Switching into Anesthia from EM

[EC3]

I'm a PGY1 in a good EM program but I'm not sure if I made the right choice for specialty. Anesthesia was one of the other fields I was considering and I am now wondering if maybe that would be a better choice. For me the ER shifts are just taking a toll on me physically and emotionally. I feel like I'm never quite caught up in terms of sleep and emotionally I find that I am already starting to get bitter and jaded dealing with the variety of personalities that present to the ER. Also, while I don't mind the primary care aspects so much, I find that most of my shifts are dealing with run of the mill primary care problems that are usually not diagnostically challenging. On top of this, the patients seem relentless in their expectations and regardless of how efficiently I try to be, I can't ever seem to please everyone. I'm tired of being the middle man who's always having to explain to the patient why the admitting service hasn't come yet, why they had to wait so long to be seen for their runny nose, or why CT-scan, X-ray, or the lab hasn't posted results yet. Overall, I just feel like there is a lot of unnecessary stress and that specialties like anesthesia offer some of the positives (such as procedures, lack of continuity of care, good hours and pay, and interesting work) while eliminating some of the negatives that come from working in a clinic environment.

So with that said, does anyone have advice or thoughts on how to best approach a possible switch into anesthesia? Do I have to repeat first year or can my PGY1 year of EM satisfy the intern year requirement for anesthesia? Also, can I try to get a contract pre-match or do I have to file ERAS again. Any advice, opinions, or otherwise would be greatly appreciated as I think this is something I'm seriously considering. I'm not quite ready to make a decision just yet but I'd like to know details in case I end up needing to pull the trigger. Thanks in advance.

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[Ender]

I'm a PGY1 in a good EM program but I'm not sure if I made the right choice for specialty. Anesthesia was one of the other fields I was considering and I am now wondering if maybe that would be a better choice. For me the ER shifts are just taking a toll on me physically and emotionally. I feel like I'm never quite caught up in terms of sleep and emotionally I find that I am already starting to get bitter and jaded dealing with the variety of personalities that present to the ER. Also, while I don't mind the primary care aspects so much, I find that most of my shifts are dealing with run of the mill primary care problems that are usually not diagnostically challenging. On top of this, the patients seem relentless in their expectations and regardless of how efficiently I try to be, I can't ever seem to please everyone. I'm tired of being the middle man who's always having to explain to the patient why the admitting service hasn't come yet, why they had to wait so long to be seen for their runny nose, or why CT-scan, X-ray, or the lab hasn't posted results yet. Overall, I just feel like there is a lot of unnecessary stress and that specialties like anesthesia offer some of the positives (such as procedures, lack of continuity of care, good hours and pay, and interesting work) while eliminating some of the negatives that come from working in a clinic environment.

So with that said, does anyone have advice or thoughts on how to best approach a possible switch into anesthesia? Do I have to repeat first year or can my PGY1 year of EM satisfy the intern year requirement for anesthesia? Also, can I try to get a contract pre-match or do I have to file ERAS again. Any advice, opinions, or otherwise would be greatly appreciated as I think this is something I'm seriously considering. I'm not quite ready to make a decision just yet but I'd like to know details in case I end up needing to pull the trigger. Thanks in advance.

No, you do not have to repeat PGY 1 year, and you may be able to get an out of match position (CA1). However, it all depends on how go of an applicant you are and how well you present yourself. CA1 positions (PGY2, basically first year of anesthesia) open up periodically at different institutions. Departments may or may not actively fill these positions or even anounce them depending on how big of a department they are and how much they need that extra resident the fill the gap. First thing you have to do is come up with a good reason to WANT to do anesthesia. Not liking ER is not good enough. I am not trying to be confrontational, I am just being real. Programs will want to be sure that you are going to stick with anesthesia.

Now if you cannot get an out of match position you will have to apply throught the match for a CA1 position two years out. By that time you will have completed ER (if in a 3 year program, unless of course you apply this year) and may change your mind about 3 more years of residency. Also ER may have grown on you by then and you may find that you actually enjoy it. As you know being an ER attending is much better than being a resident. These are all important considerations. Good luck with your choice and check out the open anesthesia positions area of this forum.

