Ask An Anesthesia Resident Anything

[PMPMD]

I'm a PGY4 anesthesia resident with 6 weeks left of residency. I will be starting a critical care medicine fellowship in July. Ask me anything you want to know about anesthesia residency.

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[docelh]

Do you ever have moments where you'd rather be the surgeon? Why or why not?

 

[AsianPersuasion]

Do you mind giving a run down of what you do everyday?

Thanks

 

[cliffhuxtableDO]

can you break down your residency year by year, please?

 

[patel2]

I'm a PGY4 anesthesia resident with 6 weeks left of residency. I will be starting a critical care medicine fellowship in July. Ask me anything you want to know about anesthesia residency.

1. Is it essential now days to do a fellowship because of CRNAs? How do you think the profession will change over the next few decades with increasing CRNAs and their powerful lobby groups?

2. Do you want to go into private practice after your fellowship?

3. What are your residency hours like (total number per week, amount of call hours?)

4. What are the dynamics of the OR? Do the surgeons respect/get along with anesthesiologists, or are the stereotypes of surgeons berating ad disrespecting the anesthesiologists true? I have heard from a friend that the ortho surgeons are way more laid back and easier to work with than some others.

 

[HH Holmes]

I'm a PGY4 anesthesia resident with 6 weeks left of residency. I will be starting a critical care medicine fellowship in July. Ask me anything you want to know about anesthesia residency.

What's your usual day like (arrival time/departure time etc...)?

Did you mainly get scut like pre-ops and post ops?

If so, at what point did the attendings leave you as the only anesthesiologist in the OR?

Thanks!

 

[2sk0ol4c0ol]

Hey Nice There should be more of these. I read somewhere that anesthesia residents are required to do a one year surgical or medicinal internship. I wasn't so clear on what was meant by this, or if this was true at all. Does this mean you do the same internship as IM interns or General Surgery Interns? Or does this mean that you choose between using anesthesia during a surgical operation or using anesthesia in a non-surgical environment.

Also I've read about anesthesia fellowships such as pain medicine, pediatric, cardiothoracic, etc. Do you know anything about these fellowships and do you plan on sub-specializing?

 

[PMPMD]

Do you ever have moments where you'd rather be the surgeon? Why or why not?

No, I'm glad to do what I do. When I rotated on surgery in med school, I liked working in the OR, but preferred the anesthesia side.

 

[PMPMD]

Do you mind giving a run down of what you do everyday?

Thanks

Depends on what rotation I'm on. For a typical OR day, we arrive 0615-0630, set up the OR, go to preop the pt, and start the first case by 0715. The day usually ends 1600-1700, but this is variable. The pace of the day depends on how many cases we do. Some days (ENT, cysto, some gen surg) are fast turnover, while others dqys we might do one big case that takes all day.

We also cover the SICU, labor and delivery, pain clinic, pre-admissiom testing (preop clinic), PACU and sometimes we coordinate the ORs.

 

[deleted307836]

How stressful is anesthesia? How often do you find a patient "crashing"? Have you ever dealt with an unexpected death in the OR?

 

[WingedOx]

Do you ever get tired of "SIR!? SIR!? YOUR OPERATION IS OVER. NO! DON'T PULL ON THAT! KEEP YOUR ARM DOWN, SIR?"

Do you realize how truly awesome you all look wearing a surgical gown backwards?


/sorry, had to.

 

[Thornwalker]

I'm a PGY4 anesthesia resident with 6 weeks left of residency. I will be starting a critical care medicine fellowship in July. Ask me anything you want to know about anesthesia residency.

MS0 here.... may I ask how you decided on anesthesiology? What would you say your primary interest was in before starting school and how did that change/evolve when you got on the wards? I've been curious as to how everyone finds out what they want to go into.

Thanks in advance.

 

[PMPMD]

can you break down your residency year by year, please?

The intern year is usually transitional (rotating). It may or may not be at the same place as years 2-4 (prelim+advanced vs categorical). This will usually include medicine, surgery, ICU, and sometimes ED, OB, peds.

