anesthesia vs pathology

[pathman1]

Hello, i am a 3rd yr medical student trying to decide between path and anesthesia. I have pretty much completed my rotations and am basing my decision through a process of elimination. I have boiled it down to anesthesia or path, since i am looking for a good lifestyle field, w/good hours (money is not very important to me). I was wondering if anyone knew which field (anesthesia or path) carries more liability? Which is more stressful? I know anesthesiologists make more money (but again this not extremely important to me). If you mess up in anesthesia--does that mean you're branded by the surgreons as a poor anesthesiologist and they may chose not to work with you? I know the fields are on opposite sides of the spectrum but just curious if anyone had any feedback.

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[b&ierstiefel]

Hello, i am a 3rd yr medical student trying to decide between path and anesthesia. I have pretty much completed my rotations and am basing my decision through a process of elimination. I have boiled it down to anesthesia or path, since i am looking for a good lifestyle field, w/good hours (money is not very important to me). I was wondering if anyone knew which field (anesthesia or path) carries more liability? Which is more stressful? I know anesthesiologists make more money (but again this not extremely important to me). If you mess up in anesthesia--does that mean you're branded by the surgreons as a poor anesthesiologist and they may chose not to work with you? I know the fields are on opposite sides of the spectrum but just curious if anyone had any feedback.

I sympathize with your position...as these kind of career decisions can be difficult to make. Anesthesia vs. path is a very tough choice since both fields have relatively good lifestyles. You are right in that anesthesia makes more money but here you have to worry about malpractice. Pathology has this problem to a much lesser extent. in either field, if you do a poor job, the surgeon will have his/her way with you.

Which of these two fields are you more interested in with respect to subject mater?

 

[jeff2005]

I would say anesthesiology is far more stressful - especially when the pt is crashing and everyone is looking at you. When all is calm - which should be most of the time - I can see it getting boring. So, I see anesthesiology as lots of boredom punctuated with moments of sheer terror.

 

[deschutes]

I think it will be difficult to find the answers that you are looking for here - anesthesia vs. path as a career decision is a fairly uncommon phenomenon!

In response to your question about liability and stress - you can mess up in pathology and be branded as a poor pathologist and your colleagues may not want to work with you either

Have you done a rotation in Path? What did you think of it?

 

[sandyworks]

my dad is actually an anesthesiologist, and he works A LOT. while this hasn't happened to him, it's certainly true that anesthesiologists in private groups get black listed, if they've got some unpleasing habits, like nose picking or killing patients.
on a serious note, though, when the going gets tough and you're with a pretty cocky surgeon, you get the rap for a lot of b.s. (i.e. surgeon cuts through the aorta and yells "Dr. X, I could really use some pressure here, if you're feeling up to doing your job!") maybe not quite that extreme, but you get the point.
having said all that, he really loves it and thinks OB anesthesia is particularly rewarding. stay away from hearts, though. it's not just that reimbursement is less than 50% of what it was a few years ago, it's also very arduous and unrewarding.

 

[pathman1]

I sympathize with your position...as these kind of career decisions can be difficult to make. Anesthesia vs. path is a very tough choice since both fields have relatively good lifestyles. You are right in that anesthesia makes more money but here you have to worry about malpractice. Pathology has this problem to a much lesser extent. in either field, if you do a poor job, the surgeon will have his/her way with you.

Which of these two fields are you more interested in with respect to subject mater?

I think i am more interested in path--but just wanted to address your point on "doing a poor job." I feel in path you have less of a chance of making a wrong decision b/c you can always consult your colleague who is down the hall. I have a feeling that there is also more time to make a decision in path than in anesthesia? Path also seems like it has a more stable daily schedule with less surprises. you agree??

 

[b&ierstiefel]

I think i am more interested in path--but just wanted to address your point on "doing a poor job." I feel in path you have less of a chance of making a wrong decision b/c you can always consult your colleague who is down the hall. I have a feeling that there is also more time to make a decision in path than in anesthesia? Path also seems like it has a more stable daily schedule with less surprises. you agree??

i do agree with you pathman. there is also the issue of wording things in a particular way to cover your ass...the art of dictation. but that is a matter of a different conversation.

pathology is nice because the sense of urgency that is inherent in other fields that have more relevance to critical care, for example, is not there. you are correct...anesthesia is more real time in nature...you do more thinking on your feet. when the BP drops what are you gonna do? pathology affords you more time to think through things and more or less, take your time.

