Step I for Anesthesiology

Discussion in 'Clinical Rotations' started by bigfrank, Feb 26, 2002.

  1. bigfrank

    bigfrank SDN Donor
    7+ Year Member

    Joined:
    Feb 20, 2002
    Messages:
    2,067
    Likes Received:
    8
    Hello everybody. I've heard a great deal as of late as far as "how competitive anesthesiology is becoming." My question is, would someone please be specific?

    What Step I score is considered strong? 215? 240?

    What field is it similar to in terms of competiveness? Is it surpassing General Surgery? Is it approximating Ophthalmology?

    Thanks, Frank <img border="0" alt="[Clappy]" title="" src="graemlins/clappy.gif" />
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
  2. Hybrid

    Hybrid Junior Member
    7+ Year Member

    Joined:
    Feb 17, 2002
    Messages:
    16
    Likes Received:
    0
    IMO right now if you are an MD and personable you should not have a problem. It is increasing in competitiveness but is nowhere near optho. There is still FMGs getting slots. Just relax and do good on your interviews
     
  3. brownman

    brownman Member
    7+ Year Member

    Joined:
    Oct 14, 2001
    Messages:
    68
    Likes Received:
    4
    Big Frank,

    Relax my man. I do agree that it is far more competitive than most years...but it's still not opthamology. But in answer to your question: can we predict the future? I don't think it's possible, but I will say this much. It will be far more competitive when you apply. How much so is hard to say...but I think if you got the average on the boards...in a few years you should be able to match into good community programs for sure....and maybe some academic ones as well. The problem is I have no idea how to gauge what's going to happen at the upper end. The top programs filled even when times were tough (or came close to it)...so now that the pendulum has swung back, the demand across the board is greater. I wouldn't worry about the job market when you come out however. Unless the drop in surgeons just ends up being ludicrous (which is possible, but I doubt it) then anesthesia will have a bright future regardless. Remember it wasn't that many years before anesthesia that radiology had no one applying (94, 95, etc.). Now radiology is ultra-competitive and they predict the job market to be wide open for some time to come. In the end, you'll be fine. You'll match somewhere nice, and hopefully have a lifestyle to boot.
     
  4. navs

    navs Member
    10+ Year Member

    Joined:
    Oct 16, 2001
    Messages:
    98
    Likes Received:
    1
    Hi bigfrank,

    Don't worry I don't think anesthesia will become as comp. as opthal. or rads. any time soon.

    It is true that it is becoming more popular and will continue to do so, BUT u should have no problem finding a position somewhere.

    As stated previously, even during the rough times in anesth. recruitment the top programs never felt much of a pinch, so with it being hotter these programs would be much harder to get into then normal.

    Either way if u want anesth. I don't think with above avg. resume u would have trouble finding something somewhere.

    Good luck.
     
  5. neutropeniaboy

    neutropeniaboy Blasted ENT Attending
    10+ Year Member

    Joined:
    Feb 10, 2002
    Messages:
    948
    Likes Received:
    191
    Status:
    Attending Physician
    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by brownman:
    <strong>Big Frank,

    Relax my man. I do agree that it is far more competitive than most years...but it's still not opthamology. </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Ophthalmology really isn't competitive. Applicants' average USMLE scores over the last 5 years have been in the low 220s, which probably isn't statistically different from the national mean. At our school, the majority of people who matched didn't do a lick of research and most of them weren't AOA. Oy...

    Dermatology is competitive. Radiology is competitive (and popular).
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
  6. Hybrid

    Hybrid Junior Member
    7+ Year Member

    Joined:
    Feb 17, 2002
    Messages:
    16
    Likes Received:
    0
    :rolleyes:

    for the life of me I will never understand why anyone would want to do Radiology. I like to sit in a dark room without sunlight and nobody to talk to and dictate into my little phone all day and night. That would be fun.........
     