Ender

 

[Jeff05]

anesthesia has its own real share of negatives. like every other specialty. i would sit tight and allow yourself to get used to your residency. quitting after 2months is premature.
if everyone who wanted to quit after 2 months would, there would be no surgeons.

have you ever done a real anesthesia elective? any real experience in the field? i would try to work it into your schedule this year, before you make any decisions.

 

[2ndyear]

I'd wait it out. I have some EM friends and as I understand it, patient complexity increases as you progress in most programs. They're also getting some pretty good deals working 12-15 8-10 hour shifts/month! Granted it's hardly 9-5, but you're still at home at least half the day. I am sometimes jealous of this as I'm doing cases all night and have been up for 20 hours on a weekend.

 

[EC3]

anesthesia has its own real share of negatives. like every other specialty. i would sit tight and allow yourself to get used to your residency. quitting after 2months is premature.
if everyone who wanted to quit after 2 months would, there would be no surgeons.

have you ever done a real anesthesia elective? any real experience in the field? i would try to work it into your schedule this year, before you make any decisions.

I did a full anesthesia elective as a med student, got honors on the rotation. I really enjoyed the work and the biggest negatives I had regarding anesthesia weren't really work related and had to do more with the politics of anesthesia and the future of the specialty.

 

[EC3]

I'd wait it out. I have some EM friends and as I understand it, patient complexity increases as you progress in most programs. They're also getting some pretty good deals working 12-15 8-10 hour shifts/month! Granted it's hardly 9-5, but you're still at home at least half the day. I am sometimes jealous of this as I'm doing cases all night and have been up for 20 hours on a weekend.

For me it's not just about total hours, though. I feel like half my shifts in the ER are just dealing with personality issues and trying to play crisis interventionalist. It's depressing having everybody always pissed off at you for no other reason than they have pain and things are taking too long.

As others have said, this is a bit premature, but I figured I'd get my feelers out since I really enjoyed anesthesia as a student and was wondering if a switch would even be feasible.

 

[Mac Six]

OP, give it time. Residency just sucks. Sorry, just no way around it. We deal with malignant personalities as well such as from some of our attendings and surgeons. I guess it's the grass is greener syndrome. As time progresses, things will turn around. I'd give it until the end of this year. If things don't improve, give us a look. We'd be happy to help you out.

 

[Gimlet]

It's depressing having everybody always pissed off at you for no other reason than they have pain and things are taking too long.

Anesthesiologists definitely deal with their fair share of people who are pissed off at them for reasons beyond their control. (Surgeons coming to mind mostly here, among others)

With experience, I'm sure you'll develop mechanisms to diffuse those situations without having people get ornery with you.

 

[maceo]

So with that said, does anyone have advice or thoughts on how to best approach a possible switch into anesthesia? Do I have to repeat first year or can my PGY1 year of EM satisfy the intern year requirement for anesthesia? Also, can I try to get a contract pre-match or do I have to file ERAS again. Any advice, opinions, or otherwise would be greatly appreciated as I think this is something I'm seriously considering. I'm not quite ready to make a decision just yet but I'd like to know details in case I end up needing to pull the trigger. Thanks in advance.

switch to radiology. trust me. Much much much better specialty for your sanity

 

[maceo]

I did a full anesthesia elective as a med student, got honors on the rotation. I really enjoyed the work and the biggest negatives I had regarding anesthesia weren't really work related and had to do more with the politics of anesthesia and the future of the specialty.

you are a thinking man you are going far. Our specialty is a pain in the ass because of the politics.. plain and simple

 

[jumpingjax]

