why low - middle competitiveness for gas?

[neurotrancer]

I have looked up and seen that competitiveness for entry into a gas residency as a U.S. M.D. isn't all that tough. Why is that? What do you think are some of the cons of gas? It seems like there are many things about it which would make it that much more attractive that it would be one of the more competitive fields.

Is it that people don't like the responsibility? Every field of medicine has great responsibility.

Is it that you're staring at monitors most of the time and people think it might be boring? Well, as an internist you're looking at charts/lab printouts all day as well as interviewing/examining pts.

I was told that if you like phys and pharm (my favorites from the preclinical years), this might be something worth looking into. Hence, I'm asking these q's. Sorry if they've already been answered elsewhere.

Thanks!

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[apma77]

its been answered 3000000000000000 times on this forum
look it up!

 

[xampower]

I agree that it has been stated on many other forums but I also think lack of exposure and misunderstanding is also a reason that not many go into anesthesia. I didn't consider anesthesia until I ran out of options when trying to decide on a specialty June of 4th year. The specialties that I was considering I just flat out hated and an intern told me I should do an anethesia elective. I thought I would hate that as well...why? My, along with most of my classmates only exposure to anesthesia was walking into the OR after scrubbing in and looking over at the anesthesiologist sitting behind the curtain, and thinking how boring. I had no clue what went on prior to my walking in the door or after closure. The PACU meant nothing to me at the time as well. It wasn't until I did my first day of anesthesia that I had a completely, and I mean completely, different perspective of the profession. I realize now how little my friends in school know about anesthesia. They don't even know what goes on during the surgery because they are on the other side of the curtain. None of them have done electives in gas b/c they have the same perspective I had prior to doing an elective. It's their loss in my eyes. Poor uninformed souls....have fun doing surgery and IM!!

 

[txdoc2b]

I also think it's because there are so many spots available for gas. Like at least all the ones I interviewed at had betweeen 6-20 spots for CA-1. (I'd say average was around 12) Compare that to other programs that are somewhat diserable or "competitive" like radiology, ortho, plastics, etc., and that makes for a LOT more oppurtunities.

 

[erasmus31]

I agree with the above 2 posts, but 2 common knocks I hear from people about gas are:
1.) Boring...boring...boring...
2.) You are not providing direct care for the pt-you are more like a consult service to the surgeon (ie. Anes. rarely "cure" anything)

I personally do not agree completely with these knocks-I am just saying what the criticisms I hear from other students/doctors. Essentially, EVERY field has its pros and cons-you have to decide if the cons are really that importatnt to you.

For me, I can see the whole consult service argument, but it doesn't bother me-I don't need the gratification of "curing" someone. As for being boring-that may be true, but when it hits the fan, it certainly will not boring, and I think there is something rewarding about being the guy everyone looks to to fix a problem quickly-even if it happens infrequently.

 

[GasEmDee]

I agree with the replies above:

1) Exposure - In many schools, anesthesia is not required as a clerkship. Thus, many of the students will become exposed to the specialty only through their surgery rotations. I think this provides a pretty dim view of what anesthesiologists do. It makes anesthesia look pretty darn boring. Furthermore, even when one does an anesthesia rotation, its a little more difficult from the student perspective to get a feel for the specialty than it would be in other specialities, because one does not get to do much as a student. It is also not readily apparent what is going thru an anesthesiologists mind as he or she is working. A lot of ppl think that anesthesiologists just sit there.

2) Number of spots - There are huge numbers of training spots. Just take a look at the top programs. Many of them has 20 or more spots. Now consider how many derm spots the top programs have.

3) Sociopolitical context - Back in the mid 90's, the field suffered a pretty devastating blow when word got around that there would be no anesthesia jobs. Applications to residencies dropped precipitiously. Many programs could not fill their rosters. Some programs closed shop completely. If you looked at the residency rosters for anesthesia programs in the 90's, there were tons of FMG's, even at the superstar programs, because few american grads wanted to enter the specialty.

At any rate, all this is fine with me. It just means we have our choice of residencies and jobs.

 

[chicamedica]

I disagree about "not curing anyone". When the crap hits the fan, as was mentioned, and the pt is crashing, or someone is coding, the anesthesiologist is the one who is responsible and the expert on resuscitating the pt. That sounds like a real cure to me. It's just that diagnosis and treatment in anes is on a very acute basis, so it's not the typical picture of a doc in the office "curing" a URI (chronic by anes standards), cancer, or rash, or a surgeon in the OR curing a non-functional organ via transplant (which wouldn't be possible without you anyway).

most chronic illnesses aren't curable to begin with, so i don't feel like I'll be missing out on even that aspect of medicine by going gas. In fact i'd take the former acute type of curing over the latter, any day.

I think the difference rests, as mentioned, in not officially "owning" the patient (although if the pt sues the surgeon, the anesthesologist still get named in the suit). For me personally, it doesn't bother me that much. I don't need the spotlight or recognition for "saving the pt" that surgeons or IM physicians get, but in fact I don't want that. I'm a relatively shy person, and all I need to feel fulfilled is knowing inside myself that I helped.

 

[GasEmDee]

Two other things that I forgot to mention. Some people fear that the anesthesiologist is the surgeon's lackey. I have yet to see this attitude for myself, but I'm still far too early in my training to say much about it.

Also, anesthesiologists dont get much glory. The work is done behind the scenes, although one does have greater visibility to patients than say a radiologist.

 

[UTSouthwestern]

Two other things that I forgot to mention. Some people fear that the anesthesiologist is the surgeon's lackey. I have yet to see this attitude for myself, but I'm still far too early in my training to say much about it.

Also, anesthesiologists dont get much glory. The work is done behind the scenes, although one does have greater visibility to patients than say a radiologist.

You don't want the spotlight in private practice. That usually means you did something horribly wrong.

In a way, I don't mind if the myths perpetuate themselves. Just makes it a little more certain that the people going into the field have done their homework and really love the work.

I wake up every day excited to go to work not only because of what I will see and do, but also because I go home completely satisfied and with my pager off.

 

[GasEmDee]

You don't want the spotlight in private practice. That usually means you did something horribly wrong.

Yes, my point being that this is not a field that one chooses for the glory. I agree with you. I dont mind the myths being perpetuated to a certain extent. However, I wouldnt want the field to be marginalized, misunderstood, or unable to attract talented people as a result.

 

[doc05]

it's not competitive because (1) # spots - there are tons; (2) minimal exposure during med school - although I did a rotation and was very bored; (3) you're essentially 2nd banana in the OR and many people don't want that.

as a side note, most of my classmates going into anesthesia are doing it for the lifestyle and money, not because they really enjoy it. at least that's what they say.

 

[xampower]

i'm not sure about this, but i would assume that at least a few people shy away from anethesia because of turf issues with CRNAs..

Here we go again....

 

[U4iA]

oh man, scratch that i said that... i don't usually come to the anesth forums and i didnt know that it was an issue.. but it is possible that people knowing NOTHING about anesthesia could be concerned about this..

 

[Wahoowa]

You don't want the spotlight in private practice. That usually means you did something horribly wrong.

In a way, I don't mind if the myths perpetuate themselves. Just makes it a little more certain that the people going into the field have done their homework and really love the work.

I wake up every day excited to go to work not only because of what I will see and do, but also because I go home completely satisfied and with my pager off.

I have done a few anesthesiology rotations as a medical student. Between them and every rotation I do during my internship year, I know I made the right choice going into anesthesiology.