  7. bigfrank

    bigfrank SDN Donor
    7+ Year Member

    Joined:
    Feb 20, 2002
    Messages:
    2,067
    Likes Received:
    8
    I won't be applying for 3 years. I was curious as to about THEN. I know that nobody knows for sure, but I was just hoping for some reassurance, I guess.

    Best wishes, frank <img border="0" title="" alt="[Wink]" src="wink.gif" />
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
  8. Voxel

    Moderator Emeritus 7+ Year Member

    Joined:
    Nov 5, 2001
    Messages:
    658
    Likes Received:
    2
    That's ok Troll. We don't need to respond to any Trolls from Lubbock, TX. You can read some of my posts on why I find radiology to be interesting as well as those of my future colleagues. Otherwise, if you are looking to get a rise out of my fellow future radiologists or myself, it will not happen, buddy. Buh-bye.
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
  9. godfather

    godfather Member
    10+ Year Member

    Joined:
    Oct 13, 2001
    Messages:
    96
    Likes Received:
    4
    anaesthesia although more competitive than it used to be still can't be considered a super competitive residency. I think this year(i hope i don't jinx myself for the match) if your a US grad and apply smartly you'll easily match somewhere. However with about 900 spots in the country and with most med schools this year having anywhere from 5 to 25 people going into anaesthesia(i think there's like a 100 medschools in the country) one can easily see that if a few more people per med school apply in the coming years, how you can easily have alot more than 900 us grads vying for those 900 spots and thus leaving some people left out. This year most people don't know how tough the match will be because alot of people that are going into rad, derm and ortho have anaesthesia as a backup choice. Another source of applicants comes from people switching careers, as on my interviews i have counted 4er docs, 3 surgery, 2peds, 2 male ob-gyns that are either now applying for anaesthesia or were residents at the places i interviewed at. ie it seems like anaesthesia attracts more career changers than other fields. As far as what's going to happen three years from now, you just can't tell, i mean if demand remains high or they expand into new territory with new procedures, and salaries remain high , its only going to get more competitive. on the other hand if Crna's get more privelages and the distinction between the mda and crna is eroded the field may collapse for mds. however just based on my interviews and the quality of the applicants from my school i believe alot more people are going to go into anaesthesia and make it moderately competitive for the next 2 or 3 years. AS far as optho, i don't know what to make of that argument. people on this board seem to think it's a super tough residency to get but looking at the people that matched into optho from my school one wouldn't think its that competitive. I mean everybody from my school who applied (we had 10 people match into optho) found a spot, and although they weren't at the bottom of the class, they weren't exactly AoA and i don't think any of them did any research. For the most part they were regular average students and ALL of them matched. So i guess i don't know what to make of optho, although i do know that if optomoterists just got prescribing rights in a couple of states and this can't be good if your going into optho.
     
  10. Jubal

    Jubal Member
    7+ Year Member

    Joined:
    Dec 10, 2001
    Messages:
    36
    Likes Received:
    0
    AS far as I know, in 2001 there were a total of 713 US senior students recruited into Anes via match. There were 1104 positions offered through the match and this should not change significantly this year. My calculations show a decrese in the number of positions offered to 1033, but I might be wrong in my math, cos I know many programs went with all their positions in the match whereas last year they were still signing them prematch to FMGs...
    However the feedback I've been getting is that applicants esp US have doubled if not more thna that at some centers. (some are reporting 8 times more U.S. applicants than last year-but this is an exception). So even last year we were around 70% US seniors matching, with many more applying I guess(and matching into their first choice specialty). I bet you this year, one could fill only with US seniors, or nearly do so.
    And I am a bit lesss optimistic of the job market in 8-10 years from today...there've alsways been cycles...

    Back to topic however: there is no cut-off score, however many PD's seem to place imortance on scores. I would say that it is more important to have excellent LOR's and a dedication for Anesthesia (including research, extra-curricular involvement) than to have a fantastic step one score and be a nullity otherwise. However, the higher the score, the better! No high scores, still no problem if you have what i mentioned above. Also if you have a faculty memeber at your school that really believes that you'll make an excellent Anesthesiologist, he'll help you!
     
