Three months in and completely burnt out

[burnoutman]

Burnt out.

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[Noyac]

This may come across as a but critical as maybe it should. If you are burnt out already then you need to look for another specialty. An easier anesthesia program will be of no service to you and then you will enter practice bitter and dangerous. Anesthesia is not for people who can't do long hours at times and stressful cases at times.

Well I guess you could do pain.

 

[20x20]

I am not a resident yet, but I would suggest you evaluate the whole situation. The burn out may not be due to anesthesia or the specific program. Instead, you might just be having a difficult time transitioning from intern year to CA1 year. Talk to your fellow residents and see if they can give you advice about handling the work load at your specific program. Talk to your attending or PD for advice. I am sure they have seen and helped other past residents who had difficulty in the beginning. Can't hurt to ask them for guidance/assistance. They all want to see you succeed.

 

[pgg]

There's not a lot of info in your post. What qualities do you think will be different at another program? What do you mean by burnt out?

Hours too long, and you're tired?

Malignant pimping?

Are you leading your class in sentinel events?

Problems with life outside of medicine?

Do you have a history of depression or anxiety or anything along those lines?

As a new CA1 the learning curve is steep but it stays steep for a long time. Residency is a grind. We all felt beat down at one time or another.

Most likely, a different anesthesia program is not the answer. If you can't get through this rough time, anesthesia might not be right for you.

 

[BuzzPhreed]

Suck it up. Or get off the ship.

 

[BLADEMDA]

Burn Out as a CA-1? No such thing. You are confusing the subject of Burn-Out with getting your ass whooped as a Resident. They aren't the same thing.

My partner suffers from Burn Out but he has been at this gig for 30+ years. I feel it too at times but I'm over 20 years in Private practice.

Burn Out with less than 10 years post residency shouldn't happen and it certainly shouldn't be a factor during Residency.

 

[BobBarker]

Letme make this easy on you.

1. Your attending puts the patient to sleep.
2. You put the tube between the cords.
3. You keep the patient asleep.
4. You keep the vital signs within normal limits.

 

[BuzzPhreed]

You are confusing the subject of Burn-Out with getting your ass whooped as a Resident. They aren't the same thing.

Exactly!

Honestly, we don't need people like this in our specialty. If you can't handle the heat, get out of the kitchen. It takes a certain kind of personality, a mix of laid back and knowing when to "step to the mic with Micatin", to be successful in this profession. If you're whining after only three months, newsflash...

 

[kazuma]

Its actually not that uncommon to feel like quitting around this time CA1 year, we were told we'd feel that way we I started. In fact I occasionally had some crazy thoughts pop into my head around Oct/Nov CA1 year. Crazy things like switching programs, CT surgery etc. Hindsight that would have been a terrible idea and I couldn't be happier now.

The first six months suck for the most part and its a pretty rough transition with more liability and responsibility placed on you than residents in any other field.

I'd give it a few more months before you try to jump ship to a different program or specialty. Chances are that other programs will have the same problems as your current shop, maybe even worse. Anesthesia is a good gig, I enjoy it and I couldn't imagine doing anything else. Once you gain more experience and become more confident, skilled and quick, things get better.

 

[BuzzPhreed]

There were a couple of residents that dropped out of Anesthesiology in my class for various reasons (incompetence, bad fit, not the "ROAD" specialty they thought it was going to be, couldn't handle being the keyboard player in the band and not the lead singer, etc.). It's better to recognize this earlier rather than train a pencil-pusher who's going to kowtow to the CRNA overlords.

 

[caligas]

"You hate your job? There's a support group for that. Its called everbody, we meet at the bar."

-Drew Carey

Seriously though, give it a year, you will feel better with some experience and confidence. Dont leave the best specialty in medicine.

 

[deleted126335]

Agree with the consensus. This may not be the specialty for you. Possible exception if this is an extremely gung ho malignant program that just doesn't suit your personality.

 

[urge]

I'm a burnt out ca-1 at a strong program. Stupidly, I matched here because of the location and their outstanding fellowship matches. However, I'm burnt out and want out ASAP. How hard is it to a) find a more friendly program? b) match there. c) get a decent private practice job after doing that?

Can I look for programs without alerting the program director?

Unless you tell us why it is that you are unhappy, we cannot help you. What I gather is that you seem to think that your program is "unfriendly". I don't know what that means.

Switching programs from strong to mediocre is a red flag for jobs.

 

[anbuitachi]

which program is this??

 

[BuzzPhreed]

which program is this??

Irrelevant.

This is a common feeling among many residents in any given program at this point in their training. It either gets better, or it gets worse. Most don't openly gripe about it on a forum though.

