Please ease my fears about anesthesia?

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SandP

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I already know about all the awesome things about anesthesia but attendings or senior residents, would you be able to address some of my concerns?

1. How much does supervising cRNAs suck?
2. I am interested in either CC or peds fellowship. Recently I heard there is projection in 2025 to be an oversupply of CC trained physicians....???? should I be concerned?
3. Is the job market as bad as radiology (as far as cycles go)?
4. would you still recommend the field to your child (if you have one) or someone else close to you?
 
1). Yes. Sucks. Especially since they are trying to take your job.
2). Do what you like
3). No. There is a recent growing demand for anesthesiologists.
4). Yes
 
I already know about all the awesome things about anesthesia but attendings or senior residents, would you be able to address some of my concerns?

1. How much does supervising cRNAs suck?
2. I am interested in either CC or peds fellowship. Recently I heard there is projection in 2025 to be an oversupply of CC trained physicians....???? should I be concerned?
3. Is the job market as bad as radiology (as far as cycles go)?
4. would you still recommend the field to your child (if you have one) or someone else close to you?

1) probably worse than you imagine. haven't done it yet myself but will do so in a few months. but thats the impression i get from this forum
2) no i would not be concerned
3) Our job market is much worse than radiologys. They have AI to be concerned about but thats way later if it happens IMO. We have real current threats from CRNAs taking our jobs. Radiology job market is excellent right now. Per Merritt Hawkins, Radiology is the 4th most requested job request in 2018, with anesthesiology at #18, so radiologists are in a lot more demand than we are.

4) Id dissuade them from going into medicine in general, but if for whatever reason they choose MD, then i would not disuade them from Anesthesiology. I'd just tell them to do what you think you are interested in. But i can provide them with all the Pros and Cons (that many med students get wrong when deciding) about anesthesiology since im anesthesiologist
 
But i can provide them with all the Pros and Cons (that many med students get wrong when deciding) about anesthesiology since im anesthesiologist

user-feedback-im-listening.png
 

stuff med studs commonly get wrong is they think anesthesiology is a lifestyle specialty and it's chill. I can't tell you how often i was told when i was in medical school that anes is ABC, airway book chair.

Another mistake is they think anesthesiologists get paid one of the highest in all of medicine. which again is false, because they see those forbes rankings

Those 2 are the biggest ones
 
I also thought the title referred to patient fears of anesthesia instead of a physician's concerns about the specialty of anesthesiology.
 
Anesthesiology sucks.

Do specialized surgery, cardiology, or GI. Then it will not matter how bad you are, the hospital will cater to you as long as you bring a few patients a week.

Critical care is silly. I think that’s a job for interns or generalists.

Peds is a passion. If you have it good for you.
 
Anesthesiology sucks.

Do specialized surgery, cardiology, or GI. Then it will not matter how bad you are, the hospital will cater to you as long as you bring a few patients a week.

Critical care is silly. I think that’s a job for interns or generalists.

Peds is a passion. If you have it good for you.
Why do you think cc is silly?could you please elaborate?
 
1) I do both supervision (sucks) and my own cases, yay. Try finding something doing your own cases, but few and far between. for those that have them, good for you. I’m a pedi guy, 10 years in and last eve /early this am had a 3 hour old, 33week term infant for ex lap, dead gut: told anesthetist, I got airway, probably get written up for not being team player. That’s the tough part of Care Team, in dysfunctional teams, which I gather most are, you have to play politics or you’re written up/made a pariah. Personally, I wouldn’t mind care teams if we as anesthesia doctors and leaders of the team were truly supported as such; like a GM or player/coach..,had to make reference for NFL draft tonight! Go Patriots - trade out of first for 7 5 round picks - lol.
2) Do GI or specialty surgery, prob still pressure from APPs but st end of day ain’t no one telling the Neurosurgeon/GI what they want to do-
If you bring patients to hospital , you’re at the table.
As anesthesia you can get a spot but it’s scraps and usually serious compromises .
 
1. there are far, far more MD only jobs on the West Coast than East. IF you can find MD-only in a suitable location then go for it. Supervision isn't as bad as this board makes it out to be though it's not as good as doing your own cases.

