Only 6% of anesthesia residents actually regret their specialty choice

[26B]

Saw a recent thread where it was noted that "Anesthesia Residents Has 2nd Highest Percentage of Career-Choice Regret".

However, after actually looking at the paper briefly, that conclusion is very misleading, if not downright wrong. After going through 3 pages of the other thread, it seemed like only one person had caught on to this, so I figured I'd make a new thread here.

The paper in question: Association of Clinical Specialty With Symptoms of Burnout and Regret Among US Resident Physicians

Here's what the authors of the paper asked:

Resident physicians were asked, “If you could revisit your career choice,would you choose to become a physician again?” and “If you could revisit your specialty choice, would you choose the same specialty again?”

Response options were “definitely not,” “probably not,” “maybe,” “probably,” and “definitely yes.” Responses of “probably not” or “definitely not” indicated career and specialty choice regret.

Looking at the results, 20.6% of anesthesiology PGY-2s had career choice regret, which is in fact #2 behind Pathology (see table below). However, the question asked here was "would you choose to become a physician again?", not whether they would choose the same specialty again.

Looking at the results for specialty choice regret, anesthesiology actually ranks very low at just 6%.

In fact the authors concluded that:

Training in anesthesiology, emergency medicine, family medicine, pediatrics, psychiatry, ophthalmology, and orthopedic surgery (range of RRs, 0.20 to 0.58) was associated with a lower RR of specialty choice regret during the second year of residency relative to training in internal medicine.

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[Mad Jack]

Yeah, similar results for psych- "I shouldn't have become a doctor, but since I'm here already this isn't the worst thing to do"

 

[deleted875186]

I don’t know. As an anesthesia resident I know I regret my specialty choice. It seems like a fair number of people here also do.

 

[dannyboy1]

I don’t know. As an anesthesia resident I know I regret my specialty choice. It seems like a fair number of people here also do.

I’m not sure why people hate anesthesia so much. I work in the northeast for an AMC mostly working with CRNA’s. By SDN definitions my life should be one of unending misery. Yet i usually work less than 50 hrs/week, have most of my weekends off, and make close to 400k. All with just 4 years of residency and no fellowship. If there is an easier way to make decent money in medicine without too much of a time investment I haven’t found it....

 

[Psai]

I’m not sure why people hate anesthesia so much. I work in the northeast for an AMC mostly working with CRNA’s. By SDN definitions my life should be one of unending misery. Yet i usually work less than 50 hrs/week, have most of my weekends off, and make close to 400k. All with just 4 years of residency and no fellowship. If there is an easier way to make decent money in medicine without too much of a time investment I haven’t found it....

Asl

 

[Mr.S]

I’m not sure why people hate anesthesia so much. I work in the northeast for an AMC mostly working with CRNA’s. By SDN definitions my life should be one of unending misery. Yet i usually work less than 50 hrs/week, have most of my weekends off, and make close to 400k. All with just 4 years of residency and no fellowship. If there is an easier way to make decent money in medicine without too much of a time investment I haven’t found it....

You probably havent done enough cases..
Or you just happen to be in a non-malgnant atmosphere (rare). It is very possible though.

 

[dannyboy1]

You probably havent done enough cases..
Or you just happen to be in a non-malgnant atmosphere (rare). It is very possible though.

Nope. Just that the reality of this specialty fits my personality like a glove. I’m very type b, “go along, get along” type of guy. I think that it is the greatest thing in medicine that I can take a patient to PACU, give report, and then they will be out of my life forever. I realize that my employer views me as nothing more than a pair of scrubs that they would love to replace with a CRNA ( or make my salary equivalent ). I can’t predict what the future holds for MD’s in anesthesia but for now I enjoy what I do.

 

[pgg]

It's OK to be happy.

Just thought that needed to be said.

 

[deleted171991]

Nope. Just that the reality of this specialty fits my personality like a glove. I’m very type b, “go along, get along” type of guy. I think that it is the greatest thing in medicine that I can take a patient to PACU, give report, and then they will be out of my life forever. I realize that my employer views me as nothing more than a pair of scrubs that they would love to replace with a CRNA ( or make my salary equivalent ). I can’t predict what the future holds for MD’s in anesthesia but for now I enjoy what I do.

