Which anesthesia subspecialty has the most longevity?

[94hdogs]

Basically what the title says. I feel like cardiac would be a burnout career. Not sure about peds or pain management.

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[nimbus]

Basically what the title says. I feel like cardiac would be a burnout career. Not sure about peds or pain management.

I know a couple peds guys who went and got other jobs after mandatory retirement from my group at age 70. One of them also through hiked the Grand Canyon on his 70th birthday.

 

[94hdogs]

I know a couple peds guys who went and got other jobs after mandatory retirement from my group at age 70. One of them also through hiked the Grand Canyon on his 70th birthday.

Wow that's impressive. Did they get rehired somewhere else as general anesthesiologists?

 

[nimbus]

Wow that's impressive. Did they get rehired somewhere else as general anesthesiologists?

One guy went to the local university. The other went to work at a proton therapy center sedating kids. They both had long careers at a childrens hospital and both continued to do peds only.

 

[94hdogs]

One guy went to the local university. The other went to work at a proton therapy center sedating kids. They both had long careers at a childrens hospital and both continued to do peds only.

That's frickin' awesome. Glad to see it.

 

[kidthor]

I will say about peds that the job market is tricky. For those who get a 100% peds job at a place they like then happiness and longevity is probably good. But those jobs are not plentiful and many peds jobs are mixed practice of various forms. Many metro areas may only offer mixed practices. Some metro areas have a pure peds hospital but if that area isn't hiring then you're SOL.

 

[94hdogs]

I will say about peds that the job market is tricky. For those who get a 100% peds job at a place they like then happiness and longevity is probably good. But those jobs are not plentiful and many peds jobs are mixed practice of various forms. Many metro areas may only offer mixed practices. Some metro areas have a pure peds hospital but if that area isn't hiring then you're SOL.

What is longevity like for mixed practices?

 

[Guillemot]

Both peds and cardiac take call. Pain doesn’t necessarily. Not sure what tou mean by longevity… Non-****ty work hours? That can be had in any of the above.

 

[94hdogs]

Both peds and cardiac take call. Pain doesn’t necessarily. Not sure what tou mean by longevity… Non-****ty work hours? That can be had in any of the above.

Like which one do you see doing if you were 70-80 years old.

 

[nimbus]

Like which one do you see doing if you were 70-80 years old.

I’m in my mid 50s and just stopping cardiac now because of the q4 call, the very early mornings, and because the field has evolved a lot in the last 10 years and I felt it was time to make room for new, better trained blood. But it’s a very engaging subspecialty and I will miss parts of it. Especially working within a tight knit team where everybody is on the same page and appreciates each other.

 

[94hdogs]

I’m in my mid 50s and just stopping cardiac now because of the q4 call, the very early mornings, and because the field has evolved a lot in the last 10 years and I felt it was time to make room for new, better trained blood. But it’s a very engaging subspecialty and I will miss parts of it. Especially working within a tight knit team where everybody is on the same page and appreciates each other.

I actually appreciate this. I'm just a second year med student but I've been looking for a specialty where I can be part of a team where we all can work together in harmony. I've only experienced this feeling a few times in my life where you feel like you belong to a group of people and you all have each other's back.

 

[kidthor]

What is longevity like for mixed practices?

It depends on what the person wants in life. If you just want to take care of kids then longevity is meh in a mixed practice. If you are ok being an mostly adult generalist then it’s ok probably, especially if you only take pediatric call.

I actually appreciate this. I'm just a second year med student but I've been looking for a specialty where I can be part of a team where we all can work together in harmony. I've only experienced this feeling a few times in my life where you feel like you belong to a group of people and you all have each other's back.

What you’re looking for is entirely reasonable and wonderful. Unfortunately I’ve never personally seen that kind of setup in practice. But I’m sure it’s out there….

 

[dannyboy1]

Gotta say, I never understood the “I only want to do kids” peds mentality. Pediatric anesthesia is stressful and labor intensive as compared to adults.

 

[ambiturner]

Anesthesia and surgery are risky choices if you want to work into your 70s. I’ve met a few over 65 going strong but any number of common orthopedic, eye or nerve issues will significantly limit your career while these same ailments would just be minor setbacks in, say, internal medicine or psychiatry.

In anesthesia I think academics gives you the best shot at longevity. Lots of academic groups let you scale back or take less/no call as you age and the call burden is pretty benign even for junior faculty due to the sizes of the groups and residents in house. Plus residents do a lot of the lifting/pushing/positioning that requires a good back.

Doing 100% peds is stressful at first but gets easier, plus the patients are small so it puts less strain on your body. I get irritated when I have to move a 100 kg patient!

 

[vector2]

I know multiple 60-65+ anesthesia critical care attendings in academics/quasi-academics. Not the most stressful gig with fellows/residents and if you're not taking overnight call.

 

[GassYous]

I know a few 65+ guys still doing cardiac cases but the number of people who gave it up is way bigger

 

[agammaglobulin]

I’d think job flexibility is more important than sub specialty. Does the job allow you to give away call? Take more vacation? I imagine those are bigger factors for longevity than the specialty itself.

 

[OptionOffense]

Anesthesia and surgery are risky choices if you want to work into your 70s.

Most Anesthesiologists are at least thinking hard about retirement around 55.

 

[Twiggidy]

The job where you don't take call or if you have too you get to take call few if any weekends and all the calls you're at home.

 

[docbsb2015]

People want to work in their 70s??

 

[nimbus]

Gotta say, I never understood the “I only want to do kids” peds mentality. Pediatric anesthesia is stressful and labor intensive as compared to adults.

Adults are just really huge kids with bad hearts and lungs.

 

[OptionOffense]

The job where you don't take call or if you have too you get to take call few if any weekends and all the calls you're at home.

