PLK7905

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Hi,
I'm a 4th year med student. I am currently applying for categorical medicine positions, but am having second thoughts. I just started an (2 week) anesthesiology rotation, and have done about 3 days worth. I have to say the specialty is becoming very interesting to me--the residents and attendings all seem very happy, there are many procedures to do, and I like the brief but intense patient encounters. I also like the fact that a life outside of medicine seems to be a top priority for people who choose anesthesia. I'm not quite ready to chuck the idea of internal medicine all together, and I realize it is probably too late to apply for this years match.

So my question is, if I decide that I really would like to do anesthesiology, is it a good idea to continue with my categorical medicine applications, and then try to apply through eras for a PGY-2 spot during my internship year--are there many of these available? My husband and I were planning on relocating for residency (though I could probably get a categorical medicine position in a program here), but I don't want to drag him around too much--so, it would be tough to go somewhere else and have to move again in a year. Any input you all have is appreciated. I haven't totally thought this out yet. I had briefly thought of anesthesia before, but never really had an opportunity to do a rotation in it before. But I think it might suit my personality style well...

Thanks!
 

militarymd

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I think that would be fine to continue with your medicine internship.
 

2ndyear

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Yes, it's possible and people do it all the time. You would be applying for CA-1 positions in your intern year. I had people in my intern class do this and it worked out fine for them. There are spots available, some programs even hold open spots for people like this. You do need time off for some interviews which can be hard depending on what month you're in, and could involve blowing well deserved vacation days on interviewing.

I'd stick out your next two weeks in anesthesiology, really pick the brains of residents and attendings to make sure that it's something you'll like, and then decide. Even if you are on the fence by all means get a letter of rec from an attending! You probably won't have time in your intern year to do this.

If you decide to do it then you have the option of either categorical or preliminary medicine. Categorical gives you more stability should you decide not to do anesthesia.

Since you only want to move once you might want to consider this when you rank medicine programs. A place like Chicago, Boston, etc will allow you access to many of each program.
 
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TheSandMan

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If your an average to strong candidate and definitely decide on anesthesia by the end of your rotation, you may want to consider not ranking any categorical programs and then scrambling for an anesthesia spot, afterwhich you can scramble for a prelim spot. sounds crazy, but the truth of the matter is that its a lot harder to get a spot outside the match than scrambling for a spot, mostly because there are a lot fewer programs offering spots outside the match than there will be unmatched spots, along with the fact you that you will competing with a lot more competitive pool for an out of match spot (i.e. medicine and surgery residents from 1st year on up). If you match at a medicine catagorical program, you wont be able to go throught the scramble. Also, when time comes to interview at programs outside the match, your probably going to feel a little guilty about interviewing at other programs when you feel like your part of a team at your program (unless you end up at a place that is miserable). Worst case senario, you don't get an anesthesia spot and end up scrambling for a catagorical medicine spot( which there are always plenty of, even for great programs).
Either way, definitely get some strong letters from the people your working with along with expressing your interest for the field and networking early so that you will have connections when it comes time to scramble or find an out of match spot.
I actually went through a similar experience last year and though it sucked to go through all the stress, I'm glad I figured out what I wanted before I started residency and not after.
 

Idiopathic

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TheSandMan said:
the truth of the matter is that its a lot harder to get a spot outside the match than scrambling for a spot, mostly because there are a lot fewer programs offering spots outside the match than there will be unmatched spots,
Im not sure I agree with this, this year.
 

mountaindew2006

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PLK7905 said:
Hi,
I'm a 4th year med student. I am currently applying for categorical medicine positions, but am having second thoughts. I just started an (2 week) anesthesiology rotation, and have done about 3 days worth. I have to say the specialty is becoming very interesting to me--the residents and attendings all seem very happy, there are many procedures to do, and I like the brief but intense patient encounters. I also like the fact that a life outside of medicine seems to be a top priority for people who choose anesthesia. I'm not quite ready to chuck the idea of internal medicine all together, and I realize it is probably too late to apply for this years match.

So my question is, if I decide that I really would like to do anesthesiology, is it a good idea to continue with my categorical medicine applications, and then try to apply through eras for a PGY-2 spot during my internship year--are there many of these available? My husband and I were planning on relocating for residency (though I could probably get a categorical medicine position in a program here), but I don't want to drag him around too much--so, it would be tough to go somewhere else and have to move again in a year. Any input you all have is appreciated. I haven't totally thought this out yet. I had briefly thought of anesthesia before, but never really had an opportunity to do a rotation in it before. But I think it might suit my personality style well...

Thanks!
I'll be the voice of realism. But anesthesiology as you know has become more competitive this year. Additionally, more and more programs are shunning away from 'advanced' spots (even though they say they have them on ERAS) and are converting to just categorical anesthesiology (pgy1-4). why? they've found that if a resident does their prelim/TY year at the same institution they will be doing PGY2-4...they end up 'better' at the end. Just what i heard.........
 

UTSouthwestern

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mountaindew2006 said:
I'll be the voice of realism. But anesthesiology as you know has become more competitive this year. Additionally, more and more programs are shunning away from 'advanced' spots (even though they say they have them on ERAS) and are converting to just categorical anesthesiology (pgy1-4). why? they've found that if a resident does their prelim/TY year at the same institution they will be doing PGY2-4...they end up 'better' at the end. Just what i heard.........
Actually, it has more to do with changing residency requirements that are forcing programs to incorporate the intern year to be able to meet the requirements of the ABA.
 

militarymd

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mountaindew2006 said:
...they end up 'better' at the end. Just what i heard.........

Not accurate...there was actually a panel discussion on this at the ASA....no one is sure which way is better.
 

UTSouthwestern

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militarymd said:
Not accurate...there was actually a panel discussion on this at the ASA....no one is sure which way is better.
The guys that went through medicine prelim years or full medicine residencies seemed to reach a higher level of comfort and ability faster than their counterparts in our program at least.
 
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