I'm advocating (again) sucking it up and getting more comfortable with the "flow" of how things go in the OR. There is a lot to know and do when you first start and, yes, it can be overwhelming. As you continue your training it gets easier. You understand that "flow" and the expectations and what constitutes good effective care. By the end, you are doing cases with aplomb and wishing the attendings would just get out of your hair and leave you alone. At some point, you realize that you are (honestly) better than a lot of them are.

But, for some... they squeak through. They're miserable. They hide it for the entire three years. Then, they get out and they make the worst, most unreliable, and laziest anesthesiologists. I imagine that many of them go into hiding behind a bunch of CRNAs. And those same CRNAs can smell it a mile away.

As I said already, we don't need more people like that in our profession. If this poster is having serious doubts -- serious enough to come post on this forum already -- then just leave the training and go be some other kind of doctor. It's not going to be better anywhere else. If it is, they aren't training you properly... and you're still going to suck as an anesthesiologist.

 

[GassmanMD]

Irrelevant.

This is a common feeling among many residents in any given program at this point in their training. It either gets better, or it gets worse. Most don't openly gripe about it on a forum though.

I'm advocating (again) sucking it up and getting more comfortable with the "flow" of how things go in the OR. There is a lot to know and do when you first start and, yes, it can be overwhelming. As you continue your training it gets easier. You understand that "flow" and the expectations and what constitutes good effective care. By the end, you are doing cases with aplomb and wishing the attendings would just get out of your hair and leave you alone. At some point, you realize that you are (honestly) better than a lot of them are.

But, for some... they squeak through. They're miserable. They hide it for the entire three years. Then, they get out and they make the worst, most unreliable, and laziest anesthesiologists. I imagine that many of them go into hiding behind a bunch of CRNAs. And those same CRNAs can smell it a mile away.

As I said already, we don't need more people like that in our profession. If this poster is having serious doubts -- serious enough to come post on this forum already -- then just leave the training and go be some other kind of doctor. It's not going to be better anywhere else. If it is, they aren't training you properly... and you're still going to suck as an anesthesiologist.

He can always go into academics....


Just kidding! Just kidding...

 

[BuzzPhreed]

He can always go into academics....


Just kidding! Just kidding...

(In the meantime, I'm just trying to figure out how I can get the same connection to the guy that provides the beer to you in your avatar. I've got a four-pack of Heady Topper in the fridge right now, but I'm still jealous.)

 

[DermViser]

This may come across as a but critical as maybe it should. If you are burnt out already then you need to look for another specialty. An easier anesthesia program will be of no service to you and then you will enter practice bitter and dangerous. Anesthesia is not for people who can't do long hours at times and stressful cases at times.

Well I guess you could do pain.

I guess Anesthesiology isn't a ROAD type specialty after all?

 

[pgg]

This is a common feeling among many residents in any given program at this point in their training.

The first 5-6 months of my residency were kind of rough. At times I thought I was being treated poorly. Even in retrospect, I think I was, by a couple of attendings. Two of them, if I ran into today, I probably wouldn't speak to.

I think some people get broken by this. It pissed me off and made me want to prove I was good enough. I'm not sure if I'd have read as much or worked as hard as I did if not for those two jerks giving me a hard time.

It either gets better, or it gets worse.

There it is. It got better for me, as it does for almost everybody.


Here's what you do, burnoutman - either
1) Prepare to leave the specialty for another. But even if you do this, you need to keep working hard and try to excel, because any future program director is going to talk to your current program director.

or

2) Double your efforts the next two months. Put aside just about everything else in your life. Go to bed early. Get up early. Read, read, read. Get to the OR early and make sure your day's setup is perfect. Spend as much time on your preops as you need to ensure your pre-case presentations to your attending of the day are smooth and complete and as good as they can be. Read more, do practice questions. In a couple months you'll take the AKT-6. Kill it. Just kill it. No excuses, no "I'm a bad standardized test taker" just kill it. Sometime around January your score will come back, and if it's 90+ all those attendings who are giving you **** now will believe you're a genius and they'll remember how squared away you were the last two months. And from then on you'll be golden, off the radar. And because you worked so hard the preceding few months, you really WILL be as good as they think you are.


In other words, whether you stay in anesthesia or you don't, the only decision and course of action you won't regret a year from now is what BuzzPhreed said:

I'm advocating (again) sucking it up

The only exception to the truth of this would be if, as I mentioned earlier, you are depressed and need treatment. In which case the time to get help is right now. But the forum can't help with that.

 

[BuzzPhreed]

The only exception to the truth of this would be if, as I mentioned earlier, you are depressed and need treatment. In which case the time to get help is right now. But the forum can't help with that.

