pedi->anesthesia?

[mailee88]

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I am currently matching for pedi this year and thinking about switching to anesthesia next year. what advice do you have regarding making my rank list? should i definitely focus on academic programs where there is an anesthesia residency available? does that give me a better chance to get a CA1 spot next year? or does it matter that I am at a free-standing pedi hospital? (i.e. children's oakland, chla, etc) would that decrease my chances at all? any advice on switching in general would be helpful too! thank you!!

 

[Lara]

Hi Mailee,

Sorry I can't answer your question - but I'm also seriously considering both peds and gas (see my post in the General Residency Forums). I think you said you were doing a peds anesthesia elective this month - how has your experience been, and what made you decide?

btw, thanks for all your program reviews on the peds forum - Miami was especially helpful. 🙂

 

[mailee88]

Lara,
Yes, I did read your post...it sounded disturbingly similar to my situation It also sounds like a lot that you like/dislike the same things that I do about each field. I am currently at Baylor doing a pediatric anesthesiology elective. I have been going back and forth each day and as the rank list deadline is inching closer and closer...the palpitations are increasing...here's my thoughts about this dilemma so far...I have talked with SO many people (mostly attendings and residents here) about this...and many of whom KNOWS of someone who switched from pedi to gas...i even met a guy at the post office who is a CA 1 and did pedi last year!!

Pedi - great patient contact (probably the number one thing I will miss)...I love working with families and developing a relationship with them over time. On the downside, I don't know if that is something I will eventually get sick of...especially with all the "difficult" patients/families. I also hate rounding and seeing kids over and over in the hospital...which is why i went into pedi and not IM...high turnover rate...they are sick, then they get better. I also just love being around kids..they have such a great spirit about life...and to walk into the hospital each day and see your *hopefully* smiling kiddos is such a great feeling...to know that you have made a difference. if i did go into peds, i think i would do some type of fellowship that is procedure-heavy...probably cardiology or critical care....in that case, lifestyle would be a problem...and i love so many diff aspects of medicine that i dont know if i want to be THAT specialized...but i love the critical care aspect of it...doing something more than just immunizations/milestones/runny noses...

Anesthesia - for one thing...if i did this field, I would *definitely* do a pedi fellowship afterwards, i don't think i can do anything but work with kids...that is something i am absolutely sure about. i have come to appreciate this field a lot more in the past week or so...and it has definitely started to appeal to me for several reasons. first, i love the fact that you work from start to finish...you don't bring your work home with you. second, it has tons of procedures and you get to be in the OR working with the surgeons...which i also love since i almost went into OB (thank god i got outta that one!). third, you do develop a relationship with the family/patient...ti's a very fast/intense relationship...you have to make the parents feel comfortable letting go of their child and putting him into your arms...putting 100% trust into your skills. it's a great feeling to take that child from the parents and being able to confidently give them that comfort level...it's a short but great relationship. i also love that this field is very creative and it's kinda like "magic"...there is no black and white about it...every patient is diff. and each case is unique...are so many protocols to medicine...it's nice to put some creativitiy into it and work outside the box...there and most of all...it's the lifestyle and $$...i love medicine, but i want a live outside of medicine...i talked with an attending during a case who told me this..."you may not believe me now, but in 10 years, it won't matter that you are doing a murmur workup on your kiddo, following them each year for a VSD, or intubating for yet another tonsillectomy and starting your 5,000th IV...the only thing that will matter to you while you are at work is your kids and your family waiting at home". work is work...that is all. i want the time to spend with my family and have the life i want outside of these hospital doors...

the main neg. things about gas that bother me is...1)no continuity 2) you don't really diagnose anything...you are basically managing and assisting surgery 3) there is no autonomy...you are always the consulting service...in other words, a patient can't come in and JUST see you...unless u go into pain

i hope this helps you a little...i still have a couple of weeks to decide...and i probably won't completely decide until 1/2 way through next year...🙁
good luck!!! email me anytime if you have any add't questions! we should keep in touch as my month here continues!! 🙂

 

[UTSouthwestern]

You would probably enhance your chances with a more academic setting. Coming from community peds as opposed to Stanford, Baylor, etc. may not hurt you but definitely won't help you as you may see nothing but relatively healthy pedi patients.

