OB resident wanting to switch to anesthesia!!!!

[Anesthesia4me]

Hello,

I am currently in my PGY-1 for OB and am looking to switch into CA-1 spot for anesthesia in 2009/2010. I have a few questions:

1) I am hoping to slip in for 2009 so that I don't have to take a year off or worse do another intern year. I looked at the requirements for transitional year and all I would be missing would be the one month of ER and ICU. Do you think I should just go through the match for 2010 or try for 2009 and just explain my situation?

2) How difficult is it to switch from one specialty to another? I originally was torn b/t OB and anesthesia and realize that I made the wrong decision 🙁 I was a competitve applicant from med school (240s on step exams) but now I'm afraid that I will look like crud b/c I am changing specialties. . . any advice?


3) Also any advice on how to break the news to my PD?

Since I've only been doing OB for a month, I am going to give it until mid Sept before breaking it to my PD just so I can be sure that I am making the right choice (and to give me a chance to do some more gyn before calling it quits). Is waiting until Sept going to put me a greater disadvantage? I still have all my ERAS LORs for anesthesia, so all I need to do is write a new personal statement. . .

Any advice you can give would be awesome. Don't sugar coat, just tell it like it is 🙂 Thx.

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[radslooking]

Hello,

I am currently in my PGY-1 for OB and am looking to switch into CA-1 spot for anesthesia in 2009/2010. I have a few questions:

1) I am hoping to slip in for 2009 so that I don't have to take a year off or worse do another intern year. I looked at the requirements for transitional year and all I would be missing would be the one month of ER and ICU. Do you think I should just go through the match for 2010 or try for 2009 and just explain my situation?

2) How difficult is it to switch from one specialty to another? I originally was torn b/t OB and anesthesia and realize that I made the wrong decision 🙁 I was a competitve applicant from med school (240s on step exams) but now I'm afraid that I will look like crud b/c I am changing specialties. . . any advice?


3) Also any advice on how to break the news to my PD?

Since I've only been doing OB for a month, I am going to give it until mid Sept before breaking it to my PD just so I can be sure that I am making the right choice (and to give me a chance to do some more gyn before calling it quits). Is waiting until Sept going to put me a greater disadvantage? I still have all my ERAS LORs for anesthesia, so all I need to do is write a new personal statement. . .

Any advice you can give would be awesome. Don't sugar coat, just tell it like it is 🙂 Thx.

My two cents. Im not a gas man, but think I can give you a few bits of info.
1. Your first year should count, (or at least most of it) Most transitional, surgical, or medical internships count. http://www.acgme.org/acWebsite/RRC_040/040_prIndex.asp
2. there are four year categorical programs with an integrated first year, and 3 yr programs (better for you). I think the former are a bit harder to get into, but I'll let the gurus comment on that. I know of former residents who have switched into 4 yr categorical without isssues.
3. switching is more common than you think. you should be able to find a spot.
4. I would not tell your PD anything until you have decided you want to switch.
5. Applying for the match may be difficult, as you will need time to interview. I would do it, mind you, I think the issue will be finding time. At that point you may need to tell your PD. And I don't know how kind they'll be about giving you time off. The best bet is talking to the Anesthesia PD where you are (if you trust them) as well as PD's around the country where you want to go inquiring about spots for 2009. There are often spots outside the match that they will take you for. Also, your LOR's are still applicable so they could look at those. Write a reason why you are switching, include your references, cv, scores, and your'e good to go.
6. The spots they take for 2009 are relatively fluid. Some will interview now, others during match season. Getting started ASAP is always a good idea.
7. I would finish out the year, since you'll need to anyway. When you know you are switching for sure and don't want to continue on, then you can tell your PD.

 

[Bougie]

The most important question:

Why?

Why do you want to switch? Is it because you truely love anesthesiology? Or is it because OB is too tough and being an intern is tougher? Do you think anesthesia is feet up on the anesthesia machine doing Sudoku?

