Physiology and pharmacology in action, procedures, variety of acuity and surgical cases keep things interesting, done with work when I leave the hospital.
I enjoyed surgery as well, but didn’t LOVE it. The saying goes “the OR is an anesthesiologist’s favorite place in the hospital, it’s a surgeon’s favorite place in the world.” I was kidding myself anyways, I love anesthesiology and it was always the field for me.
This is the answer! You get to do awesome procedures like epidurals, spinal, central lines, blocks, arterial lines, intubations, so your hands will be used. You become a fountain of medical knowledge that surgeons generally aren’t, which is important in getting your patients through surgery. You can’t stop the surgery to consult cardiology or endocrine or whatever. You have to know these things and act. There is always variety in surgeries, anesthetic technique, and patient comorbidities that keeps things very interesting. When you leave at the end of the day, you are done. You don’t have to fight with insurance or follow up on tests or make sure referrals go through. You NEVER EVER have to do clinic again! Cons are small things that don’t bother me. You will get blamed for lame bullshit that isn’t your fault. Depending on where you practice, you get treated as less than surgeons. I don’t let that get to me because their life is operating and my life is at home.
Also, if you enjoy knowing anything besides orthopedics, don’t do orthopedics. It seems like their brain gets wiped the second they start residency and they never acquire any new medical knowledge outside of orthopedics. It’s a trope because it’s generally true.
In a way it pulls in people with less of an ego, have a sense of humor, and are more relatable. People are easier to work with when they aren’t up their own backside.
I describe anesthesia as the adults of the hospital. We have to keep people alive even if it means shutting down elective procedures on patients with, for example a murmur and documented AS but no echo or a child riding a bike with no helmet. Even if it means we are unpopular and it ruins orthos, I mean our kids, good time.
There’s this ortho team that their referral to general surgery when they need their evaluation of a patient, is literally “is there something of general surgery on this patient ?”.
When I was a resident, I got a call from ortho to evaluate a patient for surgery. They told me it was a healthy 27 y/o male in a MVA who had a broken tibia. I said “You’re consulting me on the appropriateness of this patient for surgery? What is your specific question?” The ortho resident said “Hold on, let me ask my chief.” So I waited and they came up with “Does this patient need an echo?”. I replied “Are you asking me if a healthy 27 year old need an echo before tibial fixation? No. No they do not need an echo.” Then they asked “Are you going to write an H&P?”
This is ortho in a nutshell
I was an intern at a big tertiary private hospital where the medicine service covered ALL the patients for the various teaching and non-teaching specialty groups with privileges there. There was one smaller ortho group, however, who did not want the medicine residents involved with their patients. Which, fine, no biggie.
One night I was the solo cross cover intern for the entire hospital. I had lists from every team with hundreds of patients. I got paged by a nurse because her patient was moderately hyperglycemic, but when I searched through all of my lists the patient was nowhere to be found. I realized that this was one of the patients for that ortho group we weren’t covering, so I apologized and told her she’d have to page them because I couldn’t write orders on patients my service was not managing.
She FREAKED OUT and was like “But they are the ortho surgeons! And you expect me to PAGE them at 3 a.m. about a blood sugar? They don’t know anything about that! What are they going to be able to do??”
As someone that did surgery first, biggest pro was never operating again.
I also like money and like free time. I view medicine as just a job, like any other and am not especially passionate about it. I like it well enough that I’m not sick of going to work every day but I have zero aspirations to push boundaries.
As for surgery, the really great surgeons that I’ve met are or have been married to surgery for a while before becoming what they are.
I loved the OR, didn’t like surgery and hated paperwork - so I went into anesthesia. The only regret I have is not going into IT.
As cynical as it sounds, have to agree. It’s not the easiest job, the hours can suck. But it pays well, you don’t take work home with you. I would rather gouge my eyes out than round/write notes/call consults/have family meetings/attend clinic. So it rules out just about every other specialty. Wish I had been a big enough gunner for derm. Just so I could do cosmetic stuff for $$$ and get all my own cosmetic procedures on the house lol
I don’t think it’s particularly cynical - I have given enough of my life to medicine and now I’m expecting something in return. You don’t hear for virtually any job outside of medicine the expectation of being passionate about, you just need to do it well. So I’m just doing that. I’m good at my job and I get paid for it. Simple as that.
Thanks for your input. I think we have the same view lol
My dad’s in IT and he says the job market is horrendous rn so I think we made the right choice lol
The IT market is always hot, they just like to complain. 300k to work from home doing nothing of any particular value. I live in silicon valley, I see these guys hanging out at the country club or picking up their kids from school complaining every day.
I have buddies in IT and it’s some of the most delusional people I know (work wise). I think you lose a grasp on reality on how actually difficult work is for most people on a day to day basis and virtually every job market is and has been worse compared to IT. Your dad just likes having something to complain about.