  11. bigfrank

    bigfrank SDN Donor
    7+ Year Member

    Joined:
    Feb 20, 2002
    Messages:
    2,067
    Likes Received:
    8
    Thanks for all your help, guys. I was just curious as to what the prevailing opinion was. It seems that everyone has pretty consistent opinions, to summarize:

    Anesthesiology is going to get MORE competitive. Those that have a TRUE INTEREST in the field (not in it for the $$$) and good board scores will be at an advantage. I know I'm not a genius but I am willing to put in the time to succeed.

    Best wishes to all, Frank C.
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
  12. dr.evil

    dr.evil Senior Member
    Physician 7+ Year Member

    Joined:
    Oct 30, 2001
    Messages:
    390
    Likes Received:
    0
    Status:
    Attending Physician
    "Competitiveness" in specialties always cracks me up. What does it mean to be a competitive specialty? Does it mean you have to have high board scores and AOA to get a spot? Does it mean that there are only 100-200 spots across the nation? I don't really understand it.

    They're are only so many positions for residency and only so many graduating seniors each year. How can so many specialties be "so competitive". My idea of competitive would be a specialty that has more people applying than there are residency positions available (kind of like applying to med school).

    But that's really not very accurate either. Is radiology/ophthamology really "competitive"? Do only AOA/step 1 of 230+ get these spots? No. Even people in the bottom quartile of their class will match in radiology. They just will.

    If you apply for internal medicine at the "top 10" programs in the nation and only place these on your rank list, that is probably super competitive for you. If you are a superb student with excellent boards and apply for Orthopedics at only lower tier programs then that may not be considered very competitive for you at all. I really feel like it's all pretty relative.

    One exception may be ORL where boards are averaging 234 and students are usually AOA and there are not a ton of spots, but even then there are exceptions.
     
  13. bigfrank

    bigfrank SDN Donor
    7+ Year Member

    Joined:
    Feb 20, 2002
    Messages:
    2,067
    Likes Received:
    8
    What is ORL?
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
  14. neutropeniaboy

    neutropeniaboy Blasted ENT Attending
    10+ Year Member

    Joined:
    Feb 10, 2002
    Messages:
    948
    Likes Received:
    191
    Status:
    Attending Physician
    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by bigfrank:
    <strong>What is ORL?</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Otorhinolaryngology. Also: ORLHNS (head and neck surgery).
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
  15. Jubal

    Jubal Member
    7+ Year Member

    Joined:
    Dec 10, 2001
    Messages:
    36
    Likes Received:
    0
    ORL=ENT (ear nose throat)
     
  16. Jubal

    Jubal Member
    7+ Year Member

    Joined:
    Dec 10, 2001
    Messages:
    36
    Likes Received:
    0
    ORL=ENT (ear nose throat)
     
  17. Sevo

    Sevo Senior Member
    Lifetime Donor Classifieds Approved 10+ Year Member

    Joined:
    Nov 19, 2001
    Messages:
    167
    Likes Received:
    1
    Status:
    Attending Physician
    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by bigfrank:
    <strong>

    Anesthesiology is going to get MORE competitive. Those that have a TRUE INTEREST in the field (not in it for the $$$) and good board scores will be at an advantage. I know I'm not a genius but I am willing to put in the time to succeed.
    </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Although I agree, anesthesiology will be fairly competitive in the near future (in terms of securing those coveted university positions), it will probably never be as bad as everyone thinks it will be.

    Wheras the number of positions in rads has stayed down since the nadir in interest in the mid 1990s, it seems like every anesthesiology program plans on increasing by at least 25% over the next few years (in response to the recent interest in the field) in order to cut down on CRNA costs.

    It sucks and only hastens to ruin the job market for the field for the future. As one program director told me, the 2003 "class" of CA1s are likely to see a job market very different from the one that we're seeing now.