2) I wouldn't be concerned about finding a job as a CC doc. I'd be more concerned that it's almost impossible to practice both CC and anesthesiology outside of academics.

3) I don't know the job market for radiology. I know they all universally do fellowships and often super fellowships. Anesthesiology is not that.

4) I would not recommend Anesthesiology to my children. There are simply better alternatives in almost every situation with every personality type.
 
1. there are far, far more MD only jobs on the West Coast than East. IF you can find MD-only in a suitable location then go for it. Supervision isn't as bad as this board makes it out to be though it's not as good as doing your own cases.

2) I wouldn't be concerned about finding a job as a CC doc. I'd be more concerned that it's almost impossible to practice both CC and anesthesiology outside of academics.

3) I don't know the job market for radiology. I know they all universally do fellowships and often super fellowships. Anesthesiology is not that.

4) I would not recommend Anesthesiology to my children. There are simply better alternatives in almost every situation with every personality type.
Thanks for your response. What specialties would you recommend instead?
 
Why do you think cc is silly?could you please elaborate?
That’s an entire other thread.

Perhaps start a thread titled “Why Is CC silly?” and you might come to understand.
 
Thanks for your response. What specialties would you recommend instead?

I don’t know you. What other specialties are attractive to you? What type of personality do you have? I was interested in cardiology and ortho. I should add that I am personally happy in anesthesiology. But I’ve been party to the struggles of the field and when I look at other specialties I see fights they’re not having to fight. We are generally a passive field that’s been taken advantage of by surgeons, administrators, and the AANA. I just don’t want that for my children should they choose a medical career. There are better options.
 
Yes, soothe him (and me) with sweet sweet lies

1 month until ERAS opens...
 
1.) I do 25-30% supervision and the rest solo (on the east coast). My preference is solo, but supervising doesn’t necessarily suck, it’s just annoying. I left internal medicine because I didn’t want to be running around writing notes all day and that’s what I do when I’m supervising. My biggest challenge on supervision days is figuring out the logistics of giving my CRNAs lunch breaks in between starting cases and doing blocks. It drives me nuts.

2.) If you think you want to do CC then do internal med. It’s a much better option.

3.) There are tons of jobs. There are few good jobs. By the time you finish you will be working for someone, not for yourself.

4.) I would not do anesthesiology again. In my specific case, I would have done an IM subspecialty instead of a second residency. Whether or not I would choose IM or anesthesia again out of med school is a more complicated question. At this point I would not recommend anesthesia to my children and may actively discourage them from attending med school.
 
Meh.

1. Supervision is hard and often frustrating. There is LOTS of stuff that gets done that I wouldn't have done myself, and stuff doesn't get done that I would have. I check in on my rooms frequently, and prescribe the specifics of what I think is of particular importance.

2. I did CC; best decision I ever made within anesthesiology. People are not getting younger nor less sick. I don't have a crystal ball, but there are lots of jobs now.

3. I have no clue what the radiology job market is like.

4. I love my job; left a prior career to do medicine. Would do anesthesia again. If my children end up interested in medicine, I would encourage them to see if anesthesiology seems like a good fit.
 
I already know about all the awesome things about anesthesia but attendings or senior residents, would you be able to address some of my concerns?

1. How much does supervising cRNAs suck?
2. I am interested in either CC or peds fellowship. Recently I heard there is projection in 2025 to be an oversupply of CC trained physicians....???? should I be concerned?
3. Is the job market as bad as radiology (as far as cycles go)?
4. would you still recommend the field to your child (if you have one) or someone else close to you?

1. Probably a lot. Thankfully my shop is MD only and I have never had to supervise.
2. Your interests and desires will likely change as you go through residency. I went in thinking definitely cardiac and after two months of it i said no way. I liked it but it wasn’t worth scarifying another year of attending salary for slave labor.
3. Job market is good right now in my area, at least for generalists.
4. If they were in medicine yes I think it is a good field, no other field I rather be in. Depends on personality, what type of setting you like to practice in etc.
 
I already know about all the awesome things about anesthesia but attendings or senior residents, would you be able to address some of my concerns?

