Ask An Anesthesia Resident Anything

[PMPMD]

Just curious, how much do you make?

I'm a resident. I earn 7 figures, if you count the 2 after the decimal point.

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[PMPMD]

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?

You need a certain amount of dexterity, as anesthesia is a procedural field. However i wouldnt rule anything out until youve tried it. My opinion is that some people learn procedures faster, while others have to practice more. Its not like we're sewing in CABG grafts after all.

 

[PMPMD]

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.

I dont go to a top residency so i cant say about AOA.

Research in a field is always better than another field. If you are between 2 fields, pick a topic that covers both. For example, if you think you like anesthesia and ER, do a project on airway management, which is common to both.

Away rotations can be useful. You have to be on your A game 24/7, which can be taxing. Its also a good way to see if you like the program.

 

[jvesco22]

What were your opinions/perceptions of Anesthesia before you entered med school and how have they changed now?

 

[PMPMD]

What were your opinions/perceptions of Anesthesia before you entered med school and how have they changed now?

I actually did some OR shadowing and thought that anesthesia looked boring. This was because i didnt really understand what we do, and the thought processes that go on, etc. I feel that anesthesia is a field that's hard to appreciate until you actually do it for yourself. There are many layers to every field. As a med student, I focused on the procedures: intubations, a-lines, spinals, epidurals, etc. As a new resident on my own for the first time, I just tried to keep the patient alive. As a midlevel resident, i learned the various subspecialties. Now, Im focusing on more macroscopic things, like how to run 3 ORs at once.

There is a lot of multitasking in anesthesia, and a lot of the work takes place outside of the OR. this was a surprise to me vs my perception as a med student. Anesthesia is more stressful than the laid back stereotype. Things can go very bad, very quick. When a pt goes asystolic, your own heart may feel like it skips a beat. The motto of our profession is 'vigilance': you gotta watch em like a hawk. There is a trend towards older paients with more medical comorbidites coming to the OR. This makes our role as perioperative physicians even more important. What we do is acute medicine for surgical patients. This is often just as important as the actual anesthetic.

 

[ozzi22]

have you ever had the opportunity to moonlight? and if so, was it hard to find moonlighting opportunities? also where did you moonlight, was at at the OR or ER or clinic? also how much did you make from it?

 

[FlowRate]

How did you decide between similar specialties like ICU (fellowship specialty right?), EM, and TSurg? Was there a decision to be made at all? Pay/Step1/Certainty?

 

[PMPMD]

have you ever had the opportunity to moonlight? and if so, was it hard to find moonlighting opportunities? also where did you moonlight, was at at the OR or ER or clinic? also how much did you make from it?

Our dept has ample internal moonlighting opportunities in the OR and ICU. We make $65-75/hr.

 

[PMPMD]

How did you decide between similar specialties like ICU (fellowship specialty right?), EM, and TSurg? Was there a decision to be made at all? Pay/Step1/Certainty?

Doing the rotations made the decision for me.

 

[ozzi22]

Our dept has ample internal moonlighting opportunities in the OR and ICU. We make $65-75/hr.

thanks

 

[boko]

i know it has been a while since you first entered med school...but how did you make the transition from undergrad to med school more bearable??? you always here how the way you study in undergrad has to be significantly changed because there is just sooo much more material in med school to learn.

btw thanks for taking the time to answere everyones questions!

 

[Snoopy92]

Would you do it again?

 

[PMPMD]

Would you do it again?

Yes, definitely.

 

[PMPMD]

i know it has been a while since you first entered med school...but how did you make the transition from undergrad to med school more bearable??? you always here how the way you study in undergrad has to be significantly changed because there is just sooo much more material in med school to learn.

btw thanks for taking the time to answere everyones questions!

It was a difficult transition for me too. Most of the material in med school isn't all that hard to learn, there's just a lot of it. You need to have excellent time management. I don't think there's a single easy way to go about studying in med school, you have to find a system that works for you.

 

[patel2]

How does compensation work in PP? Do you bill the insurance companies plus get a fee from the surgeon or hospital subsidies? And then do the partners split everything up based on seniority?

Is it difficult to get gigs where you are the exclusive anesthesiologist for a private group of surgeons, like say a group of ortho surgeons or plastic surgeons?

 

[PMPMD]

How does compensation work in PP? Do you bill the insurance companies plus get a fee from the surgeon or hospital subsidies? And then do the partners split everything up based on seniority?

Our billing is based on the surgical procedure, the length of time, and the complexity of the patient. We also bill for procedures such as central lines, epidurals, etc. Yes, many groups receive subsidies from the hospital. Some anesthesiologists are salaried, while others get paid based upon what they bill.