    The take-home point: Don't choose a field because the pay's good now. Do what you WANT and LIKE to do and the money will likely follow.
     
  18. brownman

    brownman Member
    7+ Year Member

    Joined:
    Oct 14, 2001
    Messages:
    68
    Likes Received:
    4
    Agreed,

    No one will see the job market that is seen currently. It doesn't matter what program you graduate from now...you can get a job anywhere. But the good programs churn out good positions even in tough markets. If you look at the graduating class at the top twenty programs in the mid 90's (94, 95, 96); every single one had people that they placed in private practice. It won't be as it is currently when even community graduates are getting amazing offers....but it will still be good for the next eight to ten years. I can't predict after that (I don't know how the surgeon shortage is going to affect a variety of fields, path and anesthesia specifically). I actually believe (and according to most studies released) that CA 1's in 2003 will actually have very choice job offers (depending where they go of course for their training). There just aren't as many of them, and they will go to the students graduating from generally strong programs with large alumni bases etc. So, in terms of the field I wouldn't worry. I also wouldn't worry about matching. Worry most about whether you:

    a) like physiology and pharmacology FAR MORE than pathology

    b) IF MOMENTS WHERE EVERYTHING IN YOUR KNOWN WORLD OF EXISTENCE HAS BECOME UTTERLY INSANE (which will happen a few times in your life as an anesthesiologist)

    and

    c) you can stand the fact that 80% of your day will consist of you sitting there doing...NOTHING. Trust me...my biggest fear is the boredom. There are a lot of people who don't mind making 250,000 a year sitting on their ace. I, unfortunately, am not one of those people.

    Well, those are your considerations. Figure out from these points whether you like anesthesia. The guys who are graduating and being courted by everyone everywhere...well they deserve it. These guys went in to the field when there were no jobs, and people feared the field. Granted they may not have been the best students in their school, or class. But still...
     
  19. joethestuff

    joethestuff Member
    7+ Year Member

    Joined:
    Dec 7, 2001
    Messages:
    38
    Likes Received:
    0
    Thats the ultimate irony isn't it? That the ****tiest students from 4 or 5 years ago are sitting in the best postion in medicine from a financial standpoint.

    In '97 & '98 aboulutely no "decent" medical student was going into Anesthesiology with the horrors stories from the front lines of the field. Complete and utter gloom and doom with FMG's matching in over 50% of the slots and many going unfilled. The best and the brightest stayed away in droves and left the field to the bottom feeders and FMG's.

    Now look who stands to benefit from the dearth of Anesthesiologists? Those same bottom feeders, dregs, and sub-190 USMLE losers who had no options.

    There is no justice!
     
  20. HairlessHeart

    HairlessHeart Member
    7+ Year Member

    Joined:
    Sep 21, 2001
    Messages:
    66
    Likes Received:
    0
    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by brownman:
    <strong>Worry most about whether you:

    b) IF MOMENTS WHERE EVERYTHING IN YOUR KNOWN WORLD OF EXISTENCE HAS BECOME UTTERLY INSANE (which will happen a few times in your life as an anesthesiologist)
    </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">That's an interesting statement. Can you give an example related to anesthesiology?
     
  21. navs

    navs Member
    10+ Year Member

    Joined:
    Oct 16, 2001
    Messages:
    98
    Likes Received:
    1
    Hi Hairless,

    The comment might have been overdone, but true at time. If u are in the O.R. when a pt. on the table is crashing (i.e. sats, HR, BP, etc.) look at who's sole responsibility it is to make him stable again.

    It is the anesth. job. BUT I do agree I don't think it is as glamorous as it was made out to be, considering this is what the anesth. is taught to respond to.
     
  22. gasdoc

    gasdoc Member
    7+ Year Member

    Joined:
    Mar 29, 2001
    Messages:
    52
    Likes Received:
    0
    I was very impressed by the thought that went into this discussion concerning future anesthesiologists so I thought I put in my 2 cents.