1. How much does supervising cRNAs suck?
2. I am interested in either CC or peds fellowship. Recently I heard there is projection in 2025 to be an oversupply of CC trained physicians....???? should I be concerned?
3. Is the job market as bad as radiology (as far as cycles go)?
4. would you still recommend the field to your child (if you have one) or someone else close to you?
1. Supervising and depending on anybody you cannot fire sucks royally. The main reason doctors were treated well in the past was that they were the ones paying the salaries.
2. There is already an overproduction of generalist anesthesiologists, and soon there will be one of fellowship-trained ones. There is also an overproduction of CRNAs trying to replace us. Should you be concerned? Is the Earth round?
3. That's an interesting question to ask on an anesthesiology forum. Let me remember the last time I looked for a job as a radiologist...
4. If s/he was so dumb to go to medical school in the first place... there are worse specialties than anesthesia. Critical care comes to mind *cough. 😀
 
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I already know about all the awesome things about anesthesia but attendings or senior residents, would you be able to address some of my concerns?

1. How much does supervising cRNAs suck?
2. I am interested in either CC or peds fellowship. Recently I heard there is projection in 2025 to be an oversupply of CC trained physicians....???? should I be concerned?
3. Is the job market as bad as radiology (as far as cycles go)?
4. would you still recommend the field to your child (if you have one) or someone else close to you?

1. I don't supervise - the thought of having to spend my days making sure CRNAs get their breaks while playing firefighter would make me ill. Conscious choice to find a practice where I do my own cases.
2. Do what interests you but be pragmatic about your choice. That being said the job market is great in my region for peds folks who are willing to also do adults.
3. The head of HR keep telling us there's going to be a shortage of anesthesiologists (and cRNas for that matter) in the next 5 years. We have not been able to keep up with the need to hire.
4. If they insisted on going to med school and it's a good personality fit.
 
1. there are far, far more MD only jobs on the West Coast than East. IF you can find MD-only in a suitable location then go for it. Supervision isn't as bad as this board makes it out to be though it's not as good as doing your own cases.

2) I wouldn't be concerned about finding a job as a CC doc. I'd be more concerned that it's almost impossible to practice both CC and anesthesiology outside of academics.

3) I don't know the job market for radiology. I know they all universally do fellowships and often super fellowships. Anesthesiology is not that.

4) I would not recommend Anesthesiology to my children. There are simply better alternatives in almost every situation with every personality type.

In regard to number 1, I would argue that supervision is literally the only thing that is as bad in real life as SDN makes it out to be on the internet.
 

Servile Field. Wasn't a good choice for me. Agree with picking any Surgical Subspecialty, GI or Cards if your scores permit.
 
Supervision 100% depends on the crew of CRNAs you have. There will always be a few militant ones or senior ones that will roll their eyes and pretend not to give a S*** about what you're saying but you if you have a majority that are at least pretending to be collaborative then its not too bad. Some of them do not know what they do no know and that is the scary part. Still would rather do my own cases any day.

Job market seems good especially in the west coast.
 
supervision not bad at all. We employ all our CRNAs and AAs so they know who the boss is and do a case however you want them to, nor do I have to give breaks to people during cases as that what the floats are for.
 
My cousins dogs brothers wife had surgery once and she was awake and felt the whole thing and was paralyzed and then got nerve pain for life and the surgeon said it was from the anesthesia
The vet said it was from anesthesia.
 
1.) Imagine coming into rooms and finding that your patients frequently have undiagnosed ICP as the CRNA plays on his phone with the end tidal CO2 in the 20s. Or if it's not that, then they are running grannie at 1.5 MAC. It's just new ways of mismanagement mystery every time!! But you still have to play nice, or they will hate you.
 
1. How much does supervising cRNAs suck?
2. I am interested in either CC or peds fellowship. Recently I heard there is projection in 2025 to be an oversupply of CC trained physicians....???? should I be concerned?
3. Is the job market as bad as radiology (as far as cycles go)?
4. would you still recommend the field to your child (if you have one) or someone else close to you?