I need to save this post for future residents. This is the secret of happiness in anesthesia (and possibly in corporate medicine in general): not giving a ****.

 

[Orin]

There's an error in their calculations. Based on their data, the least regretful specialty to go into is neurosurgery, which is -10.6 with 0% regret, because as we all know, neurosurgeons are never wrong.

 

[Stank811]

Just remember if you are miserable for years on end...it is your choice.

I couldn’t be happier with my career choice. Anesthesiology is an amazing profession.

Many of these anonymous posters who hate the profession and predict its demise likely are benefiting from having you think that way. Don’t fall for the BS...there are many great places to practice anesthesia and many different scenarios but it is up to you to make your choice to find the group that best fits your ideal practice.

 

[BCM]

I don’t know. As an anesthesia resident I know I regret my specialty choice. It seems like a fair number of people here also do.

I know there are old threads that address this. Life as a resident is MUCH different than as a practicing attending. I can’t tell you how many times I’ve had another physician or surgeon tell me they wish they were an Anesthesiologist. Find some mentors outside of the residency if you need confirmation.


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[rakotomazoto]

Life as a resident is MUCH different than as a practicing attending.

Exactly. Residency wasn't great, but I got through it. Now life is significantly more awesome.

 

[rakotomazoto]

It's easy to get tunnel vision. I see my friends in other industries and although some of them have less stringent schedules, they deal with their own headaches and mostly get paid much less than I do. The fact that a percentage of physicians regret their career choice is the mentality that the grass is always greener somewhere else.

 

[deleted50478]

There's an error in their calculations. Based on their data, the least regretful specialty to go into is neurosurgery, which is -10.6 with 0% regret, because as we all know, neurosurgeons are never wrong.

Sometimes neurosurgeons disagree with each other

 

[WholeLottaGame7]

No regerts

 

[Mr.S]

they would love to replace with a CRNA ( or make my salary equivalent ).

and they likely will.. I say give it 10 years. Guaranteed. Nurses and doctors get paid the exact same especially CRNAs.
At the Dept of Veterans Affairs, nurses are independent already. Moreover, they get the same exact vacation benefits as physicians do. 26 days PTO.

The only problematic part for the bureacrats is the "liability part". They cant figure out how to make CRNAs take the liability. Once they figure it out, We ARE OUT!!!! with all our student loan bills to pay. They may make the "surgeon" captain of the ship. So they would HAVE to be the supervising physician.
That may work.
Make them take some anesthesia rotations.. voila.. supervisor

 

[2Fast2Des]

I know there are old threads that address this. Life as a resident is MUCH different than as a practicing attending. I can’t tell you how many times I’ve had another physician or surgeon tell me they wish they were an Anesthesiologist. Find some mentors outside of the residency if you need confirmation.


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I feel like most surgeons even in pp couldn't give a rats a** who is at the head of the bed. Some are nice but most thank everyone except the anesthesiologist at the end of the cases. As long as the case gets done nobody cares. That being said as an introvert I got used to that and certainly appreciate the opportunity to move on the next thing quickly as this field offers. I would certainly regret medicine if I had specialized in anything else

 

[Mr.S]

. I can’t tell you how many times I’ve had another physician or surgeon tell me they wish they were an Anesthesiologist.


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That is not a compliment by the way. That is a back-handed compliment. They are saying "you dont do Squat all day. Thats what I wanna do."

 

[2Fast2Des]

and they likely will.. I say give it 10 years. Guaranteed. Nurses and doctors get paid the exact same especially CRNAs.
At the Dept of Veterans Affairs, nurses are independent already. Moreover, they get the same exact vacation benefits as physicians do. 26 days PTO.

