Med student interested in anesthesiology. Still worth pursuing?

[JPSmyth]

I am an MS1 interested in anesthesia. I have done some shadowing in the field and I enjoyed my experience more than most other specialties I have shadowed in. I like being in the OR but not necessarily being the one doing the cutting. I think it is interesting work, not just rendering people unconscious but the nerve blocks and other procedures as well. I feel that I will enjoy the work I'm doing for the most part in anesthesia. However, reading this forum has made me scared to enter anesthesia.


The outlook on the internet seems to be that AMCs are taking over entirely, and there will be no good jobs in 8-10 years. Anesthesiologists will be working longer hours for less pay while "managing" 10 CRNAs at once.


If I am able to attend a "good" anesthesia residency, is this still inevitable? I know there is a ton of doom and gloom on the internet but can any attendings chime in and offer input regarding potential positives of the field?


For example, would a job working roughly 50 hours/wk, call not often, making 300k/year, not in major city, with 10+ weeks vacation be possible? It seems that this is reasonable now from what I have seen online, but will these jobs be gone in 8 years? I don't want to pursue anesthesia only to graduate and be stuck in a field that works you to death for low pay, or even worse there won't be many jobs for anesthesiologists since it's cheaper to employ CRNAs?


Thanks in advance

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[Arch Guillotti]

 

[JPSmyth]

Is that implying that I'm going to get bombarded with advice not to go into this field?

 

[kjamess]

don't do it. kowtowing to nurses and all (jk...sort of)

 

[AdmiralChz]

Is that implying that I'm going to get bombarded with advice not to go into this field?

Utilize the search function to see one of the other 10,000 posts on this topic.

Interestingly, this conversation goes the same for just about every specialty on SDN although the reasons for avoiding specialty X is different for each. Surgeons readily suggest GI, anesthesia suggests surgical subs, rads suggests derm, EM suggests OH GOD DONT DO IT. Funny, but sorta sad.

 

[aneftp]

Anesthesiology continues to match very well. (Although these days the match stats are inflated due to more lcme med schools (15 new lcme med schools in past 16 years and not much more overall residency slots in all specialties.

It's more of a middle tier specialist

The anesthesia field is changing. There will still be jobs. The population is getting older. But like others have posted. There is a race to the bottom due to competition from mid levels. It feels almost like what happened with psychiatry vs psychologist over lapping.

 

[AdmiralChz]

In all honestly, you'll probably get a better and more personally tailored answer from the physicians you've shadowed and worked with. Get their impressions of the current landscape and gather some information.

No matter what you do, make sure you choose a specialty you enjoy. A career is a long, long time and no one has a crystal ball when it comes to healthcare. At least be employed in a job you love.

 

[JPSmyth]

Utilize the search function to see one of the other 10,000 posts on this topic.

Interestingly, this conversation goes the same for just about every specialty on SDN although the reasons for avoiding specialty X is different for each. Surgeons readily suggest GI, anesthesia suggests surgical subs, rads suggests derm, EM suggests OH GOD DONT DO IT. Funny, but sorta sad.

I have been searching and reading this forum for years now, and reading the anesthesia forum for months. I see that the majority of posts are regarding AMCs, CRNAs, DNPs, and all the other negatives about the field but I have seen small glimpses of hope on occasion haha. and you're right I have noticed that too. every field seems to have the grass is greener mentality, aside from ortho and derm

 

[Carbocation1]

I have done multiple anesthesia rotations, and all my attendings have been negative about anesthesia. I've gotten to know them personally and they feel comfortable sharing their true thoughts with me. On my current rotation, I debate CRNAs daily about the AANA propaganda they spew towards me. I've seen firsthand the disproportionate disrespect anesthesiologists endure. But, I'm still applying gas this cycle because there is nothing else I could tolerate in Medicine and it's too late now to find something else, even though I am a top student. Analyzing compensation reports and looking at gaswork.com helps ease my decision - I just hope the field doesn't drastically go south when I graduate Residency.

