Is Anesthesiology still a good choice for Medical Students?

[pgg]

Would you guys consider Gas almost a hybrid of IM and EM? I feel like Gas gives a good combo of each.

Absolutely.

Wut -

We spend a lot of time on rounds discussing the asymptomatic hypokalemia of homeless people requesting dilaudid IVP.

Oh outstanding

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[pgg]

Is this a red flag?

I don't think so.

I've heard that if you don't enjoy ICU, anesthesia may not be the right specialty choice, since you're basically running your own ICU in the OR. This has got me thinking, and I'd be nice to get some more input from residents.

As I like to say, anesthesia in the OR is exactly like running your own ICU, except there aren't any nurses to get in the way. Or social work. Or families. Or nutrition consults. Or PT/OT. Or consultants to chase down. Or orders to re-enter after the patient gets back from CT because the charge nurse deleted the last set prior to "transfer" to CT. Or 18-week trached rocks on complication #18 who'll never be discharged except through the basement.

Lots of anesthesiologists didn't particularly like their ICU time. Most anesthesia residents do very well on their ICU rotations, and most are glad to leave when their 4 week blocks are up.

 

[hivoltage]

I don't know what to say other than if your worried about stuff like this, just don't go into medicine.All I can say is make sure you get Board Certified ASAP, if not you unfortunately arn't worth a damn, whether thats valid or not.

well thanks for the advice.. I/we are already in medicine. Should we just walk away from it now.

My point is miamidc, dont stick your head in the sand and not be cognizant of whats going on. Thats what got us in this mess in the first place. IF you have to do a damn fellowship to be competitive,(after four years) then our residency programs are failing miserably.. DOnt say.. (they wont let CRNAS do this or that).. they are doing it dude. Be a realist. Deal with facts not wishes.

 

[PMPMD]

Would you guys consider Gas almost a hybrid of IM and EM? I feel like Gas gives a good combo of each.

Anesthesia involves critical care medicine, for surgical patients.

 

[dhb]

As I like to say, anesthesia in the OR is exactly like running your own ICU, except there aren't any nurses to get in the way. Or social work. Or families. Or nutrition consults. Or PT/OT. Or consultants to chase down. Or orders to re-enter after the patient gets back from CT because the charge nurse deleted the last set prior to "transfer" to CT. Or 18-week trached rocks on complication #18 who'll never be discharged except through the basement.

Lots of anesthesiologists didn't particularly like their ICU time. Most anesthesia residents do very well on their ICU rotations, and most are glad to leave when their 4 week blocks are up.

Wholeheartedly agree

 

[MCAT guy]

HiVoltage does sound very negative. There are little, if any, positive things in any of his responses.

Just sounds bitter.

 

[hivoltage]

HiVoltage does sound very negative. There are little, if any, positive things in any of his responses.

Just sounds bitter.

Healthcare is not a positive place to be at nowadays. If you want me to say everything is just F****** rosey I can do that and lead more un informed astray. Thats fine

 

[GoodmanBrown]

Healthcare is not a positive place to be at nowadays. If you want me to say everything is just F****** rosey I can do that and lead more un informed astray. Thats fine

Hivoltage,

Will you get out when your loans are paid off? Medicinesux seems to have jumped ship as soon as he could. (And seems to be happier for it.)

 

[pgg]

HiVoltage does sound very negative. There are little, if any, positive things in any of his responses.

Just sounds bitter.

Negative opinions aren't invalid. (Just stick your head in the milmed forum sometime for some really bitter posts.)

It does sound like he's in a perfect storm of a bad practice environment though.

 

[hivoltage]

Hivoltage,

Will you get out when your loans are paid off? Medicinesux seems to have jumped ship as soon as he could. (And seems to be happier for it.)

I will get the **** out as soon as i get my loans paid off.. if not sooner

 

[hivoltage]

Negative opinions aren't invalid. (Just stick your head in the milmed forum sometime for some really bitter posts.)

It does sound like he's in a perfect storm of a bad practice environment though.

i may be in a bad practice environment.. but there a lot of bad ones. A LOT. Hey for all you people who think im just a bitter guy I want the more experienced people out there to refute my points that i made in earlier posts..

