Anesthesiology: It Doesn't Fit!

I'd like to think that the universe is fundamentally based on order. The physicists have already tackled this question, from Einstein's relativity ("God does not play dice") to more modern quantum mechanics and its uncertainty.

Still, things tend to fit into a sensible world-view, right? Those who work hard get rewarded and those who are lazy end up on the bottom.

We all know that life isn't by any stretch of the imagination fair, and that the world often works in chaos-mode. Kids starve in Africa, bad things happen to good people, the hard-working go unrewarded and the hero goes unsung.

In medical specialties, I came to the realization that things do have an internal order. The specialties with a better lifestyle/income are predictably harder to match into because of competition resulting from too many students vying for few coveted spots.

"Better/Lifestyle" specialties equal harder to get while "Not-so-fun/lower-income" specialties *cough* Family Medicine *cough* are easy to match into because "nobody" wants them. It makes sense...work hard to match into dermatology, get the 9-5, Monday-Friday hours, no call, and (extremely) high pay. Screw around, mess up your USMLE Step I score, and get matched into FM with long hours, call, and lower pay.

But someone has messed up my lofty world-view!

Anesthesiology! You dastardly creature! I do not get you...

From what I hear, you are (relatively) easy to match into, pay well, have super hours, are definitely a "lifestyle" specialty, and don't even have many litigation issues. Wait...easy to match into? How does that work? One of my EM-bloggers, EM Physician, puts it so eloquently:

For one, [anesthesiology] was a very easy specialty to get into. Not a whole lot of butt kissing involved. The salary was great. The job market, wide-open. It was known as a ‘life-style’ specialty, which allowed time to enjoy life outside of medicine, and that appealed to me. Anesthesiologists only deal with one patient at a time, and they sit all day (and read magazines) behind the curtain. What a life!!

So that's what I hear...the 90% boredom, 10% super-crazy life of the anesthesiologist. And medical students don't know anything about the specialty unless they do a rotation on it during medical school. Is it a closely-guarded secret? Is it a conspiracy? Is there a hidden evil in the specialty that nobody knows about?

*shakes head* I just can't accept this. A lifestyle specialty like that, so easy to match into. What ails it? An uncertain future (all of medicine faces this, though)? Encroachment from mid-levels?

Anesthesiology, you puzzle me with your defiance of logic. At the least, you make me very curious. I do not know what I want to specialize in, but I hope to unlock your secrets one day. That's for sure.

Waiting

So I've been around the "blogosphere" lately, reading blogs from medical student to attending. I even ran across the blog of a girl who is a pre-med, detailing her daily life as a health-sciences student shooting for a spot at Medical School. For now, I am the only "MS0" blogger that I know of (that's MS-Zero; Medical Student, year zero, a denomination for those accepted but not yet started). There aren't too many MS0 bloggers, simply because it is a very temporary status that kids only ever have for perhaps 3-9 months.

I am finishing up my very last class for college, and I have to say it is a nice, refreshing break from everything else. One week from this moment, Wednesday, May 16th, 2007, I'll be officially in summer vacation at last! I plan on working only part-time at my research lab, then shadowing a few docs in (hopefully) some different specialties. Kids on Student-Doctor Network give the advice of shadowing while you can because, unlike rotations, you get a unique glimpse into physician life at a private/community hospital as opposed to a gigantic teaching hospital. Even as such, they make the important point that you can never truly step into someone else's job even for a moment. Think about watching a grandmaster play chess; you see him/her move pieces every once in awhile...easy job, right? The mental aspect of being a physician is probably far more than half of the job and its stresses. Watching an anesthesiologist sit in the OR might lead me to believe, "what an easy and boring specialty!" but I must remember that the anesthesiologist is (hopefully) running through 100s of scenarios in his/her head, utilizing the years of training they've received.

Nonetheless, I look forward to sitting around the local ED overnight or on a busy Sunday, seeing once again all the crap that Dr. Emergency has to deal with. I hope to see some oncology-related docs, as we have a very good cancer center in my town.

But you know what? At this point, you kind of sit down and breathe slowly, relieved, having passed the toughest part: getting in. I believe that those of you out there who really understand what you are getting into will be happy from that point on. Medicine's future is uncertain, bureaucratic systems and legalities creep in on all sides, but those of us with the fortitude to take the beatings and belief that this is what we are meant to do no matter what, will keep marching. Just read Hoover's article posted on medschoolhell.com to get an idea of how much you trudge through just to get in (and that's just the beginning of the floggings you'll take).

I think the best thing you can do as an MS0 is to mentally prepare yourself. And I do not mean studying Grey's Anatomy all summer. I mean:

-look into the field of medicine in general
-ask questions
-read through medschoolhell to learn about all the bad stuff in medicine
-search yourself
-meditate
-vacation
-see friends and family
-read the blog of the depressed ER doc who suffers multiple law-suits and burn-out
-search yourself again and ask, "am I ready?"

The idea is to realize that medicine is exactly what you want to do, and all you want to do. This is how I have arrived at the point where I am. I am, on some level, the doe-eyed, idealistic, hopelessly optimistic pre-med that everyone starts out as. At the same time, I am doing my best to keep informed, get different perspectives, and make sure that there is nothing else I want to do. Is there? Not a thing (besides "Lead Game Programmer" and "Rock Star"). These soul-searching questions are certainly things to ask yourself before you even apply; I did those things then. But just as much after acceptance and through the training process, these are things to always be aware of. If you can take it, warts and all, then you're one of the few who will lovingly shoulder the burden of medicine and commit yourself to a lifetime of its practice.

I got my class schedule...I start a week and a half earlier than I anticipated. I'm game, are you?