 

[AdmiralChz]

I have done multiple anesthesia rotations, and all my attendings have been negative about anesthesia. I've gotten to know them personally and they feel comfortable sharing their true thoughts with me. On my current rotation, I debate CRNAs daily about the AANA propaganda they spew towards me. I've seen firsthand the disproportionate disrespect anesthesiologists endure. But, I'm still applying gas this cycle because there is nothing else I could tolerate in Medicine and it's too late now to find something else, even though I am a top student. Analyzing compensation reports and looking at gaswork.com helps ease my decision - I just hope the field doesn't drastically go south when I graduate Residency.

Yikes. I'd go somewhere else for residency.

 

[JPSmyth]

I have done multiple anesthesia rotations, and all my attendings have been negative about anesthesia. I've gotten to know them personally and they feel comfortable sharing their true thoughts with me. On my current rotation, I debate CRNAs daily about the AANA propaganda they spew towards me. I've seen firsthand the disproportionate disrespect anesthesiologists endure. But, I'm still applying gas this cycle because there is nothing else I could tolerate in Medicine and it's too late now to find something else, even though I am a top student. Analyzing compensation reports and looking at gaswork.com helps ease my decision - I just hope the field doesn't drastically go south when I graduate Residency.

What do you debate CRNAs about? And do they endure abuse from the surgeons or from CRNAs/DNPs?

I'm a bit confused about the dynamic, because when I shadowed it was all attendings and residents in anesthesia. thanks

 

[Moose A Moose]

I have done multiple anesthesia rotations, and all my attendings have been negative about anesthesia. I've gotten to know them personally and they feel comfortable sharing their true thoughts with me. On my current rotation, I debate CRNAs daily about the AANA propaganda they spew towards me. I've seen firsthand the disproportionate disrespect anesthesiologists endure. But, I'm still applying gas this cycle because there is nothing else I could tolerate in Medicine and it's too late now to find something else, even though I am a top student. Analyzing compensation reports and looking at gaswork.com helps ease my decision - I just hope the field doesn't drastically go south when I graduate Residency.

Are you sure to inform all that you debate that you're a top student?

Smh

 

[DetectiveAlonzo]

If ur happy with the worst case possibility that you will oversee nurses to do your job for you and making nurse-like wages while doing it, then go for it.

Worse comes to worst... if a hospital wants to hire you vs. a CRNA (once they gain equal liability and rights and privileges)... you can rest in the fact they'll probably hire you over or that CRNA's pay (~200k).

If you do end up in this profession, be a man. Have a goddamn backbone and speak up for yourself and your profession. Our previous generation ****ed us over by letting nurses think they are better than us and it's our responsibility to grab the ASA by the balls and get back to the glory days.

 

[Uisa]

First off, there is no way to exactly know what will happen in the future. Having said that, anesthesiology as a field is NOT going away. Will your roles change as an anesthesiologist? Possibly. Will you get paid less? Possibly. Will grass always seem greener on the other side? Yes. Does that mean it's actually greener? Who knows. Will we all become government employees and make 100K a year, regardless of what your specialty is... also possible.

My perspective is that you should, first and foremost, choose something you like doing. Choosing something based on circumstance and speculation will lend itself to different set of problems in the future.

Also, happiness and fulfillment in your field should mostly be based on something intrinsic you feel/experience, if you put too much of your happiness/fulfillment on things outside your control you are setting yourself up for a life of perpetual disappointment.

My advice is to try do well during med school and on standardized exams to keep every (specialty) door open. Try all the specialties, leave nothing on the table and then choose the one you feel the most passionate about. If that happens to be anesthesiology, then do it.

 

[JPSmyth]

First off, there is no way to exactly know what will happen in the future. Having said that, anesthesiology as a field is NOT going away. Will your roles change as an anesthesiologist? Possibly. Will you get paid less? Possibly. Will grass always seem greener on the other side? Yes. Does that mean it's actually greener? Who knows. Will we all become government employees and make 100K a year, regardless of what your specialty is... also possible.

My perspective is that you should, first and foremost, choose something you like doing. Choosing something based on circumstance and speculation will lend itself to different set of problems in the future.

