Why anesthesiology? Please pick something else!

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beezar

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Ok, I give in. I just need to vent: I am applying to anesthesiology myself next year, and am doing it because I actually love it. If anesthesiologists earned half the amt of money they earn and worked harder, I would still go. Now all you people who are doing it just for pay and lifestyle... I don't like you! Argh! I hear talk from potential radiology applicants saying that anesthesiology is their backup... ridiculous!

Ok, ok, I'm not really serious, and I'm really not that disturbed by it. And I'd probably do the same thing if I didn't like any specialty that much. So I'm just bitching, cuz when I was seriously considering anesthesiology a few years ago, it was so easy to get in where you want to go... now I have to compete with all you people with high step scores, tons of honors, aoa and stuff. damnit!
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Although I didn't go into ANES, I too get a little peeved by those who go into fields with a huge weight emphasized on lifestyle. Much like it pains me to hear from people when they hear that a person who has high board scores and are at the top of their class are not reaching their full potential if they go into Fam Prac or Psychiatry.

Most people who I talk to who are residents in ANES do not talk about how much they love the field or how exciting it is. They talk about how much money they can make when they graduate, or how much they heard they friend is making in ANES, or how many days they will have off next rotation...on their "grueling ANES month".

Medicine has moved in some ways far beyond people doing it for the love of medicine. And in some ways, I guess we can blame medical education for that. Do you think many of those people who are going into radiology would have gotten in if they said in their medical school application essay..."actually, I don't really enjoy having that much interaction with patients. I kinda like just reading films and doing some procedures. I get more than enough patient interaction with them when I get them to sign the consent form..." What happened between the time when they were first accepted to medical school, all wide eyed and eager, to...nah...it's just a job so I might as well make alot of money when I'm doing it.

Hopefully, people will see past monetary gains. They'll realize that when it's all said and done, if you chose a field you don't really like just for the money, you'll be a very miserable person indeed. No matter how much you're making.

Just my nickle...
 
I think more and more individuals are looking for a career in medicine rather than a life in medicine. Many people, myself included, want to be great spouses and great parents in addition to being great doctors. Unfortunately, many positions in medicine, especially in primary care, make this very difficult. So it is a big mystery why people flock to derm, optho, pm&r, rads, and anes? So while some people do persue careers in somewhat less demanding fields for the money and free time they offer, I would bet most who head these routes just want more out of life than missing their kids T-ball games to go admit hypertensive, diabetic patients with COPD who just won't give smoking. God Bless those of you heading into primary care. You are a step away from sainthood in my book.
 
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I have been thinking about this for a long time. It seems that everyone these days is choosing lifestyle first. I personally think that this is a legitimate choice; however, I think that it is disturbing that so many people are choosing their careers based on this. When you are going to work for 20-30+ years, you better choose something that you love, not just like. I have a few friends who chose specialties based on lifestyle. They are not very happy with their careers, and they can't wait to retire one day. They may be the minority, but it's something to think about. I have other friends who love anesthesiology, and they are completely happy with their careers. The difference is that they chose anesthesiology for the work, not for the time out of work.

I believe the ridiculous residency hours have created this trend. This is why I personally can't blame everyone for their choices. However, with that said, we all knew what we were getting into when we came to med school. Everyone is aware of the long hours and demanding schedule. I think that when you choose to apply to medical school, you are choosing a career where you are going to have to sacrifice an awful lot. You certainly shouldn't have to give up your entire life, but I really don't think you have to give everything up.

I feel it's best to do what you love. With all of the work that everyone puts into becoming a physician, you are cheating yourself otherwise.
 
This passage from the post " ALL students going into surgery..." is very appropriate in the context of this discussion:

Two years ago, I was involved in a discussion on professionalism with a group of medical students. A couple of the students stated their belief that the idea of profession was outmoded. Furthermore, they asserted that the notion of the societal benefit of medicine was at times overstated. Their point was, I believe, that medicine was only one of many ways to benefit society and that it was only a job, like many other important jobs. This led to a discussion of the relative importance of medical practice to society compared with other jobs.

