In what specific ways is SRNA training inferior to resident training? Are there any procedures or cases that CRNAs aren't allowed to perform? At my institution, I see SRNAs going to the same lectures, grand rounds, M&Ms and this is making me gravely concerned. Also, most attendings don't seem to have a problem with teaching them alongside residents. I've heard and believe that when doodoo hits the fan, physicians are best equipped to handle the situation. However as a ms4, I've never witnessed this personally. In terms of residency, what should I look for in a program that'll best help me combat this threat in the future? I apologize if this comes off as incredibly naive/offensive.
It varies from institution to institution. My program would let CRNAs do spinals and lumbar epidurals (mostly on OB), and arterial lines. Never a PNB or a central line. I never even saw an SRNA until I was a CA3 at night supervising CRNAs who would occasionally have them alongside. They did go to grand rounds but did not go to our resident lectures or M&Ms.
There are a couple big differences in training. For one, the requirements for case types and procedures are waaaaay lower than for anesthesia residents. And even with that, they will frequently have to count procedures/cases that they watched or split with another SRNA. Also, SRNAs pay tuition to attend school, and thus there are financial motivations to open schools and enroll as many students as possible, even if that means the quality of applicant/product suffers.
There are many smart and very technically proficient CRNAs out there, many of whom I would certainly trust to take care of myself or a family member. But if you told me that some random CRNA that I didn't know was going to be taking care of me/family member, I'd be a little nervous just because there is such a huge variety in quality.
I think PGG said something awhile ago about the high end of the CRNA knowledge/skill bell curve overlapping with the low end of the MD bell curve, and I think that's a good description. But I also that the the CRNA bell curve is much wider and flatter.
When looking at a program with CRNAs, you should find out the answers to a couple of key questions. You want a chief or attending making the daily schedule, with resident assignments being first/best. The CRNAs should be breaking out residents for lectures, relief, etc, and not the reverse (residents will occasionally have to relieve CRNAs for call assignments, I get it). You should never be sharing a room with an SRNA. I personally wouldn't want to be sharing non-grand round lectures with SRNAs, either.
This is not to bash CRNAs. I get along well with the vast majority of them. But in an academic institution, their job should be to handle the lower-educational value clinical work and support the department's mission of resident education by getting them out for lectures, etc. In a smaller program, this might mean mostly boring cases (eyeballs, etc). At my program, there were enough cases that CRNAs still got to do big neuro, vascular, onc cases, so it probably wasn't terrible. Regardless, they get rewarded handsomely for their efforts.