Well, yeah, good point. Thanks for bringing that up. That (hopefully) goes without saying. And, of course, nothing to sniff at. You get can get beat like a red-headed stepchild in residency, and no one likes it. It can wear you down. Don't let it break you. Or, worse, let it be the genesis of a mental illness.

 

[Planktonmd]

Put on your big boy panties and suck it up!

 

[anbuitachi]

this actually came up during my interview at a decent school in nyc. he told me in Ca1, its stressful, a lot more stressful than what students were expecting when they chose anesthesiology. he said in CA1 residents are just trying to survive. after that it gets better

 

[deleted171991]

I guess Anesthesiology isn't a ROAD type specialty after all?

It is. As in you feel like a road as everybody else steps on/over you.

 

[KPride]

Irrelevant.

This is a common feeling among many residents in any given program at this point in their training. It either gets better, or it gets worse. Most don't openly gripe about it on a forum though.

I'm advocating (again) sucking it up and getting more comfortable with the "flow" of how things go in the OR. There is a lot to know and do when you first start and, yes, it can be overwhelming. As you continue your training it gets easier. You understand that "flow" and the expectations and what constitutes good effective care. By the end, you are doing cases with aplomb and wishing the attendings would just get out of your hair and leave you alone. At some point, you realize that you are (honestly) better than a lot of them are.

But, for some... they squeak through. They're miserable. They hide it for the entire three years. Then, they get out and they make the worst, most unreliable, and laziest anesthesiologists. I imagine that many of them go into hiding behind a bunch of CRNAs. And those same CRNAs can smell it a mile away.

As I said already, we don't need more people like that in our profession. If this poster is having serious doubts -- serious enough to come post on this forum already -- then just leave the training and go be some other kind of doctor. It's not going to be better anywhere else. If it is, they aren't training you properly... and you're still going to suck as an anesthesiologist.

As a practicing CRNA (and MS III), I can say this is very true. If anesthesiologists want to secure they place in anesthesia, these lazy, incompetent anesthesiologists need to be whipped into shape or be sent to the corner to lick their wounds. It is probably the only way to win the specialty back. IMHO. As for the OP, if it is depression, seek help. If the workload seems too much, give it until the end of CA 1. If it gets better, CONGRATULATIONS, you made it (at least until you get to CV and peds). If it gets worse, go find something that makes you happy.

 

[BuzzPhreed]

As a practicing CRNA (and MS III)...

Assuming you're going into anesthesiology (?).

Get back to us in 6 years and tell us if "you didn't know what you didn't know."

 

[KPride]

Assuming you're going into anesthesiology (?).

Get back to us in 6 years and tell us if "you didn't know what you didn't know."

Heard about that article. Yes, I am going into anesthesiology. Obviously I see there is a big difference (and I am not talking about money) between the two professions which is my reason for returning to school. I also think that the majority of CRNAs have no problems with anesthesiologists (other than some of your colleagues can be very disrespectful and condescending while being a complete idiot in the OR -- how can you NOT know how to intubate or start an IV?) and have no desire to "takeover" the specialty. They just want to come to work, do a damn good job, be recognized as the good providers they are, and take their butts home. There are very few who want to be doctors and those that do, we go back to school. But yes, in 6 years, I am happy to update you.

 

[GassmanMD]

In a couple months you'll take the AKT-6. Kill it. Just kill it. No excuses, no "I'm a bad standardized test taker" just kill it. Sometime around January your score will come back, and if it's 90+ all those attendings who are giving you **** now will believe you're a genius and they'll remember how squared away you were the last two months. And from then on you'll be golden, off the radar. And because you worked so hard the preceding few months, you really WILL be as good as they think you are.

This is what worked for me. 90%tile and above on the AKTs/ITE and your attendings can't touch you!

Buzz, you could trade those heady toppers for almost anything. They are liquid gold in a can! some people will pay up to $70 a can, no joke.

 

[BuzzPhreed]

I also think that the majority of CRNAs have no problems with anesthesiologists (other than some of your colleagues can be very disrespectful and condescending while being a complete idiot in the OR -- how can you NOT know how to intubate or start an IV?)...

Not my personal experience with the younger ones. And, you're close enough that you can now include yourself as one of our colleagues. Aside from that, if a CRNA can't efficiently start an IV or intubate someone then they shouldn't be in the OR. Forget the fact that many of the newer ones want to do regional and put in central lines, etc.

Buzz, you could trade those heady toppers for almost anything. They are liquid gold in a can! some people will pay up to $70 a can, no joke.

Trade 'em? Hell no! I'm going to drink 'em!