Also, happiness and fulfillment in your field should mostly be based on something intrinsic you feel/experience, if you put too much of your happiness/fulfillment on things outside your control you are setting yourself up for a life of perpetual disappointment.

My advice is to try do well during med school and on standardized exams to keep every (specialty) door open. Try all the specialties, leave nothing on the table and then choose the one you feel the most passionate about. If that happens to be anesthesiology, then do it.

Thanks. I would enjoy anesthesiology as a specialty, but future salary is a concern of mine as my loans will be almost 300k by the time I am done and I don't want to be drowning in debt. I certainly hope that physicians don't become government employees making 100k per year, otherwise I'm screwed

 

[bashwell]

Thanks. I would enjoy anesthesiology as a specialty, but future salary is a concern of mine as my loans will be almost 300k by the time I am done and I don't want to be drowning in debt. I certainly hope that physicians don't become government employees making 100k per year, otherwise I'm screwed

$300k, crazy! But still I've heard of some people with big loans who have become pediatricians, FM, and general IM and it seems like they are finding a way to make it work (e.g., PSLF I think?).

 

[JPSmyth]

$300k, crazy! But still I've heard of some people with big loans who have become pediatricians, FM, and general IM and it seems like they are finding a way to make it work (e.g., PSLF I think?).

I'm attending my in-state medical school too, that's the worst part. It's the cheapest possible option for me. Really wish I moved to texas before applying, those schools are dirt cheap for in-state students

I'm sure in the future if all physicians become govt employees paid 100k there has to be some sort of loan forgiveness involved for new grads... hopefully

 

[d9sccr]

$300k, crazy! But still I've heard of some people with big loans who have become pediatricians, FM, and general IM and it seems like they are finding a way to make it work (e.g., PSLF I think?).

It's really not that crazy anymore. Even in-state schools cost >$30k/yr now, leaving tuition alone at >$120k. If you're taking out money for tuition, you probably need living expenses as well. Figuring rental costs $1k/month, that's >$40k annually. Now realize that loans grow at almost 7% since the whole ACA debacle (which also included legislation regarding education...wut?).

If take out no more than $40k/yr, after 4 years of residency, you're already looking at $250k

 

[Carbocation1]

What do you debate CRNAs about? And do they endure abuse from the surgeons or from CRNAs/DNPs?

I'm a bit confused about the dynamic, because when I shadowed it was all attendings and residents in anesthesia. thanks

CRNAs keep throwing their BS AANA funded equivalence studies at me, saying MDs in anesthesia don't make any difference. They despise their MD supervisors and talk **** behind their backs, though I guess this is common in most jobs outside of Medicine as well. One CRNA I argue a lot with is an older dude who is retiring this soon and has no skin in the game - he genuinely wants me to pursue something else out of concern for my future. He's a CRNA with exceptional skills though (military guy) and I don't think he realizes the quality of new CRNAs being mass produced from SRNA mills these days.

The MDs I've encountered are spineless and take crap from all OR staff members - including the janitor who is sweeping the room in between cases yelling at the MD to get outta the way while he is trying to set up his next case. That said, I have seen a few instances of MDs who put nurses, techs, and even surgeons in the their place but this was rare.

I just hope it gets better in PP... I am already planning my exit strategy from Medicine in case it doesn't.

 

[bronx43]

CRNAs keep throwing their BS AANA funded equivalence studies at me, saying MDs in anesthesia don't make any difference. They despise their MD supervisors and talk **** behind their backs, though I guess this is common in most jobs outside of Medicine as well. One CRNA I argue a lot with is an older dude who is retiring this soon and has no skin in the game - he genuinely wants me to pursue something else out of concern for my future. He's a CRNA with exceptional skills though (military guy) and I don't think he realizes the quality of new CRNAs being mass produced from SRNA mills these days.

The MDs I've encountered are spineless and take crap from all OR staff members - including the janitor who is sweeping the room in between cases yelling at the MD to get outta the way while he is trying to set up his next case. That said, I have seen a few instances of MDs who put nurses, techs, and even surgeons in the their place but this was rare.