The only problematic part for the bureacrats is the "liability part". They cant figure out how to make CRNAs take the liability. Once they figure it out, We ARE OUT!!!! with all our student loan bills to pay. They may make the "surgeon" captain of the ship. So they would HAVE to be the supervising physician.
That may work.
Make them take some anesthesia rotations.. voila.. supervisor

I thought maybe that surgical residents should rotate in anesthesia for some time to understand what we actually do so they can get some perspective instead of calling the anesthesia by the airway
"can you do mac but make sure pt won't move and isn't responsive?"
... Um not MAC?
"why you put LMA? I want Mac, pt wake up better mac"

but now maybe just leave them as it is since they may use it as the learning time to supervise haha

 

[Stank811]

and they likely will.. I say give it 10 years. Guaranteed. Nurses and doctors get paid the exact same especially CRNAs.
At the Dept of Veterans Affairs, nurses are independent already. Moreover, they get the same exact vacation benefits as physicians do. 26 days PTO.

The only problematic part for the bureacrats is the "liability part". They cant figure out how to make CRNAs take the liability. Once they figure it out, We ARE OUT!!!! with all our student loan bills to pay. They may make the "surgeon" captain of the ship. So they would HAVE to be the supervising physician.
That may work.
Make them take some anesthesia rotations.. voila.. supervisor

Either he doesnt understand the practice/business of anesthesia or he does and his hoping his rhetoric benifits his business model.

Quick question...if CRNAs and anesthesiologist get paid the exact same why would you hire a CRNA?

 

[Mr.S]

Either he doesnt understand the practice/business of anesthesia or he does and his hoping his rhetoric benifits his business model.

Quick question...if CRNAs and anesthesiologist get paid the exact same why would you hire a CRNA?

From the corporate C-suite, why are paying a premium for doctors?
You hire CRNAs because you cant find enough docs to staff all the rooms. So CRNAs would fit the bill.

 

[dannyboy1]

and they likely will.. I say give it 10 years. Guaranteed. Nurses and doctors get paid the exact same especially CRNAs.
At the Dept of Veterans Affairs, nurses are independent already. Moreover, they get the same exact vacation benefits as physicians do. 26 days PTO.

The only problematic part for the bureacrats is the "liability part". They cant figure out how to make CRNAs take the liability. Once they figure it out, We ARE OUT!!!! with all our student loan bills to pay. They may make the "surgeon" captain of the ship. So they would HAVE to be the supervising physician.
That may work.
Make them take some anesthesia rotations.. voila.. supervisor

I used to worry about this when I worked with experienced CRNA’s. Then my hospital got a whole bunch of brand new ones. The difference was pronounced. In no way are brand new CRNA’s ready for any sort of independent practice. Healthy patients coming for routine procedures WILL die. And the surgeons and hospitals know it. Problem is how do you differentiate (legally) a brand new CRNA from an experienced one? They are both liscenced and there is no residency or board certification process. In the eyes of the law CRNA’s are all equivalent. It is hard to run a practice and create bylaws where certain CRNA’s will require supervision, and others won’t. And who will decide when a CRNA is able to practice independently. Therefore they all need to be treated as the lowest common denominator because quite a few of them need direction even for “routine” cases.

 

[AdmiralChz]

Arghhh I hate being happy in my ACT practice! I need to read more SDN and get more jaded.

Seriously, tho.

 

[Stank811]

From the corporate C-suite, why are paying a premium for doctors?
You hire CRNAs because you cant find enough docs to staff all the rooms. So CRNAs would fit the bill.

I wouldn’t pay a premium for anesthesiologist either. But if I was in the c suite I wouldn’t employ CRNAs or anesthesiologists. I would contract out the services to a group...but that is my own bias coming through bc I am not employed. You can find PP and employed positions that are great and you kind find ones that are terrible. One Isn’t necessarily better then the other.

 

[Mr.S]

In no way are brand new CRNA’s ready for any sort of independent practice. .

In no way are ANY CRNAs ready for any sort of independent practice.
Our govt and laws are FUBARd.
And you cited exactly what the problems are.

You love your job. Because you dont want to realize what you are up against.
We're playing in a realy nasty arena.