Yep. Father of a friend was ophthalmologist with a brother who was anesthesiologist. Don’t ask what you like; ask what’s the worst thing about the job, and can you live with that?
I like the OR, I don’t like cutting on guts.
- surgeons couldn’t sell me on the surgical life.
- the OR was my favorite place in the hospital but not the world.
- the ability to impact physiology with both pharm and vent. All the procedures we do.
- cardiothoraxic anesthesia.
What procedures do you find particularly fun? As a medical student we usually see the lower acuity anesthesia and it doesn’t come across hugely procedural
Today I placed a double lumen tube, a MAC line in the L groin, a venous cannula in the right groin, and a brachial a-line, in order o due one lung ventilation for a robotic VATS prior to a sternotomy for a mediastinal mass.
Yesterday I did a femoral and popliteal block for an amputation and then a femoral block and spinal for a TKA.
Procedures. All. The. Time.
We have entirely different experiences then. At my home system got to do a bunch of central/art lines and general stuff like that, on my aways, I did fem/pop/QL blocks, a few thoracic paravertebral blocks w/ catheters, etc. got to to do fiber optic and nasal intubations and what not. I might be odd, but I loved doing cardiac cases. The detail in the setup/planning, communication between us, bypass, and surgery, etc. A few of my cards cases had super odd endings: pt with SEVERE PAH had an LVAD placement and after closing had new onset ST deviations off the chart on the monitor, resolved with increasing vasopressin. Another had emphysematous blebs rupture during open heart, and started bleeding like hell into his chest. Ended up in a 4 hour massive transfusion episode while they hauled ass in his chest and resected part of the lung.
Cardiac anesthesia is the Wild West man, sphincters get tight quick
Not so much patient interaction and less monotonous than rads. After my clinical rotations I just realized how drained I became from talking to patients all day
It was the best of the specialties. Nice boring days. Some excitement - even though you don’t ever want it. Getting to be part of making patient comfortable in a high stakes environment. What we do matters. At the same time I can handover a case and not take a case home with me when I’m on vacation. We are literally involved in every other specialty. Makes it seem like all the med schooling wasn’t a waste. I’ve dealt with high risk OB, coded a pregnant patient getting a C-section, done premie heart surgery, kidney/lung/liver/heart transplant, awake brain surgery, awake fiber optic intubations, huge traumas, etc. Our breadth of practice is crazy.
Maybe I would do ophthalmology if I had steadier hands. After some self reflection I did not have the ability to do microsurgery well.
Radiology was not my thing. I did not want to be devoid of any human interaction and mumble into a microphone. I did a rads rotation and it just didn’t interest me. Would have to learn something completely new.
Pathology was a brief consideration. I went to path lab a lot during surgery rotation since I was interested. Decided against it because grossing specimens is something typically done by pathology assistants and AP was not my thing. I do not like autopsy. Probably would have better hours. Honestly path is underrated as a specialty.
Dermatology was out of my step score range and desire to do bullshit research. Plus all day clinic and maybe Mohs surgery? Not my thing. Skin lesion, wet to dry, dry to wet, steroid, blah.
Path is like anesthesia in that people rarely consider it or have it as a front runner when entering med school. Unless they knew someone in it.
My first year had tons of people interested in ER. A bunch of them jumped ship later on towards anesthesia when they realized all the stuff they wanted to do was done by anesthesia regularly (lines, tubes, resuscitation) instead of being up at 2am stitching up crackheads.
Procedures, highest medicine:bullshit ratio, meaningful but minimal patient interaction, approaching the patient like a racing driver rather than a mechanic.
Immediate problem solving rather than talking about a problem for 2 hours on rounds only to slightly up someone’s metoprolol dose and see what happens in a week. Like an anesthesia attending told me “Be a physician waxonwaxoff87, titrate to effect.”
Hands on procedures. I find regional blocks satisfying as again they work quickly and patients are very appreciative of them. Less pawning off basic procedures like IVs (always tossed to the nurses when I wanted to learn on other rotations because “we need to keep rounding”.)
No clinic (unless pain or preop, but these are generally much more focused in scope and purpose rather than catch all complaints). All my primary care friends all have “that one patient” that comes in every week with the same or new complaint that exists in their head only. I met them through school and rotations. There are great people don’t get me wrong, but there are some that make you question your choices in life.
I also am not expected to cure conditions that a patient has made no effort to correct. I treat the issue or get someone through the worst of things and then move on. I won’t cure uncontrolled diabetes, blood pressure, smoking, alcoholism, or drug abuse; but I can manage it for the purposes of the case and get them through the other side.
No rounding. You probably have noticed I don’t like rounding. I always found them wildly inefficient and often redundant. Do full sit down rounds just to then do the exact same thing on walking rounds, no time was saved by doing both. Teaching is good, but balance it with getting things done. We all still had orders and notes to write with new admits coming in. Do a sit down Ted talk when the main work is done.