 

[GA8314]

Dude, this field is not for everyone.

Even routine, B&B cases can be stressful at times. Being intuitive for anesthesia, able to handle periods of great stress, and be good at the art of this gig is important. Granted, this is learnable, but it's often under appreciated I think.

 

[deleted171991]

This is what worked for me. 90%tile and above on the AKTs/ITE and your attendings can't touch you!

+1 from another lazy, good for nothing anesthesiologist, or whatever Buzz called people who felt miserable in a malignant program.

Don't despair, kids, there is light at the end of this 3 year-long tunnel.

 

[KPride]

Not my personal experience with the younger ones. And, you're close enough that you can now include yourself as one of our colleagues. Aside from that, if a CRNA can't efficiently start an IV or intubate someone then they shouldn't be in the OR. Forget the fact that many of the newer ones want to do regional and put in central lines, etc.

I was actually referring to the docs that can't intubate or start IVs. You'd be surprised by how many they are like that. There was a guy in my class that joined the AIG so I asked him why he wanted to be an anesthesiologist. He said he wanted a job that paid a ****load of money without him having to work. He just wanted to supervise CRNAs. That's how the specialty became endangered; because of anesthesiologists with that same mentality. If more MDAs would actually do some work and quit playing Soduko and shopping online in the breakroom, CRNAs wouldn't have room to takeover. If you train somebody to do your job and leave them alone to eventually do your job better than you, then they will probably think they are as good or better than you. I worked with a set of docs that did at least 50% of their own cases. I respect those guys and gals so much and they made me want to do more, be more. They were damn good at what they did and a CRNA would never be able to replace them!

 

[ranvier]

Doing well on ITE/AKT is an excellent investment.

 

[deleted171991]

Doing well on ITE/AKT is an excellent investment.

There is a study which shows that anesthesia residents who pass their ITEs in all 3 years have a 90+% statistical chance to pass the written boards on first attempt.

 

[lyn2006]

Buzz, you could trade those heady toppers for almost anything. They are liquid gold in a can! some people will pay up to $70 a can, no joke.

Ha, we just had our chimney swept and gave the guy some of our heady topper since he did such a great job - I always forget how lucky we are to live near such great beer (as we get ready to drink 5 growlers of Hill Farmstead beer this week also... you should check it out if you haven't already)

 

[BuzzPhreed]

Ha, we just had our chimney swept and gave the guy some of our heady topper since he did such a great job - I always forget how lucky we are to live near such great beer (as we get ready to drink 5 growlers of Hill Farmstead beer this week also... you should check it out if you haven't already)

I officially hate you.

 

[GassmanMD]

I officially hate you.

Second that!!!! Ugh if you only knew what I go through to get fresh heady shipped across the country ...

 

[courtnes]

Ha, we just had our chimney swept and gave the guy some of our heady topper since he did such a great job - I always forget how lucky we are to live near such great beer (as we get ready to drink 5 growlers of Hill Farmstead beer this week also... you should check it out if you haven't already)

+5000 points for UVM come rank list time.

Sorry, OP - for you: get help, if you need it. Figure out if anesthesia really is for you. Good luck, regardless of if it is or isn't.

 

[Hockeyguy]

jesus 3 months

 

[fakin' the funk]

Burnt out.

I'm shocked at how much advice and speculation there is on this thread when WE HAVE NO INFORMATION other than the OP is burnt out.

OP, tell us more and maybe we can have a reasonable conversation / consultation.

Everyone else, wtf?!

 

[pgg]

I'm shocked at how much advice and speculation there is on this thread when WE HAVE NO INFORMATION other than the OP is burnt out.

OP, tell us more and maybe we can have a reasonable conversation / consultation.

Everyone else, wtf?!

1) The OP has edited his post. There used to be more information there.

2) When the OP chose not to post any followups, the discussion went in several directions, the way discussions on the internet do.

 

[BuzzPhreed]

Everyone else, wtf?!

Three months into my training I was frustrated, exhausted, bewildered, sometimes pissed-off at the way attendings (and other staff) talked to me, confused about where everything was, sometimes overwhelmed at how much I was already expected to know... also excited, interested, grateful I was there, challenged, fascinated, and looking forward to go in and learn how to do these cases.

I was not "burnt out".

Maybe this was phrased poorly. But this is the way that the OP chose to express it. Anyone who is "burnt out" after three months seriously needs to look at the deeper reason why. Perhaps this isn't the field for them.

 

[deleted171991]

Three months into my training I was frustrated, exhausted, bewildered, sometimes pissed-off at the way attendings (and other staff) talked to me, confused about where everything was, sometimes overwhelmed at how much I was already expected to know... also excited, interested, grateful I was there, challenged, fascinated, and looking forward to go in and learn how to do these cases.