I'm a PGY1 in a good EM program but I'm not sure if I made the right choice for specialty. Anesthesia was one of the other fields I was considering and I am now wondering if maybe that would be a better choice. For me the ER shifts are just taking a toll on me physically and emotionally. I feel like I'm never quite caught up in terms of sleep and emotionally I find that I am already starting to get bitter and jaded dealing with the variety of personalities that present to the ER. Also, while I don't mind the primary care aspects so much, I find that most of my shifts are dealing with run of the mill primary care problems that are usually not diagnostically challenging. On top of this, the patients seem relentless in their expectations and regardless of how efficiently I try to be, I can't ever seem to please everyone. I'm tired of being the middle man who's always having to explain to the patient why the admitting service hasn't come yet, why they had to wait so long to be seen for their runny nose, or why CT-scan, X-ray, or the lab hasn't posted results yet. Overall, I just feel like there is a lot of unnecessary stress and that specialties like anesthesia offer some of the positives (such as procedures, lack of continuity of care, good hours and pay, and interesting work) while eliminating some of the negatives that come from working in a clinic environment.

So with that said, does anyone have advice or thoughts on how to best approach a possible switch into anesthesia? Do I have to repeat first year or can my PGY1 year of EM satisfy the intern year requirement for anesthesia? Also, can I try to get a contract pre-match or do I have to file ERAS again. Any advice, opinions, or otherwise would be greatly appreciated as I think this is something I'm seriously considering. I'm not quite ready to make a decision just yet but I'd like to know details in case I end up needing to pull the trigger. Thanks in advance.

Hey man, think real carefully before switching into Anesthesia. As some of the other posts suggest, there are a lot of "issues" with anesthesia. There is so much I didn't know about this field that I honestly would not have chosen it if I could go back in time. The politics and job outlook alone scare the hell out of me.

I have plenty of ER friends that hated it early on and ended up loving it. Give yourself some more time before you do something stupid.

 

[ZAZA67401]

What are the political issues that you have noticed in Anesthesia? What things did you wish you had known before doing it? Just curious

 

[treasurefull2]

Hey man, think real carefully before switching into Anesthesia. As some of the other posts suggest, there are a lot of "issues" with anesthesia. There is so much I didn't know about this field that I honestly would not have chosen it if I could go back in time. The politics and job outlook alone scare the hell out of me.

 

[jetproppilot]

I empathize with you.

I worked as a firefighter/paramedic for a cuppla years before college, then as a paramedic for EMS while in college.

I went to med school destined to be an ER doc. Because of my experience on my anesthesia rotation, and probably also because Da U didnt have an ER residency at the time, I selected anesthesia.

As a resident I moonlighted 48 hours a month in a pretty busy ER for nearly 3 years....after about the second year of working in an ER I was confident I had made the right decision for me.

Twelve years outta residency I'm still convinced I made the right decision.

Remember, though, everything becomes a job after a while....but could you do your selected specialty 10 years from now and still be happy?

There are alotta useful posts on this thread.

I agree that maybe its kinda early to make a decision.

At a certain finite point in the future you will know whether ER is for you or whether you should consider switching to another specialty.

EVERY specialty has its list of s hit that sucks.

I think the key is to try and think about your happiness years from now and how your job will affect your ability to be happy. Big decisions take time.

So give it some time.

Remember that your career in whatever you choose may be twenty, thirty years long! Its important for you to find satisfaction in your chosen career.

I'm sure at some point in the next, say, 6 months to a year your decision will become clearer.

Best of luck with whatever you decide.

 

[EC3]

Just wanted to say thanks to those who have posted thus far... great advice and much appreciated. I'm going to give it some time but keep options open. Thx again.

 

[Planktonmd]

Dude, you're such a sh itbag... Who the fu uck are you? All your posts have been completely worthless...

Dude, this is absolutely unprovoked and unnecessary.

 

[racerx]

Dude, you're such a sh itbag... Who the fu uck are you? All your posts have been completely worthless...

Kinda like the one you just posted?

I actually thought the advice JumpingJax gave was pretty "sound" sounding.

 

[Bougie]

For me the ER shifts are just taking a toll on me physically and emotionally. I feel like I'm never quite caught up in terms of sleep and emotionally I find that I am already starting to get bitter and jaded dealing with the variety of personalities that present to the ER. On top of this, the patients seem relentless in their expectations and regardless of how efficiently I try to be, I can't ever seem to please everyone.

You are a RESIDENT!!!! This is common to every RESIDENT in any specialty. Again, stay the course. Give it 6-8 months like JPP said.