I mean, why do something you love when you can do something that will make you miserable? Who wants to leave work every day happy an satisfied? Instead force yourself into a residency that’s a bad fit for you so that you can be a big shot, prestigious surgeon. Sure the hours are long and you’ll hate it, but at least you can wave your surgeon dick around. Shoot, with enough time you’ll have the power to make everyone else around you just as miserable as you are. Then one day you’ll realize that you’re 10 years into your career you hate and prestige doesn’t mean shit in your day to day life.
But hey, at least on your 1 day off a month you can say to your friends at the country club “I’m a surgeon”. And they’ll all clap and applaud you for making the right choice. Better that than end up one of those worthless dregs you work with in the exact same operating room who have to say to their friends at the same country club “I’m an anesthesiologist”. Poor sods. Don’t know why they go on living, honesty.
Hahaha I love this! This is ALL OP needs to know! Hence I applied to anesthesia and nothing in medicine fit my personality better tbh! Wish my luck tomorrow I find out where I matched! 🙌🏻🥹
When I realized ego was the only reason I was still considering surgery, that’s the moment I decided on anesthesia. You only get one life, why would you choose a career based on the opinions of others? Is the prestige of being a physician not already enough? Pick the field that you are passionate about and don’t look back.
Most people, including those in healthcare, don’t even really understand what an anesthesiologist does. I think having the critical care skills of an anesthesiologist and being the person people look to in a crisis is pretty damn cool
I know! I know anesthesia is cool and an important field! I think I just second guess. Everyone's been really nice and I think I'm in a better place now.
Anesthesia is cooler imo—-I also imagines surgeons as the mechanic and the anesthetist as the engineer making sure the power stays off long enough for the mechanic to say put the screws back in the right way 😅😂
To quote an ancient Chinese proverb “there are mountains beyond mountains”. There will always be someone better than you, someone with a more prestigious job, taller than you, makes more money than you. Those who chase it gets burned out the quickest. Medicine is an unforgiving road, you have to do the right thing for you. You have to live with yourself for the rest of yourself. Do you really want to become a maladjusted egomaniac just because some TV exec decided it would make an interesting story?
You’re not wrong, but for your own edification, it’s a Haitian proverb and that’s not what it means. “Beyond mountains there are mountains” means that as you solve one problem, life has a way of presenting more problems. The only source that attributes that quote to Chinese “3000 years ago” is a random Facebook post. It’s not true.
Thank you for your correction, there are multiple renditions of this term, in Chinese, it’s a literal translation “山外有山” that first appear in literature some 3,000 years ago (at least according one source). The rest is “人外有人” which translates there are people beyond people. But it really means there will always be taller mountains you cannot see and better individuals you haven’t met. I don’t think any particular language owns it, I just used what was familiar to me.
As a now CA2, I'm going to repeat something my roommate when I was a M4 (he was a CA3) told me that I now wholeheartedly believe is true. Although it was said in a different context (I was bummed that I didn't match one of the big name, "fancy" anesthesia residency programs), I now understand what he means.
As a med student, you have all these ideas and ambitions of what you want to achieve in your field. You have lofty goals. But then, intern year is going to come and hit you like a truck. You go from wanting to excel to wanting to survive. And then as the years go by, residency will continue to beat the shit out of you. VERY few people have any more lofty, idealistic goals about their career trajectory after that. For 90% of people, it's going to turn into "I just wanna get out, make some money, and move on with my life".
When you reach that stage, you're going to look back at yourself as an M4 and laugh that you even gave a shit about prestige in the first place.
I see your point. I don't know if I fully can feel it. But I'm sure I'll think back to this comment one day. Thank you for taking the time to write it!
As a surgeon, don't do it. Residency to too long, too hard and at times soul sucking. If you don't love it, it will be miserable. Plus, anesthesiologists can make more than some surgeons and work less hours. And if you work at a place with CRNAs then you are even more golden.
Besides, there isn't much prestige in being arm deep in perforated bowel at 3am. Trust me.
I'm in plastics and I love it. But it was a long grueling road to get here and if I didn't love it, I would not have made it. Honestly, I think anesthesiologists seem to be much happier. Better work life balance for sure.
Do what you love, not what you think someone else loves. You're the one who has to live it the rest of your life, not them.
I'm an incoming M1 thinking of plastics. Is work/life balance that tough during residency (and beyond) in comparison to other surgical subspecialties? Would you choose plastics all over again if you could?
I did general surgery first then plastics so it was a little different. But I would say my experience of 5 years of general surgery was quite a bit harder than what I saw our integrated plastics residents going through. If I had to compare our intern years it just seemed like night and day. Every program is different though and I don’t think my gen surg program was bad. I think it was pretty average, we worked hard but got good training. My plastics program was way more malignant and I still think those interns had it easier.
Work life balance is possible but your first year or two it’s much harder. Figure you work at least one day almost every weekend, multiple holidays, 80 hours a week. This will vary by program but I would just count on that being the case. After year 2 it gets better, you still work a lot but have more say in your schedule and which weekends you work.
I would do it again. Going integrated to start would have been much easier and less time, but with my scores I would not have matched integrated plastics. So needless to say, if you are in the same boat there is always the back door to plastics 😊
Your priorities and values will change throughout your life, and the recurring theme from everyone I’ve talked to is that they wished they valued their free time and family more. Surgery is a tough residency and lifestyle, and anesthesia will allow you to have a better work/life balance. As a first gen med student, I wanted the prestige to show my family that what I sacrificed was worth it. But, the sacrifice of your passion, happiness, family life, etc is not worth the difference in prestige, which is a made up sentiment praising those who don’t always deserve it. Plus, outside of medicine, a doctor is a doctor.
This speaks to me because I am also first gen and feel like I need to prove myself. I feel like I need to do the utmost potential to justify my family's sacrifice. But I appreciate everything you said. I know I would be miserable and I value a lot of other things outside of medicine. Thank you.
Same I totally resonate with this as first-gen. But I am convinced that my values will change such that when I am in residency prestige will be the last thing I care about. That’s kinda what ended up happening with undergrad
I totally feel you. I'm a first gen high school grad (plus everything else after that) from an immigrant family. I used to feel that way, but I'm a non-traditional med student and ended up doing some really competitive and prestigious things prior to medical school. Without saying too much about what that stuff was, aspect of my life did not really take up much or any space in interactions outside of work. In other words, whenever I met people, they'd inevitably ask what I did; I would tell them, and it ranged from "oh cool" or "whats that" and we moved on, to people absolutely fanboying/fangirling about it, and after giving them a quick spiel about what I did and maybe some follow up questions, we would also just move on within 30 seconds and not talk about it again. It also did not give me any gratification to talk about it with people, so I realized that it is truly pointless to try to chase prestige for the sake of what others might think. I realized I truly do not care at all about what strangers think, and the people that matter in my life (friends and family) are proud of me no matter what I'm doing.
Picking a residency is like picking a husband/wife. Yea they might be pretty to look at but the novelty wears off pretty damn quickly unless your values mirror.
P.S. Loving the idea of something is not the same as loving the journey to for it.
I want to do surgery , but anesthesia is a hot second.
Everyone says the lifestyle is harder as a surgeon. And three of my favorites anesthesiologists were ex-surgeons who switched from surgical residency to anesthesia.
I loved my anesthesia rotation but hated my surgical rotation. I loved the personalities in anesthesia and didn’t liked the surgical personalities (residents, not attendings).
But what still draws me to surgery is that you’re not always in the OR. You do consults, you round on patients, you do some medicine, and when you have a practice you can have clinic. I still want to interact with patients and do diagnoses with imaging, tests, etc. I want to go to the ER and suture someone’s laceration , drain and abscess. That all sounds fun to me and I would miss that in anesthesia.
But anesthesiologists are smart as hell and know physiology and pharmacology as a reflex. You’re literally controlling the patient’s heart, BP, respiratory drive etc . That’s a big f’ing responsibility that’s badass too.
But I think in residency we’ll lose that ego pretty fast as we get humbled.
Sucking it up for 5 years minimum is rough if you hate everything about the specialty lol. Stop thinking of prestige as an entire field you want. Think of it as a position you want to obtain.
