surgical subspecialty to anesthesia

[BJtide]

I have recently early matched into a surgical subspecialty but have been thinking that I made a mistake for some time and seriously considering switching to anesthesia. I will begin my intern year this July which will consist of 6 months of my surgical specialty and 6 months of general surgery. When is the best time to contact anesthesia programs to land a PGY2 spot next year or simply to inform the programs of my situation so they will have me on their radar. Also, what are my chances of landing the PGY2 spot given that the programs that I am interested in usually fill their quotas? My class rank is 1 out of 100 and step 1=238, step 2=256. Appreciate any advice or thoughts.

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[bubalus]

Advice: If you haven't read the answers to your previous post, read them. If you have, read them again. Go see the anesthesiology PD at your home program ASAP and talk to him/her. Search the archives. This has been discussed every month or two.

As for timing. The 2009 PGY-2 anesthesia spots are going to fill through the match in a few weeks. It's too late now to do anything but scramble, so you may want to try that. Before deciding to scramble, you should talk with the anesthesia PD and whatever faculty member is involved in match advisement, writing your dean's letter, etc. If you reapplied through the match, that would be in Septemer. If you wanted to go outside the match, send CVs in July.

 

[pd4emergence]

I think that it is too late for you to match through the NRMP. I also would not suggest scrambling. You just don't know where you will end up. I know there are programs that hold 1 or 2 spots outside of the match for highly qualified residents that have decided to switch. Those are the spots you will be looking for during your intern year. Give it some time during your intern year, then if you still want to switch, talk to your current program director and then the anesthesiology PD at your institution. If you are unsuccessful during your intern year at securing a spot, reenter the match for a PGY 2 position. It might put you a year behind but at least you would be able to go to a quality program and not a program that did not fill. Good Luck.

 

[BJtide]

Thats good advice and is my plan at the present time. Thanks for taking the time to share your thoughts.

 

[cchoukal]

And of course, think this over LONG and HARD before committing to anything or talking to anyone at your home institution. You didn't say much about why you think you would prefer anesthesiology over your subspecialty. There aren't many surgery subspecialties in the early match (nuerosurg, ophtho, urology, and some plastics). Could it be that you're worried about lifestyle? It's probably not as bad as it looks, you get used to it, and it's better after residency. That and I'd hate for someone to define their love of their work by how little they have to perform it.

Have you thought about how it'll feel to give up such a prestigious specialty for one that tends to be looked down upon by those in your current matched specialty? Being an anesthesiologist isn't easy, either in terms of the actual work and knowledge base, but also in terms of how it feels sometimes to know some of your colleagues think you're lazy or stupid or that what you do isn't really important. A lot of people think anesthesiologists aren't even physicians, that the surgeons are their "bosses," and that your job entails going in, knocking the patient out, and leaving.

I'm not saying all these to be a jerk, but just to encourage you to really think about what you're giving up, what you're signing up for, and why. Make sure you look at the long view and consider what your life will be like in a decade, not in a year. Many surgical subspecialists are happy, well-adjusted people, who love what they do and have good lifestyles.

For the record, I'm an anesthesiology resident who strongly considered ENT (so strongly that I interviewed and submitted at least one rank list to the early match (ENT was early match back then) before withdrawing from the match at the last minute). I don't regret it, but these are some of the things that kept me up at night while I was deciding.

 

[BJtide]

Thank you for your thoughts and your not being a jerk at all. It's important for those in my situation to be well informed.

I will tell you that my specialty is, as you say, well respected and my program is relatively resident friendly. None of my experiences have convinced me that the lifestyle will be bad. From what i've read and experienced, anesthesia is probably a more difficult road overall considering everything that it entails for me at this point.

I will take your advice and not make a move until i'm pretty sure and if i do, it will be because i feel the specialty will fit me better. And i try, as everyone does, to not let others opinions influence me in any way althought at times i'm sure it can be difficult. But i do feel like anesthesia fits me and my personality well. I guess its hard for me to think that people actually think you guys aren't important because usually the more responsibilty you have, the more important you are.

Thanks again

 

[nociceptor]

My class rank is 1 out of 100

you have to do better than that to get into GAS.

 

[Ferdie]

have you considered giving your specialty a try for a few months, come July? I mean, at one point you clearly must have been interested in it, and you haven't exactly "worked" in it yet, you know? maybe you will fall in love all over again with it

then again, maybe not. it's just a thought, but you might as well give it a whirl

 

[71263]

If I were on a residency board, my biggest concern would be commitment.

If you could do all those interviews and convince people so seriously that you want to go to their program in that specialty, and then so suddenly after match be so easily convinced that it isnt for you, my first question would be why anyone should believe that you wont do the same in anesthesia...

You have great stats, but this is a situation that will certainly raise eyebrows, and one that you should definitely be prepared to answer...

 

[BJtide]

your point is very well taken and has kept me up a few nights. thats while i will honor my first year contract and give it 100%. just want to get some advice from the experts if i do decide to change. We all made big commitments just going through med school and we all deserve to be happy with our jobs. thanks for the input and i will be more than ready to answer that question even before it is brought up. I do think anesthesia is great and my interest seems to be increasing as i read more about the science and practice of it.

 

[m3unsure]

And of course, think this over LONG and HARD before committing to anything or talking to anyone at your home institution. You didn't say much about why you think you would prefer anesthesiology over your subspecialty. There aren't many surgery subspecialties in the early match (nuerosurg, ophtho, urology, and some plastics). Could it be that you're worried about lifestyle? It's probably not as bad as it looks, you get used to it, and it's better after residency. That and I'd hate for someone to define their love of their work by how little they have to perform it.

Have you thought about how it'll feel to give up such a prestigious specialty for one that tends to be looked down upon by those in your current matched specialty? Being an anesthesiologist isn't easy, either in terms of the actual work and knowledge base, but also in terms of how it feels sometimes to know some of your colleagues think you're lazy or stupid or that what you do isn't really important. A lot of people think anesthesiologists aren't even physicians, that the surgeons are their "bosses," and that your job entails going in, knocking the patient out, and leaving.

I'm not saying all these to be a jerk, but just to encourage you to really think about what you're giving up, what you're signing up for, and why. Make sure you look at the long view and consider what your life will be like in a decade, not in a year. Many surgical subspecialists are happy, well-adjusted people, who love what they do and have good lifestyles.

For the record, I'm an anesthesiology resident who strongly considered ENT (so strongly that I interviewed and submitted at least one rank list to the early match (ENT was early match back then) before withdrawing from the match at the last minute). I don't regret it, but these are some of the things that kept me up at night while I was deciding.

I am not so sure if MANY surgical subspecialists are happy especially ENT and even ophtho. I assume the grass is always greener on the other side.

Anesthesia at least allows for shift work and you know when you're on and when you're off. The hours may not be great especially if you want to live near a big city and want to make more money. But I assume that applies to all specialties. The great days of Medicine are over.

 

[TaiShan]

Once you jump out, there is no way you can come back. Why do not you give your current speciality a try at first? With your stats, you can get an anesthesia spot somewhere pretty much whenever you want.