switching into Anesthesia .. need advice please

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medstud1

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I am a PGY1 currently in a strong internal medicine categorical program and want to switch into Anesthesia. I have come to this realization after doing my intern year during this period of time that internal medicine is not the right field for me. Only problem is that I am no longer at my home institution and want to acquire a CA-1 position for 2005. I've been calling programs and they all tell me that they are filled at this time. Ive been contemplating entering the ERAS application and match for 2006, but need letters of recommendations. for my situation, what type of letters do you all recommend? Do i need to get a chairman's letter from the anesthesia dept? That is tough to do as an intern since i do not have any elective time. Also, I do not want to tell the institution about my thoughts about getting out of the program because 1) they may make life a living hell for me the rest of the year 2) what if I do not make or acquire a spot in anesthesia, then it would be very poor on my part.

Some have suggested that I wait till next year to apply through the match and be double boarded, but I dont see how that will help me in the long run into my career if I want to do anesthesia and perhaps a fellowship. My options are 1) call different programs and pray to god there is an open spot for 2005 2) enter the ERAS match for 2006 and get 3 letters of recommendations in time, which would be hard to do, esp i dont really know what type of letters I need or 3) wait till next year to apply for the match and be double boarded in internal medicine and start anesthesia. I know the field is starting to get competitive so i want to get my foot in the door ASAP. Any advice would be greatly appreciated. 🙂
 
How many programs have you contacted? There are 129 anesthesia programs in the country right now, and I find it hard to believe that all the CA-1 spots are taken. If for some reason you are looking to go to a top program, you may need to finish IM to make yourself a better candidate. But there are plenty of programs out there that will give you good training if really want to leave now. They may not be in CA, NY, or Chicago, though. Where are you training now?
 
I was in the same predicament just one year ago. So, I called several programs and found only a few that were open. It was made more difficult because I only wanted to be in Chicago or Houston. I applied for the open CA-1 positions for 2004 by fax - (Baylor, UIC, Rush, and U of C had one or two openings apiece). I also applied for CA-1 positions for 2005 through ERAS. luckily i was able to score a spot for this year.

as for letters. i had 3 internal medicine letters from my prelim year and a letter from my neurology program director. i didn't get any anesthesia letters as i didn't think that the anesthesia attendings i worked with as a medical student would remember me enough to write a strong letter (2 years ago).

as for elective time, i too did not have any elective time to do an anesthesia rotation so i basically skipped some "required" conferences and lectures to spend time in the OR. luckily, my program director was understanding and spoke to the anesthesia program director to help me set this up. I would arrive to work early 2-3 times/week to get my work done early and then sneak off to the OR during my down time. I would usually team up with one of the CA-1s and help with a case or two. The attendings were very accomodating and taught me quite a bit.

good luck.
 
Thanks everyone for you help. Ive called a number of programs this week and there are still no spots currently. Ive searched this forum too. I know Anesthesiology is what I want to do and be happy with. The problem as I forsee now is getting the letters of recommendation. I do not know whether telling my program is in my best interest at this time because theres a chance they will not be supportive, esp if they know one of their stronger residents wants to leave the program. Im afraid to ask letters from attendings Ive worked with already because they might tell my program director, even though my evaluations have been outstanding/superior region. I think entering the ERAS for CA-1 for 2005 and possibly the match for 2006 is in my best interest since it worked for "PINKY", but I prefer to find a spot outside the match and also to stay within an academic program instead of a community based program. Any further help and advice is greatly appreciated.
 
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