I would like some personal experience on this question:
What anesthesia residencies offer the best quality of life? Who is happy? Thanks
What anesthesia residencies offer the best quality of life? Who is happy? Thanks
do a search with cushy...i think it was discussed before. of the places i interviewed i have to recommend VCU. they get paid $70/h past 3pm, the call was super reasonable, etc. (after the intern year which seemed typical of a medicine heavy intern year), nice COL, attendings seemed cool...
Oklahoma also seemed cushy...intern year was SUPER cush while still offering a good experience. they had a similar deal with moonlighting past 3pm. these were the only cushy places i think i interviewed...neither offered a lesser quality experience, imho.
Quick question about VCU, do they accept COMLEX? Even just for an away rotation?
I think I've commented on this before but, if not, I'll comment again...
What makes anesthesiology residency tough is that you are a slave to your room. You hit the door at 6:15 AM and you don't stop working until you leave, minus your couple of breaks. This is what a lot of residents on other services don't realize. Medicine residents can take a break from rounding. Surgeons often get substantial breaks between cases. When you're done with a case, you have to take the patient to the PACU, make sure they're okay, go back to your room and finish set-up for the next case, go to the holding area, get your patient, start the next case, do the next case... repeat until your cases for the day are done.
It can be exhausting. You start to relish your breaks during the middle of the cases because that's pretty much it. You can't just simply step out if you want to, like in between rounding on patients, and you aren't "done" at 11:00 AM when rounds are finished to do other things and kind of have your own plan for getting the rest of the work done the rest of the day. When you're in the OR, you have to remain vigilant even if the patient seems to be on auto-pilot. And, that is mentally taxing. It is truly 1:1 critical care. Even surgical residents aren't in the OR as much as we are.
Having said that, programs that routinely keep you until 5:30-6:00 PM (sometimes later) every night start to wear on you. By the time you get home in the evening, after doing post-ops and prepping for next day's cases, you are completely wiped out. I often get home after 7:00 PM, eat dinner, and am pretty much too tired to do much else. I still try to make time to work out, but even that is hard. And, my call days are brutal because we are often running OR's late into the night, and we still have to do all the add-on pre-ops, cover traumas, codes and airways, and do a whole host of other things (like manage patient's on the pain service) that most people don't realize. You literally cover every inch of the hospital if you are an anesthesia resident. I tell people this and they find it hard to believe, but when I explain our responsibilities I usually get a "wow, I never knew you guys did so much."
An anesthesia program that is routinely working you 65+ hours per week is, in my opinion, sacrificing a large part of the academic mission simply to get the work done. In my program, we have been routinely pushing 75+ hours per week lately. It's too much. Sure, I'm getting great training with a phenomenal case mix, but right now I'm just wishing it was over.
That's the key question I would ask on the interview trail. Ask residents what in-house time they are providing primary coverage per week. During our 1:1 months, when attendings have to be in the room the whole time they realize how brutal it can be. That's why getting out at 3:00 PM seems like a luxury, but when you're up at 5:15 AM every morning and have to be in the hospital, dressed, and ready to go by 6:15-6:30 AM, you realize that even working until 3:00 PM you're putting in a solid 8.5-9 hour day. Now, add call to that and you're already pushing 55 hours per week.
I think a program that averages 55-60 hours per week is ideal. If you're going over 65+ hours you're pushing it and something will start to suffer (i.e., your time to engage in research and keep up with academics). I would flat-out avoid programs that work you greater than 70 hours per week on average. While this is under the ACGME rules, it's still excessive for the type of work we do.
You think this sounds whiny, consider that top executives are considered to be really busting their balls if they're regularly working 50 hours per week.
-copro
Every specialty has its worst day. Go to do Trauma or Vascular surgery for 3 months and you will thank your lucky stars that you're an anesthesia resident.
do a search with cushy...i think it was discussed before. of the places i interviewed i have to recommend VCU. they get paid $70/h past 3pm, the call was super reasonable, etc. (after the intern year which seemed typical of a medicine heavy intern year), nice COL, attendings seemed cool...
Oklahoma also seemed cushy...intern year was SUPER cush while still offering a good experience. they had a similar deal with moonlighting past 3pm. these were the only cushy places i think i interviewed...neither offered a lesser quality experience, imho.
