Well both have lots of similarities. However, one could not imagine anything more different. Anesthesia is a very dynamic(except for pain-management which is a relaxed, office-based subspecialty)specialty. And one should get into Anesthesiology only if you feel it, know what you're getting into. Mandatory contact with the specialty in med school is so scarce that one can get a very deformed impression on what Anesthesia is. I cannot speak for PM&R. Anesthesia however can be the most rewarding specialty if you really live it. Do not understnd me wrong: each individual might find something else more rewarding; I personally love patient interaction and find it quite rewarding. However, I get bored, hearing the same stories again and again. And I know one day I will hate it. With Anesthesia, after I hated it at start, after 2 years exposure, when I had to leave, I had withdrawal symptoms: found myself going back to the OR, etc. It's true, it was cardiac anesthesia, which is the most interesting, challenging subspecialties in Anesthesiology. (my personal opinion, again)
My advice: get some exposure, see what you like. Than think what's more imortant: life-style, money, etc. For me life outside medicine(family relaxation)is very important. However I cannot conceive a career in medicine outside of Cardiac Anesthesia. And I believe there will be time for both...hopefully
Also, as I said some anesthesia subspecialties can be very stressful as oposed to PM&R or Pain Management. Hours again: Pain is the opposite of Cardiac.
Nowadays, Pain and Regional anesthesia seem to have gained a lot of popularity. Schedules are less brutal thna in Neuro or Cardiac Anesthesia. Again depends what you like...
As for Anesthesia getting more competitve, that's correct. However, medium or good scores and a curriculum of dedication to Anesthesia, can get you in at very good programs. Let's not forget that IMG's are still 50 % of the resident body, and while not all of them are top-notch(as with AMG's) program directors have experience with them, and do not look at them with susspicion. Hell, there're programs who've built their reputation on IMG's work.
