Scrambled into Anes

[Valvool]

I am a fourth year student who failed to match into EM. My board scores and grades are excellent and I am still not sure why I did not match. I had to SOAP Mon-Wed of this week. I applied widely to specialties I felt paralleled well with EM or that I interest in, and I applied to several Anes programs for that reason. Procedures, intubations, lines, etc--those are my favorite aspects of ER medicine. On Wed, thankfully, I had ten offers, including multiple offers at several Anesthesiology programs, a Diagnostic Radiology position, and numerous positions in FM, IM, and Peds. I ended up choosing an Anes program and, while I am still adjusting to my new reality, today I am relatively satisfied with my decision.

I have four weeks left in medical school and it's basically open--I could take vacation in April, or choose to do another clinical rotation. Since I haven't had much anesthesiology exposure, I wonder if I should forego the vacation and do four weeks of Anes? Or does it even matter at this point? For multiple reasons, I don't plan to reapply to EM next year--I struggled with my decision to apply to EM to start with because my interests were so varied and I saw myself being happy doing any number of things. I was excited about EM, but I also loved other specialties--at the end of third year I even requested a second meeting with the dean to discuss whether EM was right for me. So perhaps I am not as heartbroken as someone who had their heart absolutely set on EM.

I was really looking forward to vacation in April and cringe at the thought of giving it up, and I am showing up for an Anes residency on July 1st regardless, so I wonder if doing four weeks of Anes would make a difference at this point. Just wanted to get your perspectives on this.

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[BobBarker]

Take vacation. You will be happier in anesthesia than EM. I thought I wanted to do EM for a long time before deciding on anesthesia and I am so happy that I did.

 

[Antigunner]

Honestly, at this point I would take the vacation. I think a lot of the utility of doing a rotation during medical school is mostly to learn about the field and whether it would be a good fit for you, and that part is already settled for you. You have the next four years to learn everything you need to know to become a proficient anesthesia provider.

That being said, it's likely that the rest of your class will have a good bit of experience from their rotations, so if it's important for you that you not feel "behind," then a rotation could at least let you get your feet wet and become familiar with the basics.

Would it have to be a full four weeks, or could you set up a 2 week rotation and 2 weeks of vacation? That would sort of give you the best of both worlds.

Good luck with your decision, and with your residency - hope you find that anesthesiology is a good fit for you

 

[muchmargarita]

take vacation. Just work hard on your anesthesia months during your intern year.

 

[Consigliere]

Damn, kid....I would have taken the Radiology position.

 

[Nooblet]

take vacation. Just work hard on your anesthesia months during your intern year.

Yeah this. Congrats and welcome

 

[Medstudentquest]

I am a fourth year student who failed to match into EM. My board scores and grades are excellent and I am still not sure why I did not match. I had to SOAP Mon-Wed of this week. I applied widely to specialties I felt paralleled well with EM or that I interest in, and I applied to several Anes programs for that reason. Procedures, intubations, lines, etc--those are my favorite aspects of ER medicine. On Wed, thankfully, I had ten offers, including multiple offers at several Anesthesiology programs, a Diagnostic Radiology position, and numerous positions in FM, IM, and Peds. I ended up choosing an Anes program and, while I am still adjusting to my new reality, today I am relatively satisfied with my decision.

I have four weeks left in medical school and it's basically open--I could take vacation in April, or choose to do another clinical rotation. Since I haven't had much anesthesiology exposure, I wonder if I should forego the vacation and do four weeks of Anes? Or does it even matter at this point? For multiple reasons, I don't plan to reapply to EM next year--I struggled with my decision to apply to EM to start with because my interests were so varied and I saw myself being happy doing any number of things. I was excited about EM, but I also loved other specialties--at the end of third year I even requested a second meeting with the dean to discuss whether EM was right for me. So perhaps I am not as heartbroken as someone who had their heart absolutely set on EM.

I was really looking forward to vacation in April and cringe at the thought of giving it up, and I am showing up for an Anes residency on July 1st regardless, so I wonder if doing four weeks of Anes would make a difference at this point. Just wanted to get your perspectives on this.

Hey congrats! Out of curiosity since I saw the title of your post, how do you feel the SOAP was? Did you think it was an organized system, did you think it made the process easier,etc? I was curious how it would work and since I matched I did not participate in it and you are the first person who I know SOAP'ed successfully.

Did you interview for the positions over the phone/in person, etc?

 

[BLADEMDA]

I am a fourth year student who failed to match into EM. My board scores and grades are excellent and I am still not sure why I did not match. I had to SOAP Mon-Wed of this week. I applied widely to specialties I felt paralleled well with EM or that I interest in, and I applied to several Anes programs for that reason. Procedures, intubations, lines, etc--those are my favorite aspects of ER medicine. On Wed, thankfully, I had ten offers, including multiple offers at several Anesthesiology programs, a Diagnostic Radiology position, and numerous positions in FM, IM, and Peds. I ended up choosing an Anes program and, while I am still adjusting to my new reality, today I am relatively satisfied with my decision.

