Seeing the light?

[nooans]

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I am a 4th year medical student who matched into a very competitive surgical subspecialty this year. I am currently in a 2 weeks long Anesthesiology rotation, and find myself immensely enjoying this rotation. Now, I am having a second thought regarding my career decision.

During medical school, I was so focused on doing "surgery", and didn't pay too much attention to what's happening on the other side of the drape. The nature of work that entails manipulation of human physiology utilizing pharmacology is very interesting to me. (Physiology and pharmacology were my favorite subjects!) Anesthesiology is not a life style specialty, but I believe it will keep me busy enough to feel engaged in my work, and also allow me to have more time for my interests outside medicine as well.

I really hope this will just end as a "fling" (I am still very excited about my matched specialty). However, I will spend a month in anesthesiology rotation during my intern year, and I will get a chance to seriously assess the field. I wonder if you can help me to understand how I should approach this matter, so I can make an unbiased objective decision. (for ex) what kind of goals should I have during my anesthesiology / ICU rotations next year, how to approach to people who could help me to make switch, etc.) I am an AMG with high 250s on both Step I and II + AOA at my school.

Thanks!

 

[gasattack3]

I am a 4th year medical student who matched into a very competitive surgical subspecialty this year. I am currently in a 2 weeks long Anesthesiology rotation, and find myself immensely enjoying this rotation. Now, I am having a second thought regarding my career decision.

During medical school, I was so focused on doing "surgery", and didn't pay too much attention to what's happening on the other side of the drape. The nature of work that entails manipulation of human physiology utilizing pharmacology is very interesting to me. (Physiology and pharmacology were my favorite subjects!) Anesthesiology is not a life style specialty, but I believe it will keep me busy enough to feel engaged in my work, and also allow me to have more time for my interests outside medicine as well.

I really hope this will just end as a "fling" (I am still very excited about my matched specialty). However, I will spend a month in anesthesiology rotation during my intern year, and I will get a chance to seriously assess the field. I wonder if you can help me to understand how I should approach this matter, so I can make an unbiased objective decision. (for ex) what kind of goals should I have during my anesthesiology / ICU rotations next year, how to approach to people who could help me to make switch, etc.) I am an AMG with high 250s on both Step I and II + AOA at my school.

Thanks!

I'm happy with my choice to pursue anesthesiology. That being said, if you can gruel it out in that surgical subspecialty, during hard residency years, then many of those specialties have a good deal to offer. It's a personal decision only you can make.

 

[Ronin786]

I'm happy with my choice to pursue anesthesiology. That being said, if you can gruel it out in that surgical subspecialty, during hard residency years, then many of those specialties have a good deal to offer. It's a personal decision only you can make.

Yup. I dont think anybody can make this decision for you, especially since you apparently matched into the field you wanted.

Personally, I think you should finish your Anesthesia rotation and then take a long look at what you like in each specialty. You could be bummed about your matched specialty due to not matching high enough on your ROL, or maybe due to some post-match psychological thing.

See the pros and cons of each field and try and focus on why you wanted your field in the first place.

 

[imfrankie]

I enjoy anesthesia--and don't have what it takes for surgery even if I didn't. But let me tell you, you will not have to compete with a nurse for work as a surgeon.

 

[ctsicu]

Agree with imfrankie...I actually switched out of a surgical sub specialty to do anesthesia...and I love it but am not very confident or optimistic about the future. Surgery will likely still be fine In 20 yrs-I don't know if I could say that about anesthesia. Physician anesthesia anyway.
While I don't really regret it because ultimately I didn't enjoy the surgical field, I sometimes wish I had picked something else in which I didn't have to deal with crnas and lack of independence.

 

[naus]

Seems like grass is always greener.

 

[Dejavu]

Agree with imfrankie...I actually switched out of a surgical sub specialty to do anesthesia...and I love it but am not very confident or optimistic about the future. Surgery will likely still be fine In 20 yrs-I don't know if I could say that about anesthesia. Physician anesthesia anyway.
While I don't really regret it because ultimately I didn't enjoy the surgical field, I sometimes wish I had picked something else in which I didn't have to deal with crnas and lack of independence.

36 yrs ago, I was a CRNA, 20 yrs ago I went to Med School and Residency.

36 yrs ago, everybody was talking about the anesthesia profession going to hell in a hand basket, 20 yrs ago nobody was going into anesthesia because of doom and gloom.

And here we are, anesthesia is a great profession, and we are still talking about it,

Life is cyclical, I guess.

 

[imfrankie]

Thanks for the perspective Dejavu

 

[Dejavu]

Thanks for the perspective Dejavu

You are so welcome.

Being old does give one perspective about a lot of things.

It doesn't necessarily make you wise though.