 

[dannyboy1]

That is not a compliment by the way. That is a back-handed compliment. They are saying "you dont do Squat all day. Thats what I wanna do."

And I always tell them that nobody forced you into becoming a surgeon. If you were able to match into surgery you certainly could have matched into anesthesia somewhere....

 

[Stank811]

In no way are ANY CRNAs ready for any sort of independent practice.
Our govt and laws are FUBARd.
And you cited exactly what the problems are.

You love your job. Because you dont want to realize what you are up against.
We're playing in a realy nasty arena.

Laws are just laws. Yes I am sure some high powered lobbyist with billions behind them got laws through allowing independent practice...with the intent to see if they could get rid of anesthesiologist...the architect of Obama care came straight out and said we need far fewer anesthesiologist and radiologist should be non existent...but that doesn’t mean the experiment will work

 

[dannyboy1]

You love your job. Because you dont want to realize what you are up against.
We're playing in a realy nasty arena.

I realize what we are up against. We are up against capitalism (I.e our employers will want to get the most out of us while paying us as little as possible. Just like everyone else in the world). Will the supply of Anestheisia providers drive down market rates or will surgical demand outstrip the supply? Will hospitals and surgical centers eventually employ most surgeons and be able to force independent CRNA’s on them? Will insurance reimbursement fall to the point where it is no longer profitable to run an anesthesia practice? Who knows. I know nothing lasts forever. I just need it to last until I retire

 

[pgg]

You love your job. Because you dont want to realize what you are up against.

This is pretty condescending. You're essentially saying that he is naive and foolish because the only possible reason he could be happy is through ignorance of the way things really are.

 

[Mr.S]

This is pretty condescending. You're essentially saying that he is naive and foolish because the only possible reason he could be happy is through ignorance of the way things really are.

exactamundo

 

[BCM]

That is not a compliment by the way. That is a back-handed compliment. They are saying "you dont do Squat all day. Thats what I wanna do."

Bottom line is that I enjoy being an anesthesiologist and I am proud of my career choice. A few of my fellow residents and partners actually practiced other specialties and made a career change to become an anesthesiologist (myself included).

I did not take it as a compliment from other specialists, just an observation. I certainly didn’t see it the way you described.


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[anbuitachi]

I think that is because MANY residents today chose anesthesiology b/c they didn't like any other field. it's a common answer i hear among residents ("I chose anes because i hated everything else")
Therefore there is a lot of career choice regret but less field choice regret

This likely has something to do with less awake patient interactions, more control over patients, and doing cool stuff.

As you can see from this graph, although some of you have decent jobs, SDN is not representative of the overall field by any means.. (we only have >90 percentiles). It's slightly old, but newer versions would likely just have salaries shifted up for inflation for all fields

 

[deleted171991]

Next time any of us, PIGS, complain about our jobs, remember this:

 

[anbuitachi]

Next time any of us, PIGS, complain about our jobs, remember this:

In other words, 3700000 people make as much or more than you do in the US!

 

[nimbus]

In other words, 3700000 people make as much or more than you do in the US!

I can live with that.

 

[mmag]

Most people don't work the hours our jobs ask of us. McDonalds don't have 24 hours shifts and if it did ask its workers to work like a resident for the federal minimum wage and abide by federal overtime law, ($7.25*40 hours + $7.25*1.5*40)*48 weeks = $34,800 which is above the median wage. Most states have minimum wages that are above the federal min wage.

Anesthesiologists work a lot of hours even compared to most physicians.

Next time any of us, PIGS, complain about our jobs, remember this:

 

[AdmiralChz]

This is pretty condescending. You're essentially saying that he is naive and foolish because the only possible reason he could be happy is through ignorance of the way things really are.

He's a little more aggressive about it, but many have said the same to me before for being positive on the job around here. “You just haven’t been working long enough to be beat down” etc... Misery loves company?

Next time any of us, PIGS, complain about our jobs, remember this:

Great graph, I think many would do well to remember this around here. You are included in that, FFP.

 

[deleted171991]

Next time any of us, PIGS, complain about our jobs, remember this:

Great graph, I think many would do well to remember this around here. You are included in that, FFP.

