Second thoughts on career choice and residency training

[drlard]

Hello everyone. I've recently been having a lot of second thoughts both regarding my choosing anesthesia as a career (versus a more well respected specialty), as well as my choice in where to train for residency. I was just wondering if other people are having the same thoughts or am I going crazy?

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[BassDominator]

I originally had this fear. For a long time, I was hesitant to tell others I was considering anesthesia. However, once I got more clinical exposure, I realized this wasn't always true.

There will always be other docs who don't give you the proper respect. Unfortunately, there are some really bad anesthesiologists out there. However, there are also some really great ones out there who get a lot of respect, because they are amazing at what they do. Like anything in life, you have to earn respect.

Anesthesia has gotten a lot safer in recent years, but it's still a dangerous business. There are folks out there who are competent, and there are folks who have some real finesse. Personally, I don't care what others think. As long as the patient has a good outcome, I know I'm doing a good job, and that's all I need....

 

[VentdependenT]

Its only natural to panic when finally commiting yourself to one thing. Ask any of your buddies who are about to be married.

As for the respect issue, I'm afraid I can't commiserate with you. I believe that the amount of respect deserved is dependent on the individual in question, not the field in question (or even profession). There are a lot of bitter folks in medicine. Don't let their own misgivings about their own lives interfere with whats going on in yours.

UCSF is one kick ass program in one kick ass city. You picked the right field. You'll rock it like a champ.


Vent

 

[BassDominator]

There are a lot of bitter folks in medicine. Don't let their own misgivings about their own lives interfere with whats going on in yours.

.... and they're just really jealous of us. A lot of docs I know say if they had it to do again, they definitely would have done anesthesia.

Congrats on USCF.... I'm jealous!

 

[aphistis]

Its only natural to panic when finally commiting yourself to one thing. Ask any of your buddies who are about to be married.

Tell me about it; that's me, 100%.

 

[powermd]

I admit I had these feelings for a few months during third year when I first considered anesthesiology. When telling certain non-medical people, and a few classmates what I planned to specialize in I would get "anesthesia??" "Isn't that BORING??" I never really saw this attitude around the hospital though. On my rotations in anesthesiology and surgery I noticed the anesthesiologists got a lot of respect for their expertise (even among surgery people when no one from anesthesia was around). Like most fields, however, I think the respect given to anesthesiologists is less dependant on field as it is on individual merits. People respect good doctors regardless of what specialty they practice.

 

[undecided05]

A friend of mine is now a 2nd year at UCSF. When going over some of the same fears, he stated that he couldn't be happier with anesthesia or UCSF. My advice is to relax. While gas gets shat on by others, so does everything else.
Double blind study= two orthopods looking at EKG
Family Practice= jack of all trades, master of none
OB/GYN= couldn't decide between surgery and medicine... they suck at both
Medicine= Likes to think, can't act
Peds= Veternary medicine
Psych= don't want to be real doctors, crazier than their patients
Gas= Why they don't look out the window in the morning... gives them something to do in the afternoon.

You get the point.

 

[Meza]

As a resident, it's difficult to really know what your life is going to be like as a practicing specialist. I had to switch programs in mid-training. At that time I was seriously contemplating switching specialties. But I stuck with anesthesia, and realized that my previous program just sucked. Now I'm finishing up at a different anesthesia program, and I'm excited again. I'm looking forward to my first job, with is already all lined up. And now realize that once I got myself out of a bad situation, things brightened up for me. Hang in there, things will probably be better once you get out of residency.

 

[shahenshah]

Hi Meza,

could you please tell a bit more on your reasons..what were the sort of cons you experienced at your program...also could you talk about some of the sort of jobs/work (in terms of setting, pay, lifestyle etc) awaiting you on finishing your residency

 

[Tenesma]

everybody goes through doubts before starting residency.... and I think the most common source of these doubts are twofold

1) there is NO way anybody will ever truly understand what anesthesia is like until you become an anesthesia resident.... you might have done anesthesia as a 3rd year med student, you might have done a few months of 4th year electives in anesthesia, you might even do an elective during intern year in anesthesia... you think you know, but you have no clue what so ever..... Until you are responsible for a patient pre-operatively, intra-operatively and post-operatively, you will never understand.

2) other people's opinions: just like i said in point #1, if you can't truly grasp what you are getting into (and you want to do anesthesia), how can you expect other people (who don't want to do anesthesia) to have the slightest clue.... maybe in some institutions where anesthesiologists (primarily due to language barriers) have become subservient there are "respect" issues --- but trust me, anesthesia is one of the respected fields of medicine as soon as the **** hits the fan.... Nobody understands pharmacology and physiology better than an anesthesiologist - and when a patient is critically ill, the surgeons will turn to you and ask for your help.

