Monday, September 27, 2010

Why I Chose Anesthesiology

Fall is the traditional time of year when medical students finally decide on which residency they want to apply for.  It is not an easy decision.  You are racked with anxiety and uncertainty. "What if I go into this field and realize I made a mistake?  Will I be miserable for the rest of my life?" I field many questions from students about why I went into anesthesiology.  Like everybody else, it was not a clear cut choice for me.

I actually thought I wanted to be an anesthesiologist when I started medical school.  But once you're in school, you are dazzled and distracted by all the different specialties students rotate through. What made it even harder was that my medical school didn't even offer a rotation in anesthesiology, not even as part of the surgery rotation.  So anesthesiology quickly dropped out of consideration, more out of default than anything else.  As I explain to med students, anesthesiology is not a field that is easy to love.  There is no glamor in this field.  There are no TV shows or movies about the bold, courageous, caring, handsome, intelligent anesthesiologists.  Instead we are only mentioned when something goes wrong, like a patient having surgical recall or the anesthesiologist who is caught behind the drapes shooting up and passing out. I think the easiest way to understand why I chose anesthesiology is to first explain why I didn't go into other medical specialties. Then I will discuss all the positive aspects of this terrific and maligned field and why it is the perfect medical practice for me.

Internal Medicine. Are you kidding me?  Couldn't stand the constant rounds every morning during med school.  The endless mental masturbation on the eighteenth differential diagnosis of hemoptysis and fever just bored me out of my mind.  What's worse, once you're in private practice, you are perceived as a mental midget by the subspecialists, someone who couldn't cut it in a subspecialty field.  You are left with the hypertensive, diabetic, COPD, poorly compliant patients that nobody else wants to handle.  Definitely out.

Pediatrics. Love the kids. Hate the parents. (Same reason I don't like to do pediatric anesthesia.)

OB/GYN. There really was nothing I liked about this field.  All the different STD's I saw every day in clinic made me want to scrub my eyeballs and nostrils raw after work.  The birthing process may be a miracle, but it can be really disgusting when feces and urine start flying out with every contraction.  Plus this is becoming a female physician only field.  Sorry guys, you may have a thriving practice now but you are a dying breed.  Most women prefer to have other women examine them and deliver their babies.

Emergency Medicine.  Loved this rotation as a student.  I think most med students get a tremendous thrill in the ER.  You are finally doing fun things like suturing up lacerations or diagnosing and treating acute MI's and DKA's. It was a blast. Unfortunately I didn't have it until April of my senior year, much too late to change residencies. In retrospect, I'm glad I didn't do ER.  I'm not the kind of person who likes to juggle fifteen patients at a time while dealing with the latest trauma that rolls through the door.  This pace leads to pretty fast burnout.  Want proof? You rarely see old ER docs.  I have no idea what happens to them when they turn fifty.

Family Practice. Our school had a huge emphasis on turning out FP physicians.  We had several required rotations in this field.  To me it felt just like Internal Medicine but with added Pediatrics and OB/GYN, which made it a triple negative in my book.

Medical subspecialties. The three years of Internal Medicine pretty much knocked these out of consideration.

ROAD (Radiology, Ophthalmology, Anesthesiology, Dermatology). Radiology was one field I hoped I would love.  Instead I was extremely restless sitting in a dark room every day looking at the same films from the same ICU patients; one day the only change maybe a new line was placed, or the patient was intubated overnight and then extubated a few days later.  That was one rotation I dreaded going to every morning. Ophthalmology, too competitive and really gave me no intellectual stimulation.  Seriously they have a sub subspecialty in vitreous humor? Dermatology was again too competitive.  Why is this field in such high demand?  Are there that many slacker med students who only want 9-5 jobs looking at eczema and prescribing topical steroids?

Pathology.  Didn't like looking into a microscope all day evaluating purple and blue spots.  Hated cadavers.  Cant. Get. That. Smell. Out. Of. My. Hair. Yuck.

Psychiatry.  I actually loved this field.  I had a terrific attending during this month.  He made psychiatry seem so much fun.  You can definitely have great stories to blog about if you are a psychiatrist.  I seriously considered Psych until I realized there was very little we could actually do for these patients.  Seemed like we would try to treat a patient with a drug. If that didn't work we'd try another drug. If that didnt' work, we'd try another one... They all seemed to cover up the symptoms without ever really curing them.  This was a couple of decades ago.  Hopefully newer treatments have been developed since then to improve these patients' lives. This is a field that still makes me think, "What if?"

This is running pretty long.  My feelings about blogs is that they shouldn't take more than two minutes to read so I'll continue this topic in another installment later.  I'll talk about which residency I did match into after graduation from med school, and it wasn't anesthesiology, GASP!

Continue here.


  1. I found this extremely insightful as well as helpful. Thanks heaps for writing it (in addition to being useful, it was funny...cheers for that)!

  2. Insightful as always

  3. where to see the next one?

  4. i think this post is tremendously biased. you just gave yourself a hundred reasons (if that's possible) why you didn't pick this o that but you didn't clarify why you did choose anesthesia (which isn't heaven nor paradise ...dealing with a guy who's sleeping all the time lol)

  5. Yeah, what you gave us was helpful, but I really wish you would have told us why you chose anesthesiology and not just why you didn't chose the other fields.

  6. If any of you have a little bit of time to talk to a current student in regards to this field and answer some questions I have, please reach out to me. I don't have any family in this career path and it's difficult to network when you don't know the right people. Please reach out to me.

  7. I must say that's an impressive post.

  8. Very impressive thoughts over this particular topic.

  9. Anesthesia resident here. This post is SPOT on with my reasoning for choosing anesthesia. I basically ruled out everything else, then when I discovered anesthesia it was like a eureka moment. Very satisfied with my choice.

  10. I really feel the same about every single specialty you talked about. I chose anesthesia and will start residency soon but sometimes get annoyed with myself not going for a more competitive specialty with my scores. I some time think I had to do IR! But I hate sitting in dark room in front of computer so much. I am so anxious that maybe I made the wrong decision. Do you have any advice for me?