The next 3 years of residency PGY 2-4 are called Clinical Anesthesia years 1-3 (CA 1-3). You will usually start out paired with a resident or attending ij the room with you your first month or 2. Then you will be on your own in the OR - but there is always an attending supervising you, but they will not be in the room most of the time.

Throughout the 3 years of anesthesia, you will progress from basic to advanced cases, including cardiac, neuro, peds, OB, vascular, etc. You will do at least 4 months of ICU, and required time in Pain clinic, PACU, and other rotations.

 

[PMPMD]

1. Is it essential now days to do a fellowship because of CRNAs? How do you think the profession will change over the next few decades with increasing CRNAs and their powerful lobby groups?

2. Do you want to go into private practice after your fellowship?

3. What are your residency hours like (total number per week, amount of call hours?)

4. What are the dynamics of the OR? Do the surgeons respect/get along with anesthesiologists, or are the stereotypes of surgeons berating ad disrespecting the anesthesiologists true? I have heard from a friend that the ortho surgeons are way more laid back and easier to work with than some others.

1. I'm doing a CCM fellowship because i like working in the ICU. There is a whole subforum dedicated to CRNA issues so you can read more there. Bottom line: what seperates a MD anesthesiologist from a nurse anesthstist is medical judgement.

2. Not sure. Depends on a lot of factors, but I am leaning toward academics.

3. Our typical hours are 60-70 / week. Some programs are more or less than this. Also it varies by rotation.

4. I have had very few problems with surgeons (could count them with one hand). There are stereotypical personalities, and people who like to yell a lot, but its rarely malignant or directed at me.

 

[cliffhuxtableDO]

The intern year is usually transitional (rotating). It may or may not be at the same place as years 2-4 (prelim+advanced vs categorical). This will usually include medicine, surgery, ICU, and sometimes ED, OB, peds.

The next 3 years of residency PGY 2-4 are called Clinical Anesthesia years 1-3 (CA 1-3). You will usually start out paired with a resident or attending ij the room with you your first month or 2. Then you will be on your own in the OR - but there is always an attending supervising you, but they will not be in the room most of the time.

Throughout the 3 years of anesthesia, you will progress from basic to advanced cases, including cardiac, neuro, peds, OB, vascular, etc. You will do at least 4 months of ICU, and required time in Pain clinic, PACU, and other rotations.

thanks!

 

[PMPMD]

What's your usual day like (arrival time/departure time etc...)?

Did you mainly get scut like pre-ops and post ops?

If so, at what point did the attendings leave you as the only anesthesiologist in the OR?

Thanks!

I answered some of this above. Preop and postop assessments are part of our duty (and required for reimbursement) and not scut.

 

[HH Holmes]

I answered some of this above. Preop and postop assessments are part of our duty (and required for reimbursement) and not scut.

Thanks!

And I meant paperwork, not the actual assessments.

Thanks though, very informative.

 

[PMPMD]

Hey Nice There should be more of these. I read somewhere that anesthesia residents are required to do a one year surgical or medicinal internship. I wasn't so clear on what was meant by this, or if this was true at all. Does this mean you do the same internship as IM interns or General Surgery Interns? Or does this mean that you choose between using anesthesia during a surgical operation or using anesthesia in a non-surgical environment.

Also I've read about anesthesia fellowships such as pain medicine, pediatric, cardiothoracic, etc. Do you know anything about these fellowships and do you plan on sub-specializing?

As above, we can do all medicine, all surgery, or transitional (mix of all rotations). Also, some people switch in from OB or peds, they get credit for the intern year requirement.

I am doing an ICU fellowship, I am moderately knowledgeable about the other fellowships and would be glad to answer specific questions about those.

 

[PMPMD]

MS0 here.... may I ask how you decided on anesthesiology? What would you say your primary interest was in before starting school and how did that change/evolve when you got on the wards? I've been curious as to how everyone finds out what they want to go into.

Thanks in advance.

I came into med school wanting to do ER or rads. I did an anesthesia rotation MS3 year, loved it, and didnt like the other rotations as much. You will find out what you like as you rotate through everything

 

[SarahBellum1]

What type of personality do you think tends toward anesthesiology?