I asked this group of students the following question, "If you were a physician in private practice working 45 to 50 hours weekly, and wanted to give a gift of your time to benefit society, would you be more effective providing indigent care or teaching an inner-city child to read?" I have subsequently had this discussion with more than 200 of our medical students in small groups. There are considerable differences in responses by sex, but the results have been remarkably consistent from group to group: 80% of the women queried believe they would contribute as much by teaching reading than by providing indigent care. Twenty percent of the men feel the same. I posed a second question to the students, "Do you view your medical career as a job or a profession?" Eighty percent of the women state it is a job, while 50% of the men make the same response. Women usually state that the all-consuming commitment to profession is not what they want. Before rushing to judge me as antiwoman, let me tell you that I have a daughter in medicine who has made me sensitive to the need for a life away from our patients. The need to balance work with home and family is a feeling stated by virtually all students regardless of gender. This need for a balanced life is crucial and should be encouraged. On the other hand, it is clear from my discussion with students that the "only a job" mentality often translates to tightly fixed or controlled working hours with a "shift" mentality. The phrase "I want to be off duty when I leave the office or hospital" is frequently heard. The notion of continuity of care is not valued much in this ethic. I believe this attitude of wanting to do shift work is common and is another lifestyle factor that makes surgery less attractive as a career.

I worry that this emphasis on a job rather than a profession does not serve patients well and is particularly ill suited to surgery, with its important emphasis on continuity of care. If the only factor involved in motivating physicians to get up at night to see a patient, persevere on a hard case, or do other necessary but sometimes onerous work on behalf of our patients is because it is a job, we may be in trouble. One can always change jobs."
 
So why the bad rap for radiology? I don't hear anyone moaning about people wanting to be pathologists. And they don't talk to patients either. The beauty of medicine is that there is room for people who want/need to interact with patients and those who would not mind not interacting with patients but instead interacting with referring physicians as consultants. You or the admissions committee should broaden your/their definition of who it means to be a doctor. There are plenty of people who love radiology and pathology and will be quite happy doing it for the next 20-40 years.
 
•••quote:•••Originally posted by droliver:
[QB]
I asked this group of students the following question, "If you were a physician in private practice working 45 to 50 hours weekly, and wanted to give a gift of your time to benefit society, would you be more effective providing indigent care or teaching an inner-city child to read?" I have subsequently had this discussion with more than 200 of our medical students in small groups. There are considerable differences in responses by sex, but the results have been remarkably consistent from group to group: 80% of the women queried believe they would contribute as much by teaching reading than by providing indigent care. Twenty percent of the men feel the same. I posed a second question to the students, "Do you view your medical career as a job or a profession?" Eighty percent of the women state it is a job, while 50% of the men make the same response. Women usually state that the all-consuming commitment to profession is not what they want. Before rushing to judge me as antiwoman, let me tell you that I have a daughter in medicine who has made me sensitive to the need for a life away from our patients. The need to balance work with home and family is a feeling stated by virtually all students regardless of gender. This need for a balanced life is crucial and should be encouraged. On the other hand, it is clear from my discussion with students that the "only a job" mentality often translates to tightly fixed or controlled working hours with a "shift" mentality. The phrase "I want to be off duty when I leave the office or hospital" is frequently heard. The notion of continuity of care is not valued much in this ethic. I believe this attitude of wanting to do shift work is common and is another lifestyle factor that makes surgery less attractive as a career.
QB]••••I think most consider medicine as a profession...it is time intensive and much is invested by the student (a minimum of 7 years and many sacrifices). But what is the definition of a "profession"? Does a profession have to be life consuming to be a profession? Must it exclude any other goals in life? Why can't people be dedicated individuals and still go home at a reasonable hour? Does working within a time frame mean that the person is any less of a dedicated doctor?

I think medicine seriously needs to evaluate the way it treats its residents. Neurosurgery sounds like an amazing field and yet who wants to give up a family to become one?
 
