Ask An Anesthesia Resident Anything

[fnsweet]

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

Are you worried about the effects of health care reform on the future of Anesthesiology? (Over worked, under paid?)

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[bassvp]

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?

From a pharmacist's POV, I think that most physicians in a field with a "narrower" variety of meds (i.e. specialists) will often know more than the pharmacist b/c they actually see the effects of the medication. When you administer a medication 1000 times and some weird side effect pops up, the physician in charge of that is likely to remember. I would say that anesthesiologists know much more about their medications than a pharmacist would...either that, or I don't know as much as I should (which is entirely possible). ;-)

 

[iceman132]

Not sure how to delete >-<

 

[user123456]

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

hi, could you elaborate on why you thought so?
p.s. great thread, thank you for your answers

 

[PMPMD]

hi, could you elaborate on why you thought so?
p.s. great thread, thank you for your answers

Sure. I was an engineering major, which is very different from the type of learning in med school. Engineering = no memorization, all analytical/conceptual. Med school = all memorization, little analytical/conceptual. It took me a while to get used to that.

 

[muhali3]

Sure. I was an engineering major, which is very different from the type of learning in med school. Engineering = no memorization, all analytical/conceptual. Med school = all memorization, little analytical/conceptual. It took me a while to get used to that.

So did your engineering background influence your specialty choice? Is anesthesia a good choice for analytical/conceptually-minded people?

 

[PMPMD]

So did your engineering background influence your specialty choice? Is anesthesia a good choice for analytical/conceptually-minded people?

I'm sure it did at some subconscious level. I was actually set on rads when I started med school due to my interest in the imaging technology. I think anesthesia has some elements of analytical problem solving to it, especially the critical care side.

 

[shahak49]

What abt after residency? Any specific subspecialty?

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.

 

[Limetime]

Thanks for taking the time to create a really helpful thread!

P.S. After having surgery and coming home today with a pain free shoulder after a repeated nerve block, my appreciation for anesthesiologists just increased 1000 points. Thanks again for sharing your thoughts and experiences.

 

[ozzi22]

Thanks for taking the time to create a really helpful thread!

P.S. After having surgery and coming home today with a pain free shoulder after a repeated nerve block, my appreciation for anesthesiologists just increased 1000 points. Thanks again for sharing your thoughts and experiences.

 

[fnsweet]

If you don't want to comment on this it's cool, I just didn't know if you read this or not...

But is health care reform going to impact the practice of anesthesiology?

 

[ozzi22]

If you don't want to comment on this it's cool, I just didn't know if you read this or not...

But is health care reform going to impact the practice of anesthesiology?

dude chill, he is a resident. they dont have much time. its even a big deal having him starting this thread int he first place. thats why we thank him. you shuld try and be more considerate and patient for patience is virtue and without patience you wont make a good Doctor.

 

[PMPMD]

Are you worried about the effects of health care reform on the future of Anesthesiology? (Over worked, under paid?)

I have my concerns about it but it's not a huge issue to me. This will affect all specialties to varying degrees.

 

[Whatyousay]

Sure. I was an engineering major, which is very different from the type of learning in med school. Engineering = no memorization, all analytical/conceptual. Med school = all memorization, little analytical/conceptual. It took me a while to get used to that.

Did your engineering background ever come up during interviews for med schools?

Do you think it helped you in any way during the application process?

Would you say going through engineering in undergrad (the coursework, the tests, etc.) was worth the trouble?

 

[PMPMD]

Did your engineering background ever come up during interviews for med schools?

Yes. It was 8 years ago, so I don't remember the actual questions that came up.

Do you think it helped you in any way during the application process?

Yes, although I can't know for sure.

Would you say going through engineering in undergrad (the coursework, the tests, etc.) was worth the trouble?

This is a complex answer. Engineering majors are definite GPA killers, so you'll have to think hard if this is worth the risk. I really enjoyed the material, and biomedical engineering was very pertinent to medicine. Also, in the event that you don't get into med school, engineering is more marketable than most other premed majors (bio, chem).

 

[Hurricane95]

Thanks for all the answers, very helpful to all those considering the field I'm sure. It's also very reassuring to hear yet another person who is satisfied and happy with his specialty choice. I will be starting my intern year in a couple of weeks and am very stoked.

How much did you enjoy your cardiac rotations? As a med student I shadowed a few during my rotations and they seemed fairly intense compared to other subspecialties.

PS: I also did biomedical engineering as my undergrad, loved it, and am pretty sure that it contributes to the specialty choice. Several of my friends going into anesthesiology also had engineering backgrounds. Must be the combination of analytical process, physiology, and all the technology and tools we play with in the OR.