    I am currently in a California transitional program and have several fellow interns going into anesthesia (me included) and several into radiology.

    What I can see currently is that it will probably be a lot harder for med students to match into transitional spots this year and the forseeable future b/c of the influx of new radiology/anesthesia/rad/onc and PMR people.

    Secondly, as for anesthesiology's future, I like to make a few points b/c I have obviously thought about the matter b/f going in.
    1. anesthesiologists are not the only ones w/ midlevel providers (i.e. CRNAs). Virtually every single specialty of medicine has a competiting midlevel provider: family practice/general medicine/pediatrics/Emergency medicine have the PAs and NPs, OB/Gyn has the midwife, ophthalmologists have the optometrists, orthopods have the podiatrists (minor threat), subspecialty medicine docs like cardiologists and GI are using more and more PAs and NPs. I know this for a fact b/c my hospital not only uses these people, but TRAINS new ones!
    So, my point is that to use the traditional idea of anesthesiology as THE THREATENED specialty w/ CRNAs are the verge of taking over is just OUTDATED. Every single specialty, and especially the primary care ones, are in danger of having more and more of their duties performed by the NPs and PAs, who are by the way DOING MORE AND WANTING MORE AUTONOMY.
    If anything, for those interested in anesthesiology, we anesthesiologists are acustomed to having a competitor (ie. CRNA) and know how to FIGHT back. FPs and internists never had this threat until the last decade or so and in my opinion are more VULNERABLE simply b/c they are not used to dealing w/ it. The American Society of Anesthesiology I know for a fact is very much into fighting for the anesthesiologists and is VERY capable at it. The least we can do is pay our annual dues so they can continue lobbying.

    2. It is extremely important that good american medical grads (me included) go into the field b/c that's how you keep the specialty from becoming a second rate specialty as it was and is in danger of becoming b/c of the current shortage of anesthesiologists. We need more bright young anesthesiologists to go into academic anesthesia and do research and ADVANCE the field of anesthesia. We were in danger of loosing this vital RESEARCH component of the field in the last few years b/c of the shortage and quality of the people going in.

    3. From my research and own opinion, I believe the field will continue to be short on anesthesiolgists for some time (say a decade?) b/c of the effects of a few years ago (i.e. it takes longer to compensate for each year that few residents went into the field) as well as the fact that many of the early generation ofanesthesiologists are in their 60s and retiring. CRNAs will always continue to play a role in anesthesia but also remember that anesthesiologists are always needed to do INCREASINGLY MORE COMPLICATED SURGERIES ON SICKER PTS as well as MORE OUTPATIENT SURGERIES (surgeons don't want the onus of just having a CRNA provide anesthesia outpt and take the blame...).

    My conclusion is that I see a bright future for anesthesiologists. There are just as many uncertainties w/ oversupply and competition in other specialties. Anesthesiologists will always be needed. Market forces will always control the "numbers" of anesthesiologists. Try to go to a good academic program. Go into it only if you truely enjoy it. You don't need to LOOOVVE pharmacology and physiology (there's actually not that many drugs utilized and you are concerned w/ only certain vital organs). If you really LOOOVE p and p, you would go into critical care medicine (which anesthesiologist can do). If you like what you do, you will be happy. But, as someone going into the field, I see a bright future. As others have said, it will not be as good (in job finding) and lucrative as it is now, but it will continue to be highly paid.