I know where you're coming from Voxel, I almost feel guilty sometimes that I'm going into radiology. We're going to get a bad rep no matter what so it's something I'm willing to live with in order to do something I love. For me, I went to med school thinking of doing Heme/Onc but I had no idea how much I would hate it until I did a rotation in my 3rd year, nor did I know how much I would love being in the radiology department until I was doing trauma. I think you have to do what you love, first and foremost, but it was an easier decision to pick radiology knowing that I wouldn't be working 80 hours a week that's for sure. If I would have loved surgery or medicine as much, I would have done that instead and would have suffered the hours during residency. The thought of being in clinic all day makes me cringe though and my surgery rotation was so malignant and painful (even though the surgeries themselves were so cool) that there is no way I'd let myself be abused like that again.
 
coffeecat,

I think what Dr. Richardson (the author of that commentary I pasted) is getting at is a trend for today's students to want medicine to fit around their lifestyle choices, in contrast to long historical precendent for submitting personal goals to professional duties (a la the Hippocratic Oath).

He makes a very insightful argument in that text on the decline in interest in surgery (which can be extrapolated to ALL of the most rigorous medical fields) among students for several reasons. Prominent among those are:
1. The change in the makeup of today's medical student. More women + more nontraditional students = less potential population of those who have traditionally done surgery and other long training programs like Cardiology, Neurosurgery,etc...

2. The declining reimbursement for hard work leads to declining interest in hard work. If your average heart surgeon still made $1 million/year, you wouldn't have empty fellowship positions for 5 years running

3. The marginalization of surgery and surgical subspecialties as a discipline by medical school admissions committees & curriculum
 
I guess as a woman going into surgery, I'm a bit unusual, then? (I actually think more, not fewer women are going into surgery, based on what I witnessed on the interview trail.) Yes, I'm a natural workaholic, and probably not completely right in the head, so take what follows with somewhat of a grain of salt or two.

I personally agreed with much of what Dr. Richardson had to say in the article, but I found the generalization of women (I know, he qualified his statements as well as indicated that these statements were based on his personal experience) as being more lifestyle-oriented than men and more inclined to view medicine as a job rather offensive. Perhaps it stems from the way I was raised, in a medical family where the physician parent DID commit to making care of patients a priority, but in my mind, that is part of what becoming a doctor, (particularly a surgeon,) is all about. True, I have decided not to have children, which I guess some people would say is taking a radical approach to my career. I think the assumption that all women want children is backward and archaic.

I find the attitude of many of my fellow medical students (and a number of the posters in this forum) truly depressing. I don't mean to imply that we should be slaves to our profession, yet the committment that I believe one should have toward one's patients appears to be gravely lacking among a large percentage of today's future physicians. I applaud those who choose careers in anesthesiology, radiology, and other such specialties because they truly love the kind of medicine they will be practicing. To those who have chosen them solely for the perceived lifestyle benefits: :mad:

OK, I'm done with my rant for the day. Back to being a nice, happy surgery-resident-in-a-month. :)
 
As much as I really appreciate you budding radiologist making me jump through hoops just to get a study from you, I have to say that I do appreciate the work you do.

However...

Granted there may be a need(or shortage in some areas) of radiologists, dermatologist, anesthesiologist, ophthomologist...I think there may even be a bigger need for those entering primary care medical and surgical specialties.

If you wanted a career for lifestyle and money, I'm sorry, but medicine may not have been the most optimal choice for you.
 
Apparently you have some deep seeded hostility/jealousy towards radiologists. That's ok. Hopefully, you'll get over it some day.

Even though you cannot fathom this, I will be very happy being a radiologist and that's all that matters to me.

You have not constructed a logical response to my previous post. But I realize that some other physicians may think this way. And you know what, I don't care. And that's the beauty of it all.

What I will work on in my radiology group when I begin my practice, will be to make true emergency film requests turn around time as low as possible (~20-40min from start to final report, day or night). I will work on speaking with referring clinicians to get them to order the most appropriate study. Routine studies will take time because there are so many ordered and so few radiologists to read the staggering amount. I'm not sure what level of training you are in or whether you really know what's going on in private practice outside of academia. But radiology is turning into a 24/7 field and the demand for imaging services is skyrocketing. So wait your turn to get your non-true-emergency films read, just like everyone else. We'll get to your film as soon as possible. Have a great day!
 
