Thinking about switching from anesthesia to family

[DoctorDad2]

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I am currently an Anesthesia Resident and am considering swiching to Family Medicine or Emergency Medicine. I am very interested in international medicine, perhaps working for the US Embassy taking care of US diplomat families overseas. While I think anesthesia is a great field and is very usefull for short term surgery trips, it does not lend itself well to long term experiences or primary care (obviously).

At this point I am not sure what to do. I am finishing my intern year and have not yet started really doing anesthesia. I am sure I will really enjoy it. That is not the issue. I got into medicine in the first place because I wanted to use it to help others overseas and to travel. I have two children and I want them to learn firsthand what the world is like and how there are so many other ways of thinking and doing things. I also want them to be greatful for the opportunities they have in america, to learn another language, learn the value of serving others, etc. I did not learn these things till I was 20 years old. It changed my life and I want them to have that perspective. As many of you may know it is difficult to find funding for these types of activities, but I have an aquantence that works for a US embassy and has for most of his career. He loves it. Of course it is government pay which is not as good as private practice or acedemic for that matter (around $100,000), but it is doing what I have always wanted to do. In order to care for these families I would need to be boarded in either Internal Medicine (No Way!), Emergency (love the variety, but the schedule changes can be grueling), or Family Medicine (solid, broad training especially in proceedures if at the right residency program). A broad based intership (which I am finishing now) is just not enough.

Having almost finished one of the worst years of my life, I do not want to do another intership. I wanted to know if any of you know good programs heavy in proceedures, that would: 1. Give me credit for my intern year, or at least most of it, and 2. Still teach a good variety of proceedures, but not work me to death. I have a family and this year was miserable for them. I can't do it again. I need a reasonable schedule.

At the very least have any of you heard of programs giving people credit for TY type interships? Thanks for all your help.

 

[skypilot]

Doctors without borders needs anesthesiologists. If you think you will like and be good at anesthesia then you might consider continuing in that field. You could even continue into critical care fellowship if you get tired of the OR

As far as getting credit for the transitional year, I would guess that most FM residencies would give you credit for the months of the year that replaced parts of their curriculum. You probably could get 6 months of credit.

 

[DoctorDad2]

Doctors without borders needs anesthesiologists. If you think you will like and be good at anesthesia then you might consider continuing in that field. You could even continue into critical care fellowship if you get tired of the OR

As far as getting credit for the transitional year, I would guess that most FM residencies would give you credit for the months of the year that replaced parts of their curriculum. You probably could get 6 months of credit.

That is a good idea and I am sure that it would be a great experience. However, you cannot take your family with you, and that is one of the most important things for me.

 

[secretwave101]

Your specialty isn't really going to limit your international health options. Money (or the lack of it) will do that for you. Keep in mind that procedure-heavy FM is a bit of a mirage. FM procedures are generally inefficient from a reimbursement standpoint. It's better to do straight office visits with some little procedures scattered in the day.

I wouldn't drop gas because you had a crappy year. Internship year is tough no matter what. We work lots of hours too - usually close to the 80. I'd only switch to FM if you think it's cool.

 

[DoctorDad2]

Your specialty isn't really going to limit your international health options. Money (or the lack of it) will do that for you. Keep in mind that procedure-heavy FM is a bit of a mirage. FM procedures are generally inefficient from a reimbursement standpoint. It's better to do straight office visits with some little procedures scattered in the day.

I wouldn't drop gas because you had a crappy year. Internship year is tough no matter what. We work lots of hours too - usually close to the 80. I'd only switch to FM if you think it's cool.

I hope I did not give the wrong idea. I like Anesthesia, that is why I chose it to begin with. However, I have also always liked Family Medicine as well. These were my top choices and I am sure that I would enjoy both for different reasons. I think that I am now beginning to realise that my decision may have been swayed toward anesthesia because of income and lifestyle, and perhaps family medicine would really better mach my goals and interests.

Having a "crappy" year has nothing to do with it. I only mentioned that to explain that I would rather not repeat all of intern year. My interest in learning proceedures does not come from a desire to make money. I stems from an understanding that in international or rural medicine I may be the only one around to care for patients. The more well rounded I am, the better I can serve my patients. Besides, proceedures are fun.

Once again, my question is as follows, "Are there people in your program who have switch in from other fields of medicine? If so which fields and did they get any credit for there previous training or did they repeat everything? Thanks.

 

[sophiejane]

"Are there people in your program who have switch in from other fields of medicine?

Yes.

If so which fields and did they get any credit for there previous training or did they repeat everything?

It depends on the program. You are going to need to contact individual programs. The problem with a year-for year exchange is that you are unlikely to have had the right number of hours of everything the RRC requires for first year family medicine in your intern year.

