Please advise : Ranking programs Anesthesia vs Radiology

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silent_match

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7+ Year Member
Hi Everyone,

I am currently M4 student and graduating in 2014. My step scores are step 1 -255 and step 2-258. I have applied for 2014 match. I have done rotations in anesthesia, radiology and IM too.

I have applied to, Anesthesia, Radiology and few selective IM programs. I got equal amount of anesthesia (11) and radiology (12-14) interviews and 10 IM. I have given majority of my interviews in last 2 months and now I am thinking to rank programs.

But honestly, I am really confused which specialty is better than other. I would like your opinions on pros or cons of each. Life style could be better for radiologist but with changing climate of healthcare, Is radiology being hit the hardest (outsource jobs..) . Same thing with anesthesia, are CRNA out there to replace anesthesiologists. During my anesthesia interviews, I did get impression from residents, CRNA are hitting job market for anesthesiologists .

Pros and Cons of anesthesia

Pros: More social and people oriented, Above average pay.
Cons: Limited fellowship opportunities (eg pain,critical care), CRNA issues (Job threat to MDs), work with surgeons (deal with critical patients).

What is the stress of level of anesthesiologists?


Radiology: Lot of new technology to play with,many fellowship opportunities would go for IR.
Cons: Sit in a dark room alone most of the dark, may be more isolation but that could be for reason for concentration. But my main concern is job market.

Then I also have some IM interviews from good programs where I may have variety of fellowship options for future. I can rank those programs as well.

I really need sincere advice for better life style (in terms of daily stress.) and future job market. I know we can’t predict future. But I still like to make wise decision to pick right field.

Thank you so much for any feedback.
 
I think you've listed the pros and cons pretty well. Both fields have benefits and hurdles. Neither is the "lifestyle" field they were a few decades back. I think both fields are going to feel hits with the changes in the healthcare landscape, as will all of medicine eventually. I dont know if radiology will be hit "hardest" under the new health structure, or simply first, but true outsourcing is not a real concern, given the legal and license structure we have in the US, it's a decline in reimbursements for imaging, and capitation approaches that will hurt that field. And anesthesiologists will have a tough time competing with CRNAs under a healthcare plan that seeks to provide services to more people for less $, much as NPs are beginning to erode the internists territory. Sadly, in a healthcare plan which seeks to provide a minimum care level to everyone, those providing services with the minimum of schooling and training become the most cost effective.

So more importantly in your analysis: When you interviewed, who did you click with and feel like you'd fit in best with?
 
Damn, your advisors let you apply to 3 specialties, and you went on a ton of interviews for each one? You should have figured this out before applying. With your board scores, assuming you are an AMG, this is a new level of neurosis.

The fields you listed are widely different in both training and clinical practice. Ill give you my IM bias: IM offers the huge spectrum from purely cognitive (ID) to cutting edge procedures (GI with advanced endo, interventional cards). IM offers the most flexibility in potential career options, from inpatient to outpatient, procedural vs. non-procedural, as well as general medicine training should you wish to go to the private sector and not practice medicine.
 
Most radiology residents detest their prelim medicine year, and honestly there is not much similarity between IM and rads.

Only you can answer this question, and unfortunately, it's a big one.

Doing prelim medicine then going for rads or anesthesia wouldn't be a bad option because you can always switch back to IM if you realized that during your intern year you absolutely love IM. But join from IM to anesthesia or rads would be more difficult.

You have to figure out what you love more and rank those programs accordingly.
 
Just my 2 cents as an IM resident going into cardio.... Just spent some time with our radiologists, most of whom are IR and honestly they had a pretty good lifestyle. This is at a private, community hospital for what that's worth.

I wouldn't be able to tolerate a radiology residency but I really enjoyed the interventional aspect. Our IR guys spend the day going back and forth between reading films and procedures in the angio suite so the days were pretty varied and not just spent "in a dark room".

Also had a fair bit more personal interaction than I though between seeing pre/post-procedure patients, interacting with angio suite staff and having other providers come by reading room to review films.

I'll be doing cardio and enjoy angio/catheter based procedures so I'm a bit biased, but I enjoyed my rads time much more than my time on anesthesia.
 