1) Supervising is not the hellscape everyone makes it out to be on SDN. A BIG factor here as FFP alluded to is who employs your CRNAs (and AAs if applicable) - if it’s your group that really helps keep behavior and militant stances down. If it’s the hospital then a lot of the negative stuff described here can happen - they don’t respect your position or your authority so it can be a suck fest.

A further example of this - my group employs over 75 CRNAs. Overwhelming majority are affable, pleasant and do a good, no-mess job. A few are nasty - we had a seasoned veteran CRNA who took poorly to direction for our new hires like myself. After a couple nasty and dangerous interactions, she was let go. The nurses in our group were freaked and alarmed but it helped reiterate who the boss is.

2) Do what you want. Nearly every academic center in the country is hiring for anesthesia CCM. You might not be thrilled with the pay, hours or practice setup but there are strong ones out there.

3) Diagnostic Radiology is, simply, a hot mess. It’s a brutal job market out there - talk to your medical school friends who went that path, if they aren’t trying to beg their way into an IR pathway. It’s better for subspecialists at academic centers, though.

4) Sure, but as a poster above said I’d be wary about medicine in general right now. Medicare for all would spell certain doom for the current model of medicine in our country, and not in a good way. Not sure how things would shake out - those able to cater to rich folks with a cash-based practice for elective surgeries will do well, the rest will get crushed.
 
1) Supervising is not the hellscape everyone makes it out to be on SDN. A BIG factor here as FFP alluded to is who employs your CRNAs (and AAs if applicable) - if it’s your group that really helps keep behavior and militant stances down. If it’s the hospital then a lot of the negative stuff described here can happen - they don’t respect your position or your authority so it can be a suck fest.

A further example of this - my group employs over 75 CRNAs. Overwhelming majority are affable, pleasant and do a good, no-mess job. A few are nasty - we had a seasoned veteran CRNA who took poorly to direction for our new hires like myself. After a couple nasty and dangerous interactions, she was let go. The nurses in our group were freaked and alarmed but it helped reiterate who the boss is.

2) Do what you want. Nearly every academic center in the country is hiring for anesthesia CCM. You might not be thrilled with the pay, hours or practice setup but there are strong ones out there.

3) Diagnostic Radiology is, simply, a hot mess. It’s a brutal job market out there - talk to your medical school friends who went that path, if they aren’t trying to beg their way into an IR pathway. It’s better for subspecialists at academic centers, though.

4) Sure, but as a poster above said I’d be wary about medicine in general right now. Medicare for all would spell certain doom for the current model of medicine in our country, and not in a good way. Not sure how things would shake out - those able to cater to rich folks with a cash-based practice for elective surgeries will do well, the rest will get crushed.

I think that is radiology of the past? Now the salary has gone up a good chunk, and demand has gotten much higher. I dont think people have trouble finding jobs anymore...
 
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I'm fresh out of residency in the Pacific NW, PP group of about 40 anesthesiologists. mid-size city referral center with level 2 trauma, stroke center, ped hospital, 4 cardiac ORs, OB with 5000 deliveries a year. I have no fellowship, I do everything except peds cardiac, but I do all other peds. No CRNAs. 425k salary, 2 year partnership track, then a fairly good size bump once partner. Even partners are salaried but with incentives for call from what I understand.

I interviewed at 9 places before signing up with this one. We're hiring too! I'm very happy with this set up.
 
I already know about all the awesome things about anesthesia but attendings or senior residents, would you be able to address some of my concerns?

1. How much does supervising cRNAs suck?
2. I am interested in either CC or peds fellowship. Recently I heard there is projection in 2025 to be an oversupply of CC trained physicians....???? should I be concerned?
3. Is the job market as bad as radiology (as far as cycles go)?
4. would you still recommend the field to your child (if you have one) or someone else close to you?
1. Supervising 2 CRNAs is fine, 3 sucks, 4 - NFW unless I’m making ~700. I do my own cases 25-30% of the time. That’s the best.
2. Peds is “saturated” according to this board yet all our fellows had no problem getting jobs again. Many don’t want 100% peds jobs anyway. The only ones that have problems that I’m aware of are the ones that limit themselves to 100% peds in one desirable urban area.
3. AMCs are a problem. I wouldn’t work for one. If they own your desired area, that’s a big problem for you.
4. Surgery first every time. They bring in the patients, control their schedule, and have the respect of the suits. But surgery isn’t for everyone.
 
