Need advice for M4 year, possibly going into anesthesia

[Hedge Trimmer]

I'm an M4 at a pretty middle of the road US MD school in the southeast, set to apply for residency in September. Had long been planning on radiology, just finished anesthesia elective and having inklings of switching to that. I knew nothing about the field prior to this rotation.

My home school does not have an anesthesia residency, but there would be more opportunities for anesthesia rotation time in the coming months. My Step 1 is high 250's, top 25% of class but not AOA, several pubs and posters (nothing related to anesthesia), some tutoring, etc. I'm sure I could get 1 anesthesia LOR from home attendings.

I have heard that aways are not necessary for anesthesia, as they can do more harm than good. Is this true? Should I still do one? I'm not necessarily looking to be in a specific area of the country. If I did go on an away, I still feel extremely incompetent with anesthesia-related skills and am worried I'd hurt my chances more than anything. I have no problem working hard though, and can honestly get along with anybody. Overall, I'm torn on next steps.

Thank you for the help!

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[Man o War]

I'm an M4 at a pretty middle of the road US MD school in the southeast, set to apply for residency in September. Had long been planning on radiology, just finished anesthesia elective and having inklings of switching to that. I knew nothing about the field prior to this rotation.

My home school does not have an anesthesia residency, but there would be more opportunities for anesthesia rotation time in the coming months. My Step 1 is high 250's, top 25% of class but not AOA, several pubs and posters (nothing related to anesthesia), some tutoring, etc. I'm sure I could get 1 anesthesia LOR from home attendings.

I have heard that aways are not necessary for anesthesia, as they can do more harm than good. Is this true? Should I still do one? I'm not necessarily looking to be in a specific area of the country. If I did go on an away, I still feel extremely incompetent with anesthesia-related skills and am worried I'd hurt my chances more than anything. I have no problem working hard though, and can honestly get along with anybody. Overall, I'm torn on next steps.

Thank you for the help!

You don’t need an away with that step score. Just don’t be weird or arrogant and you should be able to match where you want.

 

[Dam272]

You don’t need an away with that step score. Just don’t be weird or arrogant and you should be able to match where you want.

I second this advice

 

[21Rush12]

Also M3 but yeah if you don’t need aways to convince them you’ll sell your kidney to move to California then skip it. 250+ with research you’re gonna be fine.

 

[Consigliere]

Here's my advice: don't.

 

[Macaronium]

Would recommend only if you have a particular dream program or very restrictive geographic preference. Otherwise you should be fine.

 

[repititionition]

dude, if you LIKE radiology, unless you couldn't live without doing anesthesiology... do radiology.

 

[Hedge Trimmer]

dude, if you LIKE radiology, unless you couldn't live without doing anesthesiology... do radiology.

What makes you say that? Do you mean from the lifestyle standpoint?

 

[Hedge Trimmer]

Here's my advice: don't.

Don't do an away? Or don't do anesthesiology? Just wanted to clarify!

 

[Consigliere]

Don't do an away? Or don't do anesthesiology? Just wanted to clarify!

Anesthesiology

 

[Chaddycakes21]

dude, if you LIKE radiology, unless you couldn't live without doing anesthesiology... do radiology.

I disagree. Radiology will eventually be replaced with automation.

I would run as far away from that field as I could.

 

[MaximusD]

I'm an M4 at a pretty middle of the road US MD school in the southeast, set to apply for residency in September. Had long been planning on radiology, just finished anesthesia elective and having inklings of switching to that. I knew nothing about the field prior to this rotation.

My home school does not have an anesthesia residency, but there would be more opportunities for anesthesia rotation time in the coming months. My Step 1 is high 250's, top 25% of class but not AOA, several pubs and posters (nothing related to anesthesia), some tutoring, etc. I'm sure I could get 1 anesthesia LOR from home attendings.

I have heard that aways are not necessary for anesthesia, as they can do more harm than good. Is this true? Should I still do one? I'm not necessarily looking to be in a specific area of the country. If I did go on an away, I still feel extremely incompetent with anesthesia-related skills and am worried I'd hurt my chances more than anything. I have no problem working hard though, and can honestly get along with anybody. Overall, I'm torn on next steps.

