anesthesiology

[samisab786]

lol (sorry for the cut message)
my school added a new rotation site for an elective in anesthesiology. The preceptor is a physician. I'm going to be doing it in the fall, and know only vague details about it, but was wondering if any of you have worked in that kind of a setting, whether rotation/residency/work wise, and how is it usually.
Thanks!

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[Praziquantel86]

lol (sorry for the cut message)
my school added a new rotation site for an elective in anesthesiology. The preceptor is a physician. I'm going to be doing it in the fall, and know only vague details about it, but was wondering if any of you have worked in that kind of a setting, whether rotation/residency/work wise, and how is it usually.
Thanks!

Are you a pharmacy student? And do you mean "situation" as in being precepted by a physician?

 

[Narrowstairs]

If this is a pharmacy school rotation you will probably not learn much that will be practical for your career. That being said, I think it would be extremely interesting to learn about and have this MD as your preceptor.

 

[eagles22]

How long is the rotation? Anything longer than a week full time is going to be a waste for you as a pharmacy student. You'll see the induction (which is usually a fairly standard procedure), you'll watch the intubation, then the patient is out. The surgery happens during which the anesthesiologist may give some of a set number of drugs. Then the patient is waken up. Rinse and repeat. There are a variety of anesthetics, but most hospitals are limited in what they actually have on hand so they tend to use the same drugs for each case. If you're just watching (which I assume you will be doing), it's pretty boring. Standing in a 5 hour surgery doing nothing other than staying out of the way gets tedious quickly. This is especially true if you haven't been trained in anatomy and have no idea what you're looking at.

 

[croquemonsieur]

this seems like a complete waste of a rotation

 

[xiphoid2010]

lol (sorry for the cut message)
my school added a new rotation site for an elective in anesthesiology. The preceptor is a physician. I'm going to be doing it in the fall, and know only vague details about it, but was wondering if any of you have worked in that kind of a setting, whether rotation/residency/work wise, and how is it usually.
Thanks!

My school had 4 therapeutics lectures on anesthesiology. Its definitely a very interesting area, and also one that was rewarding when I encounter the first malignant hyperthermia. We ended up using up almost the entire city's danteolene.

Anywho, not sure it you could make a whole month rotation out of it though. There are few commonly used and relevant drugs, but you can probably get those down in a week. As for preceptor being an MD, that's fine, my ID residency rotation was with the ID doc and his fellow. Other than drugs, I also learned how to diagnose histoplasmosis under microscope and silver stain. Lol. Cool stuff.

 

[Praziquantel86]

How long is the rotation? Anything longer than a week full time is going to be a waste for you as a pharmacy student. You'll see the induction (which is usually a fairly standard procedure), you'll watch the intubation, then the patient is out. The surgery happens during which the anesthesiologist may give some of a set number of drugs. Then the patient is waken up. Rinse and repeat. There are a variety of anesthetics, but most hospitals are limited in what they actually have on hand so they tend to use the same drugs for each case. If you're just watching (which I assume you will be doing), it's pretty boring. Standing in a 5 hour surgery doing nothing other than staying out of the way gets tedious quickly. This is especially true if you haven't been trained in anatomy and have no idea what you're looking at.

this seems like a complete waste of a rotation

I wouldn't write it off as a waste entirely, given that we're speculating on what the rotation entails and what this poster's career goals are. I can see anesthesiology in general being very useful for someone going into critical care, focusing on physiologic responses to pressors, inotropes, and other perioperative drugs. Having knowledge of anesthesiology work flow would be pertinent to hospital admin in terms of streamlining purchasing of anesthesia drugs, optimizing SCIP compliance, etc. Some hospitals have anesthesiologists managing the acute pain service, which would certainly be useful to an inpatient pharmacist on many different services.

And I think working directly with physicians in general is very useful, as you're able to learn the behind the scenes thought process that you're unable to glean from simple chart review is invaluable.

It sounds like an interesting rotation to me, and if you're interested in pursuing a clinical specialty, could very well end up being useful to you.

 

[eagles22]

I wouldn't write it off as a waste entirely, given that we're speculating on what the rotation entails and what this poster's career goals are. I can see anesthesiology in general being very useful for someone going into critical care, focusing on physiologic responses to pressors, inotropes, and other perioperative drugs. Having knowledge of anesthesiology work flow would be pertinent to hospital admin in terms of streamlining purchasing of anesthesia drugs, optimizing SCIP compliance, etc. Some hospitals have anesthesiologists managing the acute pain service, which would certainly be useful to an inpatient pharmacist on many different services.

And I think working directly with physicians in general is very useful, as you're able to learn the behind the scenes thought process that you're unable to glean from simple chart review is invaluable.

It sounds like an interesting rotation to me, and if you're interested in pursuing a clinical specialty, could very well end up being useful to you.

But you don't need to put in 4 weeks full time to grasp that stuff. I honestly don't know what a non-medical student would be doing all day in the OR or clinic. He's not trained in doing physicals or any other hands on skills. Even as a medical student, you don't get to do much with a physician preceptor when the cases are limited. I can't imagine what kind of stuff would fall down to the pharm student. I envision this as being a lot of standing around for the student. There has to be a better way to learn about those drugs and effects.

 

[Praziquantel86]

But you don't need to put in 4 weeks full time to grasp that stuff. I honestly don't know what a non-medical student would be doing all day in the OR or clinic. He's not trained in doing physicals or any other hands on skills. Even as a medical student, you don't get to do much with a physician preceptor when the cases are limited. I can't imagine what kind of stuff would fall down to the pharm student. I envision this as being a lot of standing around for the student. There has to be a better way to learn about those drugs and effects.