I would also point out that many surgeons retire early due to physical limitations. If you are an anesthesiologist intensivist you can round until your later years. I see this many times where surgeons lose a lot of money on the back end. Not mentioned here on SDN since not many of our older colleagues are posting on SDN. Its an issue of retiring at 62-65 because of back issues technical skills issues versus 67 - 70 basically just ICU coverage. Thats a 3 million dollar swing potentially.
 
1. It depends on your time management and communication skills. Unfortunately most physicians are not trained in effective supervision. I do my own cases, teach residents and supervise CRNAs and I like the variety and have no problem adapting to each. The advantage of having some of us supervise is that we can be flexible and handle anything that is thrown at us during the day.
2.Do what you like.
3. If you are flexible and are willing to go where jobs are at any given time, then no. There has been doom and gloom since Medicare was approved but nothing has come to pass.
4. Yes. If they have an interest. Neither of my children chose medicine and I have no problem with that.
 
1. How much does supervising cRNAs suck?
I do my own cases. It's easier on the brain because what happens to the patient is solely dependent on my actions. I have no idea what I would be like to supervise (although that may change in the future). I feel like there's a fine line between being completely hands off and micromanaging/being a fireman.

2. I am interested in either CC or peds fellowship. Recently I heard there is projection in 2025 to be an oversupply of CC
trained physicians....???? should I be concerned?


Unless you plan on winning the lotto, choose the field that you can see yourself waking up every morning and grumbling about work THE LEAST. (that could be a different specialty) I chose anesthesiology because I feel the most grumbling I would do would involve clinic work. The was confirmed during my surgery internship. Side note: I personally recommend surgery internships if you're the sort of person that "maybe wants to do surgery, but isn't sure, so you matched anesthesiology instead". You'll round. You'll write notes. You'll be in clinic. You may even operate a little bit. After all of this if you still are not feeling surgery then don't do surgery because that will be your life.

3. Is the job market as bad as radiology (as far as cycles go)?

There are jobs everywhere. The unemployement rate for anesthesiologists have to be less than 1% or even lower.

4. would you still recommend the field to your child (if you have one) or someone else close to you?

Probably not, but for a handful of reasons (some mentioned above others not). Just remember, as an anesthesiologist you're more like an offensive lineman in football. You're very important for the game but no one really cares your opinion when it comes to running the offense. I'd recommend my child most importantly to become fluent in a second language, and since I'm in the US, probably Spanish, with Mandarin a close second. If I happen to move to Europe, I'd change that to French or German. In essence, maximum marketability.
 
1). Yes. Sucks. Especially since they are trying to take your job.
2). Do what you like
3). No. There is a recent growing demand for anesthesiologists.
4). Yes

I always find it very entertaining seeing you guys hate on CRNAs. And it’s funny how it’s always the med students and novice anesthesiologists that are the ones talking bad. And just to give you guys a little bit of history, nurses were the first providers to administer anesthesia until physicians came along and decided that it was their turf and nurses should no longer be allowed. So we’re not taking away anything that wasn’t already ours. I mean, we can all be anesthesia providers and competent ones at that. Can’t we all just play nice? You’re not doing yourselves any favors. I appreciate you guys, for the time and commitment you guys dedicate to medicine. More power to you. I enjoy my work-life balance, but maybe that’s why your so bitter?
 
I think that is radiology of the part? Now the salary has gone up a good chunk, and demand has gotten much higher. I dont think people have trouble finding jobs anymore...

Thank you for speaking favorably about CRNAs. And as with any profession, there are bad apples. I really only started reading this forum because I wanted to know some of the fears anesthesia students had in training. I’m kind of terrified. Excited but def a little terrified. And then I started reading the negative comments, which honestly aren’t surprising, but it’s sad to have healthcare providers be at odds with each other. We are in a new age of healthcare and collaboration is absolutely essential to the delivery of quality patient centered care.
 
Supervision is fine so long as you set realistic goals. For me if the patient is alive and awake in PACU I put it in the win column. Also doing a lot of routine stuff helps. There are only so many ways to do a lap appy, chole , TKA, MAC case ect......
 