Thank you for the help!

Away rotations can do more harm than good only if you're a lazy **** or incompetent for your level of training.

If you bust your ass, maintain a positive attitude, and read whenever you can, you can make a great lasting impression and get LORs from someone within the program.

The truth, however, is that you may not need to create impressions with an away rotation with scores like yours from an average MD school, but anyone who tells you that away rotations are dangerous is plainly full of **** and/or gives bad advice. Just my not-so-humble opinion. YMMV.

 

[MaximusD]

I also need to mention that other than high earning potential, anesthesia and radiology are VASTLY different. Figure out what you enjoy... then choose a field.

Best of luck!

 

[TheNolano]

With your scores you will have no problem matching anesthesia at great places without aways.

I would recommend doing a variety of home rotations and compare anesthesia (and pain) vs radiology and IR. You could even get a letter or two from both and then make up your mind. Don’t worry about aways. Worry about figuring out exactly what you want.

For what it’s worth I was also gung-ho on rads until late third year. After a rotation I realized that while I loved the images, I REALLY did not like the work flow/fast repetition. Spend some more time in both and find what you love.

You’re in a great spot for either way. Don’t worry about research not being in the field. Mine wasn’t either and no interviewers cared.

Best of luck!

 

[seniormd]

dude, if you LIKE radiology, unless you couldn't live without doing anesthesiology... do radiology.

Agree. I’m in practice now and hate it. Anesthesia is one of the biggest regret specialties. You’ll be treated like a resident for the rest of your life.

 

[deleted171991]

Agree. I’m in practice now and hate it. Anesthesia is one of the biggest regret specialties. You’ll be treated like a resident for the rest of your life.

So well said.

If you want to be a doctor, do something else. If you want to be a super-midlevel minus the union rights, this is it. People who wear suits (including corporate/academic anesthesia departmental leadership) have zero respect for people in pajamas.

I got more respect (on average) as an intern than as an anesthesia resident or attending. Clothes do make the man.

 

[kkl2018]

So well said.

If you want to be a doctor, do something else. If you want to be a super-midlevel minus the union rights, this is it. People who wear suits (including corporate/academic anesthesia departmental leadership) have zero respect for people in pajamas.

I got more respect (on average) as an intern than as an anesthesia resident or attending. Clothes do make the man.

God. I'm trying to decide on specialties, and reading this makes it so hard. Is there any speciality you would have wished you went into instead? or wish your kid would have gone into instead if you could tell them? (besides surgery?)

 

[deleted171991]

IM + a good fellowship (GI/cardiac/possibly others).

Clinic is overhated. I didn't like it a lot as an intern either, but that was only because I was seeing new (to me) patients all the time. Seeing the same patients and developing a relationship over time is priceless. Even after a few days in the ICU, I have a completely different relationship with my patients than in the OR (or resident clinic).

In today's corporatist medicine, in which the employer tries to make the patient loyal to the corporate brand, not the doctor, IM is not what it used to be either, but still light-years ahead of anesthesia. Many patients still come to see a specific doctor, and will follow the doctor to her new job if it's within an hour of driving. That can't be said about anesthesia, hence an anesthesiologist is a just a replaceable cog in the assembly lane.

Ideally one should choose a specialty that satisfies three rules:
1. one has one's own patients, who actively chose one as their doctor and would follow one to a new job
2. one practices it (mostly) solo, not by supervising midlevels
3. one enjoys it and is good at it.

Forget money and lifestyle, and other imaginary things. If the above three rules are satisfied, those will follow.

 

[seniormd]

Lifestyle matters because a bad one can finish you. If you don’t fall asleep while driving, you’ll miss your kids lives. Anesthesiologists live in the wake of obstetricians. Epidural after epidural. Don’t do it.

 

[drmwvr]

dude, if you LIKE radiology, unless you couldn't live without doing anesthesiology... do radiology.

to be precise, interventional radiology.

 

[Gasgod3333]

Agree. I’m in practice now and hate it. Anesthesia is one of the biggest regret specialties. You’ll be treated like a resident for the rest of your life.