Is it difficult to get gigs where you are the exclusive anesthesiologist for a private group of surgeons, like say a group of ortho surgeons or plastic surgeons?

Usually anesthesiologists contract with the hospital, or surgical center, not directly with a group of surgeons. However, it is possible that an anesthesiologist could work for a plastic surgeon doing office based anesthesia, for example. These are probably a minority of practices though.

 

[Workingonit]

Your awesome. This discussion is so useful.
Anyway. I'm starting a DO school in august (Nycom). Did you work with any DOs or do you know if anesthesiology is DO friendly. It's a speciality I'm very interested in.

Thanks

 

[PMPMD]

Your awesome. This discussion is so useful.
Anyway. I'm starting a DO school in august (Nycom). Did you work with any DOs or do you know if anesthesiology is DO friendly. It's a speciality I'm very interested in.

Thanks

Yes, I would say my residency program is "DO friendly." One of the 2 program directors is a DO, and we have at least one DO in each class. I'm really not familiar with the stats for anesthesia as a whole. But the field is still intermediate in competitiveness, so I don't think being a DO would keep you from getting a spot. Honestly, the DO residents I've worked with have been some of our best residents, and as an added bonus, we get OMM for free!

 

[FiremedicMike]

Two questions

1. Do you know if your program takes comlex only?

2. What types of moonlighting opportunities are available to you, as in what type of work are you doing when you moonlight? On that note, how much time do you really have to moonlight?

 

[Workingonit]

Yes, I would say my residency program is "DO friendly." One of the 2 program directors is a DO, and we have at least one DO in each class. I'm really not familiar with the stats for anesthesia as a whole. But the field is still intermediate in competitiveness, so I don't think being a DO would keep you from getting a spot. Honestly, the DO residents I've worked with have been some of our best residents, and as an added bonus, we get OMM for free!

So helpful.
We definitely need more people like you on SDN. Good luck in your fellowship and thanks again.

 

[PMPMD]

Two questions

1. Do you know if your program takes comlex only?

2. What types of moonlighting opportunities are available to you, as in what type of work are you doing when you moonlight? On that note, how much time do you really have to moonlight?

1. Yes we will accept COMPLEX instead of USMLE (but other programs might want USMLE, so check around)

2. We can work in the OR (basically a continuation of what we do during the day). This is either a late shift (4 hours, about 5-9pm), or an 8 hour Saturday (7a-3p). We can also work in the ICU, usually a 12 hour Friday call or 24 hour Saturday or Sunday. I would say we average about 65 hours a week, so there is some room for moonlighting, but we are bound by the 80 hour ACGME limit.

 

[MCAT guy]

In your opinion, what constitutes a perfect first date?

 

[MCAT guy]

Two follow up questions:

• What is your favorite Cyndi Lauper song?
  
• If you could go to Disney World with any celebrity alive today, who would it be?

 

[synthase]

Two follow up questions:

• What is your favorite Cyndi Lauper song?
• If you could go to Disney World with any celebrity alive today, who would it be?

These "ask a resident anything" threads are the most valuable threads on SDN. Don't come in dropping your BS questions. (You've done this in multiple "ask a resident anything" threads.... so lame)

OP, thank you for posting!

 

[deleted307836]

These "ask a resident anything" threads are the most valuable threads on SDN. Don't come in dropping your BS questions. (You've done this in multiple "ask a resident anything" threads.... so lame)

OP, thank you for posting!

Agreed.

This message is hidden because MCAT guy is on your ignore list.

I recommend it.

 

[MCAT guy]

Agreed.



I recommend it.

 

[MCAT guy]

These "ask a resident anything" threads are the most valuable threads on SDN. Don't come in dropping your BS questions. (You've done this in multiple "ask a resident anything" threads.... so lame)

OP, thank you for posting!

lol. Pre-med angst in full affect. Don't forget to have a little fun and enjoy yourself. Uptight attitudes may help to gain a bit of medical knowledge / slightly higher GPA, but the stress inside will rub off on everyone you interact with.

Don't hold on too tight or take this game too seriously.

 

[synthase]

lol. Pre-med angst in full affect. Don't forget to have a little fun and enjoy yourself. Uptight attitudes may help to gain a bit of medical knowledge / slightly higher GPA, but the stress inside will rub off on everyone you interact with.

Don't hold on too tight or take this game too seriously.