(random rant here...have you noticed that many other medical fields involve reflex thinking instead of sequential logical thought? there is less understanding and more memorization and impulse thinking--the pump and dump phenomenon. this is reflected in whole deal with pimping...the medical students who think through answers but come up with the answer slowly, deliberately, and in deductive fashion are not rewarded. the medical students that memorize stupid minutiae and reflexively spout of lists in a matter of seconds get the good evaluations. i don't see this much with pathology. we do have more of a luxury in taking our time and thinking through things. we understand mechanisms and the pathophysiology behind disease processes and we approach things methodically and logically. that was the big appeal of path to me. i don't know about you.)

and yes, pathology has a more stable daily schedule than anesthesiology. and perhaps that's why we get paid less. oh well. i'm with you honestly; my mentality is that there is more to life than money. talk to me though in 10 years when i'm living in a van down by the river.

 

[PathOne]

Generally agree with all of the above posts. However, pathology is unique in that anybody CAN and sometimes WILL pull out your slides a week or twenty years later, and prove that your diagnosis was wrong. And while that may not put you in the poorhouse - unless you're really sloppy - pathologists are a talkative bunch when it comes to misdiagnosis, and it can pretty quickly tarnish your reputation severely. I've seen that happen several times.

That being said, stress levels and malpractise premiums are certainly lower for pathology. The only really time-critical work is frozen sections, which most find fairly straight-forward.

 

[yaah]

Frozen sections many times are easy, yes. But quite often it is just you versus the tissue, with surgeons and patients waiting for you to tell them what to do. And you can't just waffle on the answer very frequently.

The thing is, every field of medicine is going to have stress. If you are picking a field because it is the least stressful, you should probably quit now. You have to pick the field which allows you to use your interests and talents the best. Some people like the OR environment because they feel comfortable. Others don't. SOme people completely freak out when they get a frozen that they aren't sure about.

Until you sit for a day on frozen sections and try to make the diagnosis yourself, I think the "fairly straight forward" thing should be tempered. They seem easy, yes, because you are often sitting with an attending who has done this for years and knows what is going on. That doesn't mean it is.

 

[b&ierstiefel]

The thing is, every field of medicine is going to have stress. If you are picking a field because it is the least stressful, you should probably quit now. You have to pick the field which allows you to use your interests and talents the best. Some people like the OR environment because they feel comfortable. Others don't. SOme people completely freak out when they get a frozen that they aren't sure about.

That was very insightful yaah. Thank you.

 

[yaah]

That was very insightful yaah. Thank you.

We were just faced today with a complicated frozen involving a basal cell cancer of the eyelid. Not much tissue, needless to say, to provide room for error. And lots of inflammation and obscuring issues. The first time, the last frozen section was negative, but it turned positive on the permanent section after the final result. So today he was getting reoperated on. Frozen sections are not straightforward.

 

[b&ierstiefel]

We were just faced today with a complicated frozen involving a basal cell cancer of the eyelid. Not much tissue, needless to say, to provide room for error. And lots of inflammation and obscuring issues. The first time, the last frozen section was negative, but it turned positive on the permanent section after the final result. So today he was getting reoperated on. Frozen sections are not straightforward.

Absolutely! I dread my first month of frozens.

 

[yaah]

Absolutely! I dread my first month of frozens.

Well, as a resident they are pretty cool - often the attending will ask you what you think, and sort of put you in charge of everything. Then they tell you you are wrong and move on.

 

[Hero]

have you noticed that many other medical fields involve reflex thinking instead of sequential logical thought? there is less understanding and more memorization and impulse thinking--the pump and dump phenomenon. this is reflected in whole deal with pimping...the medical students who think through answers but come up with the answer slowly, deliberately, and in deductive fashion are not rewarded. the medical students that memorize stupid minutiae and reflexively spout of lists in a matter of seconds get the good evaluations. i don't see this much with pathology. we do have more of a luxury in taking our time and thinking through things. we understand mechanisms and the pathophysiology behind disease processes and we approach things methodically and logically. that was the big appeal of path to me.

that's very interesting

 

[yaah]

Path is full of reflex thinking too though - you can't spend lots of time thinking about every case you see or you would never get work done. There is a lot of pattern recognition and memorization. But it is true that thinking through things does seem to be more prevalent. Of course, a lot of the reflex thinking that happens in path comes about because of previous work and study. Some people can recognize and diagnose a fibromatosis quickly as benign but in general they have seen lots of them and spent the time it takes to be able to recognize it. I think this does happen in other medical fields as well, but it is an interesting point that "instant recall" is much more likely to be seen as reflective of a good student than careful consideration.

 

[Mrbojangles]

I'm not sure if you know this but there's opportunity for outpatient work as an anaesthesiologist like pain clinics. Also it seems that some anaesthesiologists do inpatient work in the ICU. So I geuss there are options for anaesthesiologists who don't like the OR.

Otherwise when is the earliest time you can do an elective? Since you're leaning more towards path do something like a surg path or heme path elective.