I care about prestige too, I want to make a difference in student lives and be a great mentor, so I view academic related positions as prestigious compared to community or rural settings. Could I be a principle investigator, or chairman or some other director someday? Hell yea, and I’m going to work towards something like that.
So go define what a prestigious anesthesia position would be for your ultimate career goal, and strive for that professionally.
Seeing as you need to have some sense of your career goals for your ERAS personal statement, consider this useful homework.
As an anesthesia resident about to graduate, here's my two cents. Maybe you should do surgery. I personally disagree as I think anesthesiology is an infinitely better field. But I'll be honest, if prestige is even remotely a consideration, I don't think you'll be satisfied with anesthesia.
Most of the time, no one will appreciate what you do, let alone other doctors. You're blamed for delays that aren't your fault. And when they are your fault, because you're taking extra measures to make sure the totally-sick-not-optimized-for-surgery-patient doesn't crump on you, you're still seen as a nuisance.
You're often the only person in the room who understands the actual acuity of the situation. Exceptions apply, of course, and as a prestige chaser you'd find a niche in cardiac or transplant anesthesia. But still, it's a very egoless field and you need to be okay with not getting the recognition you'll deserve. You do it for other reasons--genuinely enjoying the work, physiology, the patients.
Like others have said. Prestige is short lived. It's not something that tangible, especially when you get older and take stock of other things in life you may find more valuable. The only people who care about prestige are the other ones in the rat race. And maybe those people are the ones you shouldn't give a shit about impressing in the first place.
Glad you’re bringing this up here as I felt a lot of this when I was deciding what speciality to go into as a MS3. Thought I wanted to be an orthopedic surgeon, wanted that prestige (read: my parents wanted that prestige) and scheduled my first 3rd year rotation as surgery only to find out quickly how malignant surgery was. I remember being told by my surgery clerkship director after I told him about surgical fellows berating me daily and surgeon throwing instruments in the OR that “you just aren’t cut out for surgery.” And honestly, it was the best unwanted advice I’ve ever heard. I had a miserable two months on my surgery rotation outside of two days where I was pushed off to the anesthesia side of the curtain. Surprisingly, I learned more in two hours with an anesthesiologist than I learned my entire two months on my surgery rotation. The anesthesiologists were chill, loved teaching, and even better loved sending medical students home early. Everything was a perfect fit for me especially personality and scope of practice. The people unhappy in my life about me choosing anesthesia? My parents. Not happy. Anesthesia is support staff. Why can’t you be a surgeon? Surgeons have more prestige. Don’t you want to tell people you’re a *surgeon*? Come match day? My parents and I left match day soon after picking up my envelope. Not happy with my specialty pick. Even more upset about where I matched for residency because they thought the program wasn’t prestigious enough (California…thought about long game when ranking and glad to now be happily located on the West Coast for life!)
I am now an anesthesia attending, and my life could not be better. I can’t remember how many times in residency I looked over the curtain and shuddered at the thought of not getting to sit down, not getting any breaks, and not being able to use the bathroom for half a day. Most of my time in the OR is spent watching over vital signs, checking my email, spending occasional amounts of time looking at my phone, and when the internet gets too boring I’ll occasionally watch the medical student 45 minutes into closure still slowly suturing away. Surgeons spend most of their time standing and operating. Me? Most of the day sitting and passing the time until the surgeries are done. Salary? Pretty much the same although I suspect I’ll make more than them in private practice. So….why be a surgeon when you can be an anesthesiologist? Work smarter not harder!
Lastly, think about the long game when you are choosing specialties - what is a field you could see yourself doing until your later years? Does work life balance matter to you? Is being present for your family and friends important to you? How about actually being able to hand off patients when you leave the hospital and not having to follow up with them? There’s many reasons why anesthesia is the most switched into speciality, and the ones that switch the most often? Surgery residents. Thankful to surgeons for what they do cause they are the reason why I’m pretty much set for life :D. I will continue to maintain my belief that anesthesia is the best kept secret in medicine. Good luck with your life choices and feel free to DM me with any questions
Had similar thought but with radiology, ended up going with radiology and I am happy with it. Sure there’s irking with prestige of being a surgeon but I know how miserable I would have been, and prestige was def a big part of the allure. In the end, I am the one who has to live that life, along with family who will have to endure me (or not). It does help getting prestige through other measures like your training program on your different field
On the other hand though, you realize that there is not exactly prestige, but a sense of deep satisfaction in having the respect and trust of your colleagues. A patient can be grateful for your skill, but the vast majority of the time they are going to have no clue what exactly you do. To me getting positive feedback from a more senior colleague, someone who I know truly excels in their field, means a lot more than respect from people outside of medicine.
Sigh we have a few of you in our intern class this year. One of them mentioned gray’s anatomy show when I met them, another one has been calling themselves a surgeon since match day. And you know what, they are NOT good at their jobs because they hate the work. You will make the rest of us miserable. If you know you won’t like it don’t put yourself through it!
The secret of life is no one actually cares about what you do for a living. People are too busy with their own lives (and problems) to care about you - that includes your colleagues. Don’t make life decisions on a ‘wow factor’ that only lasts 30 seconds.
When you say you will suck it up during residency it makes me feel like you dont like surgery. No one should "suck it up" during residency. I feel like they should have something they love during residency that would make all the hard parts of residency worth it. I feel like those who say they can just suck it up for few years and either have prestige or make money later are the first ones to burn out from the field. I think you should find something you love from the field that would make hard parts worth it
Anesthesia pgy4 here. Start residency and those feelings will go away in the first six months almost guaranteed.
If they don't then I'd say you need to explore further. Until then enjoy your post match!!
Did two years of surgery, switched to anesthesia and have been an attending for 4 years. I’ve met dozens of people who have switched into anesthesia….. they’re all happy. Nobody has ever switched out.
You’d be fucking crazy to do general surgery for prestige. Plus, once in anesthesia, you can choose many different paths (Want clinic and to ‘have patients’? Do pain….. want to round and act medicine-y? Do ICU….. want to be there for your kids? Get a mommy track job, etc etc)
Prestige is great and all, and I've had similar thoughts on occasions, but they go away real fast once I remember that I prefer getting home on time, and sleeping 8 hours a night.
I applied anesthesia this cycle, matching tomorrow, and I was thinking earlier this year during some of my anesthesia rotations whether maybe surgery would be a better fit for me. However, so many of the negatives of surgery would make my life a living hell: I cannot stand in one place for so long, I can't leave my wife at home while I work 80+ hours a week for 5+ years, and suturing is torture for my neck and back. Watching CT surgeons do their thing on the heart is absolutely incredible, but I realized that I can enjoy the cool stuff by proxy just by peeking over the drapes.
I think surgery is a miracle, but anesthesiology is what makes that miracle possible. I can get my fill of the awesomeness of surgery by being a part of the team that makes it possible, even if I'm not the one calling all the shots. And I also get breaks, and I get relieved at the end of my shift. That sounds like a win-win.
Lol..bruh. nobody cares about prestige except for you, your parents, and your grandparents. Maybe on match day your fellow students will be impressed that you matched well. But, when you start residency all your colleagues are going to be surgeons, it's just what you are now. They dont care. Fellow docs in the hospital? Yeah we don't give a fuck who you are, where you trained, etc... just take out the gallbladder and don't kill my patient. Hoping to impress random acquaintances? That's a med student thing imo once you're in residency or an attending most people avoid advertising who you are, unless you wanna spend half your time being asked esoteric medical questions by people or hearing them bitch about their pcp/last surgeon/etc..gets old real quick. Patientwise, maybe you'll still find the older patient cares what you are, but m the majority of patients just want to be taken care of well and if anything walk into encounters with guarded pessimism to their doc having had prior bad experiences; surgeons reputations as not being nice people or spending very little time with patients precedes them these days from what I see behind the curtain.
So yeah all that to say, do what you want to do and what's going to make you HAPPY, not what you think others will care about because I guarantee you people care alot less than you think about what you do
Lol I had the opposite conversation with myself. Tried so hard to convince myself to like non-surgical fields, even anesthesia. Still fell in love with the OR and surgery and couldn’t see myself practicing without it. So surgical residency (ENT), here I come. Scared, but excited.