I just hope it gets better in PP... I am already planning my exit strategy from Medicine in case it doesn't.

If you're a top student, why even pursue this? Why not try and see if you can match derm? If not derm, there are at least half a dozen better specialties out there without the same problems.

 

[JPSmyth]

If you're a top student, why even pursue this? Why not try and see if you can match derm? If not derm, there are at least half a dozen better specialties out there without the same problems.

Please elaborate on which specialties? It seems derm is the last "golden" one left according to the internet

 

[JPSmyth]

CRNAs keep throwing their BS AANA funded equivalence studies at me, saying MDs in anesthesia don't make any difference. They despise their MD supervisors and talk **** behind their backs, though I guess this is common in most jobs outside of Medicine as well. One CRNA I argue a lot with is an older dude who is retiring this soon and has no skin in the game - he genuinely wants me to pursue something else out of concern for my future. He's a CRNA with exceptional skills though (military guy) and I don't think he realizes the quality of new CRNAs being mass produced from SRNA mills these days.

The MDs I've encountered are spineless and take crap from all OR staff members - including the janitor who is sweeping the room in between cases yelling at the MD to get outta the way while he is trying to set up his next case. That said, I have seen a few instances of MDs who put nurses, techs, and even surgeons in the their place but this was rare.

I just hope it gets better in PP... I am already planning my exit strategy from Medicine in case it doesn't.

If an MD anesthesiologist is making 350-400k per year (I don't think this is uncommon) then who cares if CRNAs think that they are equivalent. Don't MDs have WAY more medical knowledge than them, and a salary that is double theirs? Let them think they are equivalent, but the salary and level of knowledge of MDs say otherwise, no??

 

[Carbocation1]

If you're a top student, why even pursue this? Why not try and see if you can match derm? If not derm, there are at least half a dozen better specialties out there without the same problems.

Too late now for most competitive fields. And what specialties? There is no way in hell I am going through 3 years of internal medicine. Derm patients are the worst, and I don't want to risk not matching in a decent area. Bottom line, I would do anesthesia for CRNA wages/hours in the worst case scenario and use my free time to invest my income in a side hustle.

 

[aneftp]

It's really not that crazy anymore. Even in-state schools cost >$30k/yr now, leaving tuition alone at >$120k. If you're taking out money for tuition, you probably need living expenses as well. Figuring rental costs $1k/month, that's >$40k annually. Now realize that loans grow at almost 7% since the whole ACA debacle (which also included legislation regarding education...wut?).

If take out no more than $40k/yr, after 4 years of residency, you're already looking at $250k

Don't forget the undergrad loans! That may be another 30-80k for many people plus interest

 

[deleted171991]

If an MD anesthesiologist is making 350-400k per year (I don't think this is uncommon) then who cares if CRNAs think that they are equivalent. Don't MDs have WAY more medical knowledge than them, and a salary that is double theirs? Let them think they are equivalent, but the salary and level of knowledge of MDs say otherwise, no??

For the thousandth time: please stop looking at the money, and start looking at the hours and lifestyle. Most employed anesthesiologists are getting paid less and less above CRNA level (which is about $110/hour in my neck of woods), for much more stress and responsibility.

When you're spending every 5th night in the hospital, when you're working from 7 to 5 every day (add the commute to that), plus you have late days, when do everything - even go to the restroom - on somebody else's schedule, when you're supervising 3 CRNAs who play cowboy on your license, when your chances of partnership ever are quasi-zero, that money (especially with minimal benefits, as it is customary in AMCs) is way too little for the crap you take. As somebody pointed out, even the janitor will treat you as if you were not a doctor. Oh, and if they remember who you are, they will greet you by your first name, because you are just another kind of surgeon's helper, like a nurse or a tech.

And then, on top of all this, you'll have to deal with bad job markets in at least certain parts of the country, where you'll have to kiss your employer's hands, bend over backwards at keeping the surgeons and everybody happy, and take on massive risks by cutting corners for them. Because, if you practice anesthesiology by the book, you will find that many practices won't be happy with you. The adjective associated with this specialty most frequently is "slick", so if you're "clever" you'd better stay away for your own good.

