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I am new to this forum, but have enjoyed reading the posts and have learned quite a bit. I am a senior general surgery resident (will enter chief year July 2007) and have realized that GS is not all that I thought it was going to be despite > 2 years of trying to convince myself that it would "get better". After struggling with the idea of change and putting much thought into my decision, I want to make the switch to the other side of the drapes if you will. Why surgery is not for me and why it took me so long to make this decison is a whole other topic (but one that I would be more than happy to elaborate on in a different thread for those contemplating surgery or those who are just curious).
I feel that a little explanation as to why I want to do anesthesia NOW is warranted. Lifestyle is defintiely a huge factor. I could spend hours and pages on this forum elaborating on the specifics of GS lifestyle concerns (and again would be more than happy to do so in a separate forum) but suffice it to say my priorities have changed since I was a 4th year MS (i.e., spouse, planning a family, etc.). Please understand by lifestyle I do not mean MONEY (although the $$$ is nice), but more importantly time to enjoy the hard-earned fruits of one's labor and to develop one's self outside of their career. Also, the fact that I hate roundng on patients, can't stand office (esp. thinking about the business behind running an office in today's market), essentially being on call 24/7/365 for all sorts of BS, etc. What I specifically like about anesthesia is, in a nutshell, it's critical care . My current training program is heavily laden by trauma and critical care. We really do too much (PD will admit it), but it's simply a matter of large volume although I can't complain because you become extremely confident in taking care of the sickest trauma patients. Surgery is the "go-to" program at our institution and therefore the one most called on to manage critical care issues (even medical because until recently, our CC med docs sucked!). So we get a lot of training in managing extremely sick medical and surgical patients. Looking back on my training, I found the thing that I loved the most out of all of my rotations was critical care. It was so cool to try and anticipate the moment to moment physiologic changes in a sick patient and then to try and manipulate those parameters (with pharmacology, physiology, and mechanical interventions) to benefit the patient. That is a large part of what an anesthesiologist does on a daily basis. Also, obviously I'm procedurally oriented and anesthesia will allow me to do procedures (albeit on a much more limited basis) while still maintaining a large degree of patient contact (unlike radiology for instance). Anyway, the reason I am writng this post is to get some advice for finding a slot in 2007.
Obviously, the match is only days away (2?) for 2006 slots, and so the only way to get a slot for '06 would be to scramble. Furthermore, I'm really not that interested in getting a 2006 slot because it would require drastic changes (i.e. selling a home, relocating a family, finding a new home, etc.) fairly quickly! So I have decided to finish my surgery training and graduate in June '07. Therefore, I have several questions:
1) How competetive will I be? USMLE Step I-III scores around 225; graduated medical school AOA; strong evaluations in general surgery residency?
2) Will having completed a GS residency help or hurt? In other words, will programs take note of that and consider it a strength or will it hurt because PD's will think "I don't know what the hell I want to do with my life"?
3) Should I go through ERAS or go outside the match to find a CA-1 slot (definitely preferable)?
4) With the match just ending, when should I contact programs to check on available CA-1 slots for July 2007 outside of the match?
5) My institution does not have an anesthesia training program but has many fellowship trained anesthesiologists (most with pretty strong contacts within area programs). I have several that have agreed to write a rec letter for me. Will this suffice or hurt me because they are not academic faculty?
6) I have not talked to my PD about my decision because what I am going to do will definitely be seen as sacrilege by many attendings within the department. However, I do think he would write a good rec letter if he knows this is a well thought out decision and not knee-jerk. He's an extremely honest man, very well respected in this field, and truly wants what's best for his residents. I, however, have talked with a few associate professors in the department who understand my decision and are willing to write a rec letter for me (and have promised discretion). Should I just get these "lesser" rec letters (including my Dean's letter) or would it be better to bite the bullet and ask my PD for a rec letter and risk the info leaking (i.e. secretaries, ancillary staff, etc.) and therfore becoming a pariah in the department before I am signed by an anesthesia program. It's not that I care what others think (way past equating field of practice with level of prestige), it's just that I'm afraid it could seriously damage my career options if I can't match in an anesthesia program.