 

[pgg]

i may be in a bad practice environment.. but there a lot of bad ones. A LOT. Hey for all you people who think im just a bitter guy I want the more experienced people out there to refute my points that i made in earlier posts..

I'm in the military. They pay me about $150K/year, all told, and they're usually about 5-6 months late paying me my annual anesthesiology specialty pay because the military runs out of money and has to put stuff off until the next fiscal year. And yet my bills get paid and I live a pretty good life.

My dept head is a CRNA. The director of surgical services is a nurse. So is the XO of the hospital. The military is the poster child for CRNA independence and midlevel administrative power. And yet none of the above really bothers me (though CRNA independence isn't something I'm totally OK with). I don't feel marginalized or useless.

I have a free trip to the middle east coming up. Minus the family separation, I'm actually kind of looking forward to going (3rd trip).

I get abused with endless mandatory lowest-common-denominator online and in-person "training" ... everything from human trafficking awareness to CBRNE to FEMA to sexual harassment to computer security to anti-terrorism silliness. I admit this crap upsets and offends me on about 83 different levels.

I still love my job, despite the financial and 'hospital politics run amok' drawbacks. To borrow periopdoc's sig line, I think it's the bomb.

Then for a few days per month, I moonlight for at a civilian hospital, where all I do is anesthesia. Some of the surgeons are prima donnas, or jerks. I do "emergency" permacaths on weekends because the group needs to keep the surgeons happy. I don't need ego boosting or public affirmation of my worth; I'm happy to be a supporting actor.

I'll be out of the military in a few years. I think I'm going to be OK in the civilian anesthesia world.

I will get the **** out as soon as i get my loans paid off.. if not sooner

Where to?

 

[Consigliere]

i may be in a bad practice environment.. but there a lot of bad ones. A LOT. Hey for all you people who think im just a bitter guy I want the more experienced people out there to refute my points that i made in earlier posts..

10 years experience. No can do...

 

[MCAT guy]

i may be in a bad practice environment.. but there a lot of bad ones. A LOT. Hey for all you people who think im just a bitter guy I want the more experienced people out there to refute my points that i made in earlier posts..

Doesn't emergency medicine have similar problems?

You mentioned interchangeable, management companies taking $, keeping people happy, and midlevels. Obviously not as much midlevels but some. It appears your criticisms may apply to more than this specialty.

I'm just asking a question and not speaking as an authority.

 

[deleted126335]

i may be in a bad practice environment.. but there a lot of bad ones. A LOT. Hey for all you people who think im just a bitter guy I want the more experienced people out there to refute my points that i made in earlier posts..

20 yrs experience. Sadly I can't refute your points. For the duration of my career (and a few years before) anesthesia has been a boom/bust specialty. Peak of the boom has passed. Approaching a bust period if not already there IMO.

 

[ComfortableWolf]

So with all the doom and gloom from the experienced attending posters what should a medical student or young resident do? Forget Anesthesia all together? switch residency programs? do a fellowship? Just be aware?

Is there anybody who would still do anesthesia again? Besides for highvoltage do you still like your jobs despite the drawbacks? Would you quit if you could?

Should MDs forget about the field altogether?

 

[Ignatius J]

I am a resident and very happy with my choice. I would bet I will continue to be happy.

Some anesthesiologists are going to be miserable, and others will be very content and satisfied. To me, the degree of happiness is not necessarily purely indicative of the job potential, but more of a reflection of the individual anesthesiologist's overall personality and outlook. Just like any job.

If someone is a Debbie-downer, woe is me type, chances are they will hate their profession. If someone is a glass half-full, count your blessings type, chances are that they will appreciate every day they have the privilege to go work in an exciting field like anesthesiology.

I'm young, but that's just my .02. My Old Man is an accountant. I have friends that are CPAs that b*tch everyday about work, yet my father thinks it's the best decision he every made. So, Lesson 1: It's all PERSPECTIVE.

Point being, know thyself. Some people on here act like they have it so bad in anesthesia, but they very well could not realize that they are a 'grass is greener' type and would be griping on the other side of things if they went down a different tract. So, Lesson 2: Some people just like to b*tch. Don't listen to them.

Take those two lessons. Count your blessings. Be honest with yourself. Are you interested in the science and physiology involved? Do you like the amount of patient contact? Could you see yourself doing it?