I was not "burnt out".

Maybe this was phrased poorly. But this is the way that the OP chose to express it. Anyone who is "burnt out" after three months seriously needs to look at the deeper reason why. Perhaps this isn't the field for them.

You must have had either a surgical or an intense medical internship.

I find that the people who have the most trouble adjusting are nice intelligent people, coming from civilized medical internships, with no idea how to put in an IV, A- or central line, who find themselves suddenly swimming in deep waters with sharks, in a completely unfamiliar environment. Not only do they have to deal with the steep learning curve, but they are also surrounded by all kinds of dinguses, beginning with some of their own attendings.

Anesthesia is a beautiful specialty. It just tends to attract A-type personalities, most of whom are not nice people.

My advice to future residents, fellows and attendings is to make sure you really like the people/atmosphere at your future workplace, before you commit. Go visit multiple times if needed. There is no salary or academic brand worth having to deal with dinguses.

 

[Planktonmd]

You must have had either a surgical or an intense medical internship.

I find that the people who have the most trouble adjusting are nice intelligent people, coming from civilized medical internships, with no idea how to put in an IV, A- or central line, who find themselves suddenly swimming in deep waters with sharks, in a completely unfamiliar environment. Not only do they have to deal with the steep learning curve, but they are also surrounded by all kinds of dinguses, beginning with some of their own attendings.

Anesthesia is a beautiful specialty. It just tends to attract A-type personalities, most of whom are not nice people.

My advice to future residents, fellows and attendings is to make sure you really like the people/atmosphere at your future workplace, before you commit. Go visit multiple times if needed. There is no salary or academic brand worth having to deal with dinguses.

But ass holes are everywhere!

 

[BuzzPhreed]

You must have had either a surgical or an intense medical internship.

To be clear I meant 3 months into my CA-1 year. I did a moderately cushy medicine prelim... that had it's moments. Being in the OR was far different than basically rounding all day, though, as an intern.

Otherwise, I agree with you. The OR is historically a very cutthroat environment where things have to go right all the time. There is also a huge power differential between the surgical staff and everyone else. If you can't cut the mustard, you should've figured this out during med school. Best bet is to do at least one solid anesthesia elective if not more. I don't know how anyone could choose -- or even get matched into one -- without that on their application. I know it happens.

 

[deleted171991]

You must not have received a "I would like to spend a couple of days in the OR, so I can talk about it during my anesthesia interviews" email.

I try to be as helpful as possible to future anesthesiologists, but this pisses me off beyond anything.

 

[BuzzPhreed]

You must not have received a "I would like to spend a couple of days in the OR, so I can talk about it during my anesthesia interviews" email.

I try to be as helpful as possible to future anesthesiologists, but this pisses me off beyond anything.

There are always people who get into any residency who don't belong there. The worst case I saw was a senior resident in neurosurgery who got ****-canned in her PGY-5 year. Why they let it go on that long I don't know. She was terrible. Nice. But terrible. I wouldn't have let her remove a skin-tag from my dog.

 

[Psai]

There are always people who get into any residency who don't belong there. The worst case I saw was a senior resident in neurosurgery who got ****-canned in her PGY-5 year. Why they let it go on that long I don't know. She was terrible. Nice. But terrible. I wouldn't have let her remove a skin-tag from my dog.

wtf...
what does it take to get ****canned

 

[kazuma]

wtf...
what does it take to get ****canned

It's actually not as easy to fire a resident as you would think unless there are obvious professional violations such as substance abuse/diversion, sexual misconduct etc. PD's need to make a paper trail that shows they took all the necessary steps in giving the resident the benefit of the doubt and every chance to succeed. Sometimes this can take several years. If a PD doesn't do this, the resident can file a civil suit and the PD wouldn't be protected by the institution.

Edit: We had a PGY4 Neurosurgery resident get fired at our shop. Nobody know his whereabouts as he de-friended everybody on FB. I would imagine it would be quite difficult to obtain a new residency spot after being fired.

 

[deleted171991]

When I see a program canning a resident in the final year, I find that the problem is with the program first, and the resident second.

If I were the RRC, I would put those programs on review. One cannot play with somebody's future like that, paper trail or not.

 

[kazuma]

When I see a program canning a resident in the final year, I find that the problem is with the program first, and the resident second.

If I were the RRC, I would put those programs on review. One cannot play with somebody's future like that, paper trail or not.

I agree, I know an individual from an east coast program who got fired at the beginning of CA3 year. It sounded like a like a program problem more than a resident problem. Luckily he found an FP spot.