I've got news...the grass is always greener. We have 3 residents who switched from another field (2 from surgery and 1 from OB) who thought anesthesia was cake. All three were sorely mistaken. Yes we may work less hours, but the hours we are at work are more intense than any other field. Most days you get a 15 minute break and a 30 minute lunch and the rest of the time you are directly involved in patient care. No chillin in the break room, no leisurely afternoon rounds at the cafeteria. CA-1 year was more exhausting for me than intern year. The residents who switched don't regret the decision but they all say they wouldn't have switched if they could do it again (two were just 1 year from being done).

You are way too early in your career to consider switching. And you are an intern. I seriously considered going back to my old job as stock clerk at Publix during internship. Give a few more months to OB. Talk to the anesthesia department. Ask if you can shadow a resident during a vacation week or on post call days. Not saying you shouldn't switch...this is an awesome field if it's the right field for you...but it may be a little early for you.

 

[cchoukal]

agree STRONGLY with Bougie's post. Really think about why you want to switch before you make any sudden moves. With a 240 on step I, your other stats are probably also good, and you stand a good chance of talking your way into a good program, depending, I suppose, on any geographical restrictions.

Someone correct me, but I don't think you can use the match to match into an advanced spot (PGY2) for that SAME YEAR. In other words, the NRMP would match you into a pgy2 spot for 2010 if you entered the spring 2009 match. If you want a PGY2 spot to start in 2009, you'd have to arrange something outside the match (this, however, is not difficult, as many programs find spots for people like you).

Anyway, talk to the anesthesiology residents that you meet (with due discretion, of course; you don't want your colleagues/attendings to know you're thinking about jumping ship). Ask them what they like/dislike, and what the good/bad is. If you're sure, then talk to your university's anesthesiology program PD. I'd think that would be a good first step into landing a pgy2 spot at your or another institution. The inside track is way better, I think, than going out on your own to talk to other programs.

Then, once you've got something locked down, you should come clean with YOUR program so they have a fair chance at finding someone to replace you in July.

 

[radslooking]

agree with above. Also, if possible, get a signed contract before you tell your PD.

 

[fakin' the funk]

It took 3 weeks of OB internship to convince you to swap out? Didn't you do more than that during med school?

I would think PDs would be concerned of the dependability/reliability of someone who wants out of a position after just a few weeks-to-months. Addressing that concern when the time comes would be my #1 priority.

 

[Anesthesia4me]

It took 3 weeks of OB internship to convince you to swap out? Didn't you do more than that during med school?

I would think PDs would be concerned of the dependability/reliability of someone who wants out of a position after just a few weeks-to-months. Addressing that concern when the time comes would be my #1 priority.

No, I agree with you with your thought process, but the question is, how long should I wait? I was thinking Sept/Octoberish so I could do gyn and my anesthesia rotation to give myself more time to think and compare anesthesia again.

However, I don't want to almost finish an OB residency before I switch if I continue to feel like I want to switch you know? I applied to both anesthesia and OB and then decided to only interview in OB and "follow my heart", but I don't think I realized all of the intricate aspects of OBGYN when I decided to rank only OB. Also, I am interested in REI, so we are looking at 7 more years with 4 of those seven being in something that I am currently not happy in. I am not saying that it won't get better, but I just don't see the point in waiting until year 2 or 3 to switch is all, I guess I'm not really sure when the "right" time to pursue a switch would be 🙁

 

[2ndyear]

REI is a great field. Seriously. I love anesthesia and all, but that is a nice gig. Emotionally it could be a little tough I'd imagine, but otherwise pretty cool. Just think beyond residency. If those extra 3 years are worth it in the long run, then go for it. I'd rather be an anesthesia resident than an OB resident any day though.

 

[bubalus]

Switching isn't generally a problem.

You can apply through the match that will open September. That would be for a PGY-2/CA-1 spot starting 2010.

You should also apply to programs by sending the anesthesia PD a cover letter and CV. Because you're not a graduating medical student, you can go outside the match. Many programs will take people outside the match.

You need to make sure this is what you want to do rather than doing it because life sucks as an intern and you're hoping something else would be better. I would have some concerns about someone who applied but decided not to interview in anesthesia then wanted to switch after 2-3 weeks in OB.

You're going to be practicing your specialty for many more years than you're in training. If you like REI that much, then do it.

 

[jetproppilot]

The most important question:

Why?