I always find it very entertaining seeing you guys hate on CRNAs. And it’s funny how it’s always the med students and novice anesthesiologists that are the ones talking bad. And just to give you guys a little bit of history, nurses were the first providers to administer anesthesia until physicians came along and decided that it was their turf and nurses should no longer be allowed. So we’re not taking away anything that wasn’t already ours. I mean, we can all be anesthesia providers and competent ones at that. Can’t we all just play nice? You’re not doing yourselves any favors. I appreciate you guys, for the time and commitment you guys dedicate to medicine. More power to you. I enjoy my work-life balance, but maybe that’s why your so bitter?

We dont hate all CRNA, just some. CRNAs have a role, just PA, RN, NPs have a job. That history is irrelevant. Surgeon provided anesthesia before CRNA did. Yet today we wont let surgeons provide anesthesia. Why? B/c it has gotten way more complicated than when anesthesia first came about. In the old days, getting you drunk was the anesthesia. You dont need a MD to get a patient drunk if that's your only form of anesthesia.

It's similar to AAs for CRNAs


Thank you for speaking favorably about CRNAs. And as with any profession, there are bad apples. I really only started reading this forum because I wanted to know some of the fears anesthesia students had in training. I’m kind of terrified. Excited but def a little terrified. And then I started reading the negative comments, which honestly aren’t surprising, but it’s sad to have healthcare providers be at odds with each other. We are in a new age of healthcare and collaboration is absolutely essential to the delivery of quality patient centered care.

It's definitely sad. It's insane to me there are CRNAs fighting to be called doctors or anesthesiologists in the hospital. When those ppl exist, there will always be people at odds.

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I just met a radiologist whos been practicing for about 15 years. Said the job market is red hot right now for radiology grads w/o fellowship. She also congratulated me on choosing anesthesiology.. because it has a great lifestyle... Even other MDs have no idea about lifestyle of anesthesiologists.

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Also just started covering CRNAs a few weeks ago. It is rough. I much rather supervise residents than CRNAs. I dont know if it's because they are still residents or the CRNAs have been practicing for a while, but i find the residents to be much more cautious, where as some of the CRNAs have the whatever mentality, or it'll be just fine mentality.

I only just started supervising and i already had numerous occasions with different CRNAs joining my case, where they thought its fine to just leave the patient running at HR of 110s for prolonged periods of time. Then i go in the room and they are just on their phone. Another time, a CRNA joined me, and when i checked back, the gas was turned up to 2 mac.. on an old man. it's stressful supervising CRNAs
 
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where they thought its fine to just leave the patient running at HR of 110s for prolonged periods of time. Then i go in the room and they are just on their phone. Another time, a CRNA joined me, and when i checked back, the gas was turned up to 2 mac.. on an old man. it's stressful supervising CRNAs


At least as physicians, we can figure out when HR of 110s for long periods of time is perfectly fine, and when a MAC of 2 on an old man is perfectly fine.
 
Match results signal a strong demand for anesthesiology residency programs and include growth in number of applicants, growth in positions offered, percentage of positions filled, and percentage of applicants not matched. In 2019, 4,241 candidates applied to 1,875 anesthesiology positions, with less than 50 percent of applicants matching into the specialty. There is an increasing trend in the number of anesthesiology positions offered, with 98.1 percent of positions filled in 2019.
Table 1 summarizes the number of applicants and the type of candidates who matched into anesthesiology between 2010 and 2019 (e.g., U.S. allopathic seniors, osteopathic students or graduates, other and international. See Exhibit 1 for definitions.). In 2019, 1,839 candidates matched, a 2 percent increase over 2018; it is the greatest number of matched candidates into the specialty to date. The percentage of matches by U.S. allopathic seniors and osteopathic students or graduates between 2015 and 2019 have steadily increased (1.6 percent); they represent 83.1 percent of all anesthesiology matches in 2019. For all other specialties, in aggregate, the percentage of matches by U.S. allopathic seniors and osteopathic students or graduates varied between 72 percent and 75 percent between 2015 and 2019.
 
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