 

[muhali3]

Thanks for all the answers, very helpful to all those considering the field I'm sure. It's also very reassuring to hear yet another person who is satisfied and happy with his specialty choice. I will be starting my intern year in a couple of weeks and am very stoked.

How much did you enjoy your cardiac rotations? As a med student I shadowed a few during my rotations and they seemed fairly intense compared to other subspecialties.

PS: I also did biomedical engineering as my undergrad, loved it, and am pretty sure that it contributes to the specialty choice. Several of my friends going into anesthesiology also had engineering backgrounds. Must be the combination of analytical process, physiology, and all the technology and tools we play with in the OR.

I consider myself to have an engineer's mind (very analytical/theoretical/conceptual). Are Gas and Rads the main specialties that would be a good fit for such a mindset? I like coming up with my own creative solutions rather than following some pre-defined algorithm for treatment.

 

[shaggy alfresco]

I consider myself to have an engineer's mind (very analytical/theoretical/conceptual). Are Gas and Rads the main specialties that would be a good fit for such a mindset? I like coming up with my own creative solutions rather than following some pre-defined algorithm for treatment.

Err in terms of creativity, Anesthesia ranks low on the list comparatively. I don't say that out of experience but physician surveys of specialties. There is a website (I think buffalo.edu domain) that has the surveys and which allows you to compare these things.

 

[muhali3]

Err in terms of creativity, Anesthesia ranks low on the list comparatively. I don't say that out of experience but physician surveys of specialties. There is a website (I think buffalo.edu domain) that has the surveys and which allows you to compare these things.

Yeah, I looked at it: http://www.smbs.buffalo.edu/RESIDENT/CareerCounseling/pdf/Factors/Creativity.pdf

CCM is relatively high, as is Interventional Rads. I'm assuming these subspecialties are much different in practice than their parent specialties. I'm also not sure of the difference between Pulm-CCM and Gas-CCM.

 

[PMPMD]

Thanks for all the answers, very helpful to all those considering the field I'm sure. It's also very reassuring to hear yet another person who is satisfied and happy with his specialty choice. I will be starting my intern year in a couple of weeks and am very stoked.

How much did you enjoy your cardiac rotations? As a med student I shadowed a few during my rotations and they seemed fairly intense compared to other subspecialties.

PS: I also did biomedical engineering as my undergrad, loved it, and am pretty sure that it contributes to the specialty choice. Several of my friends going into anesthesiology also had engineering backgrounds. Must be the combination of analytical process, physiology, and all the technology and tools we play with in the OR.

I liked cardiac a lot, but ended up liking critical care more.

 

[PMPMD]

I consider myself to have an engineer's mind (very analytical/theoretical/conceptual). Are Gas and Rads the main specialties that would be a good fit for such a mindset? I like coming up with my own creative solutions rather than following some pre-defined algorithm for treatment.

One of my BME mentors said that most go into surgery, rads or anesthesia.

 

[CoolWhipp]

At what point did you notice you developed a quirky sense of humor?

In terms of the doctors you have bumped into, which specialty do you feel is more likely to crack a joke?

 

[Snoopy92]

I've been shadowing a few doctors, and they always end up asking me what specialty I'm interested in. I answer anesthesia and they always reply "wow thats a really stressful residency, are you sure?" So here I am asking you, is it really that stressful? On both your work and lifestyle?

 

[PMPMD]

At what point did you notice you developed a quirky sense of humor?

In terms of the doctors you have bumped into, which specialty do you feel is more likely to crack a joke?

I think I've always had it. It's become more finely honed over the years.

 

[PMPMD]

I've been shadowing a few doctors, and they always end up asking me what specialty I'm interested in. I answer anesthesia and they always reply "wow thats a really stressful residency, are you sure?" So here I am asking you, is it really that stressful? On both your work and lifestyle?

Well its not typically too bad in terms of hours (most are 60-70 hours). Its closer to 80 when we're in the ICU. It is true that anesthesia can be stressful. The OR is a high stress environment, an when things go bad in anesthesia, they can get very bad (unexpected difficult airway, cardiac arrest, etc). It's definitely not as "laid back" as its reputation. There also can be production pressure (high turnover rooms, etc). I don't think its extremely stressful as far as residencies go, just more than the typical perception.

 

[Snoopy92]

Well its not typically too bad in terms of hours (most are 60-70 hours). Its closer to 80 when we're in the ICU. It is true that anesthesia can be stressful. The OR is a high stress environment, an when things go bad in anesthesia, they can get very bad (unexpected difficult airway, cardiac arrest, etc). It's definitely not as "laid back" as its reputation. There also can be production pressure (high turnover rooms, etc). I don't think its extremely stressful as far as residencies go, just more than the typical perception.