Why do you want to switch? .

DUDE (ETTE?) WANTS TO SWITCH BECAUSE ITS BETTER TO BE A TACO BELL MANAGER THAN AN OBSTETRICIAN.😆

 

[fakin' the funk]

DUDE (ETTE?) WANTS TO SWITCH BECAUSE ITS BETTER TO BE A TACO BELL MANAGER THAN AN OBSTETRICIAN.😆

Don't obstetricians already manage disgusting meat?

 

[Kubed]

Don't obstetricians already manage disgusting meat?

I thought urology was all about meat management.

 

[Bougie]

Don't obstetricians already manage disgusting meat?

 

[Noyac]

Just some honest thoughts that came to my mind when I read this post. First, I can't remember a OB resident when I was in residency, w/c wasn't that long ago, that would have made a good anesthesiologist. I hope OB residents quality has improved.
Secondly, Do you have a spot guaranteed? If not you had better be sure you will get one b/4 you tell anyone of your intentions. Thirdly, you said you followed your heart, so what has changed? What is to say you won't change your mind again? Why would any program give you a chance to switch again (not being an arse but these are questions you will need to be able to answer when sitting in front of a PD). Lastly, what is REI? I know they are an outdoor store that is trying to limit access to trails across the country (assh*les) but how does this apply here?

 

[jetproppilot]

Don't obstetricians already manage disgusting meat?

ABSOLUTELY.

SOMETIMES COMPLETE WITH GREEN SMOKE COMMIN' OUT.

 

[Trisomy13]

Just some honest thoughts that came to my mind when I read this post. First, I can't remember a OB resident when I was in residency, w/c wasn't that long ago, that would have made a good anesthesiologist. I hope OB residents quality has improved.

Just a counterpoint... I feel the same way about most OB residents I have encountered recently, but our director of OB Anesthesia completed two years of an OB residency (he refers to it as "the dark time") before switching, doing a full anesthesiology residency and fellowship.

However, I think the resounding take home message in this thread is to switch for the right reasons. I also have a close friend who has switched residencies twice, and is now unemployed and trying to switch again. I think some serious soul-searching may have helped this person avoid years of lost work.

 

[jetproppilot]

Just a counterpoint... I feel the same way about most OB residents I have encountered recently, but our director of OB Anesthesia completed two years of an OB residency (he refers to it as "the dark time") before switching, doing a full anesthesiology residency and fellowship.

However, I think the resounding take home message in this thread is to switch for the right reasons. I also have a close friend who has switched residencies twice, and is now unemployed and trying to switch again. I think some serious soul-searching may have helped this person avoid years of lost work.

Yeah, you're right.

Gotta buddy from residency....he was general surg for 2 years then dropped out because he didnt like it...

...was back when I was moonlighting like a fool.....so he took a year off and worked for the ER company I worked for (C&M).....he fulfilled some of his dreams that year....bought a new Jeep Cherokee.....ran a marathon....

....then he got into an ENT residency, started it, then quit 😱

...he joined the Navy...

...circa 2001 I had lost touch with my friend....I was flying from central Louisiana to Sarasota Fla and had to land in Pensacola because a huge band of thunderstorms was blocking my trip.

Secured my bird, walked into the FBO flight briefing area, and there sat my friend looking at the weather on the computer!

He was doing some flight training in the Navy training turboprop (T-38?)..

So we hooked up again....I stayed the night at his condo on the beach....we went out to dinner, caught up....

He's still in the Navy....40 years old....still trying to figure out what he wants to do...

But he routinely rides in an F-18E SUPER HORNET so that in itself totally one-ups my career.

 

[jeesapeesa]

Yeah, you're right.

Gotta buddy from residency....he was general surg for 2 years then dropped out because he didnt like it...

...was back when I was moonlighting like a fool.....so he took a year off and worked for the ER company I worked for (C&M).....he fulfilled some of his dreams that year....bought a new Jeep Cherokee.....ran a marathon....

....then he got into an ENT residency, started it, then quit 😱

...he joined the Navy...

...circa 2001 I had lost touch with my friend....I was flying from central Louisiana to Sarasota Fla and had to land in Pensacola because a huge band of thunderstorms was blocking my trip.