 

[waterbottle10]

Utilize the search function to see one of the other 10,000 posts on this topic.

Interestingly, this conversation goes the same for just about every specialty on SDN although the reasons for avoiding specialty X is different for each. Surgeons readily suggest GI, anesthesia suggests surgical subs, rads suggests derm, EM suggests OH GOD DONT DO IT. Funny, but sorta sad.

Pretty much every em doc told me they love what they do and would go into the specialty again

 

[postbacpremed87]

Too late now for most competitive fields. And what specialties? There is no way in hell I am going through 3 years of internal medicine. Derm patients are the worst, and I don't want to risk not matching in a decent area. Bottom line, I would do anesthesia for CRNA wages/hours in the worst case scenario and use my free time to invest my income in a side hustle.

Path and Rads. No mid-level can do those fields....unless Watson is a mid-level. I'm still not convinced we want to leave cancer diagnoses to a computer.

 

[JPSmyth]

For the thousandth time: please stop looking at the money, and start looking at the hours and lifestyle.

When you're spending every 5th night in the hospital, when you're working from 7 to 5 every day (add the commute to that), plus you have late days, when you're supervising 3 CRNAs who play cowboy on your license, that money (especially with minimal benefits, as it is customary in AMCs) is way too little for the crap you take. As somebody pointed out, even the janitor will treat you like you were not a doctor.

Are there still PP that exist where MDs can work 50 hours/week or less with minimal call? If so, is there a chance that these will all become taken over by AMCs?

 

[waterbottle10]

Are there still PP that exist where MDs can work 50 hours/week or less with minimal call? If so, is there a chance that these will all become taken over by AMCs?

Yea there is but chances are you aren't getting that job. I wouldn't get your hopes up.

 

[deleted171991]

Pretty much every em doc told me they love what they do and would go into the specialty again

For $350/hr and the number of shifts they work? You bet.

 

[deleted171991]

Are there still PP that exist where MDs can work 50 hours/week or less with minimal call? If so, is there a chance that these will all become taken over by AMCs?

Weak yes to the former. Empathetic yes to the latter.

 

[deleted171991]

All these questions have been asked and answered on the forum. Nothing has changed into better, au contraire.

If you are not literally passionate about the field, don't go into it. This applies to many specialties, but nothing like anesthesiology. Do not go into anesthesiology just because it's the lesser evil.

 

[Carbocation1]

Path and Rads. No mid-level can do those fields....unless Watson is a mid-level. I'm still not convinced we want to leave cancer diagnoses to a computer.

BLAIR HANLEY FRANK@BELRIL JUNE 20, 2017 3:41 PM
"He doesn’t believe that human radiologists will exist in five years as a result, for example."
Vinod Khosla predicts AI will replace human oncologists

 

[JPSmyth]

For $350/hr and the number of shifts they work? You bet.

EM has the highest documented burn out rate of all specialties...

 

[GravelRider]

Too late now for most competitive fields. And what specialties? There is no way in hell I am going through 3 years of internal medicine. Derm patients are the worst, and I don't want to risk not matching in a decent area. Bottom line, I would do anesthesia for CRNA wages/hours in the worst case scenario and use my free time to invest my income in a side hustle.

Three years of internal medicine was actually pretty sweet...in retrospect. I work way harder now than I did as a third year IM resident. Sure, intern year was awful, but second and third year was a breeze. I spent more time moonlighting for extra dough and enjoying the city I was living in at the time. Late days were usually happy hours that went a little long. Third year IM was actually a great time to learn because you had interns to do the scutwork and you could focus on medical management.

Don't choose a career based on perceptions of what residency is like. Think long term and where you'll be in 10-20 years.

 

[deleted171991]

EM has the highest documented burn out rate of all specialties...

Anesthesia shouldn't be much further down the line.