I might be asking the wrong person for this question because you're still a resident but for those attendings around you, are they always stressed? The doctor I spoke to said that anesthesia doctors tend to have a ton of stress even after residency because of the chances of malpractice combined with other day duties.

 

[muhali3]

Do you intend to use your BME experience in any tangible way while in medicine?

 

[PMPMD]

Do you intend to use your BME experience in any tangible way while in medicine?

Hmm not currently.

 

[PMPMD]

I might be asking the wrong person for this question because you're still a resident but for those attendings around you, are they always stressed? The doctor I spoke to said that anesthesia doctors tend to have a ton of stress even after residency because of the chances of malpractice combined with other day duties.

I don't think they're "constantly" stressed. The job has its stressful moments, though.

 

[patel2]

What do you do while on relatively long/simple surgeries with fairly low risk of complications? Read? Is it tough not to day-dream in the "bread-and butter" cases when things are just going smoothly?

 

[FiremedicMike]

Discovery fit and health has been airing old episodes of Trauma: Life in the ER (the best medical show ever). I recently caught an episode where they took an abdomen straight to the OR, and when they started to open, blood came pouring out. The surgeon/surgical resident kicked it into high gear and cut the patient from to top bottom and started tossing bowel out in a hurry looking for the bleed. I think they found and repaired it, but my daughter made me turn it off, so I'm not sure .

Anyhow, bringing it back to this thread, in situations like that where there's an internal bleed that's not going well, what is the anesthesiologist's management? Are you frantically pushing meds to maintain BP, infusing blood, etc, or does your pace not change much as you wait for them to repair the injury. Of course I'm sure you can't give me blanket answers, I'm just curious if everyone gets into high gear in these scenarios or just the surgeons.

 

[PMPMD]

Discovery fit and health has been airing old episodes of Trauma: Life in the ER (the best medical show ever). I recently caught an episode where they took an abdomen straight to the OR, and when they started to open, blood came pouring out. The surgeon/surgical resident kicked it into high gear and cut the patient from to top bottom and started tossing bowel out in a hurry looking for the bleed. I think they found and repaired it, but my daughter made me turn it off, so I'm not sure .

Anyhow, bringing it back to this thread, in situations like that where there's an internal bleed that's not going well, what is the anesthesiologist's management? Are you frantically pushing meds to maintain BP, infusing blood, etc, or does your pace not change much as you wait for them to repair the injury. Of course I'm sure you can't give me blanket answers, I'm just curious if everyone gets into high gear in these scenarios or just the surgeons.

In those situations (hemorrhagic shock), we will resuscitate with volume quickly. Hopefully, there are blood products in the room, and there is adequate IV access. Also, having a rapid infuser (Level 1, Belmont) is helpful. There is a good deal of recent evidence that giving plasma and platelets early in the course of trauma resuscitation improves outcomes. But if you are waiting on the blood products to arrive, we would give IV fluids. Pressors are not the ideal way to correct BP in that situation. It's important not to over-correct the BP, since this would exacerbate bleeding. And yes, our pace changes very much. If we "wait for them to repair the injury", the patient will not survive.

 

[FiremedicMike]

In those situations (hemorrhagic shock), we will resuscitate with volume quickly. Hopefully, there are blood products in the room, and there is adequate IV access. Also, having a rapid infuser (Level 1, Belmont) is helpful. There is a good deal of recent evidence that giving plasma and platelets early in the course of trauma resuscitation improves outcomes. But if you are waiting on the blood products to arrive, we would give IV fluids. Pressors are not the ideal way to correct BP in that situation. It's important not to over-correct the BP, since this would exacerbate bleeding. And yes, our pace changes very much. If we "wait for them to repair the injury", the patient will not survive.

And all of these things are being done at the discretion of the anesthesiologist and independent of what the surgeon is doing? If so, that's hot.

 

[Hurricane95]

And all of these things are being done at the discretion of the anesthesiologist and independent of what the surgeon is doing? If so, that's hot.

Yes.

Surgeon does not dictate medical management of the patient.

 

[UACOM-T2017]

Hi @PMPMD

I was wondering why you chose CC anesthesia fellowship over peds, cards, pain, or the other fellowships. I'm interested in CC anesthesia as well as an MS3. What's your practice like? Combination CC/OR, straight CC, or all OR?

Thank you!

 

[Psai]

last seen april 9 2015