How I became an Anesthesiologist 

How I Became an Anesthesiologist

By #LifeofaMedStudent




The clinical years of medical school are kind of like a bad middle school dance. There are specialties you want to dance with but are out of your league. There are specialties that like you, but you just can’t like them back. Throughout the year people and their desired specialties are pairing up, and you’re wondering if you’ll be left out. And all that is before the horrific process that is THE MATCH.

How did I end up in anesthesia? Well, I always was interested in anesthesia, even before medical school, I just had the wrong idea why. In the end, I guess I ended up in the same place, just with a more complex path.

I always thought I wanted to do either primary care or chronic pain (father was a small town chiropractor and always referring patients to PCPs and pain docs). I had an entire part of my life believing I would end up a rural primary care doctor (a whole other post), but as medical started I had leaned toward chronic pain, and maybe even anesthesia. There are a couple of paths to get into boarded chronic pain – neurology, psych, anesthesia – and anesthesia seemed to pay the best with the best lifestyle as a backup. Ok, simple enough I’ll get finish medical school, anesthesia, and then chronic pain fellowship. THEN I actually went to medical school.

There seem to be two types of medical student on clinical rotations: those who like everything, and those who like nothing. I liked none of it. Sure I didn’t mind a few rotations here and there but for the most part, I couldn’t imagine doing any of them for more than a few weeks.

I HATED ROUNDING (still do). Clinic hours bored me. Chronic pain was quickly ruled out as was all primary care. Surgery was cool in short bursts, but the residency is anything but short bursts. I had the vanity but not the board scores for plastic surgery. I wanted a good lifestyle but didn’t have the board scores for derm or optho either. And of course, I had way too good of a tan for radiology.

So what’s left? Basically down to anesthesia and emergency medicine. No rounding. Acute care for potentially very sick patients. Hands-on care, with procedural over academic treatment. Shift work with a good lifestyle and good to great pay.

Why did anesthesia win out for me? Well unfortunately with current healthcare delivery I felt EM was about 80% primary care and 20% acute lifesaving care (and maybe that’s generous). You may do a procedure or two per shift or none at all. You may save a life or you may simply treat dental pain. With anesthesia, you do procedural work every single day, and any case is an emergency if you don’t do a good enough job.

The more I get into anesthesia the more I love it. I compete every day with myself on how efficient I can be. I love the pressure that comes with people waiting on you to successfully accomplish something (Sure, let the intern suture close for an hour, but if my art line isn’t done in under 2 min all hell breaks loose). The pharmacology and physiology that you get to see in real-time amaze me. I get to stick needles in people and intubate every day. I’m very good at a select skill set that terrifies other physicians. I love that when things are going poorly, a good anesthesiologist is the leader and the calmest person in the room.

It’s like being the best mix of an airline pilot with a doctor. Take off and landing is where you make your money, and in between, you just make sure the surgeon doesn’t bring down the plane. Anesthesia is truly a great specialty. And it’s really a specialty unlike any other in medicine. Trust me, I know, because I didn’t like any of the others.

Hit the comments section with your thoughts! How did you pick your specialty?


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  1. Well I came into medicine not sure exactly what I wanted to do and figured would like OB/GYN and always took those medical specialty quizzes and plastics came up number one in virtually every instance.
    My first rotation of 3rd year was Emergency Medicine so that was scary. I tend to like controlled environments and no surprises as best as can be accounted for. Surprisingly I loved EM the adrenaline rush the mix of patients and differentials along with a good mix of procedures to do. I feel most like a physician when doing physicals and there’s a lot of that in EM.
    Finally made it to OB/GYN and really enjoyed it. A good mix of procedures and surgeries and being in the OR is awesome. But the best part is delivering babies. I would come home excited and thrilled with what I was doing every day on the rotation plus really connected with these doctors the most.
    In the end I will be pursuing OB/GYN for all the above and much more. EM I like a lot and wouldn’t run from it at all…it just goes to show there’s a big difference between what you think a speciality will mean to you as opposed to actually participating and doing it. So never close a door on a specialty until you’ve gone through it yourself.

  2. Hilarious well written article that resonated so well with me. Absolutely one of those students who hates everything and am down to two widely different choices: rheumatology and EM. Action packed or easy coasting – I can’t do anything else between.

    • Oh wow those couldn’t be more different. EM probably has a higher income potential but also likely higher burnout rate working those shifts forever. Rheum would easily win on lifestyle points, those would be nice hours and do they even take call?! Haha good luck picking ! Let us know what you end up going with.

  3. My path to anesthesia was pretty similar to yours. I like an active workday, prefer to see rapid results, don’t like dictating, and can’t stand to be scrubbed in for more than a few minutes at a time. I loved my elective anesthesia rotation late in my third year, and didn’t look back.

    Ten years into practice, I still think I made the right choice, but it’s not exactly exciting like it once was. And that’s OK, because excitement in anesthesia is rarely the good kind. Fortunately, I’ve been paid well, and have every penny I’ve earned. Work is now optional. I opt to continue working for now, but can see the light at the end of the tunnel.


    • Thanks for the comment PoF! I love anesthesia for both the excitement and the skill set to handle it, as well as the much more frequent mundane days. The pay is luckily such that, as your blog so excellently demonstrates, with a little forward thinking and “relative” frugality – work can become optional fairly quickly. For my readers, FIRE – Financial Independence and Retire Early – is a goal of mine. PoF has blazed the path, and his blog is both interesting from a medical profession side and serves as a “how to” guide to FIRE goals.

  4. Both of your comments and the post make anesthesiology sound like a great choice; can either of you comment on the rise of CRNA’s, how it’s affecting you now, and how it looks to change things going forward? That’s the only part scaring me away right now…

    • I had a signed job offer 16 months before I will finish residency. My class of 26 anesthesia residents all have jobs with still 8 months to go. There are no shortage of need for board certified anesthesiologists. The rise of CRNAs may change how we provide care in some ways, with more supervision and peri-operative care teams, but the job market looks great for physician anesthesiologist leaders.

  5. Thank you for this post, I’m an IMG who really wants to get into anesthesia. I got 241 on step1 and 250 on CK, got some pubs. May I get an advice on how to boost my CV for enhancing match probability?

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