Why don't you tell us what your rotations are this year--that might make it easier to compare. Here's my year, for example--see if yours looks similar:

OB/Gyn: 8 weeks
Pediatrics inpatient: 8 weeks
Pediatrics outpatient: 4 weeks
Medicine inpatient: 8 weeks
Adult medicine outpatient: 4 weeks
Night float: 4 weeks
EM: 4 weeks
Surgery: 8 weeks

Still, no matter what we say, the buck stops with each individual program.

Sounds like you have the heart of a generalist stuck in a specialists body. 🙂 Best of luck.

 

[EdibleEgg]

For some reason there were quite a few people who switched from other residencies to Family in my residency class and the one before it. It included one interventional radiologist (who had been practicing for 20 years), an anesthesiologist practicing for one year, a guy who completed one year of anesthesia, another who completed a year of peds, a practicing pathologist, a guy with two years of ER. I think they were all happy with the switch. Some got credit for their prior residency experience, others didn't. It all depended on the rotations done. For example the radiologist and pathologist started over. The anesthesia guys got partial credit for the year (I think they exempted the surgery and MICU rotations) and finished several months early. The ER guy had to do a little OB, but basically started as a PGY-two and a half. This would all be program specific and you should call around to check into things. Family medicine offers a great deal of flexibility and is great for international medicine (that's what I'm doing for the moment and I love it), but really think your decision through. Just make sure you have realistic expectations and best of luck.

 

[DoctorDad2]

For some reason there were quite a few people who switched from other residencies to Family in my residency class and the one before it. It included one interventional radiologist (who had been practicing for 20 years), an anesthesiologist practicing for one year, a guy who completed one year of anesthesia, another who completed a year of peds, a practicing pathologist, a guy with two years of ER. I think they were all happy with the switch. Some got credit for their prior residency experience, others didn't. It all depended on the rotations done. For example the radiologist and pathologist started over. The anesthesia guys got partial credit for the year (I think they exempted the surgery and MICU rotations) and finished several months early. The ER guy had to do a little OB, but basically started as a PGY-two and a half. This would all be program specific and you should call around to check into things. Family medicine offers a great deal of flexibility and is great for international medicine (that's what I'm doing for the moment and I love it), but really think your decision through. Just make sure you have realistic expectations and best of luck.

Thanks for the info. I am really interested to know where you did your residency. Also I would love to hear about what and where you are doing international medicine. Send a private message if you like. Thanks again.

 

[CaymanIslander]

I am currently an Anesthesia Resident and am considering swiching to Family Medicine or Emergency Medicine. I am very interested in international medicine, perhaps working for the US Embassy taking care of US diplomat families overseas. While I think anesthesia is a great field and is very usefull for short term surgery trips, it does not lend itself well to long term experiences or primary care (obviously).

At this point I am not sure what to do. I am finishing my intern year and have not yet started really doing anesthesia. I am sure I will really enjoy it. That is not the issue. I got into medicine in the first place because I wanted to use it to help others overseas and to travel. I have two children and I want them to learn firsthand what the world is like and how there are so many other ways of thinking and doing things. I also want them to be greatful for the opportunities they have in america, to learn another language, learn the value of serving others, etc. I did not learn these things till I was 20 years old. It changed my life and I want them to have that perspective. As many of you may know it is difficult to find funding for these types of activities, but I have an aquantence that works for a US embassy and has for most of his career. He loves it. Of course it is government pay which is not as good as private practice or acedemic for that matter (around $100,000), but it is doing what I have always wanted to do. In order to care for these families I would need to be boarded in either Internal Medicine (No Way!), Emergency (love the variety, but the schedule changes can be grueling), or Family Medicine (solid, broad training especially in proceedures if at the right residency program). A broad based intership (which I am finishing now) is just not enough.

Having almost finished one of the worst years of my life, I do not want to do another intership. I wanted to know if any of you know good programs heavy in proceedures, that would: 1. Give me credit for my intern year, or at least most of it, and 2. Still teach a good variety of proceedures, but not work me to death. I have a family and this year was miserable for them. I can't do it again. I need a reasonable schedule.

At the very least have any of you heard of programs giving people credit for TY type interships? Thanks for all your help.

Excuse my French, but ARE YOU FLIPPIN CRAZY!!

I mean, it would be one thing if you were not at all interested in Anesthesia, but you like Anesthesia.

Here are some things to consider.

Anesthesia salary: 300-400k
FM salary: 120-180k

Anesthesia has more vacation months. Take vacations with the fam and show them the world.

Trust me, you are not going to want to live in some third world country forever. Daydreaming is one thing, but lets get back to reality.

Do Anesthesia. Send your kids to some good private schools. You can have a good life, no call, lots of vacation, money popping out of every orifice of your body etc.

