PM&R or Anesthesiology

[GassYous]

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Full disclosure - I really know very little about the program. I know people that teach there.

When I rotated there as a resident some years back, that was my experience and that is what the residents said. The staff is rarely there. That is good and that is bad.

However, things change. Bad things happen and staff become more mandated to be there. So who knows what it is like now.

When I was a resident, I was VERY impressed at how independent they practiced...they got things done and quickly. But also, they did things I would NEVER do and thought was somewhat dangerous. I thought..well, at least they have their indepedence.

If left to do anesthesia on your own, you will learn bad habits. If you have an attending by your side constantly, you will learn great habits, but probably lack in true confidence and independence. I'm sure there is a good balance.

Depends on the attending.

 

[Sriddymopboi]

Full disclosure - I really know very little about the program. I know people that teach there.

When I rotated there as a resident some years back, that was my experience and that is what the residents said. The staff is rarely there. That is good and that is bad.

However, things change. Bad things happen and staff become more mandated to be there. So who knows what it is like now.

When I was a resident, I was VERY impressed at how independent they practiced...they got things done and quickly. But also, they did things I would NEVER do and thought was somewhat dangerous. I thought..well, at least they have their indepedence.

If left to do anesthesia on your own, you will learn bad habits. If you have an attending by your side constantly, you will learn great habits, but probably lack in true confidence and independence. I'm sure there is a good balance.

Thanks for the insight. My recent impression of the program is that the residents still practice very independently and they seem to take pride in that.

 

[avalon10]

The difference between these two specialties is self- and situational-awareness.
If your awareness is strong do anesthesia; if not, do PM&R.

I’m speechless reading about the factors people take into account to pick their specialty. I mean, don’t get me wrong, we all want quality of life, salary, reasonable call schedules etc etc but I never see as top factor what really pleases you doing for the rest of your life. What challenges you to become better at. What you derive pleasure from. What patient population you would love to serve. This for me is a red flag that people with this mentality or differently, with lack of deeper interest for medicine and it’s particularities, should not be in medicine at the first place. It’s true that after several years doing the same thing gets you into a terrifying routine no matter what specialty you do, but having this feelings even before starting is concerning to me

What a ridiculous comment. You’re “speechless”?!? You sound like some med school professor who tells med students that the only reason to choose a specialty is because they’re “truly interested” in it, or they should choose the specialty that they’re “passionate about.” That they shouldn’t dare to consider lifestyle/money etc. It’s such an unbelievable load of BS that is a real disservice to med students.

People can feel free to choose whatever field they want for whatever reason they want to, and only an ignoramus would judge someone else’s choices based on their own criteria and opinions.

It’s a red flag to me that you’re so high and mighty that you think you know the “right reasons” for people to pick what specialty to pursue, when the truth is you don’t, and it’s none of your business anyway. This is the real world, where there are actually real-world factors in choosing one’s career, and not just “lack of deeper interest for medicine and its particularities.”

And who on earth do you think you are to judge whether someone should be in medicine or not?!? Are you the god of med school?!? If not, why don’t you keep your ridiculous comments to yourself.

 

[deleted162650]

Thanks for the insight. My recent impression of the program is that the residents still practice very independently and they seem to take pride in that.

I trained at UCSD. It’s been a number of years now, and there have been some leadership changes in the interim so keep that in mind . . .

The culture at UCSD has always been one of early and liberal autonomy on the part of the residents. That doesn’t mean you never see the attendings. They are there for you when needed. You will get in OR teaching. They will give you breaks. But they are not gonna sit in the room and hand hold all day.

You get 2 weeks 1:1 with a CA-3, then 2 weeks 1:1 with an attending, then it’s a “call me if you need me” sorta vibe after that. I always felt the degree of attending involvement was commensurate with and appropriate for the level of case complexity and resident experience/skill level. It’s pretty routine to extubate solo in the fall of your CA-1 year, start blood on your own, etc. As a CA-3 doing a B&B lineup, you may go the day without seeing your staff. You are never left out to dry though.

The only time I felt I may have had a little too much autonomy was the time I had to come off pump alone - 6mo into my CA-1 year.

Honestly, it woulda annoyed the living crap outta me if I had my attending in the room the whole case every day.

 

[Silo004]

I trained at UCSD. It’s been a number of years now, and there have been some leadership changes in the interim so keep that in mind . . .