I think that hours worked may not be the most accurate way to determine if a program is cush or non-malignant. I think rather than looking for a 'low-hours' program, I would ask the residents in privacy if the majority of attendings treated you like future colleagues vs 9 year olds. I
just curious, asides from OB, do anesthesia residents work weekends? If you're pulling 6am-6pm x 5 days a week that's 60 hrs, so i'm gonna guess that at least you get weekends off, esp since ORs are usually closed except to emergencies? i think the hardest part of my rough rotations so far in med school have been that 1 day a week is not enough to recover. i feel like i'm willing to work the weekdays hard as long as you get a good 2 mornings a week to sleep in
just curious, asides from OB, do anesthesia residents work weekends? If you're pulling 6am-6pm x 5 days a week that's 60 hrs, so i'm gonna guess that at least you get weekends off, esp since ORs are usually closed except to emergencies? i think the hardest part of my rough rotations so far in med school have been that 1 day a week is not enough to recover. i feel like i'm willing to work the weekdays hard as long as you get a good 2 mornings a week to sleep in
What anesthesia residencies offer the best quality of life? Who is happy? Thanks
I would ask the residents in privacy if the majority of attendings treated you like future colleagues vs 9 year olds.
weekends are filled with semi urgent (often surgeon convenience in reality) cases and plenty of trauma, appys, bowel perfs, etc. That keeps 2-3 residents (home call resident often gets called in for a while + 2 in house all day) every weekend day at my place, and that is not uncommon among residency programs. There is also CT call on weekends and many places have transplant and other specialty call on weekends. Counting all that we spend less time in hospital than the medicine and surgery people on average. What your describing above is called a regular job, you're not gunna find that in any residency (ok maybe path or derm)...and not necessarily after residency either.
I'd like to add my 2 cents to this thread.
For our colleagues out there that havent reached anesthesia residency yet, Copro's thoughts, feelings, descriptions, and emotions about what its like to be an anesthesia resident are SPOT ON.
Dudes got cred' in my book.
If you're looking for an anesthesia resident reality blog, read his posts.
His eloquent metaphor of being a slave to his assigned OR.....totally concur. Minimal downtime except for the cuppla breaks.
Reminds me of a night on call with an attending....who eventually made Chair of the department eek....who now I believe took a job at my alma mater, Da U...
Anyway, attending dude comes in after several hours...its around 9 pm...tells me theres dinner for me in the residents lounge....be back in 20 minutes or so...
WOW! I thank him and leave, ravenous...looking forward to whatever he's got waiting for me....
Pizza Hut?
Some chinese takeout?
I'm salivating on the way to the lounge.
I arrive to find..
ONE UNPREPARED PACKET OF LIPTON CUPPA SOUP.
Thanks, Doctor Melvin Gitlin.
Your generosity is remembered to this day.
I would add though, that the autonomy I received as a CA-3 made me a better anesthesiologist.
(But I REALLY learned my trade during the first five years of my private practice life.....fortunately selected a busy group....and was paid a premium at the same time)
ANYWAY,
just agreeing that you live and die by your breaks, albeit sometimes disappointedly so.
Timtye's post about seniors salivating to finish echoed in my head as well.
My last case as a resident at Tulane was an abdominal hysterectomy....typical 4 hour ordeal of academics....
Did the case by myself (except for attending signing papers during induction), extubated at the end, rolled to PACU gave report,
and that was it.
Residency done.
No goodbyes. No thank-yous.
Cleaned out my locker and drove into the setting sun.
Jet,
How soon after you finished did you start your new job?
What did you do in between finishing res and starting said job?
This may be the wrong thread for that question...
Totally agree that wherever you go for residency, even if it's a "good quality of life" program. you will still think your quality of life is crappy. There's no such thing as a residency with a "nice" lifestyle. You're going from fourth year medical student who has most weekends and works 3-8 hours a day (typically, by the end of the year) to a job which requires nights and weekends and 12-30 hour days. No residency, no matter how cush, will seem cush to you. It'll be harder than you think no matter how cush the residency is.
I'm still very happy working 60-65 hours a week at a very well known, quaternary referral center hospital with nice faculty and solid cases. And would rather do that than work 40 a week with snooty faculty anywhere else.
and that was it.
Residency done.
No goodbyes. No thank-yous.
