MS3 trying to decide....

[LurkNoMore]

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This may be a long post, since I will try to describe my thoughts. First off, I greatly appreciate all input into my situation.
I came to medical school b/c I liked science and people, from being hospitalized several times (surgery, mono) and liking the docs and how they helped me. I find myself now, a 3rd year medical student, unsure of what I want to do with the rest of my life. Having done Peds/Med/Surg/OB I can't really see myself doing these professions (for various reasons). Going in to MS3 year I sought to have an open mind, considering things such as Medicine (possibly subspecialty), Anesthesia, and seeing if I enjoyed surgery enough to commit to its rigors.
I did a 3 week selective early on in my 3rd year in Anesthesia, expecting to love every minute of it, which I didn't, although not a true dislike either. Looking back on the experience I feel some of this is related to it being early in my MS3 year and my still learning what it is to be an MS3 (you need to go to bed at 9/10 p.m., you need to step up when a resident says "this may be a difficult airway, maybe you should wait for another one" and say, "no, I really would like to give it a shot, as long as we can bag him"). Things I didn't like were charting, and sitting for an extended period of time (you won't do too much of as an MDA), as well as being freaked out by the number of different lines running across each other. I enjoy pharmacology, physiology, and doing things with my hands (although I don't claim to be anywhere close to being able to start IV w/o assistance much less art/central lines, epidurals, et al).
I have basically talked myself in to a career in anesthesia from discussing it with various attendings/residents/current MS4's and reading posts on SDN, various other resources. This said, I have concerns about where the field is going (as I am leaning towards anesthesia partly based on a large % of MDA's being very happy with their profession, will drastic changes reverse this % in 10 yrs?), and if, choosing the specialty largely from "numbers" and the "personality type" that I ascribe myself to be (in careers in medicine, and the myers-briggs stratton thingy). One attending told me to relax, that I would need to make a "leap of faith" into anesthesia b/c it is something you won't really understand until you are a CA-1/2 truly doing cases day in day out.
I'm on F-Med right now and I will be taking call this friday night with the anesthesia residents to get a bit more exposure, I'm also looking in to doing a rotation really early 4th year, as well as an away rotation (to round out my CV, etc.). I guess, what I am saying after all of this is, can any of you out there relate to a significant portion of my story and/or lend advice (pertinent postives/negatives) relating to the things I am thinking through? Thanks again for reading my novella, and for your thoughts. Sorry for lurking for so long and now posting with such a demanding topic (all about me...), I will be more active and actually contribute info to SDN now that I am on the board I promise!

 

[jennyboo]

1. It's February of your third year. That's pretty early and most of your counterparts across the country have not yet decided for sure what they're doing. I had done an anesthesia rotation during November of my third year (three months ago, for you) and by the end of the rotation had decided I wasn't sure I wanted to do it. I was going to consider emergency medicine but didn't get to do that rotation until March, so in February of my third year I wasn't sure either. You don't have to feel certain of what you want to do yet. It will come to you sooner or later.

2. If you want to do an away rotation in your fourth year, choose a couple places to apply to this week. If you're still deciding between two specialties, you can even book away rotations in both (cancel one later after you choose your field). Away rotation slots are first come, first served. Many anesthesia programs don't accept outside rotators in July and August while they are busy with new first-year residents, so the number of slots available is even more limited. If you get your application in as soon as they start accepting them, you will definitely get the rotations you want. If you wait until the summer to apply, they will be all filled up. Apply now, cancel later if you no longer want it.

3. It won't be now, but you will eventually take a leap of faith (toward some specialty, whatever it is) and you will probably be very happy when it happens. For now, you don't need to feel rushed to make the decision immediately.

 

[Bertelman]

...you need to step up when a resident says "this may be a difficult airway, maybe you should wait for another one" and say, "no, I really would like to give it a shot, as long as we can bag him").

Can't say I always agree with this. It depends on how your rotation is arranged, but at our school we tracked one resident for three weeks. I got to know him pretty well, and I trusted his judgment. If he suggested I should sit this one out, I deferred. After three weeks, I still managed about 15 intubations. I'm not too concerned about the 1-2 difficult ones I may have declined. For the patient's sake, remember the first attempt is always the easiest attempt.

This said, I have concerns about where the field is going (as I am leaning towards anesthesia partly based on a large % of MDA's being very happy with their profession, will drastic changes reverse this % in 10 yrs?), and if, choosing the specialty largely from "numbers" and the "personality type" that I ascribe myself to be (in careers in medicine, and the myers-briggs stratton thingy).

Realize that you will have to remain adaptable and deft at modifying your practice no matter which field you enter. That is the key to success in any field. I know there is quite a bit of talk on these boards of impending changes, but realize that these threats aren't new. I'm sure you could have found similar banter 20 years ago. I'm not saying everything is rosy for the foreseeable future, just that you will find problems with any specialty. My best advice is to find a specialty that you love, then realize you will need to remain nimble in your practice to survive. There are downsides, economic and otherwise, to many fields. If you truly love the specialty, though, you should be able to survive the inevitable twists and turns.

 

[LurkNoMore]

B-man, I agree with you completely on putting the patient first, it just seemed as though I missed more opportunities than I received due to that statement, only completely successfully intubating 1x during the rotation (trying roughly 5 times, seeing cords twice). Of course I was quite happy when I was successful, it would have been nicer to have gotten a few more. I also agree with your thoughts on choosing a specialty you love and on the fact that there will always be doom and gloom talk in any field. At this point I am just trying to evaluate the field objectively, not knowing if I will love it or not (I guess the solution is as jenny suggested, get an away rotation in early). All in all, I am just uneasy at being at this point feeling that there is a long list of specialties that I would not be comfortable with, and not knowing if Anesthesia is the answer to my fears or if I am missing the boat on some other path I should be walking. thanks again.

 

[Bertelman]

B-man, I agree with you completely on putting the patient first, it just seemed as though I missed more opportunities than I received due to that statement, only completely successfully intubating 1x during the rotation (trying roughly 5 times, seeing cords twice).

I feel for you, and my comments about discretion were not so much about you. It sounds like you just had a poor environement for intubation attempts. My comments were more for the posterity of this thread and future students. As if they would use the search fx.

Hope you get better opportunities in July. Good Luck

 

[ambientbaby]

Hi Lurknomore, I feel exactly the same as you. How comforting in an uneasy sort of way...

 

[HPI]

Hey guys, I am new to this so I need a little help!
I was interested in a different field until now that I am doing more surgery (3rd yr Med Student) and realized that I actually like Anesthesiology more than anything else!
I have a question, was is the average step I and step II score accepted for anesthesiology ? I have 210 on my first step and I am trying to bump it up for step II. I have published research in ophthalmology.
What are my chances?
Thanks

 

[Bertelman]

Hey guys, I am new to this so I need a little help!
I was interested in a different field until now that I am doing more surgery (3rd yr Med Student) and realized that I actually like Anesthesiology more than anything else!
I have a question, was is the average step I and step II score accepted for anesthesiology ? I have 210 on my first step and I am trying to bump it up for step II. I have published research in ophthalmology.
What are my chances?
Thanks

You shouldn't have any problem matching. May not get your picks on location, so apply widely. I'd suggest taking Step 2 early, shoot for >220. Browse this forum. There are several threads with stats like yours.

http://gasforums.studentdoctor.net/showthread.php?t=310585&highlight=step+magic+220