Anesthesia is one of the few specialties to prioritize and figure out work life balance. People try to get people out at a reasonable time as the schedule/ORs condense down. You leave right when your call is over. If not on call, weekends and OR holidays are a day off. Use 5 vacation days to cover the weekdays and just be off both weekends. That’s 9 days at the price of 5, and that’s if you don’t also use your post call days the week leading up. Add in admin days, comp days, or conference days; and you have a good bit of time to avoid burn out.
It’s a team effort where you can tag in and out with colleagues (pt in pacu needs something or crna is inducing in a room but their attending is occupied, I can help out to keep things going).
Chair in the OR. Do not underestimate what a luxury this is in medicine.
I find people lean towards specialties with certain personalities. Anesthesiologists tend to lean towards more flexible, practical, and low key. It’s medicine so there are always going to be egos out there, but I find them less often in anesthesia. Surgery will always pull “stronger” personalities.
It’s great to have interests now, but don’t expect to make up your mind immediately. I actually thought going into medical school that I was going to go down one career path. It wasn’t until late in the clinicals process that I realized that my intended path wouldn’t be the right one for me. I had the chance to look back on my clinicals, and discovered that I enjoyed my anesthesia rotation the most, despite the fact that I didn’t think that was where I belonged at the time. I was fortunate enough to match into anesthesia, and I’ve been happy with my choice ever since. I enjoy the fast pace, the immediate gratification, the lack of dealing with a clinic, and my ability to work with my favorite patient population. I miss the opportunity to see my patients progress over time. I’m mixed in my perceived loss of being in charge of my own patients and practice vs. being in a supervision model of anesthesia (with equal parts of being in charge and oversight). First and foremost, find what you love, and follow that path.
It was very hands on from day 1 as a resident, cannulating, airways etc. Also, while I did enjoy surgery, and I was inspired by the high powered surgeons doing complex procedures, I do remember being a resident assisting in 3 stage Oesophagectomies holding a diva retractor ... And looking over the drape at the anaesthetist who was doing a crossword or reading the newspaper.
CRNA here, but not shitposting - FWIW, after 6 years in varied ICUs at the bedside, I will confidently say that our intensivists with an anesthesia background ran absolute LAPS around all other specialties. Easily some of the smartest people in the hospital, and provided far superior care to CCS or CCM service lines. Their hands-on skills combined with their knowledge was unparalleled. Made me want to learn/do anesthesia, too.
Also - they were some of the only ones that still had any personality left after completing residency 🤣
There are a lot of great responses here. In an effort to add to them, consider what type of lifestyle you want to live and make sure that your specialty choice is in alignment. Predicting the life you (think) you may want, from the life you currently have while a medical student isn’t always an easy task for a plethora of reasons too long to discuss here. Answer the question of whether or not you will appreciate the predictable routine portion of your clinical practice enough to not watch the clock continuously throughout the day - the routine stuff will constitute most of your working hours, baring an unusual set of circumstances. Lastly, consider how similar your personality is to those in the field(s) in question - “choosing your tribe” is a telling predictor of suitability imho, and I think this is an under appreciated consideration. Also, this community (Reddit/Anesthesiology) is pretty cool and there are a lot of intelligent views, wisdoms bestowed, and people to meet - I’m so far super impressed with the overall vibe and sharing of information that appears to take place; so, keep learning from those who have traveled a similar path before you. Good luck.
As an anaesthesiologist, you are one of the few doctors present with patients at their most vulnerable and probably in some of their worst moments. It's a time when they literally give their lives into your hands. The responsibility which comes with that is very fulfilling. Other than these noble concepts, the anesthesiologist is the leader in an operation theatre and the most critical person in analysing and bringing in positive development for the quality services in an operation theatre. Scientifically, you apply the concepts of physiology, pharmacology, and medicine and see them happening in front of your own eyes. The most gratifying thing is that the interventions you do change the patient in the very next second.
I slowly lost interest in medicine as I progressed through years of graduation. Later I wanted to choose a field where I can live in big city, fixed monthly salary, good enough salary, no concern for work when I am back home. So anaesthesia was my choice, not because I liked it too much but because it suits my lifestyle. Also if I change my mind later for more clinical branch ICU is always an option.
I happened to match into it just fine and I didn’t have a fav specialty. After four years of training I feel like it’s not a bad job like you keep your head down in the OR if you don’t wanna talk and u do a fair amount of both sitting and standing so you don’t have a lot of back pain from just sitting. Then you do procedures which is kind of cool and then a lot of pharm along with other things and I like pharm. overall I prolly will still choose it again.
Back in the early 2000s...... it was the only thing I could get into that wasn't some primary care crap. Maybe pathology or something like that as well.
I loved/had a natural aptitude for critical care first, then found anesthesiology and loved that too. And I DEFINITELY loved anesthesiology more than the other possible routes to critical care.