To be honest, the daytime work is a lot more taxing than night time work. Nobody is around at night so there is only so much work they can present to you. Daytime they want to pack as many cases as humanly possible between the hours of 7am-3pm when all the nurses go home

 

[GassYous]

To be honest, the daytime work is a lot more taxing than night time work. Nobody is around at night so there is only so much work they can present to you. Daytime they want to pack as many cases as humanly possible between the hours of 7am-3pm when all the nurses go home

I dunno, finishing off a case at dinner time then being called for a covid ex lap is pretty soul sucking

 

[D P356]

I dunno, finishing off a case at dinner time then being called for a covid ex lap is pretty soul sucking

Night time vascular bring back, then immediate re-bring back from pacu….that wasn’t a fun night.

 

[kidthor]

Night time vascular bring back, then immediate re-bring back from pacu….that wasn’t a fun night.

Also depending on where you are you’ll be expected to do G-Tubes, trachs, early morning ortho cases, and the like - so you may be up all night.

 

[HalO'Thane]

I know a couple peds guys who went and got other jobs after mandatory retirement from my group at age 70. One of them also through hiked the Grand Canyon on his 70th birthday.

God I hope I'm not working at 70. If I am it probably means I either screwed up my marriage or got involved in a ponzi scheme.

 

[nimbus]

God I hope I'm not working at 70. If I am it probably means I either screwed up my marriage or got involved in a ponzi scheme.

They’re both the 1 house 1 wife for 40 years type. Dunno about the ponzi scheme.

 

[GassYous]

Night time vascular bring back, then immediate re-bring back from pacu….that wasn’t a fun night.

Christ
reminds me of a all day hand surgery that got taken back in the middle of the night during residency for lost signal and I was with them the entire night. At least the patient was stable but I nearly fell off my chair at 4 am from being so tired. The hand fellows were taking turns taking naps in the corner

 

[deleted875186]

Christ
reminds me of a all day hand surgery that got taken back in the middle of the night during residency for lost signal and I was with them the entire night. At least the patient was stable but I nearly fell off my chair at 4 am from being so tired. The hand fellows were taking turns taking naps in the corner

Wtf, what were the hand fellows doing if not actively trying to fix the hand.

I’m literally imagining one hand fellow asleep, the other sitting just looking at the hand.

 

[GassYous]

I forget the details since it was from ca1 year but there was a fellow/resident team working on the leg and another team working on the hand.

 

[shepardsun]

Christ
reminds me of a all day hand surgery that got taken back in the middle of the night during residency for lost signal and I was with them the entire night. At least the patient was stable but I nearly fell off my chair at 4 am from being so tired. The hand fellows were taking turns taking naps in the corner

Nobody unfamiliar with the OR would ever guess that hand surgery is the worst, most painful type of case to sit hours wise. Complex brain surgery? Open heart surgery? Multi-organ transplants? Nope, the longest cases are the one where somebody got a splinter in their pinky and the hand surgeons work for 28 hours to suture two tiny nerves together.

 

[Twiggidy]

Christ
reminds me of a all day hand surgery that got taken back in the middle of the night during residency for lost signal and I was with them the entire night. At least the patient was stable but I nearly fell off my chair at 4 am from being so tired. The hand fellows were taking turns taking naps in the corner

This is for all the residents. I don't care what anyone in the hospital says, but if you're assigned to do a hand revascularization, you find the most comfortable chair in the entire hospital and put it in the OR that day/night. That's the only place you're going to be for a very long time and you deserve to be comfortable. Also, have your phone/ipad/cpu charger. I always hated the attendings that made a big deal about these things but they were always in their office the entire time for these cases. I pretty much told them I won't bother them the entire night so long as I'm comfortable.

 

[GandalfTheWhite]

Nobody unfamiliar with the OR would ever guess that hand surgery is the worst, most painful type of case to sit hours wise. Complex brain surgery? Open heart surgery? Multi-organ transplants? Nope, the longest cases are the one where somebody got a splinter in their pinky and the hand surgeons work for 28 hours to suture two tiny nerves together.

thats a lot of anesthesia time youre collecting. Hope its commercial insurance

This is for all the residents. I don't care what anyone in the hospital says, but if you're assigned to do a hand revascularization, you find the most comfortable chair in the entire hospital and put it in the OR that day/night. That's the only place you're going to be for a very long time and you deserve to be comfortable. Also, have your phone/ipad/cpu charger. I always hated the attendings that made a big deal about these things but they were always in their office the entire time for these cases. I pretty much told them I won't bother them the entire night so long as I'm comfortable.

I had an attending who would say that if you have time to sit down you arent paying attention or doing your job.

 

[GassYous]

thats a lot of anesthesia time youre collecting. Hope its commercial insurance



I had an attending who would say that if you have time to sit down you arent paying attention or doing your job.

Yeah your attending is a douche
I sit down like 95% of the time

 

[deleted875186]

Yeah your attending is a douche
I sit down like 95% of the time

Important people get to sit down

 

[GandalfTheWhite]

Yeah your attending is a douche
I sit down like 95% of the time

It was a cardiac attending. Maybe the field attracts certain types

 

[nimbus]

This is for all the residents. I don't care what anyone in the hospital says, but if you're assigned to do a hand revascularization, you find the most comfortable chair in the entire hospital and put it in the OR that day/night. That's the only place you're going to be for a very long time and you deserve to be comfortable. Also, have your phone/ipad/cpu charger. I always hated the attendings that made a big deal about these things but they were always in their office the entire time for these cases. I pretty much told them I won't bother them the entire night so long as I'm comfortable.

ABCs….airway, bagel, chair.

First thing I do when I enter a room is confirm that it has one of my preferred chairs.

Might as well add coffee, snacks, urinal.