These are just a few of the questions I have and would appreciate any help. I look forward to the comments (good and bad).
I feel that a little explanation as to why I want to do anesthesia NOW is warranted. Lifestyle is defintiely a huge factor. I could spend hours and pages on this forum elaborating on the specifics of GS lifestyle concerns (and again would be more than happy to do so in a separate forum) but suffice it to say my priorities have changed since I was a 4th year MS (i.e., spouse, planning a family, etc.). Please understand by lifestyle I do not mean MONEY (although the $$$ is nice), but more importantly time to enjoy the hard-earned fruits of one's labor and to develop one's self outside of their career. Also, the fact that I hate roundng on patients, can't stand office (esp. thinking about the business behind running an office in today's market), essentially being on call 24/7/365 for all sorts of BS, etc. What I specifically like about anesthesia is, in a nutshell, it's critical care . My current training program is heavily laden by trauma and critical care. We really do too much (PD will admit it), but it's simply a matter of large volume although I can't complain because you become extremely confident in taking care of the sickest trauma patients. Surgery is the "go-to" program at our institution and therefore the one most called on to manage critical care issues (even medical because until recently, our CC med docs sucked!). So we get a lot of training in managing extremely sick medical and surgical patients. Looking back on my training, I found the thing that I loved the most out of all of my rotations was critical care. It was so cool to try and anticipate the moment to moment physiologic changes in a sick patient and then to try and manipulate those parameters (with pharmacology, physiology, and mechanical interventions) to benefit the patient. That is a large part of what an anesthesiologist does on a daily basis. Also, obviously I'm procedurally oriented and anesthesia will allow me to do procedures (albeit on a much more limited basis) while still maintaining a large degree of patient contact (unlike radiology for instance). Anyway, the reason I am writng this post is to get some advice for finding a slot in 2007.
Obviously, the match is only days away (2?) for 2006 slots, and so the only way to get a slot for '06 would be to scramble. Furthermore, I'm really not that interested in getting a 2006 slot because it would require drastic changes (i.e. selling a home, relocating a family, finding a new home, etc.) fairly quickly! So I have decided to finish my surgery training and graduate in June '07. Therefore, I have several questions:
1) How competetive will I be? USMLE Step I-III scores around 225; graduated medical school AOA; strong evaluations in general surgery residency?
2) Will having completed a GS residency help or hurt? In other words, will programs take note of that and consider it a strength or will it hurt because PD's will think "I don't know what the hell I want to do with my life"?
3) Should I go through ERAS or go outside the match to find a CA-1 slot (definitely preferable)?
4) With the match just ending, when should I contact programs to check on available CA-1 slots for July 2007 outside of the match?
5) My institution does not have an anesthesia training program but has many fellowship trained anesthesiologists (most with pretty strong contacts within area programs). I have several that have agreed to write a rec letter for me. Will this suffice or hurt me because they are not academic faculty?
6) I have not talked to my PD about my decision because what I am going to do will definitely be seen as sacrilege by many attendings within the department. However, I do think he would write a good rec letter if he knows this is a well thought out decision and not knee-jerk. He's an extremely honest man, very well respected in this field, and truly wants what's best for his residents. I, however, have talked with a few associate professors in the department who understand my decision and are willing to write a rec letter for me (and have promised discretion). Should I just get these "lesser" rec letters (including my Dean's letter) or would it be better to bite the bullet and ask my PD for a rec letter and risk the info leaking (i.e. secretaries, ancillary staff, etc.) and therfore becoming a pariah in the department before I am signed by an anesthesia program. It's not that I care what others think (way past equating field of practice with level of prestige), it's just that I'm afraid it could seriously damage my career options if I can't match in an anesthesia program.
These are just a few of the questions I have and would appreciate any help. I look forward to the comments (good and bad).