Secured my bird, walked into the FBO flight briefing area, and there sat my friend looking at the weather on the computer!

He was doing some flight training in the Navy training turboprop (T-38?)..

So we hooked up again....I stayed the night at his condo on the beach....we went out to dinner, caught up....

He's still in the Navy....40 years old....still trying to figure out what he wants to do...

But he routinely rides in an F-18E SUPER HORNET so that in itself totally one-ups my career.

so your buddy is an MD? but never really completed a residency? are there plenty of those out there?

 

[jetproppilot]

so your buddy is an MD? but never really completed a residency? are there plenty of those out there?

Yep.

He's an MD that hasnt completed a residency.

Don't know how many are out there.

 

[ucsfgaspain]

I may be more forgiving than others on this forum. I'd say follow your gut. If you don't feel the love for OB get the hell out. There's nothing wrong with making a mistake and moving on. However, don't jump to gas b/c of preconceived notions that it is easy cuz it is a lot of times easy but other times it is hard as hell. Believe me, that standing on the other side of the curtain during some of your stat c-sections called by some of your attendings is a real cluster F*CK. When I'm staring at a 500 lb beached whale that is preeclamptic and whose so fat that her boobs have flipped to above her head and I've got to intubate this Jabba the HUT, my job becomes really hard.

I do think that you've really got to think hard about what you want to do in medicine. If you want lifestyle, screw gas go into derm...if you want bucks go rad onc or rads...PM me if you want to talk. I'll give you the down low about gas, at least what I think is a truly unbiased opinion (I know this is such a contradiction in terms) and also if you are interested in pain. Peace and I hope that you do find the specialty that you want to do for the rest of your career.

Hello,

I am currently in my PGY-1 for OB and am looking to switch into CA-1 spot for anesthesia in 2009/2010. I have a few questions:

1) I am hoping to slip in for 2009 so that I don't have to take a year off or worse do another intern year. I looked at the requirements for transitional year and all I would be missing would be the one month of ER and ICU. Do you think I should just go through the match for 2010 or try for 2009 and just explain my situation?

2) How difficult is it to switch from one specialty to another? I originally was torn b/t OB and anesthesia and realize that I made the wrong decision 🙁 I was a competitve applicant from med school (240s on step exams) but now I'm afraid that I will look like crud b/c I am changing specialties. . . any advice?


3) Also any advice on how to break the news to my PD?

Since I've only been doing OB for a month, I am going to give it until mid Sept before breaking it to my PD just so I can be sure that I am making the right choice (and to give me a chance to do some more gyn before calling it quits). Is waiting until Sept going to put me a greater disadvantage? I still have all my ERAS LORs for anesthesia, so all I need to do is write a new personal statement. . .

Any advice you can give would be awesome. Don't sugar coat, just tell it like it is 🙂 Thx.

 

[Anesthesia4me]

Thanks for the advice. Too clarify, when I say "follow my heart" please understand that I was coming from a romanticized idea of what OB would be like. C sections, vag deliveries, and cool gyn cases. What I didn't realize is that there is tons of follow up and despite what some folks say, it doesn't appear to be lots of family time (or as much compared to other specialties). I know that there is rounding and floor work in anesthesia and that the hours are intense (running from case to case, no breaks, pissy surgeons thinking folks should jump at their every command, crash cases and train recs), but I think I would like more away from the hospital time even if my day is intense (and believe you me, OB days are not chilling and having coffee, most days I don't even eat and I don't sit for more than maybe 30-45 minutes during my day).
I don't think that anesthesia will be a cake walk by any means, but I think it will help me to maximize my family time which has become more important to me thank long thankless hours and follow up pages all night when I'm at home. (and being a newlywed probably plays into this)

For those of you that mentioned that OB converts sucked at anesthesia, what about them sucked? Any character or worth ethic flaws that you found? Is there anything that I could do to prepare myself should I make the switch?

Thx

 

[smq123]

Lastly, what is REI? I know they are an outdoor store that is trying to limit access to trails across the country (assh*les) but how does this apply here?