    Anesthesiology will not get as competitive as radiology (which like everyone else noticed was also quite easy to get into a few years back and now anesthesiology is following its tail in becoming more competitive) b/c there are more programs and more spots (b/c it has always been a BIGGER SPECIALTY), but the good programs will get harder and harder. Just remember that in the 80s and early 90s, ANESTHESIOLOGY WAS ONE OF THE MOST COMPETITIVE OF SPECIALTIES AND ONLY THE BEST AND BRIGHTEST WENT IN. It just became an undervalued specialty that is gaining back its former value (like a good stock :) )
     
  23. brownman

    brownman Member
    7+ Year Member

    Joined:
    Oct 14, 2001
    Messages:
    68
    Likes Received:
    4
    Ok,

    My comments need edit:

    1) I state terrifying moments not because they are necessarily terrifying...they are just reasons why certain people either don't go into or drop out of anesthesia. Some people can't handle the stress of hemodynamically stabilizing a patient, etc. In that case there are fields of medicine that don't have these moments of intensity (derm, rads unless it's interventional) and you should consider them. I agree it's not earth shattering (I definately exaggerated for effect), but it's a consideration.

    2) Physio and pharm aren't necessary to love anesthesia...but they are probably the two largest components of anesthesia. No offense...but I don't see how that isn't obvious...especially physiology...IF YOU THINK PHYSIOLOGY IS LAME...you won't get a lot intellectually out of anesthesia (doesn't mean you won't be a good anesthesiologist, just there won't be the intellectual aspects of it that you want I think)...

    3) THE BOREDOM CAN BE VERY REAL AND IT DOES EXIST ( I always think of the last song I listened to...or just blank out for hours on end...just kidding).

    Jobs will be lucrative for a while...it's just that the truly lucrative ones will be diminishing in number. If you go to a good program, and do well...those opportunities will still be there.

    Ok...take care...and good luck.
     
  24. Jubal

    Jubal Member
    7+ Year Member

    Joined:
    Dec 10, 2001
    Messages:
    36
    Likes Received:
    0
    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> 2. It is extremely important that good american medical grads (me included) go into the field b/c that's how you keep the specialty from becoming a second rate specialty as it was and is in danger of becoming b/c of the current shortage of anesthesiologists. We need more bright young anesthesiologists to go into academic anesthesia and do research and ADVANCE the field of anesthesia. We were in danger of loosing this vital RESEARCH component of the field in the last few years b/c of the shortage and quality of the people going in.

    </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">That is correct. Unfortunately, the research in Anesthesia si done mainly by post-docs from all over the world, (a small number being Americans) and by very few interested residents (AMGs and FMGs). Also involvement in research and academic path is little from fellow AMG residents due to??? I dunno, I guess money(the lack of it), the clinical schedule and that you have to put in extra time from your own to do research, etc. I mean it's more lucrative to get out in private practice and finish paying your debts in half the time than you would do it following an academic path.
    And, I do not like the attitude here towards FMGs: to be clear: if any research is currently going on in Anesthesia it is their credit, and that of the dedicated US faculty memebers. Examples? All over the place: take Columbia: out of the batch of faculty they hired recently, 5 out of 7 are FMGs. Why? Because the interest of most(yes there are few interested and they are truly the elite)US grads for research is nil(ZERO). I am not saying that all FMGs are geniuses....no but the ratio of FMGs/ AMGs interested in science and research is much in the disadvantage of the latter. Several factors can be cited and discussed as the cause for it, however that's beyond the point. :cool:
     
  25. godfather

    godfather Member
    10+ Year Member

    Joined:
    Oct 13, 2001
    Messages:
    96
    Likes Received:
    4
    there's more radiology programs and positions than anaesthesia, making the it's current competitivness more mind boggling. Anaesthesia has about 110 programs.
     
  26. Amadeus

    Amadeus Member
    10+ Year Member

    Joined:
    Apr 3, 2001
    Messages:
    68
    Likes Received:
    0
    This whole debate about cRNAs taking over the job market of anesthesiologist is all based on speculation which so far hasn't significantly panned out. It seems to me that cRNAs if anything help the anesthesiologist by increasing his efficiency through reducing the overall physical work and allowing him to oversee several procedures simultaneously. Sure I can see this increasing the demand for cRNAs in the future since it makes economic sense. Anesthesiologist may now take on an increasing role as overseers of the OR especially at large procedural centers. An argument can be made that since anesthesiologists are tending to more than one room there may be less anesthesiologists needed in the future. However, like I said earlier this is all speculative. Many factors will come into play such as future surgical demand, prospects of pain management and so forth.
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
  27. Jim Picotte

    Jim Picotte Senior Member
    7+ Year Member

    Joined:
    Nov 6, 2001
    Messages:
    433
    Likes Received:
    0
    That's not entirely true, last year (2001) there were 371 PGY-1 Anesthesiology slots and 733 PGY-2 slots for a total of 1104 slots.

