Question for the senior guys

[Crash cart]

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This is a spin-off of my previous post on pressure to do a fellowship...

One of the arguments my Chair and PD give for doing a fellowship is the increasing uncertainty we face as anesthesiologists given the growth of CRNAs and AAs. When you guys were training, did you get the same argument from you staff -- that one day a CRNA is going to tke your job unless you've proved you are an 'expert' in a subspecialty? If so, have you in fact seen a demonstrable change in your career where this is becoming true or you now wish you had subspecialty training?

I am calling on you wisdom...

 

[urge]

This is a spin-off of my previous post on pressure to do a fellowship...

One of the arguments my Chair and PD give for doing a fellowship is the increasing uncertainty we face as anesthesiologists given the growth of CRNAs and AAs. When you guys were training, did you get the same argument from you staff -- that one day a CRNA is going to tke your job unless you've proved you are an 'expert' in a subspecialty? If so, have you in fact seen a demonstrable change in your career where this is becoming true or you now wish you had subspecialty training?

I am calling on you wisdom...

The old guys don't need to worry about this.

 

[Frank Rizzo]

I decided I didn't like anything enough to do a fellowship. I don't care about the 'its only a year' bull****. Had the same discussion about the CRNA thing with the higher ups. I also decided to get many other opinions from recent grads, as well as other attendings. the general take home message from everyone else, only do a fellowship if you REALLY like something, or if you want to be a player in academia. I don't fall into either of those categories, so I said F it. Time to get a real job. It felt almost liberating to come to that conclusion

 

[Crash cart]

The old guys don't need to worry about this.

Thanks, D-bag. That was a helpful post.

 

[urge]

Thanks, D-bag. That was a helpful post.

You won't get far with that attitude.

 

[Consigliere]

You won't get far with that attitude.

Actually, he's perfect for a career in academia.

 

[Planktonmd]

Thanks, D-bag. That was a helpful post.

I am not sure I understand your reaction to his post, and even if you thought that his response was not good enough I don't see why you should insult him.

 

[deleted126335]

.

 

[Tenesma]

i personally think it is foolish NOT to spend an extra year in fellowship...

that one year doesn't really cost much in terms of Opportunity Costs... you are giving up one year of salary in favor of a fellows salary (50k) and potential future job security/increased income.

Let's say that you go into private practice and things don't turn out so well... CRNAs are starting to dominate the market a bit more, there are less jobs around - how are you going to stand out? a fellowship will help...

 

[Arch Guillotti]

Also, fellowship salary isn't always the 50K that seems to be thrown around here. I do some time as an attending and am paid accordingly. You can make extra cash by doing locums/moonlighting as well. Depending on the demands of your fellowship you likely will work less than you did as a resident.

 

[mille125]

Thanks, D-bag. That was a helpful post.

I was going to impart some wisdom upon you until I read this sentiment. Good luck in your career...

 

[coprolalia]

The old guys don't need to worry about this.

Thanks, D-bag. That was a helpful post.

You won't get far with that attitude.

Actually, he's perfect for a career in academia.

Gasguy06, what you don't realize is that urge's original response was spot on. This string of posts should tell you all that you need to know.

I can't tell you the number of "old guys" I've seen around who really don't give a **** anymore. They are the academic "rocks" of the institution. They are the first ones who'll tell you you're wrong for trying to change things. They are the first ones who'll say that you need to learn to be a "team player" and to "respect" everyone. They are not the shepherds of our profession.

The irony is that you have sought advice from people in your program who aren't going to fight to protect our specialty anymore. The potential changes in the field that are going to occur over the next 10-15 years won't affect them. So, they have nothing to gain, and everything to lose, in being perceived as "confrontational" in their safe, protected little world.

