surg res considering anesthesia

[randomness]

So as the title suggests, I have recently begun to think strongly about anesthesia. It has only been 3.5 months into gsurg internship but here are the reasons (in no particular order) I am thinking about the change.

1. Length of residency - it has only been 3.5 months and it seems like there's a looooong road ahead. 3 years more vs. 7-8 seems like a big deal. I know this is a short-term thing but given that this is the time in life where I can have kids, do other activities etc it seems important at this time. i feel like daily i am waiting to just get a regular job.

2. Ability to do other things in life besides work/eat/sleep: I told myself i'd try and live life to the fullest during residency, but have seen clearly that it's just not too possible when you don't get weekends (or even a full weekend day off too often).. all I have time to do is come home, maybe eat and then sleep. I should be reading/studying more but even that hasn't really been happening. I have also noticed that I've become more impatient with family, friends etc even when I do make time to call them. I know that all of this is very common, but didn't quite realize how difficult it would be to do anything outside of medicine during residency.

3. Am drawn to the emergency/worst for lifestyle subspecialties: I like trauma, peds, critical care, things like that, which have variety in them. However, as I want to have a family, and that seems to be becoming more and more important to me, along with my career ambition decreasing rapidly, and therefore I want to choose a "lifestyle" specialty without q3 in-house call. Unfortunately, I find those other ones like breast, endocrine etc quite unexciting, at least at this point of time.

4. I currently love operating but can see that it may end up just being like any other job (like people here have said here before). In fact, there are already lots of times where I feel like I could take it or leave it particularly if the alternative is that I get to go home. This may be because I still don't get to actually do that much in many of the cases, but I don't find myself rushing to the ORs like I was when I was a medical student anymore.

5. I don't know how I feel about being the primary doctor anymore - this was a must for me in the past, but now again it seems like my priorities are changing. I find myself cringing at the thought of being 40 and being paged constantly by my patients, having full clinic days, and basically being pulled in all directions.
Basically, I don't wnat to look back in 8 years and regret going through surg residency becuase I couldn't find a good job that met my criteria (lifestyle, variety, moderate pay).

In thinking about this anesthesia seems like a good option because it's reputedly more easy of a residency (so hopefully more time off during the 3 years leading to my being able to focus on other activities to some extent), it's certainly shorter so I'd be able to get my regular job after that, and hopefully control my hours after that. Not being the primary doctor and really being "off" when you'r enot on call or at the hospital seems like it would be ideal for me later as well. And of course right now the pay scale is off the charts, which isn't the main thing but definitely would be a nice side benefit. Perhaps most importantly, i could do critical care and participate in the high-end, busy cases (trauma, be on the code team, do transplants) while not having that be my entire life and having a good variety as well. I have also always liked physiology and pharm and applying that in the OR definitely seems like it would be interesting particularly in the busy cases.


What do you all think about this? Are my perceptions about the differences between anesthesia and surgery correct? Any of you ex-surgery residents want to comment on what made you change yr mind?

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[Painter1]

have u looked into emergency medicine? kinda sounds like a fit. only three years (most residencies), offers relatively good lifestyle, no pagers, enough free time, fair money, plus u get trauma cases, hands on etc etc.

 

[randomness]

have u looked into emergency medicine? kinda sounds like a fit. only three years (most residencies), offers relatively good lifestyle, no pagers, enough free time, fair money, plus u get trauma cases, hands on etc etc.

Thought about that initially but missed critical care, and didn't particularly like the primary care aspect of ER. I do like taking things to completion, and 'admitting' the patient and not knowing what happened next and whether our diagnosis was right or wrong was bothersome ..

anesthesia seems more interesting comparatively due to my liking of criticalcare, and the application (and seeing immediate results of) physio/pharm.

 

[Laryngospasm]

1. Length of residency - it has only been 3.5 months and it seems like there's a looooong road ahead. 3 years more vs. 7-8 seems like a big deal.

Were you planning on a fellowship?

 

[Tenesma]

randomness...

the first 3 months of internship are very hard... the adjustment from being a medical student to somebody who is stuck alone at the hospital making decisions is a huge leap with a steep learning curve. it is physically and emotionally draining....

it is very tough to spend most of your awake hours working - and I know what you mean with the changes in interactions with family members... i remember telling my mother to get to the point and be more succinct... i paid for that.

the transition from one residency to another isn't that straight forward, and often the grass is greener on the other side. I suggest you talk to a few anesthesia folk who did gen. surg residencies... or even better board certified gen. surgeons who went back to do anesthesia residencies... their insight would be invaluable.

don't think that anesthesia residency is necessarily easier... even though it appears that way. it is very different... you carry a pager that rarely goes off - but when it goes off your ass is on the line. Which in my opinion is still better than getting paged at 3am because a patient's family (that you are cross-covering for) wants to know why the patient's dressing has red stains on it. you aren't responsible for a 45 patient trauma list that you need to pre-round, round and evening-round on... you just have one patient at a time...

there are a few things you can do - see if you can do an anesthesia elective during your internship. Tell them that you really want to get better at putting in lines, IVs and airways... don't tell anybody you are thinking about making the switch - because if you end up staying the attendings and other residents will **** all over you...

i would personally recommend waiting a few more months until you get into a good groove... and get over the 3.5 month hump that almost everybody goes through (even FP interns )

 

[randomness]

randomness...

the first 3 months of internship are very hard... the adjustment from being a medical student to somebody who is stuck alone at the hospital making decisions is a huge leap with a steep learning curve. it is physically and emotionally draining....

it is very tough to spend most of your awake hours working - and I know what you mean with the changes in interactions with family members... i remember telling my mother to get to the point and be more succinct... i paid for that.