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Wow!! 28 posts into this and I already get the common welcome of personal attack typical of posters here on SDN. :clap:

And, yes, I am very jealous of radiologists. I hate you all...I hate you all so very very much... :mad:

Dearest Baby Doc,
Had you been addressing me personally, I would have responded in kind. But I feel that whatever I say at this point is really useless as whatever opinion I may have valued of yours has faded.
When you finally get to be a doctor, or even an intern for that matter, you too will understand the grief and frustration that we all feel at one point or another in dealing with radiologist. Overall, they're good peeps. It's the bad ones however that always stay in one's mind.

My main point however is not whether you will be happy. It's not about you...no...it really isn't about you. What it was about was the fact that people choose to go into medicine for the wrong reasons, or choose fields in medicine for the wrong reasons...it's really unfortunate in some ways that such young people(myself included) are expected to make such a serious life decision with long term commitment. Being a doctor is not a hobby, you have people's lives in your hands everyday. It's a huge responsibility, no matter which field you decide on, as your judgements have great impacts. I find it hard to believe that in Europe, 18 yr olds are allowed to make such decisions, by deciding to enroll in medical school.

"So wait your turn to get your non-true-emergency films read, just like everyone else. We'll get to your film as soon as possible. Have a great day!"

I see your people interaction skills have prepared you well for the field of radiology. Keep up the good work.

And when you decide that a film is not essential or necessary or needs to be read right away, with sight unseen patient, I'll be sure to write your name at the top of my progress note. Since you'll be making so much money and have so much time off, you'll have no problems paying off your lawsuits and being available for court hearings....

Thanks!

<img border="0" alt="[Laughy]" title="" src="graemlins/laughy.gif" />
 
You just don't get it. It's too bad. However, your posts do give me a good laugh.

Yeah, I'll decide based upon what you write on the requisition form or what you tell me in person (which I will write/dictate at the top of my report). This will determine which scan is an emergency scan. That's clinical decision making. Try using it sometime, then you won't be shaken down by the malpractice lawyer too often. Buh-Bye.
 
•••quote:•••True, I have decided not to have children, which I guess some people would say is taking a radical approach to my career. I think the assumption that all women want children is backward and archaic.
••••I think you made a wonderful choice in life! Even though I am a guy, my s-mom thinks its a radical idea for me not to want to have this perfect family with the white picket fence and the dog running around with the kids. I think people should let up on the women who don't want to take the role in life as a mother. I think both women and men can lead wonderful and fulfulling lives without having to bring a child into this world.
 
Just one perspective that I haven't seen mentioned too much. It is easy to just say that more women are entering medicine, but I find equally strong the difficulties faced by even more people given long overdue changes in societal gender roles. Complicated, but: It used to be that most docs were men and "the breadwinner" of the family. If theirs were the only career it was easier to deal with things like moving for residency, making little money, or having kids. The woman did not have to sacrifice her career because statistically most didn't have them.
Now however, women are in professional careers.
So things become difficult if you are married and want kids, both are professionals or in training, and one of you is in medicine. Realistically, someone has to take a fairly severe career hit. It is hard to argue to the nonmedical spouse that this should always be them. What if the woman is a professor, lawyer, CEO? Does she quit this to move for residency, if the couple ever wants to have kids, etc. I think that this may be a powerful push towards lifestyle residencies, especially considering the relative unflexability of the harder lifestyle residencies.
 
Although, I don't think choosing a specialty soley because it is relax and/or financially rewarding is not the right attitude, I think it is inevitable that more and more students will make compromise between lifestyle and their job/profession.

Personally, I would be very happy to make the same amount of money on a per hour basis, if I only need to work 40 hrs vs 60hrs per week. True, the total amount is less, but I certainly will be more rested when I am free, I will have more free time to be with my wife and lovely kid.

I am heading towards the end of the road in my residency. When I looked back, the sacrifice I have made to be a surgeon is tremendous. 4 yrs of residency + 1yr of research, being on call an average of q3-4. I really gave up a lot of my time to achieve my goal on the expense of my family. I love surgery and it is very rewarding professionally, but there are many occasions that I am overworked and just want to kill my pager in the middle of the night. There are several occasions that I miss important events because I am on call. Obviously, there are many people who have a family and able to swing it out. But in my case, I felt like I am a lousy Dad, husband and I am expecting to make anywhere between 80k-120k the first year out of residency/fellowship!