REI = Reproductive Endocrinology and Infertility. One of the relatively good lifestyle specialties available in OB/gyn (usually ranks up there with urogyn).

 

[Bougie]

...understand that I was coming from a romanticized idea of what OB would be like.

See, this is exactly what I'm talking about. Interns in every single field (I was exactly the same way) undergo an awakening to what actual delivery of medical care entitles. It's not Grays Anatomy. Most of medicine is mundane paperwork and most patient's don't really appreciate what you do Hot 18-year old chicks won't throw their panties at you every time you nail a procedure like they do when Slash nails a solo on stage. Get used to it, it's the same in every field. You are not going to get a standing ovation after every bloody C/S, exsanguinating AAA repair, gunshot wound to the chest, or ruptured cerebral aneurysm at 3AM that you do. You have to learn that when you do an outstanding job, the only person that will often know it is you. If this is how you feel, than you have a romanticized idea of what anesthesia and every other specialty is also. You will be just as disappointed if you switch. Once again, complete your internship, spend some serious time with anesthesia, then re-evaluate. Maybe medicine is not for you. Do yourself and everyone else a favor and get another occupation.

Excuse the rant, but I'm so sick of people switching into our field because they couldn't cut it in another field or have no idea what they want to do with their lives. Why does anesthesia need to be the default catch-all for drop out flunkies when we're one of the most competitive specialties now? Shunt them instead into FP, PM&R, or McDonalds. I don't understand why knucklehead program directors take these people with a known history of indecisiveness, poor planning, and poor coping skills. It's like hiring a pothead to guard your weed stash. How about taking one of the many applicants out there who may have slightly lower numbers but truely love anesthesiology and will actually better this specialty instead of just being a warm body contributing nothing but bad press and sloth to the field. Of course there are exceptions to the above, but I haven't seen one yet. Awaiting crucifixation for my beliefs......

 

[radslooking]

DUDE (ETTE?) WANTS TO SWITCH BECAUSE ITS BETTER TO BE A TACO BELL MANAGER THAN AN OBSTETRICIAN.😆

yeah, well she wants to do gyne for a couple of months before she decides. If looking at vaginas for a coupla months doesn't change your mind, I don't know what will. 😉

 

[Gern Blansten]

DUDE (ETTE?) WANTS TO SWITCH BECAUSE ITS BETTER TO BE A TACO BELL MANAGER THAN AN OBSTETRICIAN.😆

Taco Bell manager vs taco manager

 

[KNC]

Hey!!!

None of you men can live without the vagina.....so stop pretending like you cant stand it........😀

 

[Fastrach]

Re: Bougie's last comments, I certainly agree to the extent that it's a major pain in the rear to have applicants join your program only to flake out right out of the gate. I'm now a CA3, and we just had one of our CA1's leave after one week (who, by the way, had switched out of a different field into gas...) We're also down a couple CA2's, having left earlier for similar "personal" reasons, and lemme tell ya, July is just freakin awesome, having to cover the extra call, getting no breaks/lunches, getting multiple add-on cases, leaving the hospital routinely after 6:30 these past 3 weeks... Just sayin, do Anesthesia because you know you love it, elsewise, if you flake out, you'll be putting a lot of other people in a really tight spot, stretching other residents very thin because of your lack of foresight/insight/etc...

 

[OB1🤙]

Taco Bell manager vs taco manager

I LOL'ed.

As a former Taco Bell manager while in college, I would much rather go back to that job than do OB.

*Remembers doing pelvics on mentally disabled nursing home patients with nonexistent personal hygiene in Bumf^ck, Louisiana (aka Pineville) as an MS3, and shudders. Then reaches for the zofran.*

 

[jetproppilot]

I LOL'ed.

As a former Taco Bell manager while in college, I would much rather go back to that job than do OB.

*Remembers doing pelvics on mentally disabled nursing home patients with nonexistent personal hygiene in Bumf^ck, Louisiana (aka Pineville) as an MS3, and shudders. Then reaches for the zofran.*

I KNEW IT!!!! I KNEW BEING A TACO BELL MANAGER WAS BETTER THAN OB!!!
btw Hawaiian that hospital you speak of in Pineville (Huey P) is where I moonlighted my cajones off as a resident....and very close to my original PP gig which was in the town across the Red River bridge....