I was very concerned about going into anesthesia - i thought i was going to be bored.... etc... NOTHING could be further from the truth, it is the best choice you can ever make for yourself!!! look at which specialty recruits the most transferring residents from other specialties!!! radiology, surgery, ENT, ob/gyn, EM, peds, IM have all transferred into anesthesia for different reasons...

as far as the respect issue goes ---- no matter what you do and who you are, respect is something you earn. knowledge, honesty and hard work earn respect....

 

[Intubater_X]

...my choosing anesthesia as a career (versus a more well respected specialty

Uh, which careers in medicine are more "well respected" than anesthesiology? I can tell you as a recently graduated attending anesthesiologist that respect comes from excellence in your field. If you are a conscientious, hard-working, personable individual, trust me.......you will get MAD RESPECT!!

Hope this helps..........

 

[powermd]

I think the OP is suffering from what I might call "premed syndrome"-- the notion that you're only as good or respectable as your resume and pedigree. I don't blame premeds or medical students for this because from day one in college we have the idea forced on us that MORE COMPETITIVE ALWAYS = BETTER. It's easy to get carried away with this idea and believe "if I don't go to the best college, or the best medical school, or enter the best specialty-- no one will respect me." Because of anesthesia's recent history of being less-competitive, the specialty has fallen in prestige (compared to say integrated PRS or derm) among med students. The trouble with this construct is that it's all based on ACADEMIC MERIT, which is related to how quickly you learn new information, and to some extent how well you solve academic problems. Of course, once you leave medical school and start practicing real medicine you learn that this has little correlation with success as a clinical doctor. Academic talent is just one small part of what makes an effective and respected physician. That is why few practicing doctors will still judge you based on your pedigree or specialty choice alone (and those who do are a**holes, so who cares?). Of course, if you choose to enter the academic rat-race for your career, you will need a lot of academic merit to get there, and likely a strong pedigree too if you want to go far in the ranks of academia.

 

[hermanodequeso]

hey drlard,

i sent you a pm.

 

[Meza]

Hi Meza,

could you please tell a bit more on your reasons..what were the sort of cons you experienced at your program...also could you talk about some of the sort of jobs/work (in terms of setting, pay, lifestyle etc) awaiting you on finishing your residency

My reasons for switching programs were multiple. But, primarily I was at what I perceived was a very hostile environment. It was difficult to learn, difficult to perform, and difficult to be happy. I actually would get sick and teary-eyed as I drove in to work each morning! I knew I had to make a change.

My job once out will be at a day surgery-type setting. Mostly conscious sedation and local anesthesia/regional blocks. I'm considering a pain fellowship because I perceive higher salaries and less work. But, for now, I need to make some money. Starting pay is $225,000 yr, which isn't a whole lot, but much, much more than I'm used to. I have a good friend who has his own pain management practice, and he brings in over $500,000 year in California. So, it can be done. He also has a second academic job. What this means to me is, he would have plenty of free time if he decided to only do his practice - and forget about the academic part.

Unfortunately I have call once a week, but I've been told you simply sleep on call. The group I'm joining covers a local small hospital. So, I'm stoked.

 

[medstudent2005]

excuse my ignorance..but i always thought $225000 was a whole lot...silly me

 

[dave262]

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[NaeBlis]

Yah, alot of people forget to take into account the tax burden when consider their potential attending salaries. LOL, hopefully most peole realize it before the put in the downpayment on the mansion.

 

[medstudent2005]

umm...130K...wow, that means i might be able to afford only one luxury car...and drats...just a simple 2 story, 5 bdrm house...watching my dreams swirl in the toilet bowl...

 

[dave262]

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[Pinky]

actually no dude. when you sacrafice the best ten years of your life to sit in a library or in a hospital working/studying from 6AM until 10PM each day every day and realize that if you had that kind of dedication as an investment banker or a lawyer you'd likely be a millionaire several times over, or at the very least you would have gone home and been able to watch reality TV at night and be marginally successful. But instead, you throw those years away and you are 31 just finishing residency, with >$150,000 in debt. You still drive the same crappy little honda you had as a sophomore in college. Your diet has consisted of the same crappy ass cafeteria food that you ate in high school. Somehow 130K just doesnt cut it.

I think about this every morning when I wake up ready for another call.
Especially when most of my patient's feel that THEY are doing ME a favor by "letting" me take care of them, it makes the whole thing oh so worthwhile.