If I am ambitious, well, I think I can crack 200k working 60+ hrs/week or so in a few years, and potentailly spending the whole night in the OR when I am on call. Is my wife and kid going to appreciate that? Am I going to be mcuh happier and satisfied making more money?

I really have no problem with people choosing specialty because they need to have a balance lifestyle. After all, you need to be pretty bright to enter fields like Rad, ENT, Derm, Rad Onc. Above avg. to go into ER, optho, Anesth and may be PM&R in the near future.

Before you can take care of others, you need to take care of yourself and family.

What do you all think?
 
To quote LaCirujana-
"I think the assumption that all women want children is backward and archaic."

Amen to that!! When I tell people that I'm going for a general surgery residency, I often get looked at as if I am a circus freak for NOT wanting to "settle down and have kids." While I realize the many women AND men in medicine highly prioritize lifestyle and family, there are also many of us lurking out there entered, and still view, medicine as much more than shiftwork-like job.

While I realize a lot of people (including many that I work with) view women as extremely social-oriented/perpetually maternalistic people who'd rather play with kids than contribute to medicine/society in other ways; I'm glad that I am not the only person out there who is an exception to this generalization. I certainly hope when I interview this winter that people give me a chance before instantly assuming things about me that are not true.
 
•••quote:•••Originally posted by beezar:
•Ok, I give in. I just need to vent: I am applying to anesthesiology myself next year, and am doing it because I actually love it. If anesthesiologists earned half the amt of money they earn and worked harder, I would still go. Now all you people who are doing it just for pay and lifestyle... I don't like you! Argh! I hear talk from potential radiology applicants saying that anesthesiology is their backup... ridiculous!

Ok, ok, I'm not really serious, and I'm really not that disturbed by it. And I'd probably do the same thing if I didn't like any specialty that much. So I'm just bitching, cuz when I was seriously considering anesthesiology a few years ago, it was so easy to get in where you want to go... now I have to compete with all you people with high step scores, tons of honors, aoa and stuff. damnit!•••••Hi there,

If you love anesthesia, then apply to anesthesia and let your love and interest for the specialty get you in. If you truly want to be an anesthesiologist, look at what you have to offer to the profession and not what you think your competition will be. Go for it and chose your programs wisely! :cool:
 
I don't think I should be the one saying this, but I think the nice thing about medicine (as practiced by an MD/DO) is that there is plenty of room to switch to another specialty if you don't like your current work. For example, if you come into medical school wanting to be a surgeon and decide later in school you want to be a pediatrician, then you can change your initial decision. Personally, I am thinking about pedi surgery, pedi ophth, Anesth, or FP/Psych Combo, but in years past I have also thought about
pedi onco/hemo and neonatology. Those last two I am somewhat still considering, but right now I am weighing on the first few.
 
As someone who is not going into anesthesia and who gives not a rat's ass why people choose to go into fields, let me say that by bitching and whining like babies that people are going into thing for money makes you look jealous and incapable.

20 years ago med students did not have to worry about these things because any doctor would be loaded by today's standards.

That is not the case. I guess there is a place for people in medicine who just want to make a lot of money, and some of those places are behind a microscope, in front of an x ray board, or behind the patient's head during surgery.

Whos cares. Good for these people. In many ways I wish I had it in me to say screw it and pursue one of these specialties, but as long as those people do a good job they earned the right to make that money.

Also, medicine is so noontraditional in many ways with 28 year old first year med students.

I am fortunate that I will graduate at 25 so I can complete residency and a 3 year fellowship and still be 31 with a 29 year old wife and then start a family.

We all make choices. If I was 30 now I would do anes also, but I have the luxury of doing something else that requires call.

So, again, I say stop complaining about people donig anes an rads. They worked hard in med school to be competitive for these same things. Competiton is a beautuful thing. You should have studied harder and then you wouldn't have to whine like a pathetic baby that you should get anes because you "really want it"
 
speaking of lifestyle...

what kind of hours and pay can an anesthesiologist expect? how long generally before partner? typical work schedule and vacations?

just curious.... NOT that lifestyle is important
 
Pay, vacations, work hours, etc. are all incredibly variable. YOu can work as hard or as little as you want. Obviously your salary will reflect that. I think the same holds true for all specialties in medicine. Doctors complain that they work too hard and get paid too little, but the fact of the matter is, in private practice, I believe you have greater control over your hours than most people think. It all depends on how much you want in the bank.