Also at community hospital. Our IR guys really just put in and remove Mediports and tunnelled HD caths besides reading for DR. Also a pleurax. In my two weeks with them, there was not a single procedure where they had to put a wire into a vessel and go more than 9 inches in. They do get out real early. Non-IR trained guys did one cholecyctostomy and I did joint injections and paras for the latter (under their supervision).
Frankly, I think OP is a premed.
 
from what you said, you enjoy rads much more than gas, go for rads. It is better to do what you like with a slighly less pay than doing what you dont like with slightly more pay.
 
silent_match said:
I have applied to, Anesthesia, Radiology and few selective IM programs.
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As has been said: wow!

Pros and Cons of anesthesia

Pros: More social and people oriented, Above average pay.
Click to expand...

It's definitely more social than radiology. Pay is headed downwards because of the anesthesia management companies, which basically hoover up hospital contracts and then pay crummy wages for terrible hours.

Cons: Limited fellowship opportunities (eg pain,critical care), CRNA issues (Job threat to MDs), work with surgeons (deal with critical patients).
Click to expand...

There are also fellowships in cardiac and pedi anesthesia, plus some silly fluffy ones (if you need an OB fellowship to learn epidurals, you got ripped off in residency).

Unsupervised CRNA practice would certainly alter the job market, although it's uncertain how many CRNAs actually want to practice in that environment.

Some surgeons are great, some are annoying. Working in a hospital where anesthesia and surgery have a healthy relationship, and treat each other respectfully, helps greatly.

What is the stress of level of anesthesiologists?
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This question really makes me feel like your training did not give you a great picture of what's involved with each field. Anesthesia has a lot of stress - there is time pressure, the need to react quickly, and as you noted, the occasional difficult surgeon.

Radiology: Lot of new technology to play with,many fellowship opportunities would go for IR.
Cons: Sit in a dark room alone most of the dark, may be more isolation but that could be for reason for concentration. But my main concern is job market.
Click to expand...

Only you can tell whether you like the radiology work environment. I'd personally go nuts, but then, I'm anesthesia. =)

I really need sincere advice for better life style (in terms of daily stress.)
Click to expand...

Dermatology. Pathology. Life outside medicine, if you don't have debt. Neither IR nor anesthesia is what I would call low stress.
 
PistolPete said:
Most radiology residents detest their prelim medicine year, and honestly there is not much similarity between IM and rads.

Only you can answer this question, and unfortunately, it's a big one.

Doing prelim medicine then going for rads or anesthesia wouldn't be a bad option because you can always switch back to IM if you realized that during your intern year you absolutely love IM. But join from IM to anesthesia or rads would be more difficult.

You have to figure out what you love more and rank those programs accordingly.
Click to expand...
Although what you stated might have been true in the past, the competitiveness of IM is on the rise (especially at the "top" programs) whereas rads/gas is on the decline. So, yes OP may be able to switch from Rads/Gas to IM after prelim year, he will likely not get into the caliber of program he could at this time.
 
amine2086 said:
Although what you stated might have been true in the past, the competitiveness of IM is on the rise (especially at the "top" programs) whereas rads/gas is on the decline. So, yes OP may be able to switch from Rads/Gas to IM after prelim year, he will likely not get into the caliber of program he could at this time.
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What makes you think that the competitiveness for anesthesia is on the decline?
 
Which one of these specialties did you actually enjoy (if any)? If you pick one you like, "lifestyle" won't make a difference, since you'll love being at work.
 
silent_match said:
Hi Everyone,
What is the stress of level of anesthesiologists?
Click to expand...

The stress level of anesthesia has nothing to do with the work itself, it has more to do with the fact that you basically have the job security of the janitorial staff without the benefit of a union or labor board to back you up. You have no "practice", no patients of your own and your employment is at the whim of your group. Even those of us who are lucky enough to work for well run groups have to live with the constant reminder that the groups contracts can be torn up at any time leaving you possibly unemployed for months while you look for a new job and get credentialed at a new hospital. This has happened to friends of mine and a couple of them wound up taking crap jobs far from home after going 3-4 months unemployed.

That said, I can take a 50% paycut and still make more than just about every IM physician I know, most of my work weeks are well under 40 hours and with 7 years of practice under my belt the job has become very smooth and rewarding. It just sucks to keep what could be a new porsche sitting in the bank waiting for the day my job goes up in smoke.
 
Anesthesia and Radiology are not the jobs you go into for job security. They also aren't the jobs you pick if you're really focused on living in a particular area.
 
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