Information about Residency Specialties

[Lynnea]

Hi Lynnea - this is Ms.Conception - it has been so long that i've been away from these forums, that I couldn't remember my password and was locked out of the forums, so i've re-registered.

We are Canadian, and our programs / training specialties are quite different than in the US - but I can tell you a little bit about it. In Canada medical students do 4 years of medical education, and then go on to their residency programs - here, Anesthesia is a 5 year program. You would think it would end there - but for the majority of anesthesiologists trained in Canada who have gone on to pass their FRCP, they are now required to do a Fellowship subspecialty - and that can range between where they're hoping to find work - for my husband, this meant one fellowship year of medical educator / medical simulation training (which he did via Harvard) - most of his colleagues have gone on to do cardiac or neuro anesthesia, pain, pediatrics etc.... Where we live, and according to our friends who have moved to other larger teaching centres, they must do a minimum of one year fellowship training post-residency - some centres will not hire until there are 2-3 years of sub-speciality. My husband did his fellowship in med simulation training - and then was told if he wanted a permanent contract, he would need to train further - so he went on to do another 2 years of critical care medicine which he finished this last year.

Lifestyle? I can't speak for everyone - for us, the first two years of Anesthesia residency were pretty low stress, the last three years... not so much - however that was because of demanding schedule (pgy4 and 5 had 1 in 2 or 1 in 3 in house call), plus research, plus grand rounds, plus plus plus and we had two children in second and third year respectively - compounded by a high cost of living and very crappy resident salary - when my husband wasn't fulfilling his clinical and call duties, he was picking up HMO coverage to make some more money. This continued for us because he went on to have to do three more years of training (8 total, post-grad). Now that he is done he practices a .6 in anesthesia (4 OR days, 3 in house call / month) plus 12 weeks of intensive care per year, plus or minus some weeks here and there if he decides to pick up. He now takes about 6 weeks a year holidays. (3 weeks in summer, 3 weeks in winter). Lifestyle is perception though - we had children during residency which really compounded the demand on both of us - for many years I felt very "alone" because he was rarely home, and the six months leading up to his exams were absolute hell - but now that it's all done? Life is great.

I know that in the US anesthesiologists make about 20% less than Canadian physicians, but the income is still very good.
In the US Anesthesiologist many will run multiple OR's with CRNA's assisting, whereas here, anesthesiologists only run the OR they are working in.
It's hard to get a good grasp of things and where they will go in the end - my husband was determined to do neurology or radiology from day one - but when it came to his match, he realized he was much better suited for anesthesia - and then finished that and realized he was much more interested in teaching and critical care - and went on to do that. What they "think" they want... isn't always what pans out - but if you guys can stay grounded and look at the long term and he is really happy in his specialty - you guys will have a lot of fun.

Thank you for your reply! Wow, what a journey you guys have both been through. And to think through it all you have both made it out okay, together! That is wonderful and gives me hope for me and my BF. I hope I can stay strong through it all, as right now I feel so defeated that the guy I want to spend my life with has to now dedicate much of his time to school. I am 27 (he is 24) so I'm starting to hope for marriage and children in the somewhat near future. I know he also wants those things (hopefully on a similar timeline) so we will find a way to make it work. The commitment aspect of becoming engaged and getting married is something I would like moving forward in this journey and is something that is very important to me. If I'm dedicating my life to him and making a lot of sacrifices (which I am okay with because it means we get to be together) I want to know he is just as committed to me, even through school and all that comes with it! Although I am grateful that we do have a fairly open line of communication and we both have expressed our wants and needs and we seem to be compromising as well as we can. I just hope this can continue as school goes on.