 

[EtherBunny]

I switched out of a surgical subspecialty. All I can tell you in terms of advice is a) nobody knows what the future of ANY specialty will be in terms of desirability, compensation, job opportunities, etc. and b) you can't put a price tag on happiness.

Overall, job security and pay will be higher for surgical subspecialties in the future, but there is no guarantee this will happen. Look at ophthalmology: in the 70s and 80s it was easily one of the most lucrative fields in medicine. Nowadays...not so much. In other countries physicians get roughly equal pay regardless of specialty. Are we headed in that direction now? Who knows! There is definitely a gradual shift away from disproportionate compensation for procedural specialists in favor of primary care (granted, it's a very gradual phenomenon, but occurring nonetheless). Will specialists earn roughly the same as primary care in 10 years? Possibly. The bottom line: nobody knows what the future holds for physicians in all specialties.

The happiness issue: I can tell you categorically that I'm much happier in anesthesia than I was in surgery. No question about it. I would say that the vast majority of anesthesiologists at my hospital are happy in their careers. It's a great field with a lot of perks. But it's not perfect. There are some downsides to this field, as is the case with all fields of medicine. Your job is to figure out what you need out of a career in medicine to be happy both professionally and personally. Everyone is unique. If I were you I would crank through at least 3 years of surgical residency before you decide to jump ship. You need to get through the junior year before you jump to any conclusion. Everybody hates the junior year in surgery. It's awful.

And remember: you can always switch into anesthesia, but once you switch you burn your bridges back to surgery.

Good luck with your decision!

 

[Consigliere]

I enjoy anesthesia--and don't have what it takes for surgery even if I didn't. But let me tell you, you will not have to compete with a nurse for work as a surgeon.

So true and extrememly important. Just ask those looking for jobs; they are scarce.

 

[IlDestriero]

So true and extrememly important. Just ask those looking for jobs; they are scarce.

Yes times are tougher than 5 years ago, but all the fellow and residents I work with have job offers, save one who was geographically restricted and didn't get the job he was counting on. As soon as he widened the net he had many more interviews and should be gainfully employed come July. One of his interviews is for a >90th % income position that only just became available. That's the kind of job I'd consider selling out for. When I was at a conference recently, I was approached by group's managing partner about my interest in leaving for their large PP group to be their peds division chief and an old colleague told me to call him if I wanted to join his practice as they are looking to expand by the new year. None of these jobs are advertised anywhere, but jobs are definitely there if you look and keep an active network.
As I always say when I read these posts, I don't know any unemployed anesthesiologists.

 

[CrazyJake]

2 weeks ago a buddy who is during surgery in NC told me that NPs are lobbying HARD to do "routine" surgeries (appys, hernias, gall bladders, etc) in his state. Doubt this happens, but nurses want to take over medicine any way they can.

For what it's worth.

CJ

 

[ambiturner]

2 weeks ago a buddy who is during surgery in NC told me that NPs are lobbying HARD to do "routine" surgeries (appys, hernias, gall bladders, etc) in his state. Doubt this happens, but nurses want to take over medicine any way they can.

For what it's worth.

CJ

This has been going on in the UK for some time: http://news.bbc.co.uk/2/hi/health/3580453.stm

not sure how widespread it is, but as an idea it's at least 10 years old. Google searching also reveals several other journal articles discussing minor procedures in several fields being considered safe and effective. However, this is much more in the distant future than nurses in anesthesia, which started >20 years ago, and promises only to grow in scope.

 

[nooans]

Thanks for all the advice!
It is always good to know that I have an option to switch later during the residency.
I will give my best to my matched specialty, and see how it works.

 

[uro9414]

Surgical subspecialties, especially Urology, ENT, and Ortho, are really the way to go. The residency is tough, but at the end if the day, I know I'll have pretty good job security, income, lifestyle, and a really rewarding career. Anesthesia is a great field too no doubt, and if you end up going that way, I'm sure you'll have a fulfilling career as well.

 

[BLADEMDA]

Yes times are tougher than 5 years ago, but all the fellow and residents I work with have job offers, save one who was geographically restricted and didn't get the job he was counting on. As soon as he widened the net he had many more interviews and should be gainfully employed come July. One of his interviews is for a >90th % income position that only just became available. That's the kind of job I'd consider selling out for. When I was at a conference recently, I was approached by group's managing partner about my interest in leaving for their large PP group to be their peds division chief and an old colleague told me to call him if I wanted to join his practice as they are looking to expand by the new year. None of these jobs are advertised anywhere, but jobs are definitely there if you look and keep an active network.
As I always say when I read these posts, I don't know any unemployed anesthesiologists.

Peds is hot right now. But, that too will wane as the Groups acquire new Fellowshipped Trained Docs over the next few years. Strike while the Iron is hot and right now it is on fire.