    In radiology in 2001 there were 137 PGY-1 slots and 738 PGY-2 slots for a total of 875 slots.

    While there may actually be more radiology programs, there is less total slots. This year it looks like there will be around 900 open radiology slots and I'm not sure how many more Anesthesiology slots will be open, but I've heard there will be more than last year.
     
  28. Sevo

    Sevo Senior Member
    Lifetime Donor Classifieds Approved 10+ Year Member

    Joined:
    Nov 19, 2001
    Messages:
    167
    Likes Received:
    1
    Status:
    Attending Physician
    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by godfather:
    <strong>there's more radiology programs and positions than anaesthesia, making the it's current competitivness more mind boggling. Anaesthesia has about 110 programs.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I don't think that's right. Unless my memory is shot, there's something along the lines of only 800 filled radiology vs. over 1200 anesthesia slots filled presently.

    In fact, most anesthesia programs are only running at 75% of their ACGME approved limits and are likely to go to their maximums this year. A number of programs, including Pittsburgh, have in fact, recently decided to submit requests to the ACGME to increase their resident maximums.

    Anesthesia has a history of cycling every 8-10 years, which is pretty often compared to most medical fields. The 1970s had tons of FMGs in the field, reversed in the mid 80s, and reverted back to FMGs yet again in the mid 90s (likewise their was a simultaneous boom in CRNA school enrollment during that time). The FMG trend started to reverse last year as the job market has suddenly became more lucrative again.
     
  29. Sevo

    Sevo Senior Member
    Lifetime Donor Classifieds Approved 10+ Year Member

    Joined:
    Nov 19, 2001
    Messages:
    167
    Likes Received:
    1
    Status:
    Attending Physician
    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Amadeus:
    <strong>This whole debate about cRNAs taking over the job market of anesthesiologist is all based on speculation which so far hasn't significantly panned out. It seems to me that cRNAs if anything help the anesthesiologist by increasing his efficiency through reducing the overall physical work and allowing him to oversee several procedures simultaneously...</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Attending anesthesiologts love CRNAs. You can run two rooms simultaneously and collect the fee for one (you split the anesthesia cost with the nurse) without having to sit in a room after induction. They free you up to pre-op patients, take care of PACU issues, or handle daily paperwork.

    What bothers the ASA are the recent attempts by the nurses to go beyond being glorified PAs and to go solo on their own in order to collect the full anesthesia fee. The nurses are pushing financial issues disguised under the guise of providing service to areas without sufficient numbers of anesthesiologists (rural areas) and the doctors are responding with safety concerns. When push comes to shove, safety will eventually win once lawsuits come down the pike. In addition, given the fact that most state medical boards are controlled by physicians, I doubt the CRNAs will make much progress in terms of being able to practice solo.

    As an aside, CRNAs do suck when you're a resident. At my med school hospital, the anesthesia residents are always at odds with the CRNAs for cases. Anesthesia there is run by a private group and there's a need for efficiency that outweighs the mandate for teaching. As a student, I've seen lower level residents shifted out of their rooms at the last minute to do routine cases and a CABG or a CEA suddenly given to a more experienced nurse because an attending just didn't have the time to supervise closely that day. Similar things happen on call.

    It also doesn't help when your training hospital is stocked full of CRNAs trained at a large academic or community hospital that doesn't have an anesthesia residency. At those places, the nurses are essentially trained as residents and they take that sort of mentality to their next job (i.e. I'm better than you, doctor - get out of my way). Seen that too at one place that I rotated at.