I've shadowed a couple anesthesiologists before, and I've noticed it seems pretty methodical. If there's a problem, there are certain steps you already know you need to take to fix it (generally). If my observation is correct, is this something that drew you to anesthesia? Could it be something that may make you bored after a while?

 

[FlowRate]

I came into med school wanting to do ER or rads. I did an anesthesia rotation MS3 year, loved it, and didnt like the other rotations as much. You will find out what you like as you rotate through everything

Ah those are the two I'm interested in right now, going into med school. Maybe I'll turn out an anes like you =P

 

[PMPMD]

How stressful is anesthesia? How often do you find a patient "crashing"? Have you ever dealt with an unexpected death in the OR?

It can be very stressful if someone is crashing, you can't get the breathing tube in, you have fast turnover cases, or you have sick pts in the ICU. We try to pre-empt disasters by monitoring the pt closely and intervening in a timely manner but there will always be emergencies.

I had one unexpected OR death but it was due to uncontrollable surgical bleeding (AAA gone bad).

 

[CrushMCAT]

I'll go simple.

What are your favorite and least favorite parts of your job?

Thanks.

 

[shaggy alfresco]

What do you think about the future of the specialty with re: midlevels?

 

[PMPMD]

What type of personality do you think tends toward anesthesiology?

I've shadowed a couple anesthesiologists before, and I've noticed it seems pretty methodical. If there's a problem, there are certain steps you already know you need to take to fix it (generally). If my observation is correct, is this something that drew you to anesthesia? Could it be something that may make you bored after a while?

There are really all types: introverts, extroverts, people who are laid back VS OCD control freaks.

Its good to be methodical when dealing with emergencies. For example, for low BP, I run through a list of the possible causes (preload, afterload, contractility, etc). This will help you organize your thoughts. Its important to be able to stay focused when others around you are freaking out and chaotic. If you project a calm, in control presence, it will help avoid escalating a difficult situation.

Anything can become boring after youve done 10,000 of them. I still find interestig aspects to even routine cases.

 

[live911wire]

How hard was it to find residency? (competition wise)

 

[muhali3]

Is anesthesia fun? Is it conducive to having a life outside of medicine (family, hobbies, free time)? How rewarding is the work?

 

[SarahBellum1]

It seems that anesthesiologists have short, really intense relationships with their patients. Do you wish you could have more long-term relationships with them instead?

(I'm interested in anesthesia, btw)

 

[lawdoc]

As you are planning on doing a CCM fellowship, what do you think the main difference between that fellowship versus the IM CCM fellowships (either with or without pulmonology)? I had been thinking about doing the IM route and becoming an intensivist. What do you see as the difference in practice between the anesthesia route and the IM route?

 

[FiremedicMike]

If you don't mind divulging, which program in Ohio did you match to? If you interviewed at other Ohio programs, did you find them to be particularly competitive?

 

[PMPMD]

I'll go simple.

What are your favorite and least favorite parts of your job?

Thanks.

Favorite: i'll give a couple. Variety: we take care of neonates to very elderly, all kinds of surgeries, laboring women, sick ICU patients to healthy outpatients.

Also, we get to see the effects of our interventions quickly.

Least favorite: I don't like chronic pain. But, i never have to do it again.

 

[PMPMD]

What do you think about the future of the specialty with re: midlevels?

You can visit the CRNA subforum in the anesthesia forum for all about this topic. Almost all fields have midlevel providers, anesthesia is not unique in this regard.

 

[PMPMD]

How hard was it to find residency? (competition wise)

Anesthesia is an intermediate competitiveness field. I went to an average med school, and had average stats. I matched into a respectable (if not big name) program.

 

[PMPMD]

Is anesthesia fun? Is it conducive to having a life outside of medicine (family, hobbies, free time)? How rewarding is the work?

I think its fun. But others might not, just like I didnt like specialties that others love.

Anesthesia can be very family friendly. It depends on the group you join. There are practices with no call, but you take a pay cut.