To get an idea of salaries, vacation, etc., you should check out some of the anesthesia job web sites, like gaswork.com, etc.
 
Ratty,

actually in referral-based practiced it can be very hard to limit the amount you work. Not making yourself available is a sure way to alienate referring physicians from future business. This is less true for anesthesia as they aren't really referral based
 
Good point -- I agree. I was thinking more in line about primary care doctors, who I would imagine could, at some point, stop taking new patients, etc.
 
I agree with you about specialty referall based docs who have a difficult time refusing to see new consults. However, anesthesiology lends itself more to being more flexible with work hours and call. Granted no one will ever let you become partner in an anesthesiology group if you don't take call or work less than others in the group as newly minted anesthesiologist. You will have to sacrifice income and political power, but I believe anesthesiology is flexible enough that if you are willing to make those compromises then you will be able to do so. True referal based specialists (unlike anesthesiology) will have a much more difficult or impossible time turning down consult requests or delay scheduling them in a timely fashion.
 
Originally posted by migraineboy
I think more and more individuals are looking for a career in medicine rather than a life in medicine. Many people, myself included, want to be great spouses and great parents in addition to being great doctors. Unfortunately, many positions in medicine, especially in primary care, make this very difficult. So it is a big mystery why people flock to derm, optho, pm&r, rads, and anes? So while some people do persue careers in somewhat less demanding fields for the money and free time they offer, I would bet most who head these routes just want more out of life than missing their kids T-ball games to go admit hypertensive, diabetic patients with COPD who just won't give smoking. God Bless those of you heading into primary care. You are a step away from sainthood in my book.
Click to expand...

I think MigraineBoy makes some excellent point. In fact, I counter with the prospect that some of those physicians who are miserable might not be totally attributable to the choice of specialty. I have worked w/i the medical professions for a number of years...and the docs who are the biggest bastards tend to be the ones who are "amrried" to their profession --- the ones who eat, sleep, **** & breath their careers. Maybe, if they took 'lifestyle' issues more into consideration and remembered that they are merely human beings, not even semi-god-like, and that they were, are & will be human far longer than the facade of physician lasts...that maybe they might be more content with their lives. How content can someone actually be with such a narrow focus?

I have heard this mindset referred to as the 'New Millenium Physicians' -- those that seek to balance their professional obligations with those of home, family & friends. That is the norm amongst virtually all other professions. Why should it be different for physicians? How absurdly Shakespearean to mandate that to mold the ultimate cargiver of human-kind that their own humanity must be driven from them...as I said, absurd.

Our future clientele, patients, are people...and they are demanding more & more that their physicians also be people. Before it even precipitates, do not propel this logic into that typical pre-med banter over people friendly Docs vs clinically excellent Docs w/o personalities -- those traits are not even close to being mutually exclusive; so there is no point in arguing over a non-extant conundrum.

Our patients want clinically excellent people-focused physicians...and there is no reason that they cannot have them. But, for those types of Docs to exist, the system of education & training must evolve into one that not only condones, but also fosters the concept of happy, people-friendly physicians who are content in both their professional & personal lives.

Even thought I doubt that this was too prminent in the minds of those who recently championed & ratified the new residency work hours restrictions, I think that will start us down the path of reform that will return physicians to role of people.
 
Originally posted by droliver
This is less true for anesthesia as they aren't really referral based
Click to expand...

Unless you're in pain management.
 
Originally posted by OP
Ok, I give in. I just need to vent: I am applying to anesthesiology myself next year, and am doing it because I actually love it. If anesthesiologists earned half the amt of money they earn and worked harder, I would still go. Now all you people who are doing it just for pay and lifestyle... I don't like you! Argh! I hear talk from potential radiology applicants saying that anesthesiology is their backup... ridiculous!
Click to expand...


I met a kid the other day (rads-bacup anas) and I was thinking "WTF?"
I mean...I would also do rads for half the money, but hey! Thats competition, and thats America!
We just gotta deal w/ it.
 
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