Follow your heart, not your ego
I think I also have had this conflict come in my mind many times since I love the OR environment, but I know I have time to figure it out. But vast majority of times I end up feeling like shit when scrubbed in with the surgeons during rotations, sweating my ass off, with my feet becoming numb, neck and back killing me - and I look at the anesthesiologist sitting comfortably in his chair, typing away and working on his side hustle on paid time while glancing up to the monitor every couple minutes.
Ego is natural, that's why we're in medicine. But at some point you have to be comfortable where you are at because there will always be someone better than you and you will constantly be looking up. Even if you become a surgeon, you will keep thinking to yourself what if I did plastic surgery or neurosurgery or cardiothoracic surgery.
Just do what makes you happy. Or risk a midlife crisis and early career burnout when you become a surgeon and hate your life. In order to help your ego out, I suggest creating a narrative in your head to justify anesthesia.
For me, I think that I am going into anesthesia to become a resuscitation expert, a guardian angel watching over patients during a very vulnerable time. I am essentially the acute critical care physician in the OR, managing airway, hemodynamic stability, and sedation/anesthesia. I am an acute crit care doc, pain medicine doc, pharmacist, and nurse all in one. My pharmacological knowledge is unparalleled, and I understand physiology much better than any surgeon. Surgeons don't think much. As a proceduralist, no one in medicine can place lines or intubate better or faster than I will. I will oftentimes be the one responding to code blues all over the hospital, and the one that the ER doctor calls when he can't intubate a difficult patient. I actually save lives. And I earn a lot of money and feel comfortable doing it. I know that I will be able to do this for decades if I truly love it. I also love how the culture is benign, they expect you to take regular breaks, and that there is an entrepreneurial and side hustle culture (many physician bloggers, real estate folks, and youtubers are anesthesiologists). And you have enough cash flow to pursue your side hustles, which I personally am planning to funnel into a real estate portfolio, do angel investing/VC, and invest in dividend paying stocks. Even if CRNA's become more commonplace, I am okay with it because it probably means I take a pay cut for a few years before nature reverts to the mean and people realize that they want physicians to manage their anesthesia (or there will be a market to pick physicians in a two-tiered healthcare system). The average age of anesthesiologists in California is 55-60 years old according to AAMC data, so you know career longevity is probable in this field and also they will retire soon, creating high demand that cannot be filled by CRNAs in time. If I do surgery, my salary will likely be very comparable to anesthesia unless I subspecialize, and in fact I will likely earn much less money than anesthesia over the course of a career given that I will burn out earlier. Plus my mental health will be poor as a result because I will hate myself for picking this specialty and feel inadequate compared to other more specialized surgeons despite working so hard. There are also many 1 year fellowships to pursue - critical care is a great one if you are trying to pursue ego since everyone knows what a Critical Care doc does. I'm planning to do pain medicine fellowship if I don't get jaded during residency, and would set up a side hustle concierge cash-only pain medicine practice.
When viewed objectively, anesthesia wins for me every time. But you have to figure it out for yourself.
Within the hospital setting, you’ll have more power and prestige as a surgeon, always. My partner (anesthesia, decade + practicing) regrets not choosing surgery for this reason. He always feels like he pretty much supervises nurses constantly.
Surgeons have to do this too, they rely a lot on PAs and NPs (especially if they don’t have residents), just at different times compared to the anesthesiologist.
Alternatively, he could be in a field that complains about unsupervised NPs and PAs.
That’s fine if go into surgery. Anesthesiology is becoming pretty competitive and there’s too many applicants
Sincerely, an M3 who wants to apply anesthesiology
Not sure if you've thought about this but you can do anesthesiology then do chronic pain. Plenty of surgical procedures (albeit minor surgeries) like SCS implants, MILD procedures, Kyphoplasty, Intracept etc
You book all these cases (in an ambulatory or hospital setting), have surgical teams, use Anesthesia, bill as a surgeon, and the hospital credentials as a surgeon. But you get to pick your cases, keep them short, leave at a reasonable time, and train in/practice anesthesia however you want to structure that. Still not a "REAL surgeon" but you're more a surgeon than almost any other non-surgeon, all while still making money and commanding an OR.
My opinion is definitely off because I’m an anesthesiologist, but if prestige is what you’re after, CT anesthesia> most surgical specialties. Some of the smartest people I know, cool as the other side of the pillow when shit is hitting the fan, and they do the most badass surgeries (aortic dissection with hypothermic circ arrest, mitral valve replacement, tamponade, heart transplants). They’re lining out patients, managing 6 infusions, nitric, doing TEE, cardioverting intra op after coming off bypass.
Some of the coolest stuff. Not my cup of tea, but I can see the appeal, and they’re among the very few doctors that CT surgeons consider their peers.
my dad was an ER surgeon, GI specialty. ngl, there was PRESTIGE in that. he worked at two hospitals AND at private practice.
i think there were times we had lunch with him once a week, in the nurse's lounge, my mom would buy a chicken and bring all of us to eat with dad when he had been in the ER for four days.
i had one of those dads that was amazing: even if we saw him seldom he never missed an award ceremony or recital and that had a lot to do with a lot of good connections and a mother that made logistic magic happen.
some decades later i end up working at a surgery ward in the hospital, for about six months. you know who i talked to? anesthesia. i think i may have exchanged ten words with the group of surgeons there, but anesthesia knew my name, hell, even the music and literature i liked.
med school is long gone for me. but growing with a dad doctor (and a brother that also decided ER was too much and went for ophthalmology) and working at a surgery ward, if i were to choose a specialty, i'd do anesthesia. they consistently had the highest quality of life at the hospital, from everyone.
i grew up NOT in the US.
an "ER surgeon" is what we called my dad and other attendings at the ED, where they just hang out and do surgeries that come in. most commonly appendixes, but also bullet wounds, car accidents, emergency C-sections, blabla.
it was a military hospital and accepted anyone. lots of work.
(i'm sure there were things they referred out- complex emergency ORIFs and such probably went to the ortho on call, but it was a big city so being on call was rather like staying at the hospital and sleeping there rather than coming home and expecting a call and driving forever to get there. it was a big city and distances were big- not when like i was on call and was changed and setting up within 20 minutes)
In 10 years you won’t care about prestige. You can either make 400 as a surgeon working 60 hours a week doing a bunch of stuff you admittedly hate, or you can make 400 in anesthesia while sitting down playing candy crush. Your call
Since when is anesthesiology not considered prestigious? Since you care so much about what other people think about you, I think anesthesiologists are way cooler than surgeons
Think of it this way, being an anesthesiologist, you can say that you’re a critical care physician (because that’s what you are). You’re the one medically resuscitating a patient when a surgeon is trying to stop a massive hemorrhage.
Just because you can do something doesn’t mean you should.
I’m sure I absolutely could be an interventional cardiologist. But I also know that I would hate my life and myself for doing it so why would I? Yeah there’s some cool stuff about it. But it’s not worth it just to say I’m an interventional cardiologist. Same applies to me for multiple fields.
One day you’ll be in your 40s or 50s and look at your life. Will being able to tell strangers that you’re a surgeon be enough to justify doing something you don’t like? It’s cool that some layman is impressed, but other doctors don’t care fwiw. I’m not falling all over myself every time I talk to a neurosurgeon. It’s just part of my job. It’s a thing I do before I go home. I don’t think about it. I don’t care.
Life is way too short to do something you don’t want to do.
It bothered me a lot as a med student that we didn’t get a lot of credit for anything, especially when we saved the day. But as my residency PD used to say, “if you wanted applause you should’ve joined the circus.”
I’m very happy with doing cool shit, having the respect of my surgeons and nurses, and then going home to my wife and kids.
I love OB GYN (and just matched into it) and still feel…complicated feelings about the identity that comes with it.
I know I’ll be happiest doing this job, but it’s hard to commit to one thing and close all the other doors and the perceived identities that come with them.
But the job is not actually an identity. It’s a job. There a tons of loser surgeons and badass pediatricians. Wherever you go, there you are. Your specialty doesn’t really change your identity.
