

I feel like my personality type meshes well with the field, and I like the OR but don't necessarily love it enough to go into surgery. Also anesthesia is not very competitive residency wise so I think I'll be able to set myself up to do residency in a great hospital/location.

How difficult is it to secure a job in academic medicine as an anesthesiologist? Freshly out of residency+fellowship, I've heard that anesthesiologists can expect to make roughly 300?

I don't need 400-500, I will be able to pay down my loans and live comfortable with 300, even 275. So even if salaries in the field are taking a hit, coming down from 350+, I'm fine with a job paying around 300.

According to Medscape 2018 report, it seems that the field is up 6% in terms of compensation, anesthesiologists still make good money, and they seem to have pretty good job satisfaction.

I get the CRNA issue, and supervising CRNAs might not be for everyone, but aside from that, am I missing anything major here? The AMCs also are an issue I've also heard about.

(Would consider doing pain fellowship to get a mix of OR time and interventional pain clinic)

Thank you!

A few things..

1) Every attendings opinion will vary. Speak to many attendings. each attendings circumstances will determine how they view the field, though i think you get a pretty good representation here on SDN because there are so many attendings here. Dont just listen to someone say the field is in bad shape or not, ask them WHY they think so, and analyze the reasons for yourself.

2) Like above poster, Anesthesiologists spends the most time by far of all doctors in the OR.

3) In todays market 300 in academic is reasonable. Though it's not all about total compensation in a job. Making 300k working 70 hrs a week is not the same as working 30. You get the idea. Here, starting for academic range from high 100s to low 200s, with opportunity to make 300+ if you do more calls.

4) You say that now about 275k but your opinion may change later, especially if you are someone who gets easily peer pressured. As your income goes up, you often have lifestyle inflation.

5) Don't trust medscape.. with any survey, it's going to depend on how many, and who responds. Plus they dont look at hours. Would you feel good if you are forced to work 10% more, but your salary only went up 6%. Or if you are now forced to cover 4 CRNAs instead of working alone? Reimbursements from medicare are going down, so why would salary go up when there's no shortage of anesthesiologists?
 
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Reimbursements from medicare are going down, so why would salary go up when there's no shortage of anesthesiologists?

Medicare reimbursement has been going up very slightly over the years. It’s still horrible though so you need to watch the proportion of your patients who are on Medicare.
 
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You like the OR but don't love it enough to go into surgery?

Nobody spends as much time in the OR as anesthesiologists. Surgeons don't come close.

I'm sure this is going to be refuted...
Gen Surg residents avg 75.1 hrs/wk
Anesthesia residents avg 61.5 hrs/wk
As of 2012 but still I'm sure a gap in hours still exists?

Whether the hours are misreported or not, every piece of data I find says that anesthesiologists tend to work less hours than surgeons. That has to be founded in some amount of truth.

What I meant in my original post is that I don't want to put in surgeon hours, even if the anesthesiologist spends more time in the OR, the surgeon spends more time working overall (according to the numbers). A 15 hr/week difference is a lot IMO.

I'm not looking for a "lifestyle" specialty but anesthesia seems to offer a better work-life balance than surgery, from the attendings that I've spoken with.
 
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A few things..

1) Every attendings opinion will vary. Speak to many attendings. each attendings circumstances will determine how they view the field, though i think you get a pretty good representation here on SDN because there are so many attendings here. Dont just listen to someone say the field is in bad shape or not, ask them WHY they think so, and analyze the reasons for yourself.

2) Like above poster, Anesthesiologists spends the most time by far of all doctors in the OR.

3) In todays market 300 in academic is reasonable. Though it's not all about total compensation in a job. Making 300k working 70 hrs a week is not the same as working 30. You get the idea. Here, starting for academic range from high 100s to low 200s, with opportunity to make 300+ if you do more calls.

4) You say that now about 275k but your opinion may change later, especially if you are someone who gets easily peer pressured. As your income goes up, you often have lifestyle inflation.

