Not feeling the ICU...

[SierraMist14]

So I decided on Anesthesia late in my third year. I like the procedures, the acute care, no rounding with a team, and the phys/pharm. Yes, I'm aware of the gloom and doom for anesthesia but there was nothing else I was remotely interested in and I wasn't going into a specialty that I wasn't crazy about. With that said...

I just started my intern year in the ICU and I'm not really feeling it. Is this a red flag that I won't like anesthesia? I know with anesthesia there are different routes you can take as far as academics, Private practice, different fellowships, etc. Do any of these routes give me the option of never working in an ICU? I want to either do peds anesthesia, go into PP or strictly work in an OR.

---

Members don't see this ad.

 

[psychbender]

The only way that you would work in the ICU after residency is if you specifically did a fellowship for that. Most residents don't particularly care for the unit, usually because they dislike rounding and writing notes. Unit months can be incredibly valuable, however, as they teach you how to take care of high acuity patients for more than just the brief intraop period. It is helpful when getting patients from, or destined for the ICU, as you have a better understanding of what is being done to them, and the overall treatment goals/endpoints.

Sent from my SM-G920V using SDN mobile

 

[pgg]

ICU rotations as a med student or intern can be hit or miss.

You're doing a lot of scut, you don't have a lot of experience (you've been an intern for what, 3 days?), you might not be appreciating the details of the plan, the nurses treat you like a dangerous wild animal, the RTs won't let you touch the ventilator, and maybe the senior residents and attendings don't value your opinion.

Give it some time. You don't have to love the ICU and want to work there.

 

[2Fast2Des]

I had SICU early in my intern year, absolutely hated it, mainly because I had no clue what was going on. Back as a CA1 after having some OR/anesthesia time under my belt, it went much better and I didn't dread waking up every morning. Still dreaded rounding, notes, consults.. Aka IM stuff but management wise it becomes a bit easier since I learned how the icu was kind of an extension of the perioperative period and having the pharmacological experience from the OR made me have a know how of how to correct issues. I still would never want to do it as a career because rounding and notes and too IM-y for my taste.

 

[Thepassageofgas]

So I decided on Anesthesia late in my third year. I like the procedures, the acute care, no rounding with a team, and the phys/pharm. Yes, I'm aware of the gloom and doom for anesthesia but there was nothing else I was remotely interested in and I wasn't going into a specialty that I wasn't crazy about. With that said...

I just started my intern year in the ICU and I'm not really feeling it. Is this a red flag that I won't like anesthesia? I know with anesthesia there are different routes you can take as far as academics, Private practice, different fellowships, etc. Do any of these routes give me the option of never working in an ICU? I want to either do peds anesthesia, go into PP or strictly work in an OR.

I'm a CA3 and I can assure you, ICU days are nothing like OR days. For one thing, you won't find yourself on endless, droning rounds while you're in the OR (can you tell i hate rounding?). We have to do some ICU as upper-levels, but it's for your own good--we are supposed to be the critical care expert in the OR. Maybe you aren't doing tons of procedures now, but I get lines almost daily on critical care rotations. Try to soak up all the physiology you can now, and when things get too brutal, just go to your happy place

(cue "everything is awesome" )

 

[SierraMist14]

Thanks guys. After some reflection I 've come to the conclusion that it's not the medicine of the ICU that I don't like (Some of it is quite interesting) I think it's just the intern work that sucks. It's still early though so I just have to tough it out.....still not going into a critical care fellowship though, lol.

 

[RK.md]

(cue "everything is awesome" )

Haha, right on!

There are so many different ICU arenas with tremendous diversity between them (ie, a MICU is not the CT-ICU, etc.), but as mentioned above, many residents just don't like the aspect of rounding or note writing. Talking to CCM fellows... writing notes is usually the job of the... you guessed it... interns! The fellows get to run rounds, oversee procedures, and expand their knowledge of pathophysiology and evidence-based practices.

You hit the nail on the head - it's still early, so just tough it out and learn as much as you can!

 

[AdmiralChz]

I had two rotations of ICU in my intern year, and I remember thinking this exact thing during my second rotation. ICU can be great as a medical student because you feel like you can contribute on rounds and help out with procedures if you have an awesome senior resident not looking for procedures, but as an intern it can be rough with the scut as others have said. This is ESPECIALLY true the first month of internship, where you are probably having trouble just PUTTING IN orders, much less making sure they are right! Keep at it, you may change your mind going forward.

Also, ICU is nothing like the OR