Make sure you go into it for the right reasons, with the proper perspective. Work hard and take pride in what you do. Everything else will fall into place.

 

[iwumd07]

I agree wholeheartedly. I've had three jobs prior to medical school and I've enjoyed each in their own right. I think happiness in a career choice is 90% about how well you know yourself and the attitude you put forward, and 10% how you let others affect your outlook.

I can't wait to fulfill the rest of my dreams.

I am a resident and very happy with my choice. I would bet I will continue to be happy.

Some anesthesiologists are going to be miserable, and others will be very content and satisfied. To me, the degree of happiness is not necessarily purely indicative of the job potential, but more of a reflection of the individual anesthesiologist's overall personality and outlook. Just like any job.

If someone is a Debbie-downer, woe is me type, chances are they will hate their profession. If someone is a glass half-full, count your blessings type, chances are that they will appreciate every day they have the privilege to go work in an exciting field like anesthesiology.

I'm young, but that's just my .02. My Old Man is an accountant. I have friends that are CPAs that b*tch everyday about work, yet my father thinks it's the best decision he every made. So, Lesson 1: It's all PERSPECTIVE.

Point being, know thyself. Some people on here act like they have it so bad in anesthesia, but they very well could not realize that they are a 'grass is greener' type and would be griping on the other side of things if they went down a different tract. So, Lesson 2: Some people just like to b*tch. Don't listen to them.

Take those two lessons. Count your blessings. Be honest with yourself. Are you interested in the science and physiology involved? Do you like the amount of patient contact? Could you see yourself doing it?

Make sure you go into it for the right reasons, with the proper perspective. Work hard and take pride in what you do. Everything else will fall into place.

 

[Doctor4Life1769]

I am a resident and very happy with my choice. I would bet I will continue to be happy.

Some anesthesiologists are going to be miserable, and others will be very content and satisfied. To me, the degree of happiness is not necessarily purely indicative of the job potential, but more of a reflection of the individual anesthesiologist's overall personality and outlook. Just like any job.

If someone is a Debbie-downer, woe is me type, chances are they will hate their profession. If someone is a glass half-full, count your blessings type, chances are that they will appreciate every day they have the privilege to go work in an exciting field like anesthesiology.

I'm young, but that's just my .02. My Old Man is an accountant. I have friends that are CPAs that b*tch everyday about work, yet my father thinks it's the best decision he every made. So, Lesson 1: It's all PERSPECTIVE.

Point being, know thyself. Some people on here act like they have it so bad in anesthesia, but they very well could not realize that they are a 'grass is greener' type and would be griping on the other side of things if they went down a different tract. So, Lesson 2: Some people just like to b*tch. Don't listen to them.

Take those two lessons. Count your blessings. Be honest with yourself. Are you interested in the science and physiology involved? Do you like the amount of patient contact? Could you see yourself doing it?

Make sure you go into it for the right reasons, with the proper perspective. Work hard and take pride in what you do. Everything else will fall into place.

Nicely put. I'm glad to have entered the field where the grass is always greener

 

[sevoflurane]

It may not be the 80's or early 2000's... but

I my job.

Period.

 

[deleted307836]

hivoltage = maceo for those who haven't figured it out

 

[Arch Guillotti]

hivoltage = maceo for those who haven't figured it out

nice guess since the outlook between the two is equally gloomy, but alas off the mark.

 

[scudrunner]

nice guess since the outlook between the two is equally gloomy, but alas off the mark.

How can you, as a moderator, determine this?

 

[Arch Guillotti]

How can you, as a moderator, determine this?

 

[deleted307836]

nice guess since the outlook between the two is equally gloomy, but alas off the mark.

Meh, I stand by it. He could just be in a different location which would give him a new ip address, and/or using a different computer which would give him a different MAC address.

But really the two posters are identical. Both have the same "e-mannerisms"; they don't use apostrophes, capitalize random letters in words, and are 100% doom and gloom.

I think it's fairly obvious...

the author makes it sound like all physicians wanna be employed bycorporate americal Thats crap. MEdicine is becoming corporate so hence they physicians have to work for them. There is no "work for yourself" mode anymore. very few docs work for themselves now.. its all corporate. SO we dont choose it.. its the only option in many cases

we are not valued. we are commodities. Medicine sucks in general. It really isnt enjoyable. the dynamics are totally not in your favor..