5) Don't trust medscape.. with any survey, it's going to depend on how many, and who responds. Plus they dont look at hours. Would you feel good if you are forced to work 10% more, but your salary only went up 6%. Or if you are now forced to cover 4 CRNAs instead of working alone? Reimbursements from medicare are going down, so why would salary go up when there's no shortage of anesthesiologists?

I was under the impression that academic anesthesiologists generally work less than those in PP? I wouldn't mind working 50 hrs+/week with call pretty often as a new attending to make over 300 and pay down my loans.

As for the reason why anesthesia is in decent shape, apparently there was a down period during the 90s(?) for training anesthesiologists so there are a lot of old docs and a fair amount of young docs, but not many in the middle. So when the older ones inevitably retire the need will increase. Is this true?

Thank you for your input btw
 
My experience has been that people who are the most geographically inflexible are the most unhappy. You can easily make 400k plus in anesthesia with a decent schedule if you’re willing to live in the Midwest for example. If you want to make 500 plus you can if you’re willing to work. It won’t be 8-3, and you’re going to take some call, but still very reasonable.
 
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My experience has been that people who are the most geographically inflexible are the most unhappy. You can easily make 400k plus in anesthesia with a decent schedule if you’re willing to live in the Midwest for example. It won’t be 8-3, and you’re going to take some call, but still very reasonable.

Thanks.

I'm not set on a geographic location now but when I get older and have a family who knows. I don't necessarily have a burning desire to work in a major city in the northeast or west coast though. Would work somewhere less desirable for a few years to pay down my loans then move to a "better" area to take a pay cut once I'm debt free.
 
Medicare reimbursement has been going up very slightly over the years. It’s still horrible though so you need to watch the proportion of your patients who are on Medicare.
You mean to help cover inflation? Didn't they severely cut reimbursement for several popular procedures (GI stuff, central lines).

I'm sure this is going to be refuted...
Gen Surg residents avg 75.1 hrs/wk
Anesthesia residents avg 61.5 hrs/wk
As of 2012 but still I'm sure a gap in hours still exists?

Whether the hours are misreported or not, every piece of data I find says that anesthesiologists tend to work less hours than surgeons. That has to be founded in some amount of truth.

What I meant in my original post is that I don't want to put in surgeon hours, even if the anesthesiologist spends more time in the OR, the surgeon spends more time working overall (according to the numbers). A 15 hr/week difference is a lot IMO.

I'm not looking for a "lifestyle" specialty but anesthesia seems to offer a better work-life balance than surgery, from the attendings that I've spoken with.

Yes gen surg residents avg more hours than anesthesiology residents. But you want to look at attending lifestyle..

It's hard to find accurate data but surgeons have more control over their lifestyle later on i would say. Each job is going to vary though. But AAMC.org lists General surgeon as 59 hours per week on average and anesthesiologists at 61
 
You mean to help cover inflation? Didn't they severely cut reimbursement for several popular procedures (GI stuff, central lines).



Yes gen surg residents avg more hours than anesthesiology residents. But you want to look at attending lifestyle..

Unfortunately I don't know where to find that information. But I thought attending lifestyle was what you make of it. For instance if you want to make 400+ you can choose to work more hours/take more call. If you want to make 275 you can choose to work less hours/take less call?

Thanks
 
You mean to help cover inflation? Didn't they severely cut reimbursement for several popular procedures (GI stuff, central lines).



Yes gen surg residents avg more hours than anesthesiology residents. But you want to look at attending lifestyle..

It's hard to find accurate data but surgeons have more control over their lifestyle later on i would say. Each job is going to vary though. But AAMC.org lists General surgeon as 59 hours per week on average and anesthesiologists at 61


A few years ago Medicare was $18.xx/unit. These days it’s $22.xx/unit in my area. The only procedure that I know of that went down in reimbursement are cataracts which used to be 6 base units and are now 4. There may be others but I don’t know about them.