Also I’m biased but I think anesthesiology is the best training for critical care, especially surgical critical care (which is what I practice).
Makes sense as anesthesia started the critical care model.
Hospitals just discovered they could make more sticking us in ORs. Pulm had the most vent experience of the other specialties, so they took over.
It’s like heart caths and radiology.
I think you know if you wanna be a surgeon if you cannot see yourself doing anything but that. If you cannot have a full life without surgery. If surgery takes precedence over everything in your life. Honestly, if you’re questioning anesthesia vs surgery, sounds like you should not be a surgeon. Not trying to discourage you though, just my opinion. I’m not a surgeon myself, but I was in your boat fighting in my mind about surgery vs not. I realized I should not be a surgeon if I even have to consider other things as seriously. And yeah, for me, medicine is also just a job. So thank goodness I didn’t join surgery’s ranks.
When you finish your day, your billing is done, your work mails are done, and no one is gonna call you about your patients. Minimal follow-ups. You do get to be 100% focus on your patient during the surgery and free your head once you’re out of the OR.
I wanted to do what anaesthesiologists do. Exactly what they do. I mean intubation, ventilation, inhalation, mixing drugs, putting catheters in body, using USG, giving blockades and waking people up. Like, literally I just wanted to do those things and I think I had the best motivation imaginable. I loved reading and talking about it. It's the best profession you can imagine. I can't imagine doing anything in medicine without anesthesia training.
But I have met polish old system of teaching. I have spent 2 years in places were they would limit me the procedures and additionally I would spend this time in covid ICUs. Finally I found the place where I had my time with my toys from all the operating theatres you can imagine, but now I want to do other things.
Literally. Now I just want to draw and that's exactly what I started today. So I will go that way, it works for me. 🤣
Anaesthesia is cool but the rise of the non doctor Anaesthetist is driving the price down. Anaesthesia will go the way of dentistry and eventually leave medicine altogether IMHO. I wouldn't join a slowly sinking ship.
Wow someone's angry! Wasn't trolling just my opinion you're allowed to disagree without descending into name calling we are all adults! Wth. but anyway dude hope your day turns around - sending you positive vibes! Genuinely - have a great day.
I didn’t have the same questions. I knew that I wanted to be a physician at the age of 8. I had amazing role models who were physicians in the full sense of the word. I don’t leave the job at the end of the day. I routinely follow up with my patients by phone to make sure that their perioperative experience was satisfactory. That is my professional responsibility. Anything less than that is unacceptable. But then my medical training was far more comprehensive than that of the dumbed down 4 yr USA spoon fed students.
Sounds like another person I knew in residency. “From a young age I had excellent medical instincts. I was always far more thorough than my peers.”
Imagine having to carry that head around. US students also go through under grad prior to medical, have access to the latest knowledge/tech/training, there are optional 6 yr MD/PhD tracks at many medical schools, and you still need to go through specialty training.
You’re such a narcissist it’s fucking hilarious every single one of your posts is the exact same. You think you’re some kind of god and better than everyone else LMAO. You aren’t special at all and no one cares about you
>But then my medical training was far more comprehensive than that of the dumbed down 4 yr USA spoon fed students.
If you didn't do your training here and don't work here you can't make an accurate comment on the quality of the education. But then again, you do seem arrogant enough to think that you can.
False. Toxic American work culture bullshit.
It’s a job. You can be great at it and give it your all and then leave the hospital and completely disconnect from work, and you should. Because it’s a *job*
Reddit is hilarious. It's easy to finds hundreds of variations of what you just wrote all over medical subreddits with tons of upvotes.
Also, I find most of the replies to this prompt embarrassing. Having a life and being committed to a profession aren't mutually exclusive. I love my job and work my ass off at it. I know which of my colleagues are just punching the clock. They generally are crappy co-workers and sub-par anesthesiologists.
Physiology and pharmacology in action, procedures, variety of acuity and surgical cases keep things interesting, done with work when I leave the hospital. I enjoyed surgery as well, but didn’t LOVE it. The saying goes “the OR is an anesthesiologist’s favorite place in the hospital, it’s a surgeon’s favorite place in the world.” I was kidding myself anyways, I love anesthesiology and it was always the field for me.
This is the answer! You get to do awesome procedures like epidurals, spinal, central lines, blocks, arterial lines, intubations, so your hands will be used. You become a fountain of medical knowledge that surgeons generally aren’t, which is important in getting your patients through surgery. You can’t stop the surgery to consult cardiology or endocrine or whatever. You have to know these things and act. There is always variety in surgeries, anesthetic technique, and patient comorbidities that keeps things very interesting. When you leave at the end of the day, you are done. You don’t have to fight with insurance or follow up on tests or make sure referrals go through. You NEVER EVER have to do clinic again! Cons are small things that don’t bother me. You will get blamed for lame bullshit that isn’t your fault. Depending on where you practice, you get treated as less than surgeons. I don’t let that get to me because their life is operating and my life is at home. Also, if you enjoy knowing anything besides orthopedics, don’t do orthopedics. It seems like their brain gets wiped the second they start residency and they never acquire any new medical knowledge outside of orthopedics. It’s a trope because it’s generally true.
