Pros/Cons of anesthesia/pmr/neuro?

[Bhargava Kolli]

Everytime I shadow a pain doctor from each of these three fields, they always hype up why their field was the best pathway to pain. Some things I have heard from doctors are:
Anesthesia: Two completely different skill sets, better at acutely managing the patient if complications arise, more money to fall back on otherwise
PMR: Better at actually diagnosing what’s causing the pain, more relevant information learned during residency, seeing the pt more as a whole person view. +++++ Cush residency ( something that appeals to me especially if they all end up at the same goal).
Neuro: Mostly what the PMR doctor said + plus cool fellowships such as neuro-ophtho.

If people could comment on what I have heard as listed above and what your opinions are, that would be awesome.
I know common advise is to do the residency you like the most, but if I liked all 3 equally - what would you guys recommend.

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[BoardingDoc]

EM. So when you start fellowship out of a genuine interest in pain, you're doubly rewarded by finding out how much easier and better life is outside of the pit.

 

[Dr. Ice]

Rather than focusing on something being easy, you should really try to get interested in something even though you have said you are bored by everything. Your interest in something Cush superseding all else is going to come across and you are going to be seen as not genuine at all.

PMR residency while more “Cush” than anesthesia doesn’t appeal to many people. It’s actually rather boring unless you have a strong interest in the multifaceted aspect of the speciality. You are going to likely be bored in prosthetics and tbi/sci. Asking someone how many steps are in their house is not intellectually stimulating.

I’m not anesthesia based, but I can appreciate how one has to have more of a wider breath of medical knowledge in that speciality. Having to use more brain power may offset your boredom and slightly compensate for the more difficult residency.

 

[Bhargava Kolli]

Rather than focusing on something being easy, you should really try to get interested in something even though you have said you are bored by everything. Your interest in something Cush superseding all else is going to come across and you are going to be seen as not genuine at all.

PMR residency while more “Cush” than anesthesia doesn’t appeal to many people. It’s actually rather boring unless you have a strong interest in the multifaceted aspect of the speciality. You are going to likely be bored in prosthetics and tbi/sci. Asking someone how many steps are in their house is not intellectually stimulating.

I’m not anesthesia based, but I can appreciate how one has to have more of a wider breath of medical knowledge in that speciality. Having to use more brain power may offset your boredom and slightly compensate for the more difficult residency.

That makes sense . thank you for the advice . What do you think about the other things that I have heard?

 

[geauxg8rs]

I am anesthesia based. So the correct answer is anesthesia

 

[PainDoc2025]

If you are 1000% set on pain, then PM&R for sure - way easier lifestyle during the residency than any other specialty

If you are not 1000% set on pain and like anesthesia, definitely do anesthesia residency - great market, can get a great general anesthesia job if you dont want to do pain

 

[Dr. Ice]

I think if you are business savvy, can market yourself well, and are 100% on some form of msk medicine and don’t want to take a lot of call during residency, pmr is a reasonable approach. You can open yourself up to practicing 100% regen like my former partner is doing right now

 

[bedrock]

I think if you are business savvy, can market yourself well, and are 100% on some form of msk medicine and don’t want to take a lot of call during residency, pmr is a reasonable approach. You can open yourself up to practicing 100% regen like my former partner is doing right now

How does someone do 100% regen?

Oreos and sake can only do it part time only despite having mad skills.

How can a regular doc do regen 100%?

 

[Dr. Ice]

People do it, mostly in purely affluent areas where people believe they are above the fray and that their problems “need” “cutting edge treatments” that only their wallet can afford

 

[A Deep Breath]

I know people who do 100% regen.

For example, at least a few of the most involved IOF docs, although many have some degree of a backup practice in interventional pain, PI, sports etc.

I think backup practices are what holds people back. A cash regen practice is fundamentally a different business than other practices. Among other things, a cash practice requires another level of marketing expertise.

A business coach wouldn’t tell someone to split their time between two different businesses while continuing full time clinical duties. They’d say to pick the business you want to pursue and drop the other.

Need to fully commit. Fear of failure will make one desperate for success. Don’t chip away at something and hope it grows. Time spent injecting steroids is time that could’ve been spent getting better at marketing, sales, business, etc.

However, I know that some of the prominent 100% regen people make about what the average employed pain doc does. For all of that additional work and stress. The never ending need to find new patients.

My hope for part time regen people is that they appreciate it for what it is and aren’t banging their heads against the wall trying to figure out why their practice hasn’t become 100% regen yet.

 

[drusso]

How does someone do 100% regen?

Oreos and sake can only do it part time only despite having mad skills.

How can a regular doc do regen 100%?

I'm not at 100% yet but it is possible. You build your practice slowly and organically. Your patient base is not insurance; it's word of mouth.

 

[lobelsteve]

How does someone do 100% regen?

Oreos and sake can only do it part time only despite having mad skills.

How can a regular doc do regen 100%?

Just have to believe hard enough that the $tem$ells$old actually work.
Otherwise you feel like you are driving a lambo built on lies.

 

[nvrsumr]

The local regen only docs I know are employees of chiros with one prominent exception. Usually under a general PI practice. Many doors …

 

[SSdoc33]

if you are 100% regen, you will invariable do regen procedures in spots where traditional procedures are more indicated. it is human nature.