"English Language Learners Definition of us
—used to refer to the speaker and another person or group of people as the indirect object or direct object of a verb"
Definition of US

 

[GravelRider]

The key to being happy is to not define your life by your career. It’s a job, not a calling. It’s a means to an end. It’s a way to pay the bills. Walking into work and not being completely miserable is a win that not many Americans will experience. We have the means and ability to achieve financial independence pretty quickly, despite sacrificing part of our youth for it.

Burnout in medicine is very real and a large part of it is a systems problem, but there are some things within your control. It’s ok to be happy, but it’s also ok to point out the problems and realities of a bad system.

 

[AdmiralChz]

Burnout in medicine is very real and a large part of it is a systems problem, but there are some things within your control. It’s ok to be happy, but it’s also ok to point out the problems and realities of a bad system.

There is a difference between this and mocking people who are happy and have fulfilling careers and lives. The latter happens often around here, and it’s ridiculous.

 

[DM27]

I may be a fairly simple person, but I feel lucky that I am able to do a job I enjoy with hours I consider far from onerous, and make more than twice what my parents combined made working far more hours than I do. It is useful to have some perspective of how much more money we make than the majority of people in the world, and how many "simpler" jobs that pay fractions of what we make work far more hours than us in significantly worse working conditions.

I mean seriously, my main financial stress is if me and my wife are saving enough to retire in our early 50s. That is beyond first world problems.

 

[Mr.S]

Burnout in medicine is very real and a large part of it is a systems problem, but there are some things within your control. It’s ok to be happy, but it’s also ok to point out the problems and realities of a bad system.

Not really! If it were ok to point out problems and realities of a bad system then people would do it. The reality is you are correct, it is very much a systems problem but the system castigates and pushes back harshly against people who point out a "bad" system. So people have too much on the line to jeaopadize. having said that, people still do it. IE wes fisher against MOCA, paul tierstein md of scripps clinic who is president of nbpas, paul kempen who tirelessly works pointing out the duplicity of the boards.
I encourage all of us to NOT drink the Kool-AID and point out the hyporcrisy whenever you see it at any point in your medical education. WHy? Because we are the ones who went into this with the most altruism. We are inherently NOT business men and to be taken for a ride by business men who mask as "patient safety advocates" is truly disturbing.

 

[GravelRider]

There is a difference between this and mocking people who are happy and have fulfilling careers and lives. The latter happens often around here, and it’s ridiculous.

Is it really mocking? I’m not sure that’s the right word.

There’s also a tendency to brush aside the cynics as nothing but malcontents who only know how to complain. Nobody knows what it’s like to be a bat. There are some really terrible jobs out there (we’ve seen them posted) and there are people who do not have the flexibility to change their situation. That doesn’t make their experience any less real. As with anything, the answer lies somewhere in the middle. Some of it is within your control, much of it is not.

 

[deleted171991]

There is a difference between this and mocking people who are happy and have fulfilling careers and lives. The latter happens often around here, and it’s ridiculous.

I think it's usually the other way round. When somebody is unhappy and vents here, a good number of people (who just don't know how lucky they are with their good jobs) will attack the person, labeling him/her in various unflattering ways. (It's so pervasive, and tolerated by the mods, that it has prompted me to take long breaks from this forum twice already, and simply to avoid the subject as much as I can. It's like not talking about politics with friends one wants to keep.) The prevailing thinking on this section is that, if one is not happy in anesthesia, one must be defective.

Venting helps with burnout, both the person who's doing it and those in similar situations who read it. It also helps when it results in constructive suggestions from wiser people. I am glad I haven't heard about anybody here committing suicide, but it's more frequent among physicians than we think, and we should all be more tolerant towards people who are unhappy with their jobs. They usually do have a good reason, not just personality misfit (although that's a HUGE factor that many students ignore when choosing a specialty). Also, I know of at least one case on this section (a respected frequent poster) who had to give up anesthesiology because of addiction problems (I assume related to his job). Good jobs don't cause burnout.

