I would just like to put in my two cents..?
This is the first time I am writing in the SDN forum, so please bear with me!
I am currently a first-year anesthesia resident at a major university hospital in Chicago, and I am actually going to try to switch to medicine. Let me give you my synpopsis of the pros and cons of this field:
THE CONS:
1) The most important negative, I feel, about this specialty is that it is exceptionally stressful. You sit at the patient's bedside monitoring vital signs and constantly wait for bad things to happen - a drop in their oxygen saturation, hypertension, or worse hypotension, tachycardia, bradycardia, etc. It is exhausting constantly being on your guard to be able to react immediately if something should go wrong. It is like being a critical care nurse in all honesty. Granted things go well 95% of the time, but you can not be complacent.
2) You are not autonomous in your practice. Much of what you do is in an attempt to make the surgeon happy. You must get their consent for many things (using muscle relaxants, starting lines that could get in their way, etc.), and they always manage to be in your way. It's not their fault, it's just the way things are.
3) There is absolutely no respect from anyone in the OR - not the patient, not the nurses, not the surgeon, not the surgery residents or medical students, and where I work, often not the anesthesia attendings. Nobody appreciates what you do. An operation for a very sick patient could go by perfectly smoothly (while you transfuse blood, hang fluids, draw arterial blood gases or draw blood for labs, push pressors, etc) and the only one who know that you have done any of this is you. No one else will care or remember. In this field, you can not be the kind of person who needs external reward (i.e., patients thankfulness or other colleagues appreciation of your work).
4) As much as I would not like to believe it, you are completely replaceable - by another resident, by an attending, by a nurse anesthetist, or even a well-trained medical student. I have been amazed with the degree of ease that nurse anesthetists manage such cases as open heart surgery, liver/kidney transplants, and neurosurgery. Believe me, MD's, as much as I hate to admit it, are completely replaceable in this field.
5) You are in the OR all the time. This may seem like a plus, and I thought it would be, but it can get almost claustrophobic being in 1 room for 12 hours a day. I get up at 4:45 am everyday to be in the OR at 6am. I leave anywhere from 5-7pm. I get a (strict) 15 minute break to leave the OR between 9-10 am, and I get a (strict) 30 minute lunch break between 11-1. Other than those 45 minutes I am in one room the whole day. This schedule is actually pretty common (check out
www.scutwork.com, where other anesthesia residents evaluate their programs). The surgeons are busy doing their work and the nurses are helping them, so you don't even talk or discuss things with other people. It's actually almost lonely in a way...
5) You must enjoy reading about pharmacology (the pharmacokinetics of drugs - their half-lives, vapor pressures of gases, etc.) and physics (the physics of gas flows, the mechanics of how the machine works, etc.).
So having told you those negatives, let me give you some positives...
THE PROS:
1) We only have call 3 times per month, which is very nice. This may be a little less than most programs, however.
2) When call is over, you leave at 7-8 am. That is a really nice feeling! BUT if you are up all night with trauma patients (or any patient for that matter) transfusing blood, drawiing blood gases, pushing pressors, etc., you will f\eel the need to collapse at that point ...
3) When you are on, you are on, when you are off, you are off - you do not have to keep your pager on when you are outside the hospital. You will not get paged unless you are on call.
4) The future MIGHT get better after residency if you don't mind the cons I listed above. More importantly, at least you will be paid better as an attending. The question is, will you like what you are doing well enough that you will want to do it full-time to make a living.
So those are my feelings (sorry if it took me a long time to get through it). For most people no one field is perfect, so you must find what it is you really like. Anesthesia is a good field, but you have to really like basic sciences and must be willing to be very adaptable (to be subservient?) to surgeons to be happy in this field.
The only good advice I can give to anyone is to spend A LOT of time (including taking call) on a rotation doing whatever it is you think might interest you. That will give you some idea a) if you like it, b) of what it will be like in the future.
I hope this has helped, please let me know if I can provide any other information!
Good luck in your endeavors...