I have four weeks left in medical school and it's basically open--I could take vacation in April, or choose to do another clinical rotation. Since I haven't had much anesthesiology exposure, I wonder if I should forego the vacation and do four weeks of Anes? Or does it even matter at this point? For multiple reasons, I don't plan to reapply to EM next year--I struggled with my decision to apply to EM to start with because my interests were so varied and I saw myself being happy doing any number of things. I was excited about EM, but I also loved other specialties--at the end of third year I even requested a second meeting with the dean to discuss whether EM was right for me. So perhaps I am not as heartbroken as someone who had their heart absolutely set on EM.

I was really looking forward to vacation in April and cringe at the thought of giving it up, and I am showing up for an Anes residency on July 1st regardless, so I wonder if doing four weeks of Anes would make a difference at this point. Just wanted to get your perspectives on this.

Take a vacation and if you feel guilty read a little anesthesia.

 

[Valvool]

If you look at my posts from last wk I gave a detailed recap of my SOAP experience. Overall it wasn't a terrible experience, though the phone interview marathon all day Tues was rough. I interviewed from 8a to 9p with multiple people from interested programs. The only time I felt overwhelmed and confused was on Wed as noon approached. Multiple PDs called relentlessly between 1145 and noon all wanting the same thing, my reassurance that I would choose them were they to rank me first. I was trying to research programs at the same time and I finally just stopped taking calls. I ended up with ten offers and I am grateful for it.

Thanks for the input, I will take my last 4 wks of vacation after all!

 

[UTSouthwestern]

Damn, kid....I would have taken the Radiology position.

A friend of mine did that in the scramble and thought he was the luckiest guy on the planet. Three years into practice, he went back into residency for general surgery.

Pick what you can envision yourself doing ten years into private practice, not a field you THINK you might enjoy but in reality are picking for a perceived sense of financial security or "easy" lifestyle.

 

[x10694]

A friend of mine did that in the scramble and thought he was the luckiest guy on the planet. Three years into practice, he went back into residency for general surgery.

Pick what you can envision yourself doing ten years into private practice, not a field you THINK you might enjoy but in reality are picking for a perceived sense of financial security or "easy" lifestyle.

I agree. I for one really doubt I can do radiology. I love looking at radiographs but I look at it as another tool so I can't imagine looking at radiographs all my life. Plus the voulumes are ridiculously high and in many ways its like shelving books in the library with a lot of time constraints. My eyes would hurt after a while...

 

[Josh1]

Hey Valvool
Out of curiosity why don't you think you matched? Did you not rank enough places or not get enough interviews? I saw you posted elsewhere that you received a 250 step 2, do you think it was all step 1 scores or how competitive EM has been getting? What advice do you have for us up-and-coming students?
Thanks for your input on SOAP.

 

[foxtrot]

Damn, kid....I would have taken the Radiology position.

I was thinking the same thing.

 

[Stank811]

I was thinking the same thing.

I was thinking why would you even consider radiology?

 

[x10694]

I was thinking why would you even consider radiology?

Exactly, aside from the money its like pathology, Eeewww

 

[Oggg]

+1 to what UTSW said. You have to choose a specialty out of love for the specialty. That will last forever. If you need to do an anesthesia rotation to see if you like anesthesia, then do it. I have known a handful of people who were so damn smart they could qualify for anything in the world, but they couldn't make their own decisions -- they became MDs because it seemed like a good idea. One went on to quit medicine after residency and became a magazine editor/ business person. What a waste of time ! If you finish anesthesia and then go back to do surgery or ER cuz you realize after anesthesia that you're bored, that's a waste of life.

 

[RockFoot]

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[Gimlet]

Multiple PDs called relentlessly between 1145 and noon all wanting the same thing, my reassurance that I would choose them were they to rank me first. I was trying to research programs at the same time and I finally just stopped taking calls. I ended up with ten offers and I am grateful for it.

That's interesting! During the main match, calling up an applicant to solicit that kind of information would be a major NRMP violation. But apparently it's allowed during the SOAP? I don't see how it would confer any more of an advantage during SOAP than the main match, considering the applicant could still tell 10 programs he/she will rank them number one.

What do you mean by "offers?" Do you mean 10 programs told you they would put you on their SOAP rank list? By my understanding, SOAP does away with the system where you would get "offered" the option of signing a contract with an open program.

 

[bronx43]

Damn, kid....I would have taken the Radiology position.

And have to do a fellowship to land any job... if you're lucky. Radiology isn't what it used to be, and won't ever be. Medical students are wising up to this, and that's why they had 86 open spots this year.

 

[Mr FancyPants]

To the OP, don't sweat it and take a vacation.

I was drinking the EM Kool-Aid a few years ago. Only work 3 days a week they promised...failing to mention those 3 shifts are overnight Fri-Sun during Christmas and the majority of your patients will either curse, attack or pee on you. I re-applied and matched into anesthesiology during my intern year.