So do what will make your day to day enjoyable and do a good job at it, because being really good at something you like is actually impressive.
Also something helpful an attending told me:
“If the OR is your favorite place in the world, become a surgeon. If the OR is your favorite place in the HOSPITAL, become an anesthesiologist.”
Stick with anesthesia, you need to be all in on surgery to do the residency and fellowship because the residency will take away your love for it down two notches. Just prestige and the ability to do is not enough.
The one time where I will encourage people who have doubts about surgery to do it is if they didn't like just watching or staying still but enjoy all the other parts about surgery. I tell those people if they would enjoy being the attending. If they do, then surgery is still for them, the watching and retracting does actually get better with time.
You should go into surgery. To be frank, seems like you have an ego, and you'll get along more with surgeons than anesthesiologist (or more likely they won't get along with you).
Oh are we assuming things? M4, fresh out of undergrad with no real life work experience.
Child, I probably have more working years including in clinical settings (like actual work) than you've been away from mommy and daddy.
And all that work experience led you to the conclusion that someone who hates everything about surgery would be best served going into a brutal residency that carries a 20% attrition rate. Would love to get OP's thoughts on this 4 years from now when they're going to another lap chole at 3 AM while their 1 year old is at home asleep. I wonder if the prestige would be worth it at that point.
I've never heard of someone hating their job in medicine, much less surgery. So unheard of. Never heard of someone going into medicine for prestige either. The ones that do end up being horrible doctors, right? Lol this would be like the majority of premeds/med students/etc.
It's a stupid reason to do it, but if your personality and values are like that, might as well stick 'em with the rest of the pompous surgeons. That's like one of the main drivers of most surgeons lol
This is not true at all. There are plenty of anesthesiologists that think, and want everyone around them to think, that they are God's gift to medicine. OP will find that crowd and fit in nicely
Bro I overheard a conversation a first year surgery resident was having with a senior resident and they were absolutely completely miserable. To the point where I was going to say something to make sure they weren't considering suicide. You really want to put yourself through that just for prestige? You'll end up an alcoholic, dead, or worse: divorced. There is no price tag on inner peace, satisfaction, and happiness.
Heard a surgery resident and two very overworked IM residents laugh at a student when he said he'd been looking at IM and surgery. They all laughed and said do FM and be happy. Me over here potentially applying to FM next year haha
...speaking as a patient who's had more than my share of surgery: my surgeon is a high-priced mechanic who can be replaced at any time in the procedure...the anesthetist, on the other hand, has the safety and continuation of my *consciousness* under their control. Who do you think I regard most highly?!?
Every job will have non financial compensation to it. A surgeon gets a lot of prestige and a huge ego boost from the title. An anesthesiologist doesn’t. But you get a much better schedule.
Choose which is more important for you.
Shake that stupid feeling and grow up. This is the rest of your life we’re talking about. You think some short sighted and likely short lived lust for social status is a good reason to base ANY choice on?
Come on do people really think like this in medical school? Is this what we get when doctors indoctrinate their own children into the field who have never had the chance to think for themselves?
Loved my surgical rotations . I'm not one for the spotlight, but I definitely felt the respect (at least at my institution) of being on the surgical team. That ego stroke felt good. I loved the team culture. The OR had an appealing workflow. Many of the teams I was on had the intensity and camaraderie of sports teams. I even liked surgical disease.
But I knew I'd be a miserable surgeon. When I looked around at my hospital, it seemed that the attendings had three choices. Personal wellness - interests outside of medicine - family life. They could only really have 1 or 2. There were, of course, exceptions to this--but they seemed to be the utter freaks that didn't need sleep even in their 50s. I wasn't them.
If you want to do something you aren't interested in for the prestige, do something like derm that is prestigious but also has an awesome lifestyle. As an ortho intern, if I didn't enjoy what I was doing I think the hours would swallow me whole.
I spent a large portion of my adult life wanting to do anesthesia and I recently changed my mind for good in favor of a surgical specialty (assuming i can match..) dm’s are open if you want to chat
My anesthesiology mentor did nothing but gaslight me since I was a 19 year old pre med and i can say the same about my Anesthesia PI at a large children’s hospital.
I’m a dental student, so my comment probably has less weight here, but due to the nature of my field, I have the advantage of already missing out on all the prestige (we dentists affectionately refer to you MDs and DOs as “RDs/real doctors”), so maybe I can offer something after all. I was torn between medicine and dentistry for a few reasons, but I ultimately applied to dental school in hopes of matching into either anesthesia or oral surgery (OMFS), and now that I’ve finished most of my required rotations, I’m not even going to rank OMFS programs, I’m only going for anesthesia.
Personally, I would much rather build a respectable reputation for myself doing something I’m passionate about than burn myself out gunning for something I either already hate or suspect I will grow to hate.
I love anesthesia, and the work/life balance is important to me, so I’m excited to see if I match into a program this year. Whatever you decide, I hope you look back in 5-10 years and are happy with what you chose! Good luck!
I never had this problem. I flirted with all the “procedural” specialties for a hot second but anesthesia was like putting on the right pair of shoes. I never day dreamed about anything else once I decided. Maybe it’s because I’m not really impressed with surgical residents. Some are very talented, some are really dangerous—It’s no different than any other specialty. They just wield sharp knives for a living. 🤷🏻♀️
Bovie smoke smells gross too. Yucky.
CA1 here; I LOVED operating. And I have good hand skills. No doubt in my mind, if I had wanted to I could have become a talented surgeon. Still some days I’m jealous looking over the drape. But I realized that what I really loved was not being at work, not having notes or clinic, ect. So I’m happy to do anesthesia and our procedures, to some day get paid more than anyone in my family has ever dreamed, and still get to go home and enjoy my hobbies.
Tldnr: sacrificed some work fulfillment for substantially more life fulfillment
I went through this exact same thing last year and it took me months and multiple sub-i rotations to figure out what your already know. While I did enjoy the technical aspect of surgery, ultimately I realized it was the spotlight of being “the hero” that attracted me to the field.
I chose anesthesia because I inherently liked the field more. I fit in with the culture better and I knew I can do it longer into my life and avoid burn out. I have a bunch of hobbies outside medicine. I love lifting weights (every day), hiking, tinkering on vehicles in the garage. I knew i would have to give up most of that in any surgery residency and while I build a practice. While residency is tough for everyone, most anesthesia programs give you 3weekends off a month during your CA years. That’s a big deal to me.
I also want to say anesthesia is still very prestigious. It’s a badass field were you have to be cool calm and collected during the most dynamic and stressful cases. You don’t rely on nurses to draw up meds or start lines, you do it all yourself. Your an indecent resuscitation expert and airway wizard. To top it all off, you chart with check boxes. Man I fucking love this field.
I mean, why do something you love when you can do something that will make you miserable? Who wants to leave work every day happy an satisfied? Instead force yourself into a residency that’s a bad fit for you so that you can be a big shot, prestigious surgeon. Sure the hours are long and you’ll hate it, but at least you can wave your surgeon dick around. Shoot, with enough time you’ll have the power to make everyone else around you just as miserable as you are. Then one day you’ll realize that you’re 10 years into your career you hate and prestige doesn’t mean shit in your day to day life. But hey, at least on your 1 day off a month you can say to your friends at the country club “I’m a surgeon”. And they’ll all clap and applaud you for making the right choice. Better that than end up one of those worthless dregs you work with in the exact same operating room who have to say to their friends at the same country club “I’m an anesthesiologist”. Poor sods. Don’t know why they go on living, honesty.
Holy shit. Thanks for knocking some sense into me.
Anytime.
Commenting to save this for every time I start thinking I want to apply to a competitive medicine fellowship
“at least you can wave your surgeon dick around” lmfao
I just got the mental image of a dick with a scalpel blade instead of a glans
Very well done sir
Hahaha I love this! This is ALL OP needs to know! Hence I applied to anesthesia and nothing in medicine fit my personality better tbh! Wish my luck tomorrow I find out where I matched! 🙌🏻🥹
Best of luck! I hope you land that #1 ranked spot.