the transition from one residency to another isn't that straight forward, and often the grass is greener on the other side. I suggest you talk to a few anesthesia folk who did gen. surg residencies... or even better board certified gen. surgeons who went back to do anesthesia residencies... their insight would be invaluable.

don't think that anesthesia residency is necessarily easier... even though it appears that way. it is very different... you carry a pager that rarely goes off - but when it goes off your ass is on the line. Which in my opinion is still better than getting paged at 3am because a patient's family (that you are cross-covering for) wants to know why the patient's dressing has red stains on it. you aren't responsible for a 45 patient trauma list that you need to pre-round, round and evening-round on... you just have one patient at a time...

there are a few things you can do - see if you can do an anesthesia elective during your internship. Tell them that you really want to get better at putting in lines, IVs and airways... don't tell anybody you are thinking about making the switch - because if you end up staying the attendings and other residents will **** all over you...

i would personally recommend waiting a few more months until you get into a good groove... and get over the 3.5 month hump that almost everybody goes through (even FP interns )

Tenesma, thank you very much for taking my post seriously and responding. I actually ahve been on studentdoc for a while (changed my name to maintain more anonymity to post this) and have read and found yr posts very useful before.

A few questions: I'd love to talk to old g-surg residents who are now in anesthesia. I'm sure there must be some on this forum and I'd really appreciate your input. Otherwise, I'm not sure how to go about doing that without blowing my cover and "having" to leave b/c my whole program knows I'm thinking about it.

Unfortunately, they cancelled the anesthesia intern rotation (partly because so many people were switching over is the rumor) and I doubt I will be able to do a rotation.

In terms of timing, if I want to get a position outside the match, by when do I have to decide? How have any of you who have done it gone about it?

 

[Tenesma]

there are a few anesth. residents/faculty at MGH who did gen surg residencies or ortho residencies - call the office and ask if it would be okay to talk to them... and I am sure that is true at other programs as well...

i don't have an answer for your last question

 

[bubalus]

In terms of timing, if I want to get a position outside the match, by when do I have to decide? How have any of you who have done it gone about it?

2 ways: Apply through ERAS now for a 2008 CA1 position. Some programs may offer you a 2007 CA1 position, if they have one. The other way is to send a CV and cover letter to every program you would be interested in and specifically inquire about a 2007 spot.

Good luck.

 

[supahfresh]

Randomness,

I feel your pain. I did a surgical internship so I know what the first couple of months were like. but now isn't quite the time to make a major life change. you are in the "I am hating life" phase. i also snapped at family members---freaked me out.

at least give it a little more time to settle in. I was hating it bigtime until around november and then it started getting fun (albeit busy as hell and still painful at times). and by the spring I was so comfortable i thought about staying with surgery.

heres the flip side. after adjusting to surgery, i moved and started anesthesia and I hated this transition even more. everyday i thought about quitting and going back to surgery. i still think about it. i miss it. of course i dont miss the bad nights on call but sometime i have bad nights in anesthesia and its almost worse because im not scrubbed in.

it took almost a year to adjust to anesthesia and that is a long time. i'm not saying dont switch because you have the same reasons for doing it that i did. just give yourself a little time and then decide. do an anesthesia rotation. talk to the anesthesiolgists.

 

[Hockeyguy]

Randomness,

I feel your pain. I did a surgical internship so I know what the first couple of months were like. but now isn't quite the time to make a major life change. you are in the "I am hating life" phase. i also snapped at family members---freaked me out.

at least give it a little more time to settle in. I was hating it bigtime until around november and then it started getting fun (albeit busy as hell and still painful at times). and by the spring I was so comfortable i thought about staying with surgery.

heres the flip side. after adjusting to surgery, i moved and started anesthesia and I hated this transition even more. everyday i thought about quitting and going back to surgery. i still think about it. i miss it. of course i dont miss the bad nights on call but sometime i have bad nights in anesthesia and its almost worse because im not scrubbed in.

it took almost a year to adjust to anesthesia and that is a long time. i'm not saying dont switch because you have the same reasons for doing it that i did. just give yourself a little time and then decide. do an anesthesia rotation. talk to the anesthesiolgists.

Hey Supa weren't you at St Joes in Denver? Thats where I am at. Your right it is sort of getting fun now after the terror has been stripped away. I think our surgery intership may be different than others though but your right I can see myself maybe missing it - maybe. Dr Clark is retiring this January so who knows how the program will be then.
Mario

 

[randomness]

Randomness,

I feel your pain. I did a surgical internship so I know what the first couple of months were like. but now isn't quite the time to make a major life change. you are in the "I am hating life" phase. i also snapped at family members---freaked me out.

at least give it a little more time to settle in. I was hating it bigtime until around november and then it started getting fun (albeit busy as hell and still painful at times). and by the spring I was so comfortable i thought about staying with surgery.

heres the flip side. after adjusting to surgery, i moved and started anesthesia and I hated this transition even more. everyday i thought about quitting and going back to surgery. i still think about it. i miss it. of course i dont miss the bad nights on call but sometime i have bad nights in anesthesia and its almost worse because im not scrubbed in.

it took almost a year to adjust to anesthesia and that is a long time. i'm not saying dont switch because you have the same reasons for doing it that i did. just give yourself a little time and then decide. do an anesthesia rotation. talk to the anesthesiolgists.

Hey, what yr saying does make sense. But while I know that now isn't the time to make a life change, I also feel like waiting around until the end of the year to decide doesn't help because then i'll have nothing to do for another whole year as no anesthesia spots (if that's what i decide to go for) will be open.
In fact, part of me says that I should make an appointment with the anesthesia res PD now and put my name on the list if a spot opens up for 2007 and then see if I shld apply to just this one school for 2008!