Anesthesiology or Emergency Medicine - A Branch Point
Shyam Lakshmanan, MS4, University of Cincinnati College of Medicine
There often comes a time in medical students’ lives when they have to decide on the medical specialty they will pursue for their life’s practice- what a loaded decision to say the least. It can often come down to two choices, like emergency medicine and anesthesiology, which is a very common branch point I have observed; I encountered this same dilemma and can say settling it takes a lot of hard thought. I used to think I was gung-ho EM, but after more exposure to anesthesiology, I happily made the last-minute switch to anesthesiology. This is my perspective on how it happened and my reassurance to other students that it’s OK to be stuck or to switch.
I had a year’s worth of scribing in an emergency department prior to medical school and I took on research projects in EM when starting school. There were certain qualities that I grew to really enjoy in that field from these experiences. However, from my time shadowing anesthesiology in medical school later on, I realized that anesthesiology offered the same positive qualities I enjoyed in EM. These qualities were the critical moments, team-oriented setting, leadership roles, case variety, acute care, and more immediate gratification in day-to-day patient care. I was stuck for months on how I was going to decide between these two. However, after doing some of my own research into the field, shadowing more, and consulting mentors of mine in anesthesiology, I realized that there are key enticing differences that anesthesiology offers that would keep me more fulfilled in that field.
During one of my several anesthesiology shadowing experiences, I noticed the anesthesiologist walk in and swiftly perform a peripheral line placement, mask ventilation, induction of general anesthesia, endotracheal intubation, and others, all while monitoring the patient’s vitals. Not to mention the various nerve blocks I observed in my other times shadowing. All in all, lots of engaging procedures that were common to the anesthesiology practice but occasional to the EM practice. This was the kind of daily workflow that I was looking for and that I knew would make the days fly by since I’d be consistently engaged with physically doing something to make a difference for a patient. That is a crucial distinguishing factor about anesthesiology that I have come to realize and value.
Additionally, my favorite aspects of medicine that I grew to enjoy are pharmacology and physiology- they appeal to my love for logic/reasoning a lot more than other parts of medicine do. Anesthesiology encompasses these two qualities really well on a daily basis; it would make for a very enjoyable learning experience and practice for my future. Anesthesiology also offers more focused subspecialties in terms of fellowship routes, such as cardiothoracic, obstetric, neurological, etc., through which I could be a master in whichever body system that fascinates me the most; I would not be able to pursue such an avenue in EM.
It was my rather last-minute decision to switch from EM to anesthesiology, but it was after a good amount of introspection and evaluating which qualities I love most in medicine and which specialty could best ensure my day-to-day fulfillment. I am glad to have made the transition and feel more secure than ever no matter how late into my third year it was and what my prior experiences are. I hope this can help ease the concerns of other students who face a similar situation to mine, and I hope that you too can happily decide on your ideal specialty in the end.