    They can be helpful when there's a need for someone to man the eye room or to supervise that MAC for Dr. X's facelift. They're even better to have around when you need to take that much needed mid-morning bathroom break, but beyond that, their presence in a training program is often times more detrimental than helpful.
     
  30. gasdoc

    gasdoc Member
    7+ Year Member

    Joined:
    Mar 29, 2001
    Messages:
    52
    Likes Received:
    0
    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Sevo:
    <strong> </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Amadeus:
    <strong>This whole debate about cRNAs taking over the job market of anesthesiologist is all based on speculation which so far hasn't significantly panned out. It seems to me that cRNAs if anything help the anesthesiologist by increasing his efficiency through reducing the overall physical work and allowing him to oversee several procedures simultaneously...</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Attending anesthesiologts love CRNAs. You can run two rooms simultaneously and collect the fee for one (you split the anesthesia cost with the nurse) without having to sit in a room after induction. They free you up to pre-op patients, take care of PACU issues, or handle daily paperwork.

    What bothers the ASA are the recent attempts by the nurses to go beyond being glorified PAs and to go solo on their own in order to collect the full anesthesia fee. The nurses are pushing financial issues disguised under the guise of providing service to areas without sufficient numbers of anesthesiologists (rural areas) and the doctors are responding with safety concerns. When push comes to shove, safety will eventually win once lawsuits come down the pike. In addition, given the fact that most state medical boards are controlled by physicians, I doubt the CRNAs will make much progress in terms of being able to practice solo.

    As an aside, CRNAs do suck when you're a resident. At my med school hospital, the anesthesia residents are always at odds with the CRNAs for cases. Anesthesia there is run by a private group and there's a need for efficiency that outweighs the mandate for teaching. As a student, I've seen lower level residents shifted out of their rooms at the last minute to do routine cases and a CABG or a CEA suddenly given to a more experienced nurse because an attending just didn't have the time to supervise closely that day. Similar things happen on call.

    It also doesn't help when your training hospital is stocked full of CRNAs trained at a large academic or community hospital that doesn't have an anesthesia residency. At those places, the nurses are essentially trained as residents and they take that sort of mentality to their next job (i.e. I'm better than you, doctor - get out of my way). Seen that too at one place that I rotated at.

    They can be helpful when there's a need for someone to man the eye room or to supervise that MAC for Dr. X's facelift. They're even better to have around when you need to take that much needed mid-morning bathroom break, but beyond that, their presence in a training program is often times more detrimental than helpful.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">You make very valid points here. As an intern, I am at a county hospital where the SRNA's are being trained by anesthesiologists. They come b/f the transitional interns doing an anesthesia rotation. I decided not to do a rotation likewise. As you are saying these SRNAs are already rude and think they are better than doctors especially b/c we have a family practice based residency and they know taht as CRNA's they essentially make more than the FP's. Part of the problem is when anesthesiologists negated their duties (to make their salaries bigger as well as job easier) by giving more and more duties to the CRNAs, they also created a monster that is now hard to control. You have this vocal minoirity of CRNAs who would love to see anesthesiologists disappear b/c they feel that they are good enough to do everything on their own. HOW ARROGANT! They forgot that it was anesthesiologists who trained them and made them what they are! Remember the phrase: "Don't bite the hand that feeds you." Well, some of these ungrateful CRNAs are doing just that.

    The program I am going to next year is large multihospital academic center that also has a CRNA program. I have been told repeatedly by the anesthesiologists there that CRNA competitions are a mute issue. They don't care for the CRNAs and let the residents pick and choose what cases they want. SRNAs are trained by CRNAs. If anything, these people make the resident's life easier by taking the simple cases and first calls. But, I guess if you are at a residency program run by a private for profit group, it is unfortunate. Of course they will put profit before education. But, I have a feeling these kind of setup only occurs in community setting. Large academic centers as a rule put education and resident didactics above (and maybe sometimes at the same level) as service.
     

Share This Page