 

[OB1🤙]

Dude, I almost offed myself after a month up there. Mostly due to the fact that Pineville was dry, and if we wanted any sort of social lubrication we'd have to head across the river to Alexandria, where (as you know) the hottest place in town was Chili's for 2-for-1 happy hour. And since I was exiled up there with a sorry-ass bunch of introverts, it ended up being me and the ex-military SRNAs that we dormed with hitting the "town," with occasionally hilarious and often depressing results.

I could tell a choice secondhand story about another MS3 and a stripper named Strawberry from the trailer strip club up there, but.... I better not.

You paid some serious life dues if you lived up there full time, f ukk you account notwithstanding.

 

[jetproppilot]

Dude, I almost offed myself after a month up there. Mostly due to the fact that Pineville was dry, and if we wanted any sort of social lubrication we'd have to head across the river to Alexandria, where (as you know) the hottest place in town was Chili's for 2-for-1 happy hour. And since I was exiled up there with a sorry-ass bunch of introverts, it ended up being me and the ex-military SRNAs that we dormed with hitting the "town," with occasionally hilarious and often depressing results.

I could tell a choice secondhand story about another MS3 and a stripper named Strawberry from the trailer strip club up there, but.... I better not.

You paid some serious life dues if you lived up there full time, f ukk you account notwithstanding.

I guess its a question of perspective, Dude.

I moved there when I was 32 years old.

Was there for eight years.

In a practice where I was a partner, calling our own shots with my partner colleagues.

Paying off debt, driving a new vehicle, living in a nice house...

I guess if you're looking for night life then seeking out monetary opportunity in clandestine places isnt for you.

But heres a question for ya:

Whaddya do most days after work?

You go to the gym. Even BUMFUK EGYPT locations have gyms. Then

You recluse to DA CRIB.

Regardless of where da crib is.

GOTTA VACATION WEEK?

Geez....I had an airplane when I lived up there.......I flew to Destin, Pensacola, Sarasota, Biloxi, Atlanta, Panama City, Houston, Dallas, New Orleans (had the ILS to 10 memorized), Galveston, Shreveport, Monroe, etc etc....

Yes, I lived in BUMFu kk egypt for eight years.

Gotta tell ya it wasnt bad.

TRIN lived there too.

Its all in your perspective, Dude.

I lived life to it's fullest there.

And like you said, it afforded me the fuk you account.

 

[OB1🤙]

I hear you, man, and definitely respect it.

For me personally, I gotta have either mountains or oceans around me (New Orleans was an exception, since it had good food and a poker room). I'm getting too damn old to need a nightlife- mellow beers around the BBQ with good friends is as wild as I get nowadays.

But being landlocked on flat ground makes me crazier than a $hithouse rat in a flood.

That's just me.

If the place gave you what you needed to live a happy, comfortable life, with nice ground and air-based transportation, then there's no arguing with that.

(Note to self: invest in flying lessons.)

(Also, sorry for the thread hijack. Now back to your regularly scheduled vagina jokes.)

 

[excalibur]

Oh man, gotta thank you guys for giving me a hearty laugh this Sunday morn. This thread and the every day carry thread have me keeling over.

Now then, Bruin, you're gonna have to give up the goods on this one. You can't tease me with "fellow Tulane classmate and Strawberry the Pineville trailer stripper" and not come through.

PM me.

 

[ulysees]

Hey Fastrach,
Do you guys have an open CA-1 spot at your program?!? I've just finished up my second year of internal medicine and definitely dont want to have anything more to do with IM. I hate it. I'm miserable. During my two years though I've done a bunch of ICU and anesthesia electives and found excitement and a niche for myself in the combination. I've written a statement as to why I'm switching, have strong LOR's from anesthesia intensivists (my career goal) and I've sent a cover letter along with my CV to every program in the country. I'm willing to do anesthesia/ ICU research for a year or two to prove my worth and enthusiasm for the profession. I love anesthesia and intensive care, as cheezy as it sounds, and I'll do whatever it takes to get a spot.