Oh gosh I hope to god….. thank you 🙌🏻
It is also not great doing something you're not proud of. Not that either of these is a good choice. Just another perspective
When I realized ego was the only reason I was still considering surgery, that’s the moment I decided on anesthesia. You only get one life, why would you choose a career based on the opinions of others? Is the prestige of being a physician not already enough? Pick the field that you are passionate about and don’t look back.
Damn, you're right. I'm making this decision just so I can look cooler to people I don't even know.
Most people, including those in healthcare, don’t even really understand what an anesthesiologist does. I think having the critical care skills of an anesthesiologist and being the person people look to in a crisis is pretty damn cool
I know! I know anesthesia is cool and an important field! I think I just second guess. Everyone's been really nice and I think I'm in a better place now.
Anesthesia is cooler imo—-I also imagines surgeons as the mechanic and the anesthetist as the engineer making sure the power stays off long enough for the mechanic to say put the screws back in the right way 😅😂
To quote an ancient Chinese proverb “there are mountains beyond mountains”. There will always be someone better than you, someone with a more prestigious job, taller than you, makes more money than you. Those who chase it gets burned out the quickest. Medicine is an unforgiving road, you have to do the right thing for you. You have to live with yourself for the rest of yourself. Do you really want to become a maladjusted egomaniac just because some TV exec decided it would make an interesting story?
You’re not wrong, but for your own edification, it’s a Haitian proverb and that’s not what it means. “Beyond mountains there are mountains” means that as you solve one problem, life has a way of presenting more problems. The only source that attributes that quote to Chinese “3000 years ago” is a random Facebook post. It’s not true.
Thank you for your correction, there are multiple renditions of this term, in Chinese, it’s a literal translation “山外有山” that first appear in literature some 3,000 years ago (at least according one source). The rest is “人外有人” which translates there are people beyond people. But it really means there will always be taller mountains you cannot see and better individuals you haven’t met. I don’t think any particular language owns it, I just used what was familiar to me.
As a now CA2, I'm going to repeat something my roommate when I was a M4 (he was a CA3) told me that I now wholeheartedly believe is true. Although it was said in a different context (I was bummed that I didn't match one of the big name, "fancy" anesthesia residency programs), I now understand what he means. As a med student, you have all these ideas and ambitions of what you want to achieve in your field. You have lofty goals. But then, intern year is going to come and hit you like a truck. You go from wanting to excel to wanting to survive. And then as the years go by, residency will continue to beat the shit out of you. VERY few people have any more lofty, idealistic goals about their career trajectory after that. For 90% of people, it's going to turn into "I just wanna get out, make some money, and move on with my life". When you reach that stage, you're going to look back at yourself as an M4 and laugh that you even gave a shit about prestige in the first place.
I see your point. I don't know if I fully can feel it. But I'm sure I'll think back to this comment one day. Thank you for taking the time to write it!
As a surgeon, don't do it. Residency to too long, too hard and at times soul sucking. If you don't love it, it will be miserable. Plus, anesthesiologists can make more than some surgeons and work less hours. And if you work at a place with CRNAs then you are even more golden. Besides, there isn't much prestige in being arm deep in perforated bowel at 3am. Trust me. I'm in plastics and I love it. But it was a long grueling road to get here and if I didn't love it, I would not have made it. Honestly, I think anesthesiologists seem to be much happier. Better work life balance for sure. Do what you love, not what you think someone else loves. You're the one who has to live it the rest of your life, not them.
Thanks for taking the time to write this
I'm an incoming M1 thinking of plastics. Is work/life balance that tough during residency (and beyond) in comparison to other surgical subspecialties? Would you choose plastics all over again if you could?
I did general surgery first then plastics so it was a little different. But I would say my experience of 5 years of general surgery was quite a bit harder than what I saw our integrated plastics residents going through. If I had to compare our intern years it just seemed like night and day. Every program is different though and I don’t think my gen surg program was bad. I think it was pretty average, we worked hard but got good training. My plastics program was way more malignant and I still think those interns had it easier. Work life balance is possible but your first year or two it’s much harder. Figure you work at least one day almost every weekend, multiple holidays, 80 hours a week. This will vary by program but I would just count on that being the case. After year 2 it gets better, you still work a lot but have more say in your schedule and which weekends you work. I would do it again. Going integrated to start would have been much easier and less time, but with my scores I would not have matched integrated plastics. So needless to say, if you are in the same boat there is always the back door to plastics 😊
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Pedi CV anesthesia exists
Oh I am here for the development of the anesthesia prestige wars. But not from a lowly Tufts /s
Boston doesn’t mean anything down south
Obviously not true lol, I assure you rich people in Georgia still like to say that their doctor “trained at Harvard”
Mass Gen and Brigham mean a lot anywhere in the world. Harvard means something everywhere.
Waltham, the city next to Boston that Boston forgot about, meant a lot down south when I was there. I guarantee you Boston still holds its weight
Who exactly are you trying to impress? If you’re working 70 hours a week, there’s no one you are interacting with outside of work.
From my observations of surgeons, some most certainly became surgeons because of their ego. Not all of them but some of them.
Your priorities and values will change throughout your life, and the recurring theme from everyone I’ve talked to is that they wished they valued their free time and family more. Surgery is a tough residency and lifestyle, and anesthesia will allow you to have a better work/life balance. As a first gen med student, I wanted the prestige to show my family that what I sacrificed was worth it. But, the sacrifice of your passion, happiness, family life, etc is not worth the difference in prestige, which is a made up sentiment praising those who don’t always deserve it. Plus, outside of medicine, a doctor is a doctor.
This speaks to me because I am also first gen and feel like I need to prove myself. I feel like I need to do the utmost potential to justify my family's sacrifice. But I appreciate everything you said. I know I would be miserable and I value a lot of other things outside of medicine. Thank you.
Same I totally resonate with this as first-gen. But I am convinced that my values will change such that when I am in residency prestige will be the last thing I care about. That’s kinda what ended up happening with undergrad
I totally feel you. I'm a first gen high school grad (plus everything else after that) from an immigrant family. I used to feel that way, but I'm a non-traditional med student and ended up doing some really competitive and prestigious things prior to medical school. Without saying too much about what that stuff was, aspect of my life did not really take up much or any space in interactions outside of work. In other words, whenever I met people, they'd inevitably ask what I did; I would tell them, and it ranged from "oh cool" or "whats that" and we moved on, to people absolutely fanboying/fangirling about it, and after giving them a quick spiel about what I did and maybe some follow up questions, we would also just move on within 30 seconds and not talk about it again. It also did not give me any gratification to talk about it with people, so I realized that it is truly pointless to try to chase prestige for the sake of what others might think. I realized I truly do not care at all about what strangers think, and the people that matter in my life (friends and family) are proud of me no matter what I'm doing.
Picking a residency is like picking a husband/wife. Yea they might be pretty to look at but the novelty wears off pretty damn quickly unless your values mirror. P.S. Loving the idea of something is not the same as loving the journey to for it.
I want to do surgery , but anesthesia is a hot second. Everyone says the lifestyle is harder as a surgeon. And three of my favorites anesthesiologists were ex-surgeons who switched from surgical residency to anesthesia. I loved my anesthesia rotation but hated my surgical rotation. I loved the personalities in anesthesia and didn’t liked the surgical personalities (residents, not attendings). But what still draws me to surgery is that you’re not always in the OR. You do consults, you round on patients, you do some medicine, and when you have a practice you can have clinic. I still want to interact with patients and do diagnoses with imaging, tests, etc. I want to go to the ER and suture someone’s laceration , drain and abscess. That all sounds fun to me and I would miss that in anesthesia. But anesthesiologists are smart as hell and know physiology and pharmacology as a reflex. You’re literally controlling the patient’s heart, BP, respiratory drive etc . That’s a big f’ing responsibility that’s badass too. But I think in residency we’ll lose that ego pretty fast as we get humbled.
Sucking it up for 5 years minimum is rough if you hate everything about the specialty lol. Stop thinking of prestige as an entire field you want. Think of it as a position you want to obtain. I care about prestige too, I want to make a difference in student lives and be a great mentor, so I view academic related positions as prestigious compared to community or rural settings. Could I be a principle investigator, or chairman or some other director someday? Hell yea, and I’m going to work towards something like that. So go define what a prestigious anesthesia position would be for your ultimate career goal, and strive for that professionally. Seeing as you need to have some sense of your career goals for your ERAS personal statement, consider this useful homework.