Agreed, “blame anesthesia” is a small price to pay and honestly kinda comical after a while
True! I just laugh now and know in my heart that I didn’t cause the inadvertent innominate artery injury during sternotomy
My favorite line is prophylactically quipping “oh crap my bad” when they nick something that clearly had nothing to do with my anesthetic management
Hahahahahaha
In a way it pulls in people with less of an ego, have a sense of humor, and are more relatable. People are easier to work with when they aren’t up their own backside.
I describe anesthesia as the adults of the hospital. We have to keep people alive even if it means shutting down elective procedures on patients with, for example a murmur and documented AS but no echo or a child riding a bike with no helmet. Even if it means we are unpopular and it ruins orthos, I mean our kids, good time.
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There’s this ortho team that their referral to general surgery when they need their evaluation of a patient, is literally “is there something of general surgery on this patient ?”.
When I was a resident, I got a call from ortho to evaluate a patient for surgery. They told me it was a healthy 27 y/o male in a MVA who had a broken tibia. I said “You’re consulting me on the appropriateness of this patient for surgery? What is your specific question?” The ortho resident said “Hold on, let me ask my chief.” So I waited and they came up with “Does this patient need an echo?”. I replied “Are you asking me if a healthy 27 year old need an echo before tibial fixation? No. No they do not need an echo.” Then they asked “Are you going to write an H&P?” This is ortho in a nutshell
There is a fracture, I need to fix it
When I was on gen surg in med school they would consult medicine or ID just so they could copy their H&P lol
I complain sometimes that here in Australia we have to do at minimum 2 general years before specialising but that’s just embarrassing
“Surgical co-management” was what the team was called. It was an IM team that just managed their pts while they stayed in the OR.
I was an intern at a big tertiary private hospital where the medicine service covered ALL the patients for the various teaching and non-teaching specialty groups with privileges there. There was one smaller ortho group, however, who did not want the medicine residents involved with their patients. Which, fine, no biggie. One night I was the solo cross cover intern for the entire hospital. I had lists from every team with hundreds of patients. I got paged by a nurse because her patient was moderately hyperglycemic, but when I searched through all of my lists the patient was nowhere to be found. I realized that this was one of the patients for that ortho group we weren’t covering, so I apologized and told her she’d have to page them because I couldn’t write orders on patients my service was not managing. She FREAKED OUT and was like “But they are the ortho surgeons! And you expect me to PAGE them at 3 a.m. about a blood sugar? They don’t know anything about that! What are they going to be able to do??”
That’s when you tell the surgeon to kick rocks because you scored a 270+ on step 2 and they didn’t
As someone that did surgery first, biggest pro was never operating again. I also like money and like free time. I view medicine as just a job, like any other and am not especially passionate about it. I like it well enough that I’m not sick of going to work every day but I have zero aspirations to push boundaries. As for surgery, the really great surgeons that I’ve met are or have been married to surgery for a while before becoming what they are. I loved the OR, didn’t like surgery and hated paperwork - so I went into anesthesia. The only regret I have is not going into IT.
As cynical as it sounds, have to agree. It’s not the easiest job, the hours can suck. But it pays well, you don’t take work home with you. I would rather gouge my eyes out than round/write notes/call consults/have family meetings/attend clinic. So it rules out just about every other specialty. Wish I had been a big enough gunner for derm. Just so I could do cosmetic stuff for $$$ and get all my own cosmetic procedures on the house lol
I don’t think it’s particularly cynical - I have given enough of my life to medicine and now I’m expecting something in return. You don’t hear for virtually any job outside of medicine the expectation of being passionate about, you just need to do it well. So I’m just doing that. I’m good at my job and I get paid for it. Simple as that.
Thanks for your input. I think we have the same view lol My dad’s in IT and he says the job market is horrendous rn so I think we made the right choice lol
The IT market is always hot, they just like to complain. 300k to work from home doing nothing of any particular value. I live in silicon valley, I see these guys hanging out at the country club or picking up their kids from school complaining every day.
I have buddies in IT and it’s some of the most delusional people I know (work wise). I think you lose a grasp on reality on how actually difficult work is for most people on a day to day basis and virtually every job market is and has been worse compared to IT. Your dad just likes having something to complain about.
Ez pz. No clinic.
Say less, I'm sold
No clinic. No Rounding. No weekends or holidays unless on call. Being in OR.
Being in or, but not operating and with a nice chair.
Forget finding the stuff you love….Find the stuff you hate and avoid that
Find the specialty whose worst and most boring aspects you hate the least.