Im glad you think its so easy to work 1-2 days per week and just move around like you state. It aint that way. It aint that easy. Plus sometimes you are moving around and you dont wanna be moving around. Thats always bad. DO you know how many displaced anesthesiologist occur on a yearly basis. they are not happy campers. and the job market is getting tight as hell .I am not sure why. But its mid nineties revisited I think in the next few years.

I only bring this up because hivoltage has been trolling the pre-med and med student boards with his nonsense.

 

[scudrunner]

Meh, I stand by it. He could just be in a different location which would give him a new ip address, and/or using a different computer which would give him a different MAC address.

But really the two posters are identical. Both have the same "e-mannerisms"; they don't use apostrophes, capitalize random letters in words, and are 100% doom and gloom.

I think it's fairly obvious...



I only bring this up because hivoltage has been trolling the pre-med and med student boards with his nonsense.

I think you are right- same weird style.


The dude needs to give it a rest.

 

[jetproppilot]

I love anesthesiology, yet I believe it is foolhardy to run the risk of becoming a cheap commodity when there is still time to specialize in something more rewarding of the sacrifices I have made (and will continue to make) through my formation as a physician.

You are COMPLETELY RIGHT, man.

Go into something else.

 

[hivoltage]

i dont know this maceo cat?

mcat guy: emergency medicine has similar problems but not nearly the problem with midlevels, CRNAs. IN many places you are just as good as a CRNA. How can you possible work at a place and the administration views you as "just like a crna", Its preposterous. Emergency Medicine has image problems but the midlevels are not clamoring as loudly saying they are equal with the docs over there. Or if they are, the politicians are not listening as much


COmf wolf; I enjoyed my residency. It was very different from anything else. It was very hands on and i wasnt rounding.It felt like i was accomplishing something everyday.. After residency is a whole lot different. the politics, the job, the pressure of the early mornings, late nights, the dumps from the guys older than you. getting the cases done..e specially the difficult ones. YOu are on stage all the time basically. the criticisms. You are only as good as the last case. And i am very good at what i do. But i understand the fine line im walking. I dont get paid nearly what i do.. ER doesnt nearly have the pressure that anesthesia does..

what should anesthesia resident or medical student do?

I dont have the answer to this question..... I dont. I just want every one to be informed prior to making the most important decision of their life..

call me a troll.. call me this or that.. Thats fine. Im entitled to my opinion and you dont have to believe me or anything like that..

 

[nycitygas]

Why was maceo banned?

 

[CambieMD]

It may not be the 80's or early 2000's... but

I my job.

Period.

There is no correct answer to the question asked by the op. I came to anesthesia from family practice. Anesthesia has its' ups and downs. This gig, however is great.

Perceptions can be subjective. Some may see the cup as being half full, others may see it as being half empty.

Select a specialy that you are very interested in and would select even if you did not expect big $$$$$. You have to select a specialty that you find mentally stimulating and challenging. I have found what I was looking for in anesthesiology.

Cambie

 

[Arch Guillotti]

Why was maceo banned?

he was a troll, just like this user

 

[hivoltage]

he was a troll, just like this user

Dont call me a troll. YOure a troll

 

[RT2MD]

Dont call me a troll. YOure a troll

 

[Doctor4Life1769]

Dont call me a troll. YOure a troll

Ban Hammer time..... cant touch this!

 

[pgg]

Begone! Find another bridge.

 

[sarcoid]

Dont call me a troll. YOure a troll

M.. Mm.. MWAAAAAWWWW!!!!!

I have a 5 month old who cries less than this guy.

 

[MCAT guy]

i dont know this maceo cat?

mcat guy: emergency medicine has similar problems but not nearly the problem with midlevels, CRNAs. IN many places you are just as good as a CRNA. How can you possible work at a place and the administration views you as "just like a crna", Its preposterous. Emergency Medicine has image problems but the midlevels are not clamoring as loudly saying they are equal with the docs over there. Or if they are, the politicians are not listening as much


COmf wolf; I enjoyed my residency. It was very different from anything else. It was very hands on and i wasnt rounding.It felt like i was accomplishing something everyday.. After residency is a whole lot different. the politics, the job, the pressure of the early mornings, late nights, the dumps from the guys older than you. getting the cases done..e specially the difficult ones. YOu are on stage all the time basically. the criticisms. You are only as good as the last case. And i am very good at what i do. But i understand the fine line im walking. I dont get paid nearly what i do.. ER doesnt nearly have the pressure that anesthesia does..

what should anesthesia resident or medical student do?