That is true, and I certainly can't speak to what a standard anesthesia rotation would entail. My thought would be that both this physician and the school felt that the rotation would be beneficial, so there may well be components beyond the standard anesthesia piece. Can't know this without hearing more details of the rotation, though.

 

[JLM]

I'm a little biased, but I think it would be a very interesting rotation with the right preceptor. I'm sure pharmacy students cover anesthetic gasses and their effects, but concepts such as MAC and vapor pressures really make much more sense when they are being demonstrated. And I'm sure their are some drugs in our arsenal which may be a little more interesting than those you work with every day. You will also see how little we dose things in mg/kg as we have such an intimate knowledge of our drugs that we dose by cc's and by eyeballing the patients body habitus. We dont make our IVs under a hood. We push drugs rapidly that most everyone thinks need to be given over 10 min. We frequently stick drugs into an IV bag and titrate to effect, including pressors. It's just a whole different way of playing the game, which is much more fluid and less rigorous than standard dosing regimens you may be used to. And I think learning about the delivery equipment is pretty cool. Will it help you with your future job in retail? Likely, no. But it may give you a little better understanding of one of the most misunderstood medical specialties out there.

 

[Sparda29]

I wonder if they would ever open up the field of anesthesiology to pharmacists the way they did with the CNRAs.

 

[Daiphon]

I'm a little biased, but I think it would be a very interesting rotation with the right preceptor. I'm sure pharmacy students cover anesthetic gasses and their effects, but concepts such as MAC and vapor pressures really make much more sense when they are being demonstrated. And I'm sure their are some drugs in our arsenal which may be a little more interesting than those you work with every day. You will also see how little we dose things in mg/kg as we have such an intimate knowledge of our drugs that we dose by cc's and by eyeballing the patients body habitus. We dont make our IVs under a hood. We push drugs rapidly that most everyone thinks need to be given over 10 min. We frequently stick drugs into an IV bag and titrate to effect, including pressors. It's just a whole different way of playing the game, which is much more fluid and less rigorous than standard dosing regimens you may be used to. And I think learning about the delivery equipment is pretty cool. Will it help you with your future job in retail? Likely, no. But it may give you a little better understanding of one of the most misunderstood medical specialties out there.

Keep in mind, too, that anesthesia is more than just OR time. There's preop - essential for discovery of potential med interactions; as well as pre-sedation. There's the PAC, where you deal with the washout of drugs. There might be pain clinic, which admittedly can be difficult depending on the patient population, but can also be a gold mine in terms of learning pharmacotherapy for pain... yada yada yada.

When I was an M4 I did the converse of this - I spent a month with a clinical pharmacist. One of my best months, really. Very high yield, and I appreciated the different perspective that pharmacy brought to the table.

Just be interested, and try to steer the rotation towards what'll be useful from a PharmD perspective.

Cheers!
-d

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[samisab786]

thanks for the responses. I asked because I'm a little scared because we only covered the anesthetics for a very small portion of our CNS course and it is a very different field for what we do learn in pharmacy school. Ultimately, I'm interested in getting a residency in either amcare or internal medicine and I'm really depending on some good rotation experiences and I picked this one because it sounded different and interesting. But I still have time to possibly switch my rotation to something more useful or one with a faculty member if that may be more relevant to my goals.

 

[samisab786]

Keep in mind, too, that anesthesia is more than just OR time. There's preop - essential for discovery of potential med interactions; as well as pre-sedation. There's the PAC, where you deal with the washout of drugs. There might be pain clinic, which admittedly can be difficult depending on the patient population, but can also be a gold mine in terms of learning pharmacotherapy for pain... yada yada yada.

When I was an M4 I did the converse of this - I spent a month with a clinical pharmacist. One of my best months, really. Very high yield, and I appreciated the different perspective that pharmacy brought to the table.

Just be interested, and try to steer the rotation towards what'll be useful from a PharmD perspective.

Cheers!
-d

Sent from my DROID BIONIC using Tapatalk

this is very encouraging . I favored my rotation also because the preceptor is a physician and I figured being around there might provide some interesting insight that I may otherwise not get much opportunity of seeing.

 

[UES Girl]

I worked with anesthesiologists extensively on my ICU rotation, they are Freaken amazing. Virtually every ICU attending during that 6 week rotation was anesthesiologist - those guys really know their stuff -pain management, sedation/analgesia, anything critical care related and drug related. They were insane, WAY better than the pulmonary critical care trained internists. You will learn a lot for sure.

 

[JoBreeze]

WAY better than the pulmonary critical care trained internists.

How so?

 

[PharMed2016]

I worked with anesthesiologists extensively on my ICU rotation, they are Freaken amazing. Virtually every ICU attending during that 6 week rotation was anesthesiologist - those guys really know their stuff -pain management, sedation/analgesia, anything critical care related and drug related. They were insane, WAY better than the pulmonary critical care trained internists. You will learn a lot for sure.

Anesthesiology is a really cool field. When it comes to pain management and sedation/analgesia, there is no one better. As for pulmonary-critical care physicians, they were really great too where I was at. Learn more about acidosis/alkalosis and vent settings from them than in school. Unfortunately, I didn't have the background at the time to comprehend everything that I was being told.

 

[samisab786]

This is really encouraging because I'm also interested in pain management. Thanks for the responses, I'll probably keep the rotation and do my best to make the best out of it.