Cleaned out my locker and drove into the setting sun.
Seems to me that any anesthesiology residency is better than intern year July can't come quick enough, some days..
...all I know is, is that as an intern who will be starting CA-1 in July :
1. Any call that doesn't involve admitting five patients, guaranteed, with rounding minutes after finishing the final admit note, is a good one.
2.Any day that doesn't involve having to talk to social work about said five patients' ( not so ) imminent discharge in addition to the other 5-7 patients hanging out on my board, is a good one.
3. Any day that doesn't involve fielding pages from twelve different nurses on six different floors about such and such 's blood pressure/family member is here to speak to you/just fell out of bed and needs the incident report filled out ASAP , is a good one.
Every day in medicine reinforces the fact, and makes me relieved that I chose gas. There is nothing worse than dreading waking up in the morning because you positively loathe your job. I'll take the ORs/ codes ANY day over what I deal with now. The pain management side...well..I'll just have to deal with those months....
3. Any day that doesn't involve fielding pages from twelve different nurses on six different floors about such and such 's blood pressure/family member is here to speak to you/just fell out of bed and needs the incident report filled out ASAP , is a good one.
No, but if you have an active pain service, you can expect these calls all night long to manage blocks. Calls from nurses from any of six floors on patient's you've had no real contact with before fielding a host of complaints from sleeping patients complaining of "10/10 pain" to "I can't move my leg" to "my patient is hypotensive, can you turn the epidural down?" will fill your nights instead. Now, factor in traumas and airways and codes, and you'll be lucky to get an hour or two of sleep.
We have our own set of woes. Trust me. It's not all champagne and roses being a gas resident.
-copro
Let's have a GIANT pity party for all you residents whose lives all suck sooooooo bad that you only have time to come here to complain....and don't have time to eat, bath, and sleep.
Like all us attendings NEVER had to do a residency.....oh wait....
we DID....AND BEFORE these ridiculous ACGME hour limitation rules!!!!
Damn Lifestylers!
I know that the previous gen worked longer hours, but straight from an attendings mouth, they didn't have to deal with all the crap that we have to these days meaning non-work hour issues. Scrutiny is much higher these days. Plus, patients are bigger A-holes nowadays. At least the previous gens got the respect they deserve. I find many academic attendings who liked medicine 10-20 years ago versus now.
Also, the previous gen have a highlight we won't. Protected jobs and lucrative practices which make hours as a resident more bearable. I don't think anybody these days would complain if politicians and CMS weren't out to cut us down. Also, how were trial lawyers back in the day meaning even 15 years ago? Things are out of hand these days, and medicine is not as golden as before. I assume such things make people complain.
Finally, our gen has other cultural issues including work balance and family life. Why would derm be so competitive? I don't know too many people who think acne is their passion, but the good hours are. The idea of previous gen criticizing us is similar to my parents talking about when they went to school, they had to walk 2 miles back and forth.
Life is different now. Issues then are not issues now while there are issues now that weren't around then. However, I do respect your perspective militarymd and you deserve everything for what you had to go through.
relax....I'm just having some fun needling you guys.
Last day of residency was ,without a doubt, one of the best days of my life... I was on call, 3AM get a call from burn unit to emergently intubate a big guy that had been 50% burned upper torso with smoke inhalation. Half a stick of STP and 100 o' sux-- all edema. I told myself I wasn't goin' out like this. Just rammed a 7.5 where I thought it should be and it slid in. BS bilateral and PCXR was solid. O2 sats golden and RT lady all happy. No procedure note, no charge sheet. Beeper left at OR board when no one was lookin'. Slid out hospital at 0645 with no goodby's, thank you's or gonna miss you's. Got to the apt. and loaded up U-Haul with 100% VA disability, 100% SS disability uncle( Vietnam, agent orange, PTSD--you know the bogus gig). Letter and keys in an envelope dropped in the apt. night box. No change or forwarding of address with post office, no cares about apt. or electric deposits. ZIPPY DONE EVAPORATED! Roll on out at 1700 with floorboard boom box playin' "Comfortably Numb", and a bottle of chilled Wild Turkey in the ice chest. Uncle drivin' and on outskirts of town we light up a big fat doober. I told him not to shut off the old biitch until we were home. Ole Hunter Thompson didn't have a thing on us that night... Regards, ---Zip