Intern year might be draining, but so is working 50-60 hrs a week not including call hrs and making 150k when you are 300k in debt. Smack yourself in the face (hard) and snap back to reality.

PS. I'm sure ppl would be willing to pay you cold hard cash to find out which Anesthesia program is going to have an open spot nxt year. You could sell that info...lol.

 

[secretwave101]

I'm hard-pressed to disagree with Cayman...and I'm an FP!🙁

 

[The Janitor]

Money aside, anesthesiology has absolutely nothing whatsoever in common with family medicine.

It sounds to me like you need to decide what you want to do, not where you want to do it.

 

[sophiejane]

Intern year might be draining, but so is working 50-60 hrs a week not including call hrs and making 150k when you are 300k in debt. Smack yourself in the face (hard) and snap back to reality.

Not to beat a dead horse, but I don't know many FPs working 60 hours a week. Most work 4-5 days a week, 8 am-5 or 6 pm (an hour or so earlier if you round in the hospital first) and an occasional weekend home call, depending on the arrangement. I also don't know many starting off at <160K. Nor do I know many recent grads who are $300K in debt. I suppose if you go to med school in the Cayman Islands you may well be that deep in the hole, but most folks I know owe quite a bit less than half that number, closer to $100-120K. There are also loan repayment programs galore for primary care, so it's not hard to knock that number in half or to zero in a few years.

Just trying to make the "reality" a little more accurate here.

Carry on.

 

[iatrosB]

Just trying to make the "reality" a little more accurate here.

Carry on.

I do grow tired of the "Oh, woe is primary care" sentiment that is all over these forums.

But in all fairness, anesthesiology as a LIFESTYLE (meaning money for hours, vacation, good hours, etc...) fair exceeds FM (I'd still rather poke my eyes out than do gas, which goes back to the FM and gas are VERY different...pick one).

 

[NewmansOwn]

Excuse my French, but ARE YOU FLIPPIN CRAZY!!

I mean, it would be one thing if you were not at all interested in Anesthesia, but you like Anesthesia.

Here are some things to consider.

Anesthesia salary: 300-400k
FM salary: 120-180k

Anesthesia has more vacation months. Take vacations with the fam and show them the world.

Trust me, you are not going to want to live in some third world country forever. Daydreaming is one thing, but lets get back to reality.

Do Anesthesia. Send your kids to some good private schools. You can have a good life, no call, lots of vacation, money popping out of every orifice of your body etc.

Intern year might be draining, but so is working 50-60 hrs a week not including call hrs and making 150k when you are 300k in debt. Smack yourself in the face (hard) and snap back to reality.

PS. I'm sure ppl would be willing to pay you cold hard cash to find out which Anesthesia program is going to have an open spot nxt year. You could sell that info...lol.

If you're having a bad day and want to get a hearty laugh, go into the gas forum and ask them about how they "have no call."

Anesthesiologists usually also know great lunch spots downtown, beacuse they spend so much time at the courthouse playing 'civil defendant.'

While you're at it, ask them how nice it is to enjoy a friendly, uncompetitive and completely non-threatening relationship with CRNAs.

If we're done farting daisies and rainbows here, I'll defer any further reality checks to the lovely SophieJane.

 

[sophiejane]

If we're done farting daisies and rainbows here, I'll defer any further reality checks to the lovely SophieJane.

To quote a button I used to have on my backpack in the '80s (back when I had Mork from Ork rainbow suspenders too) "Pobody's Nerfect"! Yes, I really am THAT old.

Same is true for specialties.

Just pick one you like, if you don't like it, go with your heart and change.

 

[The Janitor]

anesthesiology as a LIFESTYLE (meaning money for hours, vacation, good hours, etc...) fair exceeds FM

Is that Middle English? 😉

I'm going to translate that as "sucks compared to." I'm pretty sure that's right.

 

[CaymanIslander]

I suppose most arent as far in debt as i am after attending St. Matthew's. However, you are probably still in debt.

all i'm saying is dont do fp chasing some dream about practicing 3rd world medicine. when u have kids, u're priorities will change.

look at the job postings, anesth. are getting 10 wks vacation a year at 300-400k salaries. fp's can take a week off here and there but you have patients that need your care on a continuous basis. also, fp's do get sued, and u are "master of nothing" meaning the knowledge u are responsible for is greater.

i think fp is a great profession, but dont do it based on any unrealistic hopes for the future. u're kids arent going to want to go country skipping when they are growing up, they will seek stability.

 

[The Janitor]

when u have kids, u're priorities will change....u are "master of nothing"...u are responsible...u're kids arent going to want to go country skipping

🙄

 

[CaymanIslander]

🙄

u = you for the texting impaired. its a short way of typing the same thing. it is frequently used by the current generation to text messages.

 

[The Janitor]

u = you for the impaired.

True, that.