The culture at UCSD has always been one of early and liberal autonomy on the part of the residents. That doesn’t mean you never see the attendings. They are there for you when needed. You will get in OR teaching. They will give you breaks. But they are not gonna sit in the room and hand hold all day.

You get 2 weeks 1:1 with a CA-3, then 2 weeks 1:1 with an attending, then it’s a “call me if you need me” sorta vibe after that. I always felt the degree of attending involvement was commensurate with and appropriate for the level of case complexity and resident experience/skill level. It’s pretty routine to extubate solo in the fall of your CA-1 year, start blood on your own, etc. As a CA-3 doing a B&B lineup, you may go the day without seeing your staff. You are never left out to dry though.

The only time I felt I may have had a little too much autonomy was the time I had to come off pump alone - 6mo into my CA-1 year.

Honestly, it woulda annoyed the living crap outta me if I had my attending the room the whole case every day.

Coming off pump alone. 😵

 

[GassYous]

Coming off pump alone. 😵

It's easy. Just turn the vent back on, get rid of bubbles and push some protamine.

 

[Lidolover]

What a ridiculous comment. You’re “speechless”?!? You sound like some med school professor who tells med students that the only reason to choose a specialty is because they’re “truly interested” in it, or they should choose the specialty that they’re “passionate about.” That they shouldn’t dare to consider lifestyle/money etc. It’s such an unbelievable load of BS that is a real disservice to med students.

People can feel free to choose whatever field they want for whatever reason they want to, and only an ignoramus would judge someone else’s choices based on their own criteria and opinions.

It’s a red flag to me that you’re so high and mighty that you think you know the “right reasons” for people to pick what specialty to pursue, when the truth is you don’t, and it’s none of your business anyway. This is the real world, where there are actually real-world factors in choosing one’s career, and not just “lack of deeper interest for medicine and its particularities.”

And who on earth do you think you are to judge whether someone should be in medicine or not?!? Are you the god of med school?!? If not, why don’t you keep your ridiculous comments to yourself.

Just saw this attack haha. Too much hate and anger. Get a life sir/madam. Kind of worried how with your criteria to choose a specialty you have not gotten a life yet. Lol

 

[Consigliere]

Just saw this attack haha. Too much hate and anger. Get a life sir/madam. Kind of worried how with your criteria to choose a specialty you have not gotten a life yet. Lol

And the 't_ard has spoken.....

 

[dabears505]

Coming off pump as a ca1 6 months in? That's jacked up.

 

[deleted162650]

Coming off pump as a ca1 6 months in? That's jacked up.

That was just a one off thing. Definitely not the norm, or expected. I had called my staff multiple times with no response. Finally the CT surgeons got inpatient and said “Well, worst thing that happens is we just go back on.” Things proceeded uneventfully, and my staff came back shortly thereafter. I think his response was “cool.”

He might have been tied up in another room, or maybe just at lunch - I don’t know?

Im going with that he had supreme confidence in me, and knew I could run the show without him despite my junior status. Boom.

 

[GassYous]

That was just a one off thing. Definitely not the norm, or expected. I had called my staff multiple times with no response. Finally the CT surgeons got inpatient and said “Well, worst thing that happens is we just go back on.” Things proceeded uneventfully, and my staff came back shortly thereafter. I think his response was “cool.”

He might have been tied up in another room, or maybe just at lunch - I don’t know?

Im going with that he had supreme confidence in me, and new I could run the show without him despite my junior status. Boom.

I mean from the sounds of it you seem like the kind of guy who I'd trust with that

 

[Lidolover]

And the 't_ard has spoken.....

Thnx for your diagnosis. Speaks volumes of your experience.........

 

[Consigliere]

Thnx for your diagnosis. Speaks volumes of your experience.........

That of an astute clinician? Correct.

 

[Lidolover]

That of an astute clinician? Correct.

You might be but your...bedside manner sucks! We gotta work on that.

 

[Consigliere]

You might be but your...bedside manner sucks! We gotta work on that.

Unnecessary.

 

[chocomorsel]

You might be but your...bedside manner sucks! We gotta work on that.

It’s not bedside manner. It’s online manner.

 

[painballer27]

OP what did you end up doing?

 

[nimbus]

OP what did you end up doing?

Male model.