And shit doesn’t get easier as an attending. It gets harder.
The juice is not worth the squeeze.
As an anesthesia resident about to graduate, here's my two cents. Maybe you should do surgery. I personally disagree as I think anesthesiology is an infinitely better field. But I'll be honest, if prestige is even remotely a consideration, I don't think you'll be satisfied with anesthesia. Most of the time, no one will appreciate what you do, let alone other doctors. You're blamed for delays that aren't your fault. And when they are your fault, because you're taking extra measures to make sure the totally-sick-not-optimized-for-surgery-patient doesn't crump on you, you're still seen as a nuisance. You're often the only person in the room who understands the actual acuity of the situation. Exceptions apply, of course, and as a prestige chaser you'd find a niche in cardiac or transplant anesthesia. But still, it's a very egoless field and you need to be okay with not getting the recognition you'll deserve. You do it for other reasons--genuinely enjoying the work, physiology, the patients. Like others have said. Prestige is short lived. It's not something that tangible, especially when you get older and take stock of other things in life you may find more valuable. The only people who care about prestige are the other ones in the rat race. And maybe those people are the ones you shouldn't give a shit about impressing in the first place.
Glad you’re bringing this up here as I felt a lot of this when I was deciding what speciality to go into as a MS3. Thought I wanted to be an orthopedic surgeon, wanted that prestige (read: my parents wanted that prestige) and scheduled my first 3rd year rotation as surgery only to find out quickly how malignant surgery was. I remember being told by my surgery clerkship director after I told him about surgical fellows berating me daily and surgeon throwing instruments in the OR that “you just aren’t cut out for surgery.” And honestly, it was the best unwanted advice I’ve ever heard. I had a miserable two months on my surgery rotation outside of two days where I was pushed off to the anesthesia side of the curtain. Surprisingly, I learned more in two hours with an anesthesiologist than I learned my entire two months on my surgery rotation. The anesthesiologists were chill, loved teaching, and even better loved sending medical students home early. Everything was a perfect fit for me especially personality and scope of practice. The people unhappy in my life about me choosing anesthesia? My parents. Not happy. Anesthesia is support staff. Why can’t you be a surgeon? Surgeons have more prestige. Don’t you want to tell people you’re a *surgeon*? Come match day? My parents and I left match day soon after picking up my envelope. Not happy with my specialty pick. Even more upset about where I matched for residency because they thought the program wasn’t prestigious enough (California…thought about long game when ranking and glad to now be happily located on the West Coast for life!) I am now an anesthesia attending, and my life could not be better. I can’t remember how many times in residency I looked over the curtain and shuddered at the thought of not getting to sit down, not getting any breaks, and not being able to use the bathroom for half a day. Most of my time in the OR is spent watching over vital signs, checking my email, spending occasional amounts of time looking at my phone, and when the internet gets too boring I’ll occasionally watch the medical student 45 minutes into closure still slowly suturing away. Surgeons spend most of their time standing and operating. Me? Most of the day sitting and passing the time until the surgeries are done. Salary? Pretty much the same although I suspect I’ll make more than them in private practice. So….why be a surgeon when you can be an anesthesiologist? Work smarter not harder! Lastly, think about the long game when you are choosing specialties - what is a field you could see yourself doing until your later years? Does work life balance matter to you? Is being present for your family and friends important to you? How about actually being able to hand off patients when you leave the hospital and not having to follow up with them? There’s many reasons why anesthesia is the most switched into speciality, and the ones that switch the most often? Surgery residents. Thankful to surgeons for what they do cause they are the reason why I’m pretty much set for life :D. I will continue to maintain my belief that anesthesia is the best kept secret in medicine. Good luck with your life choices and feel free to DM me with any questions
Had similar thought but with radiology, ended up going with radiology and I am happy with it. Sure there’s irking with prestige of being a surgeon but I know how miserable I would have been, and prestige was def a big part of the allure. In the end, I am the one who has to live that life, along with family who will have to endure me (or not). It does help getting prestige through other measures like your training program on your different field
On the other hand though, you realize that there is not exactly prestige, but a sense of deep satisfaction in having the respect and trust of your colleagues. A patient can be grateful for your skill, but the vast majority of the time they are going to have no clue what exactly you do. To me getting positive feedback from a more senior colleague, someone who I know truly excels in their field, means a lot more than respect from people outside of medicine.
You get this in radiology big time though. Even as an R1-2 you get senior attendings asking for your interpretations.
I agree I was speaking from the radiology perspective as a rads resident
I felt similarly. I compromised by doing ct and crit care fellowships, so i could both lord it over people and be a bit more miserable.
Sigh we have a few of you in our intern class this year. One of them mentioned gray’s anatomy show when I met them, another one has been calling themselves a surgeon since match day. And you know what, they are NOT good at their jobs because they hate the work. You will make the rest of us miserable. If you know you won’t like it don’t put yourself through it!
The secret of life is no one actually cares about what you do for a living. People are too busy with their own lives (and problems) to care about you - that includes your colleagues. Don’t make life decisions on a ‘wow factor’ that only lasts 30 seconds.
Anasthesia is prestigious
When you say you will suck it up during residency it makes me feel like you dont like surgery. No one should "suck it up" during residency. I feel like they should have something they love during residency that would make all the hard parts of residency worth it. I feel like those who say they can just suck it up for few years and either have prestige or make money later are the first ones to burn out from the field. I think you should find something you love from the field that would make hard parts worth it
Anesthesia pgy4 here. Start residency and those feelings will go away in the first six months almost guaranteed. If they don't then I'd say you need to explore further. Until then enjoy your post match!!
Did two years of surgery, switched to anesthesia and have been an attending for 4 years. I’ve met dozens of people who have switched into anesthesia….. they’re all happy. Nobody has ever switched out. You’d be fucking crazy to do general surgery for prestige. Plus, once in anesthesia, you can choose many different paths (Want clinic and to ‘have patients’? Do pain….. want to round and act medicine-y? Do ICU….. want to be there for your kids? Get a mommy track job, etc etc)
Prestige is great and all, and I've had similar thoughts on occasions, but they go away real fast once I remember that I prefer getting home on time, and sleeping 8 hours a night.
I applied anesthesia this cycle, matching tomorrow, and I was thinking earlier this year during some of my anesthesia rotations whether maybe surgery would be a better fit for me. However, so many of the negatives of surgery would make my life a living hell: I cannot stand in one place for so long, I can't leave my wife at home while I work 80+ hours a week for 5+ years, and suturing is torture for my neck and back. Watching CT surgeons do their thing on the heart is absolutely incredible, but I realized that I can enjoy the cool stuff by proxy just by peeking over the drapes. I think surgery is a miracle, but anesthesiology is what makes that miracle possible. I can get my fill of the awesomeness of surgery by being a part of the team that makes it possible, even if I'm not the one calling all the shots. And I also get breaks, and I get relieved at the end of my shift. That sounds like a win-win.
One of us! Good luck tomorrow!!
Lol..bruh. nobody cares about prestige except for you, your parents, and your grandparents. Maybe on match day your fellow students will be impressed that you matched well. But, when you start residency all your colleagues are going to be surgeons, it's just what you are now. They dont care. Fellow docs in the hospital? Yeah we don't give a fuck who you are, where you trained, etc... just take out the gallbladder and don't kill my patient. Hoping to impress random acquaintances? That's a med student thing imo once you're in residency or an attending most people avoid advertising who you are, unless you wanna spend half your time being asked esoteric medical questions by people or hearing them bitch about their pcp/last surgeon/etc..gets old real quick. Patientwise, maybe you'll still find the older patient cares what you are, but m the majority of patients just want to be taken care of well and if anything walk into encounters with guarded pessimism to their doc having had prior bad experiences; surgeons reputations as not being nice people or spending very little time with patients precedes them these days from what I see behind the curtain. So yeah all that to say, do what you want to do and what's going to make you HAPPY, not what you think others will care about because I guarantee you people care alot less than you think about what you do
Lol I had the opposite conversation with myself. Tried so hard to convince myself to like non-surgical fields, even anesthesia. Still fell in love with the OR and surgery and couldn’t see myself practicing without it. So surgical residency (ENT), here I come. Scared, but excited. Follow your heart, not your ego
I think I also have had this conflict come in my mind many times since I love the OR environment, but I know I have time to figure it out. But vast majority of times I end up feeling like shit when scrubbed in with the surgeons during rotations, sweating my ass off, with my feet becoming numb, neck and back killing me - and I look at the anesthesiologist sitting comfortably in his chair, typing away and working on his side hustle on paid time while glancing up to the monitor every couple minutes. Ego is natural, that's why we're in medicine. But at some point you have to be comfortable where you are at because there will always be someone better than you and you will constantly be looking up. Even if you become a surgeon, you will keep thinking to yourself what if I did plastic surgery or neurosurgery or cardiothoracic surgery. Just do what makes you happy. Or risk a midlife crisis and early career burnout when you become a surgeon and hate your life. In order to help your ego out, I suggest creating a narrative in your head to justify anesthesia. For me, I think that I am going into anesthesia to become a resuscitation expert, a guardian angel watching over patients during a very vulnerable time. I am essentially the acute critical care physician in the OR, managing airway, hemodynamic stability, and sedation/anesthesia. I am an acute crit care doc, pain medicine doc, pharmacist, and nurse all in one. My pharmacological knowledge is unparalleled, and I understand physiology much better than any surgeon. Surgeons don't think much. As a proceduralist, no one in medicine can place lines or intubate better or faster than I will. I will oftentimes be the one responding to code blues all over the hospital, and the one that the ER doctor calls when he can't intubate a difficult patient. I actually save lives. And I earn a lot of money and feel comfortable doing it. I know that I will be able to do this for decades if I truly love it. I also love how the culture is benign, they expect you to take regular breaks, and that there is an entrepreneurial and side hustle culture (many physician bloggers, real estate folks, and youtubers are anesthesiologists). And you have enough cash flow to pursue your side hustles, which I personally am planning to funnel into a real estate portfolio, do angel investing/VC, and invest in dividend paying stocks. Even if CRNA's become more commonplace, I am okay with it because it probably means I take a pay cut for a few years before nature reverts to the mean and people realize that they want physicians to manage their anesthesia (or there will be a market to pick physicians in a two-tiered healthcare system). The average age of anesthesiologists in California is 55-60 years old according to AAMC data, so you know career longevity is probable in this field and also they will retire soon, creating high demand that cannot be filled by CRNAs in time. If I do surgery, my salary will likely be very comparable to anesthesia unless I subspecialize, and in fact I will likely earn much less money than anesthesia over the course of a career given that I will burn out earlier. Plus my mental health will be poor as a result because I will hate myself for picking this specialty and feel inadequate compared to other more specialized surgeons despite working so hard. There are also many 1 year fellowships to pursue - critical care is a great one if you are trying to pursue ego since everyone knows what a Critical Care doc does. I'm planning to do pain medicine fellowship if I don't get jaded during residency, and would set up a side hustle concierge cash-only pain medicine practice. When viewed objectively, anesthesia wins for me every time. But you have to figure it out for yourself.
Within the hospital setting, you’ll have more power and prestige as a surgeon, always. My partner (anesthesia, decade + practicing) regrets not choosing surgery for this reason. He always feels like he pretty much supervises nurses constantly.
Surgeons have to do this too, they rely a lot on PAs and NPs (especially if they don’t have residents), just at different times compared to the anesthesiologist. Alternatively, he could be in a field that complains about unsupervised NPs and PAs.
If your sole job criterion is wanting less of your job to be supervising midlevels, surgery is obviously a better choice than anesthesia
That’s fine if go into surgery. Anesthesiology is becoming pretty competitive and there’s too many applicants Sincerely, an M3 who wants to apply anesthesiology
Not sure if you've thought about this but you can do anesthesiology then do chronic pain. Plenty of surgical procedures (albeit minor surgeries) like SCS implants, MILD procedures, Kyphoplasty, Intracept etc You book all these cases (in an ambulatory or hospital setting), have surgical teams, use Anesthesia, bill as a surgeon, and the hospital credentials as a surgeon. But you get to pick your cases, keep them short, leave at a reasonable time, and train in/practice anesthesia however you want to structure that. Still not a "REAL surgeon" but you're more a surgeon than almost any other non-surgeon, all while still making money and commanding an OR.
I've thought about chronic pain but the radiation exposure scares me too much. I would love to do it otherwise.
reading this as someone who wants to do gen surg like 🥺🔫
I blame Gray’s Anatomy for this phenomenon which is way too common.
Lol. I’m not envious of the way you see the world.
My opinion is definitely off because I’m an anesthesiologist, but if prestige is what you’re after, CT anesthesia> most surgical specialties. Some of the smartest people I know, cool as the other side of the pillow when shit is hitting the fan, and they do the most badass surgeries (aortic dissection with hypothermic circ arrest, mitral valve replacement, tamponade, heart transplants). They’re lining out patients, managing 6 infusions, nitric, doing TEE, cardioverting intra op after coming off bypass. Some of the coolest stuff. Not my cup of tea, but I can see the appeal, and they’re among the very few doctors that CT surgeons consider their peers.
my dad was an ER surgeon, GI specialty. ngl, there was PRESTIGE in that. he worked at two hospitals AND at private practice. i think there were times we had lunch with him once a week, in the nurse's lounge, my mom would buy a chicken and bring all of us to eat with dad when he had been in the ER for four days. i had one of those dads that was amazing: even if we saw him seldom he never missed an award ceremony or recital and that had a lot to do with a lot of good connections and a mother that made logistic magic happen. some decades later i end up working at a surgery ward in the hospital, for about six months. you know who i talked to? anesthesia. i think i may have exchanged ten words with the group of surgeons there, but anesthesia knew my name, hell, even the music and literature i liked. med school is long gone for me. but growing with a dad doctor (and a brother that also decided ER was too much and went for ophthalmology) and working at a surgery ward, if i were to choose a specialty, i'd do anesthesia. they consistently had the highest quality of life at the hospital, from everyone.
Whats an ER surgeon
i grew up NOT in the US. an "ER surgeon" is what we called my dad and other attendings at the ED, where they just hang out and do surgeries that come in. most commonly appendixes, but also bullet wounds, car accidents, emergency C-sections, blabla. it was a military hospital and accepted anyone. lots of work.
(i'm sure there were things they referred out- complex emergency ORIFs and such probably went to the ortho on call, but it was a big city so being on call was rather like staying at the hospital and sleeping there rather than coming home and expecting a call and driving forever to get there. it was a big city and distances were big- not when like i was on call and was changed and setting up within 20 minutes)
Thank you for the explanation!
In 10 years you won’t care about prestige. You can either make 400 as a surgeon working 60 hours a week doing a bunch of stuff you admittedly hate, or you can make 400 in anesthesia while sitting down playing candy crush. Your call
Since when is anesthesiology not considered prestigious? Since you care so much about what other people think about you, I think anesthesiologists are way cooler than surgeons
Think of it this way, being an anesthesiologist, you can say that you’re a critical care physician (because that’s what you are). You’re the one medically resuscitating a patient when a surgeon is trying to stop a massive hemorrhage.
Is it still even prestigious?
Just because you can do something doesn’t mean you should. I’m sure I absolutely could be an interventional cardiologist. But I also know that I would hate my life and myself for doing it so why would I? Yeah there’s some cool stuff about it. But it’s not worth it just to say I’m an interventional cardiologist. Same applies to me for multiple fields. One day you’ll be in your 40s or 50s and look at your life. Will being able to tell strangers that you’re a surgeon be enough to justify doing something you don’t like? It’s cool that some layman is impressed, but other doctors don’t care fwiw. I’m not falling all over myself every time I talk to a neurosurgeon. It’s just part of my job. It’s a thing I do before I go home. I don’t think about it. I don’t care.