So, what they do instead is imagine what they'd do if they were in your shoes. Because they've learned that standing up for themselves usually just earns them a smack-down, they advocate taking the path of least resistance. And, that path of least resistance means doing something else to protect themselves - a defensive posture. They believe that, although they might win a few battles, they can't win the war. Therefore, they are advocating to you that you should be prepared to surrender... because that's what they've grown accustomed to doing.

I think if you are going to do a fellowship for that reason, it is a bad one. Like others have said, do a fellowship if you are interested in a particular subspecialty field. Otherwise, you're going to spend an extra year being miserable. Plus, you're taking a big chunk of salary out of your own pocket which means you'll have to work an extra year at the end of your career to make it up.

Read that short string of posts again. Read between the lines. There's a LOT going on in that string of posts, your own post included, that speaks volumes about the current situation, who really has your best interests in mind, and your own attitude about the subject.

-copro

 

[GasEmDee]

Hmm. I read the "old guys" comment differently. I thought he was referring to senior anesthesiologists in general, who will be retiring before these predicted changes in the profession take place. I did not think he was pointing a finger at old academicians or at people who are selling out our profession.

Gasguy06, what you don't realize is that urge's original response was spot on. This string of posts should tell you all that you need to know.

I can't tell you the number of "old guys" I've seen around who really don't give a **** anymore. They are the academic "rocks" of the institution. They are the first ones who'll tell you you're wrong for trying to change things. They are the first ones who'll say that you need to learn to be a "team player" and to "respect" everyone. They are not the shepherds of our profession.

The irony is that you have sought advice from people in your program who aren't going to fight to protect our specialty anymore. The potential changes in the field that are going to occur over the next 10-15 years won't affect them. So, they have nothing to gain, and everything to lose, in being perceived as "confrontational" in their safe, protected little world.

So, what they do instead is imagine what they'd do if they were in your shoes. Because they've learned that standing up for themselves usually just earns them a smack-down, they advocate taking the path of least resistance. And, that path of least resistance means doing something else to protect themselves - a defensive posture. They believe that, although they might win a few battles, they can't win the war. Therefore, they are advocating to you that you should be prepared to surrender... because that's what they've grown accustomed to doing.

I think if you are going to do a fellowship for that reason, it is a bad one. Like others have said, do a fellowship if you are interested in a particular subspecialty field. Otherwise, you're going to spend an extra year being miserable. Plus, you're taking a big chunk of salary out of your own pocket which means you'll have to work an extra year at the end of your career to make it up.

Read that short string of posts again. Read between the lines. There's a LOT going on in that string of posts, your own post included, that speaks volumes about the current situation, who really has your best interests in mind, and your own attitude about the subject.

-copro

 

[me454555]

Just an FYI for you guys. Spoke w/the director of the anesthesia group @ my last hospital. It was a community hospital in Long Island, private practice group. His direct quote "we really look for fellowship trained guys b/c they stand out much more". The group seems like a great group to get into and most of the docs seem happy. The older guys don't have fellowships but the newer's ones mostly did. He recommended doing one. I'm just a CA-1 so I have no other insight into the matter

 

[BubbleHead]

Good Thread GasGuy

Truly the biggest question we have as mid level and senior residents. Pass up $400K for another year @ $50K for possible job security, knowing we may never regain the lost income.

Honestly I think many places are not interested too much in fellowship training, plenty of opportunities exist across the country. A our stage, we're going to be included in the "old guys" group.

I think we will not suffer from not doing fellowships. Having said that, don't be surprised in 10 years if you want to move if you find it harder to get "that job" in "that location" if you aren't sub-specialty boarded.

For me it's a risk I'm going to take. I don't want residents slowing me down, Anesthesia or Surgical residents. I want PP hoping people there are better, quicker, and focused on personal life and private time is given a premium.

 

[Crash cart]

Thanks, D-bag. That was a helpful post.

Public apoligies to Urge for my comment. After reading through the thread, I realize the error of my ways. I appreciate the input form all, especially Bubblehead (who I know personally and can say from the heart, is a true D-Bag!).