Finishing up CA-1 now and haven't spent a second regretting it. Never did a formal gas rotation before starting and did fine. Feel free to PM any questions.

 

[Consigliere]

And have to do a fellowship to land any job... if you're lucky. Radiology isn't what it used to be, and won't ever be. Medical students are wising up to this, and that's why they had 86 open spots this year.

Wow. Thanks for the knowledge.

 

[Taurus]

And have to do a fellowship to land any job... if you're lucky. Radiology isn't what it used to be, and won't ever be. Medical students are wising up to this, and that's why they had 86 open spots this year.

Interest in radiology seems to go through booms and busts. The minute you think that it's all gloom for radiology, these types of studies come out in leading research journals.

Coronary CT Angiography Safe, Time Saving, and More Effective than Traditional Care for Evaluating Patients Arriving at Emergency Department with Chest Pain

CT Colonography Shown to be Comparable to Standard Colonoscopy for People Ages 65 and Over

Once the floodgates open for virtual colonoscopy (and it will), they will need lots of radiologists to read those studies. If CCTA becomes the standard of care, same thing. I'm confident that both will stay within the realm of radiology, especially VC, because of the high liability of missing something.

Bottom line is go with what interests you because you can't predict the future.

 

[pgg]

Once the floodgates open for virtual colonoscopy (and it will), they will need lots of radiologists to read those studies. If CCTA becomes the standard of care, same thing. I'm confident that both will stay within the realm of radiology, especially VC, because of the high liability of missing something.

The field of diagnostic radiology is in a uniquely unenviable position of becoming a commodity that can be instantly outsourced over the internet to the lowest bidder.

The very first time I saw a radiologist interpreting a study over the internet, my first thought was "neat!" and my second thought was "this is going to end badly for you guys" ...

Liability will probably preclude basements full of guys in India doing the reads for a discount, for a while. But when you don't even have to be in the same time zone as the patient, a host of job security issues are inevitable.

 

[Taurus]

The field of diagnostic radiology is in a uniquely unenviable position of becoming a commodity that can be instantly outsourced over the internet to the lowest bidder.

The very first time I saw a radiologist interpreting a study over the internet, my first thought was "neat!" and my second thought was "this is going to end badly for you guys" ...

Liability will probably preclude basements full of guys in India doing the reads for a discount, for a while. But when you don't even have to be in the same time zone as the patient, a host of job security issues are inevitable.

I'm not worried about international outsourcing because of strict medical licensure requirements we have here and hospital privileges. Also, Medicare will only pay for final reads if you are on US soil (I've confirmed this). So the outsourcing of radiology to India is overblown. However, let's take a hypothetical and assume that they allow some guy in a basement in India to do final reads for radiology. Do you think that it stops with radiology? Next, you'll have telepathology, telemedicine, telesurgery, probably even teleanesthesia. All you need is an internet connection and some on-the-ground helper like a nurse to take your orders and you can practice nearly every field of medicine from anywhere in the world. So, if radiology falls, the rest of medicine is in danger. It's the same argument I have against NP's. If they take over primary care, then all specialties are in danger. That's exactly what you're seeing now with the DNP's wanting to create their residencies in derm, cards, etc.

Because of the myriad of regulatory laws and politics involved, I don't see international teleradiology to be a problem. More likely, you will have consolidation of the many private practice and academic groups into megagroups that do domestic teleradiology. As long as I am competing against another radiologist in the US, I don't have as much issue. In fact, I'll take advantage of it by working an extra 1 or 2 hours a night in the comfort of my home to increase my annual income.

Lastly, there are some aspects of radiology that cannot be simply outsourced such as doing procedures. Who's going to be doing the biopsies, drains, central lines, angios, etc? For example, one prediction I have is that if virtual colonoscopy becomes a reality you will start seeing radiologists performing colonoscopies (since they have a map of the colon and know exactly where to go and they happen to have the patient right there in their imaging center).

Who knows what the future will hold. The most important thing is to add value and have skills that require you to be "on the ground". If you're nothing but a guy who sits behind a monitor and who doesn't interact with referrers or patients, then you're putting your career in danger. It's the same with anesthesia. You can't simply be a stool monkey. You can hire a CRNA to do that for less money.

 

[stationroad]

The field of diagnostic radiology is in a uniquely unenviable position of becoming a commodity that can be instantly outsourced over the internet to the lowest bidder.

The very first time I saw a radiologist interpreting a study over the internet, my first thought was "neat!" and my second thought was "this is going to end badly for you guys" ...

Liability will probably preclude basements full of guys in India doing the reads for a discount, for a while. But when you don't even have to be in the same time zone as the patient, a host of job security issues are inevitable.

on the flip side whats to stop ANY us radiologist to get 20 or so medical licenses and get films sent from all over the right to the inbox..

Just be the lowest bidder and you are IN..

I think its a great thing.

It will bring radiologist salaries WAY WAY DOWN.