 

[Patelkai]

I don’t know. As an anesthesia resident I know I regret my specialty choice. It seems like a fair number of people here also do.

Why do you regret it? Serious question.

 

[deleted171991]

Job Security in Medicine is a Myth | The White Coat Investor - Investing & Personal Finance for Doctors

 

[pgg]

Job Security in Medicine is a Myth | The White Coat Investor - Investing & Personal Finance for Doctors

I was just going to post the cartoon and leave it, but that might have come off as snarky and sarcastic, and that's not what I mean.

The article reminds me the cartoon and its sad, sad faces. Everyone is sad. Well, except that woman, who just looks pissed off. I assume it's because she's single, because it can't possibly be the change in her tax liability.

Anyway, the author of both the article and the cartoon are technically correct but completely tone deaf and completely miss the point.

The title of the article is "Job Security in Medicine is a Myth" and the terrifying horror scenario presented in its first paragraph is a group's contract loss ... with an offer to stay for 30% less.

Yeah, that sucks. But it's not unemployment. It's not even job loss! That scenario is not even remotely comparable to the kind of job security issues faced by workers in other industries who get laid off when a plant closes, when a company's stock drops 6% in a quarter and the board of directors has to cut some little people to fund a stock buyback, or when a laborer falls off a ladder and can't work for an extended period of time.

All those furloughed federal workers right now thought they had job security, but they wouldn't be driving Ubers right now if their doomsday scenario involved "keep working a 1%'er job for 1/3 less while you look for something better at your convenience" ...

Every anesthesiologist in the United States with an unsuspended license, no felony convictions, and a non-egregiously-bad trail of malpractice claims can find a job in a matter of days - if not hours. It may take a couple months to secure a license in a new state, but even in that worst case surely there's some locums work to be done somewhere in the same state.

What I'm getting at is that apparently the phrase "job security" means to WCI what "soulcrushing taxes" means to that cartoonist. It's ridiculous.

 

[Mr.S]

I was just going to post the cartoon and leave it, but that might have come off as snarky and sarcastic, and that's not what I mean.

The article reminds me the cartoon and its sad, sad faces. Everyone is sad. Well, except that woman, who just looks pissed off. I assume it's because she's single, because it can't possibly be the change in her tax liability.

Anyway, the author of both the article and the cartoon are technically correct but completely tone deaf and completely miss the point.

The title of the article is "Job Security in Medicine is a Myth" and the terrifying horror scenario presented in its first paragraph is a group's contract loss ... with an offer to stay for 30% less.

Yeah, that sucks. But it's not unemployment. It's not even job loss! That scenario is not even remotely comparable to the kind of job security issues faced by workers in other industries who get laid off when a plant closes, when a company's stock drops 6% in a quarter and the board of directors has to cut some little people to fund a stock buyback, or when a laborer falls off a ladder and can't work for an extended period of time.

All those furloughed federal workers right now thought they had job security, but they wouldn't be driving Ubers right now if their doomsday scenario involved "keep working a 1%'er job for 1/3 less while you look for something better at your convenience" ...

Every anesthesiologist in the United States with an unsuspended license, no felony convictions, and a non-egregiously-bad trail of malpractice claims can find a job in a matter of days - if not hours. It may take a couple months to secure a license in a new state, but even in that worst case surely there's some locums work to be done somewhere in the same state.

What I'm getting at is that apparently the phrase "job security" means to WCI what "soulcrushing taxes" means to that cartoonist. It's ridiculous.

Youre missing the point.

When you work 10 plus years to be able to be qualified for a job, you should not be working on someone else's terms.
The article mentions several ways to LOSE YOUR CAREER. This can happen to you even if you dont believe so. All you need is some anonymous complaints backed up by some body and you are "Toast". Those furloughed employees are not facing a career loss. and if they lose their 59K per year job with 5 weeks vacation, It aint hard to find another one.

 

[deleted162650]

LOL. I guess a lot depends on your overall outlook on life. The 4 types of SDN posters as illustrated by Gary Larson: