Switching from EM to Anesthesiology

[doingmyverybest]

---

Members don't see this ad.

Looking to solicit some very raw and preliminary information (decision not set in stone) on what such a move would entail.

EM PGY-1 at an established program. Desired a residency in Anesthesia for the entirety of medical school, but felt that my low board scores would have prevented me from matching (no failures, all board exams at least 20+ points above the passing mark, but still below average). Being the risk averse individual I am, I went for EM (chose a specialty where I could rely on clinical skills and thus strong letters over board exams to achieve success).

Will completing a year in EM count towards the TY/prelim intern year needed to advance to CA1? Would Anesthesiology PD's even give me a chance given my background in EM assuming I have a compelling reason to want to pursue Anesthesiology?

 

[deleted697127]

You are just finishing pgy1 year?

For anesthesia you need 6 months inpatient rotations, 1 month of ED, and can count at most 2 months of ICU from intern year. You need 4 months of ICU to graduate. Inpatient months can be rotations like cardiology and neurology and don’t necessarily need to be IM or Surgery. If you don’t meet the requirements, you will likely have to make them up before graduating.

See page 10 from ABA

http://www.theaba.org/PDFs/BOI/2017-Primary-Certification-Policy-Book

“The clinical base year must include at least six months of clinical rotations during which the resident has responsibility for the diagnosis and treatment of patients with a variety of medical and surgical problems, of which at most one month may involve the administration of anesthesia and one month of pain medicine. Acceptable clinical base experiences include training in internal medicine, pediatrics, surgery or any of their subspecialties, obstetrics and gynecology, neurology, family medicine or any combination of these as approved for residents by the directors of their training programs in anesthesiology. The clinical base year should also include rotations in critical care and emergency medicine, with at least one month, but no more than two months, devoted to each. Other rotations completing the 12 months of broad education should be relevant to the practice of anesthesiology.
The resident must complete the clinical base year before beginning CA-3 year clinical rotations.”

 

[JiPo]

You are just finishing pgy1 year?

For anesthesia you need 6 months inpatient rotations, 1 month of ED, and can count at most 2 months of ICU from intern year. You need 4 months of ICU to graduate. Inpatient months can be rotations like cardiology and neurology and don’t necessarily need to be IM or Surgery. If you don’t meet the requirements, you will likely have to make them up before graduating.

See page 10 from ABA

http://www.theaba.org/PDFs/BOI/2017-Primary-Certification-Policy-Book

“The clinical base year must include at least six months of clinical rotations during which the resident has responsibility for the diagnosis and treatment of patients with a variety of medical and surgical problems, of which at most one month may involve the administration of anesthesia and one month of pain medicine. Acceptable clinical base experiences include training in internal medicine, pediatrics, surgery or any of their subspecialties, obstetrics and gynecology, neurology, family medicine or any combination of these as approved for residents by the directors of their training programs in anesthesiology. The clinical base year should also include rotations in critical care and emergency medicine, with at least one month, but no more than two months, devoted to each. Other rotations completing the 12 months of broad education should be relevant to the practice of anesthesiology.
The resident must complete the clinical base year before beginning CA-3 year clinical rotations.”

That description, to me, sounds like ED may not count as pgy-1 year for anesthesiology.

People switch specialties all the time, so i wouldnt think that coming from EM would put you at an disadvantage.

What will put you at disadvantage is your score. You said you scored 20 points above passing. That puts you at 210’s for step 1, which is 20 points lower than the average step score for the specialty. Assuming you are a USMD with no other red flag, that score alone will screen you out at many programs. If you are a DO/IMG, you would be at worse odds.

Your best bet is to crush step 3 to show them that you can perform well on tests as to not be a problem with anesthesia boards, and network with the anesthesiology department from your current institution. Perhaps your EM attendings can make calls on your behalf. Good luck.

 

[nimbus]

Your best shot is to have your current EM attendings vouch for you that you are an above average resident despite below average scores.

 

[JiPo]

Also, unless you absolutely hate EM, i recommend that you just grind out the next 2 years.

Even if you apply in september, you wont start until the following year. You would basically finish 2 years of EM before switching to do 3 years of anesthesia, assuming they dont make you do cby year.

Smarter choice would be to just finish the 3 years of EM, and make real money earlier.

If you are at a 4 year EM program........ well... why would anyone choose a 4 year program?....

 

[TheLoneWolf]

Being the risk averse individual I am, I went for EM

 

[UnoMas]

I think he meant less likely to go unmatched but EM takes a lot more work to match i.e. SLOEs than Anesthesiology so that aint right either

 

[woopedazz]

If you are at a 4 year EM program........ well... why would anyone choose a 4 year program?....

Looks at my 5 year program that only accepts PGY3+ applicants.

 

[Hoya11]

Looking to solicit some very raw and preliminary information (decision not set in stone) on what such a move would entail.

EM PGY-1 at an established program. Desired a residency in Anesthesia for the entirety of medical school, but felt that my low board scores would have prevented me from matching (no failures, all board exams at least 20+ points above the passing mark, but still below average). Being the risk averse individual I am, I went for EM (chose a specialty where I could rely on clinical skills and thus strong letters over board exams to achieve success).

Will completing a year in EM count towards the TY/prelim intern year needed to advance to CA1? Would Anesthesiology PD's even give me a chance given my background in EM assuming I have a compelling reason to want to pursue Anesthesiology?

Yes. You may have to repeat all or part of your PGY1, but from what I know you would likely get into a mid or lower tier program. You should have just done what you wanted from the start, you likely would have matched somewhere in anesthesia. If you are a US grad, board scores that are significantlyu above passing should get you in somewhere..

 

[AnonymousPD]

dmvb,

Just to clarify, you are a current PGY-1 that is thinking of applying this fall for a CA-1 position starting in July 2021? So by then, you will have completed two years of your EM residency. Or are you planning on doing something else this coming year? If that is the case, that amount of experience will likely allow you to start right away as a CA1.

Since you matched into an established EM program, you should probably be a little more bullish on your overall application that you seem. EM is hardly the traditional "safety" match for graduating seniors. So I'd be willing to bet there are areas of your application that stand out quite positively in your favor. Going into application season, you will have more than a year of experience being a resident and discharging resident level responsibilities. That carries much more weight now. As do positive contributions to your class and department, or more importantly your lack of negative ones.

Having a compelling "reason" for going into anesthesia is not that important. All you need genuine interest born from knowing what you are getting into. Nothing torpedoes a transfer applicant faster than having limited insight into what we do and failing to demonstrate having any experience in the specialty.

 

[anbuitachi]

just finish EM and try it out as attending. Like above said, by the time you even do anesthesia, you'd be almost done with EM residency.

 

[shepardsun]

Yeah this post is kinda weird. I would say over the last few years you could argue that EM was a /more/ competitive specialty than anesthesia, so not sure why it was your back up

 

[Morzh]

I know someone who did EM (3yr program), applied to anesthesiology at the beginning of his PGY3 year, finished EM in June then straight to CA-1 in July. I guess he did enough ICU / floor months throughout his 3 years in EM so he didn't have to repeat intern year, not sure what exactly those requirements are.

Anyway he was fantastic in anesthesiology - ended up being a chief resident. Because he finished his training in EM he was able to get board certified and moonlight at a community ED 1-2 weekends per month when not on call... made 2x his residency salary doing that, which lessened the sting of extra training years substantially. Now he is double-boarded, does mostly anesthesiology but moonlights just enough EM to keep his skills up. He's very happy.

 

[deleted171991]

I always love how people waste a lot of time answering somebody with minimal posts on the forum.

A fool can throw a stone in a pond that 100 wise men cannot get out.

 

[JiPo]

I always love how people waste a lot of time answering somebody with minimal posts on the forum.

A fool can throw a stone in a pond that 100 wise men cannot get out.

Then could you provide some insight into my question? I post on SDN decent amount

Cardiac Fellowship - help ranking these 3 programs

Hi all, I am done with interviews for the season. I have a pretty good idea about my rank list, but I have trouble ranking these 3 programs. MGH, Hopkins, BI They are all clearly very strong programs with great reputations, and I am sure I will receive fantastic training in any of the three...

forums.studentdoctor.net

 

[GandalfTheWhite]

It would make sense to complete your EM residency, but if you are set on doing anesthesia, there is a combined EM + ANES program at Hopkins which will eliminate the intern year and allow you to do a 5-6 year combined program.

 

[drmwvr]

I always love how people waste a lot of time answering somebody with minimal posts on the forum.

A fool can throw a stone in a pond that 100 wise men cannot get out.

How much time did you spend on this post?

 

[deleted697535]

Your emerg residency is 3 years?
This is mind bending. I cant even...

Re op - Anesthesia electives and letters from them, and your own program are key. Id places youd like to do anesthesia residency and aim for an elective there. Obviously all electives are shut down now with covid but when it opens again

 

[Splenda88]

1 million $$$ mistake...

Considering one can work 24 hr/wk in EM and still make 200k+/yr... Why?

 

[deleted171991]

1 million $$$ mistake...

Considering one can work 24 hr/wk in EM and still make 200k+/yr... Why?

Why is Earth flat? Why is Covid a hoax? Why is anesthesia better than EM?

Because.

 

[deleted171991]

I always love how people waste a lot of time answering somebody with minimal posts on the forum.

A fool can throw a stone in a pond that 100 wise men cannot get out.

9 days, no further posts.

 

[Splenda88]

Why is Earth flat? Why is Covid a hoax? Why is anesthesia better than EM?

Because.

You are asking me?

Dealing with egotistical surgeons and militant CRNAs vs. dealing with some of the worse of our society... I really don't know.

All I can say, OP might not be the best decision making individual... How can a US MD student with ~215 step1 and ~230 step2 with no other red flags think it's more difficult to match anesthesia than EM? based on stats when we have "Charting outcomes in the match of 2018"

https://www.nrmp.org/wp-content/uploads/2018/06/Charting-Outcomes-in-the-Match-2018-Seniors.pdf

 

[deleted171991]

You are asking me?

Dealing with egotistical surgeons and militant CRNAs vs. dealing with some of the worse of our society... I really don't know.

All I can say, OP might not be the best decision making individual... How can a US MD student with ~215 step1 and ~230 step2 with no other red flags think it's more difficult to match anesthesia than EM? based on stats when we have "Charting outcomes in the match of 2018"

https://www.nrmp.org/wp-content/uploads/2018/06/Charting-Outcomes-in-the-Match-2018-Seniors.pdf

I've been saying forever that average physician intelligence is overestimated (because of past generations). This is a profession that rewards grit and social pleasantness, not intelligence.

And my questions were rhetorical.

 

[Splenda88]

I've been saying forever that average physician intelligence is overestimated.

And my questions were rhetorical.

I know...


Compare us with the average Joe, I am not sure our intelligence is overestimated...

 

[deleted171991]

Compare us with the average Joe, I am not sure our intelligence is overestimated...

Not on a relative scale; on the absolute one. We are definitely above average, as a group.

 

[dabears505]

This is such a bad idea