Also, the recommendations of an academic faculty member would probably carry a little more weight with the anesthesia admissions committees.

Good luck.

 

[cchoukal]

As I've interviewed around, I can only think of 1 program that said they accepted a peds internship as a PGY1 year. I don't recall that anyone asked specifically, and I certainly don't know whether all programs accept it, but since only one came out and said it, I got the impression not everyone may accept your intern year in peds. If you were planning on trying to match in peds at the same place you'd eventually like to do anesthesia, it would help to know if they'd accept your PGY1 year. Maybe that's an obvious point... More to the point, though, I don't think anyone would tell you that a "community" program will improve your chances over an "academic" program at doing anything else afterwards, so academic might be the way to go.

 

[Fiend]

I'm matching in anesthesia right now and have had no problems with having a PGY-1 year that is in peds. If I am not mistaken, as it stands now, PGY-1 years in IM, Peds, Transitional, surgery, and OB/GYN will count. I think even an FP year would count as well.

 

[sublimazerules]

You are absolutely riight, Fiend. However, that will only work until 2006. If one waits to enter gas until 2007, the new RRC rules will come into effect and anesthesia will be a 4 year curriculum, not a 1+3.

Mailee88, I don't think it matters where you end up, especially if local anesthesia programs do their pedi rotations at that hospital (e.g. UPenn and MCP at CHOP or BWH and BID at Boston Children's or Baylor and UT-H at TCH). You also might want to check out places where there are a lot of spots outside of the match available (e.g. Baylor, JHU, BWH.....i'm not familiar with Cali programs)

 

[Lara]

So since I'm graduating in 2006 and won't enter a CA-1 year until 2007, there's no way for me to count a peds intern year? 🙁 Will all the gas programs for the 2006 match become 4 years?

Or am I in the very last class before the new guidelines come into effect?

 

[Jeff05]

just a couple of notes.
1. there is continuity if you do pain or intensive care (i'm sure there is a niche for peds sicu for an anesthesiologist)
2. you do diagnose lots of stuff, except it's a different process. when the patient is hypoxic you better figure out why in 2 minutes -and it's not only the patient it's also the equipment you must be proficient in. intraop MI, PE, arrhythmias, shock, and the list goes on. there is definitely a diagnostic component to anes. and of course there is pain and IC
3. you can absolutely have office hours - there is always an anesthesiologist seeing patients in pre-admission testing. and of course there is pain. but, i think office hours are exactly what most of us going into anes wish to avoid.
good luck with your decision.

Lara,



the main neg. things about gas that bother me is...1)no continuity 2) you don't really diagnose anything...you are basically managing and assisting surgery 3) there is no autonomy...you are always the consulting service...in other words, a patient can't come in and JUST see you...unless u go into pain

i hope this helps you a little...i still have a couple of weeks to decide...and i probably won't completely decide until 1/2 way through next year...🙁
good luck!!! email me anytime if you have any add't questions! we should keep in touch as my month here continues!! 🙂

 

[sublimazerules]

That I'm not sure about....you may want to contact a PD in anes that you know about that (or maybe Bob Gaiser at Penn - you're in Philly, right?). You may be still be able to do it. I think I might have misspoken and maybe it's 4 years for people starting in 2007 (or in other words CA-1s staring in 2008)

So since I'm graduating in 2006 and won't enter a CA-1 year until 2007, there's no way for me to count a peds intern year? 🙁 Will all the gas programs for the 2006 match become 4 years?

Or am I in the very last class before the new guidelines come into effect?

 

[mailee88]

Is there a way to figure out which programs holds CA-1 spots? When should I start contacting them and how should I do it? is it still through the match? what about recommendation letters, should I do an elective next year during my pedi intern yr?

 

[sublimazerules]

Best thing to do, I would say, is contact PDs soon after the match (they're too busy now) to ask them these very questions. I don't know is there's a way to find a list of programs that hold CA-1 spots.....but I do know that a good number of top tier programs do (cause they can). Like I said, the best way I would think is to just call or e-mail PDs at places you think you'd be interested in.

Is there a way to figure out which programs holds CA-1 spots? When should I start contacting them and how should I do it? is it still through the match? what about recommendation letters, should I do an elective next year during my pedi intern yr?