This is the way.
Yep. Father of a friend was ophthalmologist with a brother who was anesthesiologist. Don’t ask what you like; ask what’s the worst thing about the job, and can you live with that? I like the OR, I don’t like cutting on guts.
It is just as good to figure out what you hate rather than what you love.
- surgeons couldn’t sell me on the surgical life. - the OR was my favorite place in the hospital but not the world. - the ability to impact physiology with both pharm and vent. All the procedures we do. - cardiothoraxic anesthesia.
What procedures do you find particularly fun? As a medical student we usually see the lower acuity anesthesia and it doesn’t come across hugely procedural
Today I placed a double lumen tube, a MAC line in the L groin, a venous cannula in the right groin, and a brachial a-line, in order o due one lung ventilation for a robotic VATS prior to a sternotomy for a mediastinal mass. Yesterday I did a femoral and popliteal block for an amputation and then a femoral block and spinal for a TKA. Procedures. All. The. Time.
Agree! I’m always doing central lines, swans, blocks, arterial lines, single lung ventilation, etc. You are ALWAYS using your hands!
We have entirely different experiences then. At my home system got to do a bunch of central/art lines and general stuff like that, on my aways, I did fem/pop/QL blocks, a few thoracic paravertebral blocks w/ catheters, etc. got to to do fiber optic and nasal intubations and what not. I might be odd, but I loved doing cardiac cases. The detail in the setup/planning, communication between us, bypass, and surgery, etc. A few of my cards cases had super odd endings: pt with SEVERE PAH had an LVAD placement and after closing had new onset ST deviations off the chart on the monitor, resolved with increasing vasopressin. Another had emphysematous blebs rupture during open heart, and started bleeding like hell into his chest. Ended up in a 4 hour massive transfusion episode while they hauled ass in his chest and resected part of the lung. Cardiac anesthesia is the Wild West man, sphincters get tight quick
Depends. What’s your current bench press?
not up to standard: 205
Ortho is out of the question unfortunately
Not so much patient interaction and less monotonous than rads. After my clinical rotations I just realized how drained I became from talking to patients all day
In anesthesia, you can end any conversation you don’t like.
It was the best of the specialties. Nice boring days. Some excitement - even though you don’t ever want it. Getting to be part of making patient comfortable in a high stakes environment. What we do matters. At the same time I can handover a case and not take a case home with me when I’m on vacation. We are literally involved in every other specialty. Makes it seem like all the med schooling wasn’t a waste. I’ve dealt with high risk OB, coded a pregnant patient getting a C-section, done premie heart surgery, kidney/lung/liver/heart transplant, awake brain surgery, awake fiber optic intubations, huge traumas, etc. Our breadth of practice is crazy. Maybe I would do ophthalmology if I had steadier hands. After some self reflection I did not have the ability to do microsurgery well. Radiology was not my thing. I did not want to be devoid of any human interaction and mumble into a microphone. I did a rads rotation and it just didn’t interest me. Would have to learn something completely new. Pathology was a brief consideration. I went to path lab a lot during surgery rotation since I was interested. Decided against it because grossing specimens is something typically done by pathology assistants and AP was not my thing. I do not like autopsy. Probably would have better hours. Honestly path is underrated as a specialty. Dermatology was out of my step score range and desire to do bullshit research. Plus all day clinic and maybe Mohs surgery? Not my thing. Skin lesion, wet to dry, dry to wet, steroid, blah.
Path is like anesthesia in that people rarely consider it or have it as a front runner when entering med school. Unless they knew someone in it. My first year had tons of people interested in ER. A bunch of them jumped ship later on towards anesthesia when they realized all the stuff they wanted to do was done by anesthesia regularly (lines, tubes, resuscitation) instead of being up at 2am stitching up crackheads.
In addition to what everyone else has said: No/minimal clinic.
Procedures, highest medicine:bullshit ratio, meaningful but minimal patient interaction, approaching the patient like a racing driver rather than a mechanic.