I dont have the answer to this question..... I dont. I just want every one to be informed prior to making the most important decision of their life..

call me a troll.. call me this or that.. Thats fine. Im entitled to my opinion and you dont have to believe me or anything like that..

When you talk about long hours being tough, how does that compare to general surgery or ortho? Just curious if your saying it's bad according to your expectations or compared to time consuming fields.

 

[scudrunner]

When you talk about long hours being tough, how does that compare to general surgery or ortho? Just curious if your saying it's bad according to your expectations or compared to time consuming fields.

I really don't know why you keep asking this guy questions, but he isn't going to answer this time, he's history.

Here, I'll answer for him- The hours are terrible, just terrible... much worse than any specialty in the history of medicine.

 

[RT2MD]

I really don't know why you keep asking this guy questions, but he isn't going to answer this time, he's history.

Here, I'll answer for him- The hours are terrible, just terrible... much worse than any specialty in the history of medicine.

 

[jetproppilot]

To anyone becoming discouraged by the incredible amount of negativity in this thread, just remember the universal truth that negative voices are always the loudest.

Just know that there are plenty of anesthesiologists out there who are very happy with their career choice.

 

[scudrunner]

The defense would like to to submit exhibit A: jetproppilot

... he is... The MAN.

 

[CambieMD]

i dont know this maceo cat?

mcat guy: emergency medicine has similar problems but not nearly the problem with midlevels, CRNAs. IN many places you are just as good as a CRNA. How can you possible work at a place and the administration views you as "just like a crna", Its preposterous. Emergency Medicine has image problems but the midlevels are not clamoring as loudly saying they are equal with the docs over there. Or if they are, the politicians are not listening as much


COmf wolf; I enjoyed my residency. It was very different from anything else. It was very hands on and i wasnt rounding.It felt like i was accomplishing something everyday.. After residency is a whole lot different. the politics, the job, the pressure of the early mornings, late nights, the dumps from the guys older than you. getting the cases done..e specially the difficult ones. YOu are on stage all the time basically. the criticisms. You are only as good as the last case. And i am very good at what i do. But i understand the fine line im walking. I dont get paid nearly what i do.. ER doesnt nearly have the pressure that anesthesia does..

what should anesthesia resident or medical student do?

I dont have the answer to this question..... I dont. I just want every one to be informed prior to making the most important decision of their life..

call me a troll.. call me this or that.. Thats fine. Im entitled to my opinion and you dont have to believe me or anything like that..

Everything in life has its positives and negatives. Do you honestly believe that ER doesn't have the stress that anesthesia does. I am at a level one trauma center. I can smell the stress when I have to go down to the ED.

I enjoy what I do. Life is not perfect but it never will be.

Your perceptions are your perceptions. I will not attempt to down play them.
Medical students need to get a balanced view.

Getting dumped on by more senior partners is a part of private practice.
I know a surgeon who was cheated out of 300k by his partners. He sucked it up and kept going.

Life is no more than you make it.

Cambie

 

[hoyden]

another eternal thread about half full vs half empty

 

[BLADEMDA]

This statement by you seems to contradict your stance in this thread.

Let me answer this thread. Anesthesiology is STILL a good choice for Medical Students PROVIDED that student understands what he/she is really getting into by becoming an Anesthesiologist.

Most of you on SDN are willing to dig deeper into understanding what it means to be an Anesthesiologist in 2011. That's good.

No field can provide happiness to those who wouldn't be happy anyway; or, Anesthesiology won't necessarily be your ticket to happiness.

The CRNA threat is real but manageable. Sort of like a chronic illness which requires doctor visits and several medications to control. A pain at times but manageable provided you don't ignore the problem.