Lol. You completely killed this thread with your nonsense. I am partly to blame for even commenting on your posts but I couldn’t help myself, not on these threads that are so helpful in the sea of drivel that is pre-allo. There are innumerable threads on SDN where you can “have a little fun and enjoy myself”, although my idea of fun is slightly different than yours, which seems to be making pointless posts on anonymous online forums. Leave the “ask an (anesthesia, general surgery, IM) resident anything” threads alone…they’re all we have left. I am hanging on tight and I do take this seriously because I want it and I’m going to be good at it. Oh, and I have a very fun life, just not being an a** posting 100x a day on SDN.
/rant.
Sorry, PMPMD, and thanks again.

 

[MCAT guy]

Lol. You completely killed this thread with your nonsense. I am partly to blame for even commenting on your posts but I couldn't help myself, not on these threads that are so helpful in the sea of drivel that is pre-allo. There are innumerable threads on SDN where you can "have a little fun and enjoy myself", although my idea of fun is slightly different than yours, which seems to be making pointless posts on anonymous online forums. Leave the "ask an (anesthesia, general surgery, IM) resident anything" threads alone…they're all we have left. I am hanging on tight and I do take this seriously because I want it and I'm going to be good at it. Oh, and I have a very fun life, just not being an a** posting 100x a day on SDN.
/rant.
Sorry, PMPMD, and thanks again.

Sorry to interrupt your business talk. Carry on with your very fun life!

 

[RogueUnicorn]

What the **** is going on here

 

[fnsweet]

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.) How "easy" is it to be sued in anesthesia, as in, is it possible to be sued when your best judgement resulted in harm, or would you have to be entirely negligent for a law suit?

2.) What kind of paper work, or records, do you have to do after a case? Or is it mostly just keep the records as the patient is under?

3.) What is a typical day in your program like? (starting with the beginning of your shift to the end of your shift)

Thanks

 

[WholeLottaGame7]

Sorry to interrupt your business talk. Carry on with your very fun life!

FWIW, I laughed at the Cyndi Lauper question. The Disney question, though, was just a bit too edgy...

I thought about starting a "ask an anesthesia intern anything" thread, but then I realized it would just be me b!tching about general medicine patients and counting down the days until CA-1 year starts...

 

[PMPMD]

1.) How "easy" is it to be sued in anesthesia, as in, is it possible to be sued when your best judgement resulted in harm, or would you have to be entirely negligent for a law suit?

2.) What kind of paper work, or records, do you have to do after a case? Or is it mostly just keep the records as the patient is under?

3.) What is a typical day in your program like? (starting with the beginning of your shift to the end of your shift)

Thanks

1. Anesthesia is in the higher liability category. Suits are not necesarily frequent, but probably more common than non-procedural fields. For a lawsuit to be valid, the plaintiff's attorney has to demonstrate that you breached the standard of care, and that in turn led to damages to the patient.

2. We complete a pre-operative assessment of the patient. In the OR, we maintain a record of the vital signs, drugs given, vent settings, procedures done, etc. Postop, we put in PACU orders. So most of the paper work is intraop.

3. Answered in a previous post in this thread.

 

[MCAT guy]

FWIW, I laughed at the Cyndi Lauper question. The Disney question, though, was just a bit too edgy...

I thought about starting a "ask an anesthesia intern anything" thread, but then I realized it would just be me b!tching about general medicine patients and counting down the days until CA-1 year starts...

Thank you. I knew some people out there have a sense of humor... 1 of 2 ain't bad.

Props to your signature.

 

[shaggy alfresco]

From what I can tell, Anesthesiologists do put in 60+ hours per week it seems even after residency. Is it still a ROAD specialty?

 

[MCAT guy]

From what I can tell, Anesthesiologists do put in 60+ hours per week it seems even after residency. Is it still a ROAD specialty?

I hope so, unless A is Allergy or it's ROD now.

 

[muhali3]

From what I can tell, Anesthesiologists do put in 60+ hours per week it seems even after residency. Is it still a ROAD specialty?

Didn't you read the Michelle Au interview by SDN? She works 45-55 hrs/wk. There are a large variety of practice options available.

 

[dbeast]

Lol. You completely killed this thread with your nonsense. I am partly to blame for even commenting on your posts but I couldn’t help myself, not on these threads that are so helpful in the sea of drivel that is pre-allo. There are innumerable threads on SDN where you can “have a little fun and enjoy myself”, although my idea of fun is slightly different than yours, which seems to be making pointless posts on anonymous online forums. Leave the “ask an (anesthesia, general surgery, IM) resident anything” threads alone…they’re all we have left. I am hanging on tight and I do take this seriously because I want it and I’m going to be good at it. Oh, and I have a very fun life, just not being an a** posting 100x a day on SDN.
/rant.
Sorry, PMPMD, and thanks again.