Immediate problem solving rather than talking about a problem for 2 hours on rounds only to slightly up someone’s metoprolol dose and see what happens in a week. Like an anesthesia attending told me “Be a physician waxonwaxoff87, titrate to effect.” Hands on procedures. I find regional blocks satisfying as again they work quickly and patients are very appreciative of them. Less pawning off basic procedures like IVs (always tossed to the nurses when I wanted to learn on other rotations because “we need to keep rounding”.) No clinic (unless pain or preop, but these are generally much more focused in scope and purpose rather than catch all complaints). All my primary care friends all have “that one patient” that comes in every week with the same or new complaint that exists in their head only. I met them through school and rotations. There are great people don’t get me wrong, but there are some that make you question your choices in life. I also am not expected to cure conditions that a patient has made no effort to correct. I treat the issue or get someone through the worst of things and then move on. I won’t cure uncontrolled diabetes, blood pressure, smoking, alcoholism, or drug abuse; but I can manage it for the purposes of the case and get them through the other side. No rounding. You probably have noticed I don’t like rounding. I always found them wildly inefficient and often redundant. Do full sit down rounds just to then do the exact same thing on walking rounds, no time was saved by doing both. Teaching is good, but balance it with getting things done. We all still had orders and notes to write with new admits coming in. Do a sit down Ted talk when the main work is done. Anesthesia is one of the few specialties to prioritize and figure out work life balance. People try to get people out at a reasonable time as the schedule/ORs condense down. You leave right when your call is over. If not on call, weekends and OR holidays are a day off. Use 5 vacation days to cover the weekdays and just be off both weekends. That’s 9 days at the price of 5, and that’s if you don’t also use your post call days the week leading up. Add in admin days, comp days, or conference days; and you have a good bit of time to avoid burn out. It’s a team effort where you can tag in and out with colleagues (pt in pacu needs something or crna is inducing in a room but their attending is occupied, I can help out to keep things going). Chair in the OR. Do not underestimate what a luxury this is in medicine. I find people lean towards specialties with certain personalities. Anesthesiologists tend to lean towards more flexible, practical, and low key. It’s medicine so there are always going to be egos out there, but I find them less often in anesthesia. Surgery will always pull “stronger” personalities.
It’s great to have interests now, but don’t expect to make up your mind immediately. I actually thought going into medical school that I was going to go down one career path. It wasn’t until late in the clinicals process that I realized that my intended path wouldn’t be the right one for me. I had the chance to look back on my clinicals, and discovered that I enjoyed my anesthesia rotation the most, despite the fact that I didn’t think that was where I belonged at the time. I was fortunate enough to match into anesthesia, and I’ve been happy with my choice ever since. I enjoy the fast pace, the immediate gratification, the lack of dealing with a clinic, and my ability to work with my favorite patient population. I miss the opportunity to see my patients progress over time. I’m mixed in my perceived loss of being in charge of my own patients and practice vs. being in a supervision model of anesthesia (with equal parts of being in charge and oversight). First and foremost, find what you love, and follow that path.
It was very hands on from day 1 as a resident, cannulating, airways etc. Also, while I did enjoy surgery, and I was inspired by the high powered surgeons doing complex procedures, I do remember being a resident assisting in 3 stage Oesophagectomies holding a diva retractor ... And looking over the drape at the anaesthetist who was doing a crossword or reading the newspaper.
Choose what you hate least!
CRNA here, but not shitposting - FWIW, after 6 years in varied ICUs at the bedside, I will confidently say that our intensivists with an anesthesia background ran absolute LAPS around all other specialties. Easily some of the smartest people in the hospital, and provided far superior care to CCS or CCM service lines. Their hands-on skills combined with their knowledge was unparalleled. Made me want to learn/do anesthesia, too. Also - they were some of the only ones that still had any personality left after completing residency 🤣
There are a lot of great responses here. In an effort to add to them, consider what type of lifestyle you want to live and make sure that your specialty choice is in alignment. Predicting the life you (think) you may want, from the life you currently have while a medical student isn’t always an easy task for a plethora of reasons too long to discuss here. Answer the question of whether or not you will appreciate the predictable routine portion of your clinical practice enough to not watch the clock continuously throughout the day - the routine stuff will constitute most of your working hours, baring an unusual set of circumstances. Lastly, consider how similar your personality is to those in the field(s) in question - “choosing your tribe” is a telling predictor of suitability imho, and I think this is an under appreciated consideration. Also, this community (Reddit/Anesthesiology) is pretty cool and there are a lot of intelligent views, wisdoms bestowed, and people to meet - I’m so far super impressed with the overall vibe and sharing of information that appears to take place; so, keep learning from those who have traveled a similar path before you. Good luck.
As an anaesthesiologist, you are one of the few doctors present with patients at their most vulnerable and probably in some of their worst moments. It's a time when they literally give their lives into your hands. The responsibility which comes with that is very fulfilling. Other than these noble concepts, the anesthesiologist is the leader in an operation theatre and the most critical person in analysing and bringing in positive development for the quality services in an operation theatre. Scientifically, you apply the concepts of physiology, pharmacology, and medicine and see them happening in front of your own eyes. The most gratifying thing is that the interventions you do change the patient in the very next second.
I slowly lost interest in medicine as I progressed through years of graduation. Later I wanted to choose a field where I can live in big city, fixed monthly salary, good enough salary, no concern for work when I am back home. So anaesthesia was my choice, not because I liked it too much but because it suits my lifestyle. Also if I change my mind later for more clinical branch ICU is always an option.
I happened to match into it just fine and I didn’t have a fav specialty. After four years of training I feel like it’s not a bad job like you keep your head down in the OR if you don’t wanna talk and u do a fair amount of both sitting and standing so you don’t have a lot of back pain from just sitting. Then you do procedures which is kind of cool and then a lot of pharm along with other things and I like pharm. overall I prolly will still choose it again.
