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 specialities 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. 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 on 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 isnt done in under 2 min all hell breaks loose). I also love the pharmacology and physiology that you get to see in real time. 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 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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