 

[Carbocation1]

For the Derm lovers out there:
Stanford’s Artificial Intelligence Is Nearly as Good as Your Dermatologist
Stanford's Artificial Intelligence Is Nearly as Good as Your Dermatologist

 

[nimbus]

BLAIR HANLEY FRANK@BELRIL JUNE 20, 2017 3:41 PM
"He doesn’t believe that human radiologists will exist in five years as a result, for example."
Vinod Khosla predicts AI will replace human oncologists

Khosla has obviously never had cancer himself or in a close family member. He has zero idea what he's talking about. Oncologists are invaluable in advising about treatment options, managing side effects, and providing emotional support to people being treated for cancer.

 

[postbacpremed87]

BLAIR HANLEY FRANK@BELRIL JUNE 20, 2017 3:41 PM
"He doesn’t believe that human radiologists will exist in five years as a result, for example."
Vinod Khosla predicts AI will replace human oncologists

Yeah, no. Sucks for all the guys and gals entering a 5 year radiology residency now. I call BS, especially for Pathology. I have seen studies but scaling them will be an issue. Cancer is not a homogeneous entity. One person's NSCLC is different than the next guy's. With all of the stains, IHC, molecular genetics stuff, no way.

 

[deleted171991]

For the Derm lovers out there:
Stanford’s Artificial Intelligence Is Nearly as Good as Your Dermatologist
Stanford's Artificial Intelligence Is Nearly as Good as Your Dermatologist

Anything that's image pattern recognition will be replaced by AI. No doubt about that. Just look at all the excellent facial recognition software we already have.

 

[deleted171991]

Khosla has obviously never had cancer himself or in a close family member. He has zero idea what he's talking about. Oncologists are invaluable in advising about treatment options, managing side effects, and providing emotional support to people being treated for cancer.

Yeah, oncology APRNs for more and more of that.

If something is protocol-based and repetitive, it's ripe for replacement by AI and/or midlevels.

There is a revolution in medicine, that is changing physician's lives into much worse. But we ain't seen nothing yet.

 

[Carbocation1]

Three years of internal medicine was actually pretty sweet...in retrospect. I work way harder now than I did as a third year IM resident. Sure, intern year was awful, but second and third year was a breeze. I spent more time moonlighting for extra dough and enjoying the city I was living in at the time. Late days were usually happy hours that went a little long. Third year IM was actually a great time to learn because you had interns to do the scutwork and you could focus on medical management.

Don't choose a career based on perceptions of what residency is like. Think long term and where you'll be in 10-20 years.

8 years to do interventional cards? Who knows what medicine will look like by the time you finish. GI is basically scoping, which is one CMS move from being slashed, and that's assuming you have the political gamesmanship to get a spot. The rest of IM and its subspecialties suck, ESPECIALLY as an attending.

 

[nimbus]

Anesthesia shouldn't be much further down the line.

I don't think so. If anything burnout is probably below average. I know a lot of part timers with sweet lifestyles too. No call, work when they want, say no when they want.

 

[deleted171991]

I don't think so. If anything burnout is probably below average. I know a lot of part timers with sweet lifestyles too. No call, work when they want, say no when they want.

How many of those graduated in the last 10 years?

There will be always exceptions to the rule, but I wouldn't bet my future on being the exception. "That's not going to happen to me" is so wishful thinking.

 

[Carbocation1]

Report reveals severity of burnout by specialty

 

[Carbocation1]

Medscape Lifestyle Report 2017
Carol Peckham | January 11, 2017

Medscape: Medscape Access

 

[deleted171991]

They should publish those burnout numbers by geographical area. I bet there are large differences.

 

[nimbus]

How many of those graduated in the last 10 years?

There will be always exceptions to the rule, but I wouldn't bet my future on being the exception. "That's not going to happen to me" is so wishful thinking.

Most of them. Mostly young mothers with young kids.

 

[deleted171991]

Most of them. Mostly young mothers with young kids.

Then, as we have frequently concluded, there are big geographical differences between job markets. So maybe the right question is: should I do anesthesiology if I want to live in...?

 

[pgg]

If you're a top student, why even pursue this? Why not try and see if you can match derm? If not derm, there are at least half a dozen better specialties out there without the same problems.

I would rob banks before I would do derm. Or most clinic-based specialties, for that matter. I would be miserable.