Anesthesia is a behind the scenes field. You have to derive internal satisfaction from knowing you did a good job. No ones going to pat you on the back or congratulate you. So you have to be OK with that.

 

[PremedGunner]

what was your undergrad gpa? i like to know these things...

what determines which residency you get? is it just step 1 scores? does it matter which med school you go to? sorry i'm a beginner

 

[PMPMD]

It seems that anesthesiologists have short, really intense relationships with their patients. Do you wish you could have more long-term relationships with them instead?

(I'm interested in anesthesia, btw)

This is a double edged sword. Anesthesiologists are consultants. When our patients leave PACU, they are on someone elses service. This is why we dont get called all night. But it also means the patient is likely to forget you.

Our encounters with patients are brief, but important. We have to be able to reassure patients who are anxious before surgery. The 5-10 minutes before surgery is the only time the patient will remember interacting with us.

Longer patient interactions is one of the reasons I am doing a CCM fellowship.

 

[muhali3]

what was your undergrad gpa? i like to know these things...

what determines which residency you get? is it just step 1 scores? does it matter which med school you go to? sorry i'm a beginner

You've been on this site for about a year.

http://www.nrmp.org/data/programresultsbyspecialty.pdf

Go to page 13. It'll show you what Gas PDs look at when picking a resident. Generally just from surfing these forums, it seems that Step 1 + grades in core rotations are the most important.

 

[deleted307836]

One more -- how would you compare the rigors of medical school to those of residency?

 

[muhali3]

btw, I like your avatar. Audition was quite a disturbing movie. Miike just came out with a new film, 13 assassins, it's pretty good. /end thread derail

 

[PMPMD]

btw, I like your avatar. Audition was quite a disturbing movie. Miike just came out with a new film, 13 assassins, it's pretty good. /end thread derail

Nice pickup, yes it was an intense film.

 

[PMPMD]

One more -- how would you compare the rigors of medical school to those of residency?

Its very different. The knowledge base is much more clinically focused in most fields. I actually like lecture now that its only 2 hours a week. There is still long hours and hard work, and stress. But I find residency much more enjoyable.

 

[PMPMD]

If you don't mind divulging, which program in Ohio did you match to? If you interviewed at other Ohio programs, did you find them to be particularly competitive?

I'm at Case Western/University Hospitals. This was the only Ohio program I interviewed at.

 

[PMPMD]

As you are planning on doing a CCM fellowship, what do you think the main difference between that fellowship versus the IM CCM fellowships (either with or without pulmonology)? I had been thinking about doing the IM route and becoming an intensivist. What do you see as the difference in practice between the anesthesia route and the IM route?

I think they all prepare you to be an intensivist. I think each pathway has its own strengths. Keep in mind that anesthesia CCM fellowships make up only about 10% of the total fellowship spots. Typically, anesthesia trained intensivists staff SICUs or mixed ICUs. I think the main question to answer is how would you like to spend your non-ICU time, in pulm clinic, or in the OR. For me, I didnt decide on CCM until I was already in residency, so it was a non-issue.

 

[muhali3]

Are you a guy or a girl? ...sorry, I had to ask.

edit: i know now after reading your post history.

 

[ozzi22]

thank you for this thread. it's full of win

 

[PMPMD]

Are you a guy or a girl? ...sorry, I had to ask.

edit: i know now after reading your post history.

Yeah the avatars misleading. As you figured out, Im a white guy, not an Asian girl. I would change it, but j love the movie and it seems anesthesia related.

 

[muhali3]

Yeah the avatars misleading. As you figured out, Im a white guy, not an Asian girl. I would change it, but j love the movie and it seems anesthesia related.

yeah i have a preference for female avatars as well...

 

[DocTraveler]

Would you say that AOA membership or research is important for matching into a top anesthesia residency? If research is important, does the topic or subject matter?

Also, do you think away rotations in anesthesia are important?

Thx! I love this thread.

 

[BlackHouse]

Just curious, how much do you make?

 

[thebluesteye]

How essential is mechanical dexterity to what you do on a day to day basis? If you don't have it, should you basically just rule out anesthesiology as a possible career option?