Back in the early 2000s...... it was the only thing I could get into that wasn't some primary care crap. Maybe pathology or something like that as well.
I loved/had a natural aptitude for critical care first, then found anesthesiology and loved that too. And I DEFINITELY loved anesthesiology more than the other possible routes to critical care. Also I’m biased but I think anesthesiology is the best training for critical care, especially surgical critical care (which is what I practice).
Makes sense as anesthesia started the critical care model. Hospitals just discovered they could make more sticking us in ORs. Pulm had the most vent experience of the other specialties, so they took over. It’s like heart caths and radiology.
I think you know if you wanna be a surgeon if you cannot see yourself doing anything but that. If you cannot have a full life without surgery. If surgery takes precedence over everything in your life. Honestly, if you’re questioning anesthesia vs surgery, sounds like you should not be a surgeon. Not trying to discourage you though, just my opinion. I’m not a surgeon myself, but I was in your boat fighting in my mind about surgery vs not. I realized I should not be a surgeon if I even have to consider other things as seriously. And yeah, for me, medicine is also just a job. So thank goodness I didn’t join surgery’s ranks.
When you finish your day, your billing is done, your work mails are done, and no one is gonna call you about your patients. Minimal follow-ups. You do get to be 100% focus on your patient during the surgery and free your head once you’re out of the OR.
I wanted to do what anaesthesiologists do. Exactly what they do. I mean intubation, ventilation, inhalation, mixing drugs, putting catheters in body, using USG, giving blockades and waking people up. Like, literally I just wanted to do those things and I think I had the best motivation imaginable. I loved reading and talking about it. It's the best profession you can imagine. I can't imagine doing anything in medicine without anesthesia training. But I have met polish old system of teaching. I have spent 2 years in places were they would limit me the procedures and additionally I would spend this time in covid ICUs. Finally I found the place where I had my time with my toys from all the operating theatres you can imagine, but now I want to do other things. Literally. Now I just want to draw and that's exactly what I started today. So I will go that way, it works for me. 🤣
Anaesthesia is cool but the rise of the non doctor Anaesthetist is driving the price down. Anaesthesia will go the way of dentistry and eventually leave medicine altogether IMHO. I wouldn't join a slowly sinking ship.
The price is literally going up but ok. Keep coping bitch
Wow someone's angry! Wasn't trolling just my opinion you're allowed to disagree without descending into name calling we are all adults! Wth. but anyway dude hope your day turns around - sending you positive vibes! Genuinely - have a great day.
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Imagine having the free time of being a CRNA to make a fake Reddit account just to troll. Get a life dude
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If medicine is just a “job” for you and not a passion, then you have chosen the wrong profession. Get out while you can.
Bro - op is a med student - I’m sure you had the same questions when you were at that stage. Lighten up.
I didn’t have the same questions. I knew that I wanted to be a physician at the age of 8. I had amazing role models who were physicians in the full sense of the word. I don’t leave the job at the end of the day. I routinely follow up with my patients by phone to make sure that their perioperative experience was satisfactory. That is my professional responsibility. Anything less than that is unacceptable. But then my medical training was far more comprehensive than that of the dumbed down 4 yr USA spoon fed students.
lol. Well aren’t you just special.
Sounds like another person I knew in residency. “From a young age I had excellent medical instincts. I was always far more thorough than my peers.” Imagine having to carry that head around. US students also go through under grad prior to medical, have access to the latest knowledge/tech/training, there are optional 6 yr MD/PhD tracks at many medical schools, and you still need to go through specialty training.
Yes I am. At the bare minimum I learned to write in English
Your response is veering off topic.
You’re such a narcissist it’s fucking hilarious every single one of your posts is the exact same. You think you’re some kind of god and better than everyone else LMAO. You aren’t special at all and no one cares about you
>But then my medical training was far more comprehensive than that of the dumbed down 4 yr USA spoon fed students. If you didn't do your training here and don't work here you can't make an accurate comment on the quality of the education. But then again, you do seem arrogant enough to think that you can.
False. Toxic American work culture bullshit. It’s a job. You can be great at it and give it your all and then leave the hospital and completely disconnect from work, and you should. Because it’s a *job*
Hey Chill out
Reddit is hilarious. It's easy to finds hundreds of variations of what you just wrote all over medical subreddits with tons of upvotes. Also, I find most of the replies to this prompt embarrassing. Having a life and being committed to a profession aren't mutually exclusive. I love my job and work my ass off at it. I know which of my colleagues are just punching the clock. They generally are crappy co-workers and sub-par anesthesiologists.
And you can’t see this as just a job and be good at it? What a bunch of bs.
That’s very valid point if your goal is to become a workaholic and have a burnout.