Each Medical Student should decide whether Gas is the right fit. The USA will continue to need top level Anesthesiologists to replace the retiring or semi-retiring baby boomers over the next few decades.

 

[PMPMD]

Let me answer this thread. Anesthesiology is STILL a good choice for Medical Students PROVIDED that student understands what he/she is really getting into by becoming an Anesthesiologist.

Most of you on SDN are willing to dig deeper into understanding what it means to be an Anesthesiologist in 2011. That's good.

No field can provide happiness to those who wouldn't be happy anyway; or, Anesthesiology won't necessarily be your ticket to happiness.

The CRNA threat is real but manageable. Sort of like a chronic illness which requires doctor visits and several medications to control. A pain at times but manageable provided you don't ignore the problem.

Each Medical Student should decide whether Gas is the right fit. The USA will continue to need top level Anesthesiologists to replace the retiring or semi-retiring baby boomers over the next few decades.

Boom goes the dynamite.

 

[Osteoimperfecta]

Depends on what your choices are.

 

[neurochem]

I seem to be in the same situation as the original poster...I am a med student about to enter 4th year and trying to decide what to do. I like anesthesiology for the combination of medicine and procedures, pharm and physio, the variety of cases seen at an academic center and probably most influential have been the people in the field because they seem pretty friendly and happy as a general rule. My main concern with anesthesiology is that I want to ensure myself a job when done with residency and I have heard quite a lot of negative outlooks for the future of the specialty. My other possible interest involves Internal Medicine for residency and follow that with fellowship. I have been told that Anesthesiology seems to be moving toward fellowships being more or less required...which isn't a big deal but it means that the time difference between Anesthesiology and Cards/GI is even less (5 vs. 6 years).

So what would you advise if trying to decide between a future in anesthesiology or cards/gi and what factors should I compare to decide which is a better fit?

 

[CambieMD]

So what would you advise if trying to decide between a future in anesthesiology or cards/gi and what factors should I compare to decide
which is a better fit?

How can anyone tell you what specialty would be a better fit for you.

Cambie

 

[geogil]

I seem to be in the same situation as the original poster...I am a med student about to enter 4th year and trying to decide what to do. I like anesthesiology for the combination of medicine and procedures, pharm and physio, the variety of cases seen at an academic center and probably most influential have been the people in the field because they seem pretty friendly and happy as a general rule. My main concern with anesthesiology is that I want to ensure myself a job when done with residency and I have heard quite a lot of negative outlooks for the future of the specialty. My other possible interest involves Internal Medicine for residency and follow that with fellowship. I have been told that Anesthesiology seems to be moving toward fellowships being more or less required...which isn't a big deal but it means that the time difference between Anesthesiology and Cards/GI is even less (5 vs. 6 years).

So what would you advise if trying to decide between a future in anesthesiology or cards/gi and what factors should I compare to decide which is a better fit?

Have you done rotations (preferably multiple) in each specialty? Draw up a list about what you find enjoyable and what you don't in each specialty. Rank each factor as you see fit and see how it stacks up. My thought is that choosing a medical specialty is like picking a spouse. There are many people/specialties which will be a good fit, and that "soulmates" or "perfect specialties" are an illusion. There will be things that you don't enjoy with any specialty. If you let that rule your life, you won't be happy no matter what you choose. There is no reason to think that you can't enjoy doing cards or anesthesia. Try not to let money or lifestyle be too high on teh list of deciding factors, because those thigns can change pretty quickly with the stroke of a legislators pen.

Sorry I don't have the answer for you, but this is a call that only you can make anyway.

 

[neurochem]

Thanks for the input. I have really struggled trying to decide because I did enjoy my Medicine and Anesthesiology rotations. I have sub-I's scheduled in both for the fall so I will just plan on trying not to make any final decisions until then. I think one of the biggest concerns I have is just the future in general...and in many ways I think that anesthesiology is just as uncertain as internal med (except that there seems to be more jobs in medicine). Probably my number one desire is to do something that makes me happy. I had a career for several years between undergrad and med school so I understand what it is like to work and I want to do something that I enjoy. I don't care if I make a million dollars a year but I also want to feel appropriately compensated for all the training and responsibility. This decision just seems like it is really daunting and I am afraid to make the wrong choice (even though I know that some people switch both during residency and even after completion of residency).