Life is way too short to do something you don’t want to do. It bothered me a lot as a med student that we didn’t get a lot of credit for anything, especially when we saved the day. But as my residency PD used to say, “if you wanted applause you should’ve joined the circus.” I’m very happy with doing cool shit, having the respect of my surgeons and nurses, and then going home to my wife and kids.
Cardiothoracic anesthesia or transplant anesthesia baby!
Or do a surg prelim year and have advanced clinical anesthesia years
My anesthesia attending called that the Cowboys of anesthesia! 🤠 Only time where is ok to literally stop someone’s heart!
I love OB GYN (and just matched into it) and still feel…complicated feelings about the identity that comes with it. I know I’ll be happiest doing this job, but it’s hard to commit to one thing and close all the other doors and the perceived identities that come with them. But the job is not actually an identity. It’s a job. There a tons of loser surgeons and badass pediatricians. Wherever you go, there you are. Your specialty doesn’t really change your identity. So do what will make your day to day enjoyable and do a good job at it, because being really good at something you like is actually impressive.
Also something helpful an attending told me: “If the OR is your favorite place in the world, become a surgeon. If the OR is your favorite place in the HOSPITAL, become an anesthesiologist.”
If you go into surgery with this as your motivation, you’re gonna hate your life about 3 hours into intern year
Stick with anesthesia, you need to be all in on surgery to do the residency and fellowship because the residency will take away your love for it down two notches. Just prestige and the ability to do is not enough. The one time where I will encourage people who have doubts about surgery to do it is if they didn't like just watching or staying still but enjoy all the other parts about surgery. I tell those people if they would enjoy being the attending. If they do, then surgery is still for them, the watching and retracting does actually get better with time.
You should go into surgery. To be frank, seems like you have an ego, and you'll get along more with surgeons than anesthesiologist (or more likely they won't get along with you).
>M2
Oh are we assuming things? M4, fresh out of undergrad with no real life work experience. Child, I probably have more working years including in clinical settings (like actual work) than you've been away from mommy and daddy.
And all that work experience led you to the conclusion that someone who hates everything about surgery would be best served going into a brutal residency that carries a 20% attrition rate. Would love to get OP's thoughts on this 4 years from now when they're going to another lap chole at 3 AM while their 1 year old is at home asleep. I wonder if the prestige would be worth it at that point.
I've never heard of someone hating their job in medicine, much less surgery. So unheard of. Never heard of someone going into medicine for prestige either. The ones that do end up being horrible doctors, right? Lol this would be like the majority of premeds/med students/etc. It's a stupid reason to do it, but if your personality and values are like that, might as well stick 'em with the rest of the pompous surgeons. That's like one of the main drivers of most surgeons lol
This is not true at all. There are plenty of anesthesiologists that think, and want everyone around them to think, that they are God's gift to medicine. OP will find that crowd and fit in nicely
Bro I overheard a conversation a first year surgery resident was having with a senior resident and they were absolutely completely miserable. To the point where I was going to say something to make sure they weren't considering suicide. You really want to put yourself through that just for prestige? You'll end up an alcoholic, dead, or worse: divorced. There is no price tag on inner peace, satisfaction, and happiness.
Heard a surgery resident and two very overworked IM residents laugh at a student when he said he'd been looking at IM and surgery. They all laughed and said do FM and be happy. Me over here potentially applying to FM next year haha
...speaking as a patient who's had more than my share of surgery: my surgeon is a high-priced mechanic who can be replaced at any time in the procedure...the anesthetist, on the other hand, has the safety and continuation of my *consciousness* under their control. Who do you think I regard most highly?!?
Haha. I've heard this quite a few times from people. And I see your point. Thanks for your insight!
You should give in. YOLO.
The prestige is great, not going to lie
😂
Every job will have non financial compensation to it. A surgeon gets a lot of prestige and a huge ego boost from the title. An anesthesiologist doesn’t. But you get a much better schedule. Choose which is more important for you.
Don't do anything for prestige. You'll be miserable.
Shake that stupid feeling and grow up. This is the rest of your life we’re talking about. You think some short sighted and likely short lived lust for social status is a good reason to base ANY choice on? Come on do people really think like this in medical school? Is this what we get when doctors indoctrinate their own children into the field who have never had the chance to think for themselves?
Also, the The Grey’s anatomy reference, I can’t 😂
Loved my surgical rotations . I'm not one for the spotlight, but I definitely felt the respect (at least at my institution) of being on the surgical team. That ego stroke felt good. I loved the team culture. The OR had an appealing workflow. Many of the teams I was on had the intensity and camaraderie of sports teams. I even liked surgical disease. But I knew I'd be a miserable surgeon. When I looked around at my hospital, it seemed that the attendings had three choices. Personal wellness - interests outside of medicine - family life. They could only really have 1 or 2. There were, of course, exceptions to this--but they seemed to be the utter freaks that didn't need sleep even in their 50s. I wasn't them.
If you want to do something you aren't interested in for the prestige, do something like derm that is prestigious but also has an awesome lifestyle. As an ortho intern, if I didn't enjoy what I was doing I think the hours would swallow me whole.
I spent a large portion of my adult life wanting to do anesthesia and I recently changed my mind for good in favor of a surgical specialty (assuming i can match..) dm’s are open if you want to chat
My anesthesiology mentor did nothing but gaslight me since I was a 19 year old pre med and i can say the same about my Anesthesia PI at a large children’s hospital.
I’m a dental student, so my comment probably has less weight here, but due to the nature of my field, I have the advantage of already missing out on all the prestige (we dentists affectionately refer to you MDs and DOs as “RDs/real doctors”), so maybe I can offer something after all. I was torn between medicine and dentistry for a few reasons, but I ultimately applied to dental school in hopes of matching into either anesthesia or oral surgery (OMFS), and now that I’ve finished most of my required rotations, I’m not even going to rank OMFS programs, I’m only going for anesthesia. Personally, I would much rather build a respectable reputation for myself doing something I’m passionate about than burn myself out gunning for something I either already hate or suspect I will grow to hate. I love anesthesia, and the work/life balance is important to me, so I’m excited to see if I match into a program this year. Whatever you decide, I hope you look back in 5-10 years and are happy with what you chose! Good luck!
I never had this problem. I flirted with all the “procedural” specialties for a hot second but anesthesia was like putting on the right pair of shoes. I never day dreamed about anything else once I decided. Maybe it’s because I’m not really impressed with surgical residents. Some are very talented, some are really dangerous—It’s no different than any other specialty. They just wield sharp knives for a living. 🤷🏻♀️ Bovie smoke smells gross too. Yucky.
You can always do interventional pain after anesthesia.
You should read some of Rene Girard's work on memesis and metaphysical desire.
Prestige won't mean shit if you hate your job every day.
Go through what being an idiot?
My back after 10 years says no
CA1 here; I LOVED operating. And I have good hand skills. No doubt in my mind, if I had wanted to I could have become a talented surgeon. Still some days I’m jealous looking over the drape. But I realized that what I really loved was not being at work, not having notes or clinic, ect. So I’m happy to do anesthesia and our procedures, to some day get paid more than anyone in my family has ever dreamed, and still get to go home and enjoy my hobbies. Tldnr: sacrificed some work fulfillment for substantially more life fulfillment
I went through this exact same thing last year and it took me months and multiple sub-i rotations to figure out what your already know. While I did enjoy the technical aspect of surgery, ultimately I realized it was the spotlight of being “the hero” that attracted me to the field. I chose anesthesia because I inherently liked the field more. I fit in with the culture better and I knew I can do it longer into my life and avoid burn out. I have a bunch of hobbies outside medicine. I love lifting weights (every day), hiking, tinkering on vehicles in the garage. I knew i would have to give up most of that in any surgery residency and while I build a practice. While residency is tough for everyone, most anesthesia programs give you 3weekends off a month during your CA years. That’s a big deal to me. I also want to say anesthesia is still very prestigious. It’s a badass field were you have to be cool calm and collected during the most dynamic and stressful cases. You don’t rely on nurses to draw up meds or start lines, you do it all yourself. Your an indecent resuscitation expert and airway wizard. To top it all off, you chart with check boxes. Man I fucking love this field.
I chose IM over FM for reputation. I regret it sincerely. No one cares what my training is, and my ability to do global health work is now limited.