Anyone out there as excited as I am for CA-1 year? Prelim medicine is soon to be a distant memory (hopefully) and I will never swear at my pager again at 3am when I see the ER's number on the screen indicating that I have a new admission!
Also, do the Anesthesia residents out there recommend reading up for the in-service exam? Any thoughts/advice/etc on how to transition in July?
just to clarify a few misconceptions here...
the downside:
you
will get paged at 3 am. you
will get paged to and have to go to the ER to do anesthesia H&P's for emergent cases. you
will sit in the OR from 2 am to 5 am doing some crap ortho case using toothpicks to prop your eyelids open. you
will get stupid calls from nurses on various floors at all hours of the night asking you to come evaluate a patient's perfectly well-functioning epidural. you
will have to go to the OB ward and put an epidural in a patient at 4 am, then go try to lay your head down for a few minutes only to get paged back for a stat c-section on that same patient for "non-reassuring fetal heart rhythm"... and you will get blamed for causing that. you will get blamed for causing a host of bad things that happen to the patient from RTA (because the BP dipped to 80/50 for less than 5 minutes during a 3-hour case) to post-op ileus to you-name-it. you will still be expected to act like a doctor, see patients in follow-up, treat patients in the SICU (or elsewhere when, for example, called to codes, airway emergencies, etc.). you will still have to remember medicine, surgery, and OB that you learned in school, and this will be what separates you from being other than just a techician. you will have to learn to speak-up and make decisions in the OR, sometimes that cause disagreements with the surgeon. you will have stressful cases that will test the limits of your ability, and you will go home exhausted after a 10-hour day more than you can possibly imagine now. you will learn to appreciate the "down time" in between seeing patients on the wards that will not be afforded to you as you bust your hump trying to get cases done everyday, especially if you are in a busy program. you
will be seen by many as nothing more than a tube-jockey by most other departments in the hospital, and they will look at any of your suggestions or ideas about the patient's care with a sideways glance and/or probably ignore them.
the upside:
you don't have to pre-round, round, post-round, run around... you don't have to do exhaustive H&P's or write admission orders. you don't have to sit through 35 minutes of bedside teaching about 937 differential diagnoses that the patient
could have (but clearly doesn't). you will be able to have meds at your disposal, draw them up, and administer them without having to justify your decision or thought process to some nurse who "has never done it that way before" and wants to question everything you do.
and that's just scratching the surface, kids.
). I hope i'll be able to take step 3 before CA-1, but I'm ending with some hard months, and with a MICU month last, it'll be hard to even find 2 days in a row to schedule the exam for. I suppose i'll just take it during vacation time CA-1 (I requested some vac time for early on). I doubt I'll forget so easily. . .