Agree surgeons have much more control over their lifestyle than anesthesiologists. If they don’t want to want to work Thursday mornings or Friday mornings because they want to golf or work out or attend Rotary breakfast, they don’t. 80% of the surgeon’s I know rarely if ever work nights. And the remaining 20% do 80% of the night and weekend work. I think overall a surgeon in private practice has a better lifestyle than an anesthesiologist. And unless they are a trauma surgeon, they never sleep in the hospital.
 
A few years ago Medicare was $18.xx/unit. These days it’s $22.xx/unit in my area. The only procedure that I know of that went down in reimbursement are cataracts which used to be 6 base units and are now 4. There may be others but I don’t know about them.

Agree surgeons have much more control over their lifestyle than anesthesiologists. If they don’t want to want to work Thursday mornings or Friday mornings because they want to golf or work out or attend Rotary breakfast, they don’t. 80% of the surgeon’s I know rarely if ever work nights. And the remaining 20% do 80% of the night and weekend work. I think overall a surgeon in private practice has a better lifestyle than an anesthesiologist. And unless they are a trauma surgeon, they never sleep in the hospital.

Changes to the 2018 Medicare Fee Schedule Anesthesiologists Need to Know | CIPROMS, Inc.

screening endo got cut to 3 units from 5 units , among others. can hit many groups pretty hard if they do a lot of endos
 
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Unfortunately I don't know where to find that information. But I thought attending lifestyle was what you make of it. For instance if you want to make 400+ you can choose to work more hours/take more call. If you want to make 275 you can choose to work less hours/take less call?

Thanks


If you’re going to be happy with 275, you can have a very good lifestyle just about anywhere doing anesthesia.
 
Do NOT choose a specialty based on what strangers say in an online forum. Most come here to air their grievances. Go see the EM forum sometime, probably/definitely worse over there with SGDs or whatever they call their large national corporations.

Agree surgeons have much more control over their lifestyle than anesthesiologists. If they don’t want to want to work Thursday mornings or Friday mornings because they want to golf or work out or attend Rotary breakfast, they don’t.

Not if they have slated block time... in every hospital I’ve worked in it’s “use it or lose it” so if they decide to go grab 18 holes on the reg rest assured their time will be allocated differently and their salary will take a big hit. No change for us, though.
 
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Do NOT choose a specialty based on what strangers say in an online forum. Most come here to air their grievances. Go see the EM forum sometime, probably/definitely worse over there with SGDs or whatever they call their large national corporations.



Not if they have slated block time... in every hospital I’ve worked in it’s “use it or lose it” so if they decide to go grab 18 holes on the reg rest assured their time will be allocated differently and their salary will take a big hit. No change for us, though.

i dont know man. when they talk about their new grads working 35 hr weeks making 400k, or moonlighting for 300 a hr. NOT BAD!
 
i dont know man. when they talk about their new grads working 35 hr weeks making 400k, or moonlighting for 300 a hr. NOT BAD!

Not bad at all!

... but you have to work in EM and deal with an excessive amount of BS all the time. I did some ED moonlighting in fellowship - solid pay, but ugh my soul was dead at the end of an all-nighter.

Also maybe the only specialty which allows non-trained people to work in their setting which I always thought was interesting in today’s world.
 
Not bad at all!

... but you have to work in EM and deal with an excessive amount of BS all the time. I did some ED moonlighting in fellowship - solid pay, but ugh my soul was dead at the end of an all-nighter.

Also maybe the only specialty which allows non-trained people to work in their setting which I always thought was interesting in today’s world.

well yes thats why you went into anesthesiology and not EM! i'm sure those ED docs would much rather be in the ED than the OR
 
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Not if they have slated block time... in every hospital I’ve worked in it’s “use it or lose it” so if they decide to go grab 18 holes on the reg rest assured their time will be allocated differently and their salary will take a big hit. No change for us, though.


I’m talking about guys who take EVERY Thursday morning off;)
 
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