On this note, I have a question for OP: Do you like fun? If so, how much or how little? Do you believe that "having a little fun and enjoying yourself" may take away from your future anesthesia practice?

 

[Biebs]

After your clinical rotations through gas and EM, what drew you closer to anesthesia? I would assume that they both share some similar characteristics: procedural heavy, rapid patient turn-over, multitasking/critical thinking, etc. Just curious to see what you didn't like about EM or what you liked more about anesthesia.

Also, you mentioned IM/Pulm CCM fellowships, what is your take on CCM fellowships after an EM residency? Do you think an EM residency can adequately prepare one for critical care medicine?

 

[jdh71]

Do you think an EM residency can adequately prepare one for critical care medicine?

Of course. Though, if an EM guy wants to be american board certified he has to take an IM critical fellowship, which is two years, as opposed to the 1 year gas and surgery programs.

 

[FiremedicMike]

Is there ever a time where the surgeon attempts to dictate something that would normally be your decision, i.e. a medication administration to correct a physiologic change in the patient. If this does occur, and its not a course you agree with, who has the final say?

 

[patel2]

I have a friend doing his residency at Oschner in New Orleans. I think it's atypical there in that he says on a typical week, he only works 40-50 hours a week, 6 and is out by 230 latest (pretty friendly environment he says, and with lots of case variety since NOLA has a pretty large variety with surgeries and patients).

When ranking programs, do you think places with a "cush" reputation like this are to be avoided? I.e. does the longer the hours per week in a residency ultimately prepare you better for PP so that you are better able to treat complications?

 

[WholeLottaGame7]

Thank you. I knew some people out there have a sense of humor... 1 of 2 ain't bad.

Props to your signature.

Definitely would not have made it (almost) through intern year without a sense of humor.

Also, anesthesiologists overall are fairly laid-back, with the obvious caveat that sometimes **** gets real in a hurry.

 

[PMPMD]

After your clinical rotations through gas and EM, what drew you closer to anesthesia? I would assume that they both share some similar characteristics: procedural heavy, rapid patient turn-over, multitasking/critical thinking, etc. Just curious to see what you didn't like about EM or what you liked more about anesthesia.

Also, you mentioned IM/Pulm CCM fellowships, what is your take on CCM fellowships after an EM residency? Do you think an EM residency can adequately prepare one for critical care medicine?

There is some overlap between EM and anesthesia, but they are really very different. If you're really interested in both, do the rotations and see which one you like more.

I think an EM residency prepares you for CCM fellowship, as JDH said, but keep in mind that this is not yet a well established pathway. There are many posts about this in the CC forum if you're interested.

 

[PMPMD]

Is there ever a time where the surgeon attempts to dictate something that would normally be your decision, i.e. a medication administration to correct a physiologic change in the patient. If this does occur, and its not a course you agree with, who has the final say?

I will never do something that I feel is harmful to a patient, regardless of who asks me to.

 

[PMPMD]

I have a friend doing his residency at Oschner in New Orleans. I think it's atypical there in that he says on a typical week, he only works 40-50 hours a week, 6 and is out by 230 latest (pretty friendly environment he says, and with lots of case variety since NOLA has a pretty large variety with surgeries and patients).

When ranking programs, do you think places with a "cush" reputation like this are to be avoided? I.e. does the longer the hours per week in a residency ultimately prepare you better for PP so that you are better able to treat complications?

Oschner has a good reputation. Most of the programs I looked at were in the middle range of hours. There are definitely workhorse programs out there, many of these are at "big name" institutions. I think you need to look at each programs reputation on a case by case basis.

 

[quimicosoy]

hey there...

1. what do anesthesiologists think about pharmacists?

2. Do anesthesiologists know more about the drugs they use than a pharmacist in a clinical setting?

 

[TheMagician17]

In your opinion, what was the hardest stage so far in your life in terms of transition? High School to undergrad? Medical school to residency? Obviously, it depends on the individual and varies among different scenarios, settings, background, etc, but I would still like to hear some insight, please .

 

[PMPMD]

hey there...

1. what do anesthesiologists think about pharmacists?

2. Do anesthesiologists know more about the drugs they use than a pharmacist in a clinical setting?

1. Pharmacists are great! We consult you often in the ICU

2. The pharmacists I've worked with are very knowledgeable.

 

[PMPMD]

In your opinion, what was the hardest stage so far in your life in terms of transition? High School to undergrad? Medical school to residency? Obviously, it depends on the individual and varies among different scenarios, settings, background, etc, but I would still like to hear some insight, please .

For me, the hardest transition was college to med school.