CA-1's

Discussion in 'Anesthesiology' started by otis86, Jul 28, 2015.

  1. otis86

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    How are the new CA-1's doing so far? I myself am a CA-1, and I would say I am comfortable with the OR setup, but intubation is still challenging for me. I can get the view, but exposing the vocal cords is tricky. IV lines are a 50/50 so far. How is everybody else doing in this regard? I just wanted to compare my performance. Thanks and all the best.
     
  2. rishk789

    rishk789 "Anesthesia"
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    Hang in there! I felt completely incompetent as a first month CA-1, but come December, you're going to feel SO much better about your anesthetics and perioperative management. Just try to learn something from each case and don't be flustered - we've all gone through it. :)
     
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  3. dr doze

    dr doze To be able to forget means to sanity
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    You all suck. But you will mostly all suck less with each passing day. Don't worry, all of your attendings and senior residents sucked as much as you do. The situation is critical, but not serious.
     
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  4. Docuronium

    Docuronium ASA Member
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    Let's just say that fortunately there is plenty left to learn
     
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  5. Urzuz

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    Agree with above, except for the statement that the situation is critical. It isn't. You're fine. Technical skills come with time, just focus on reading while outside of the OR and learning as much as you can from your attendings while in the OR.
     
  6. Consigliere

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    Don't worry. All the sucking will occur when you finish residency and are struggling to find a job.
     
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  7. creechy

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    Biggest douche on this board.
    You spew the same BS. If you hate what you do, just quit. With your piss poor attitude your more likely to stroke out from stress than make it to retirement.

    Hang in there guys, technical skills are what they and improve with repetition. I'm sure within a few months you'll be good enough to place an IV for this dudes trach/peg
     
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  8. pjl

    pjl ASA Member
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    CA1 progression:
    July: Lost, tired all the time, feel stupid most cases at least once
    August: Can find the OR. Tired a fair amount, feel stupid just a few times a day
    Sept: Room setup is minimal thought, can think about more than just the basics. Feel stupid just daily
    October: Basic cases are easy, still get tripped up sometimes on things that later you feel dumb about.
    November: Actually enjoy anesthesia (hopefully). Ready to progress beyond basics.
     
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  9. Consigliere

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    YOUR - possesive pronoun
    YOU'RE - contraction meaning "you are"

    You're welcome.
     
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  10. Twiggidy

    Twiggidy ASA Member
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    Malcolm Gladwell wasn't joking when he talks about the 10, 000 hr rule. Don't worry about it. You've just spent the last year round, writing note, and changing dressings; now someone is throwing an 18G IV at you and a MAC 3 blade and saying, "Go!" It takes time. You'll get better everyday. Even as an attending you'll have days or weeks where you can't place an IV to save you're life. Intubation is an art and it will be and the end of CA1/beginning of CA2 and mindless by the time you're a CA3. When you've gotten there, focus on how to make the easy intubations easier and how to approach the difficult intubations to make them look easy.

    You can't learn anesthesiology in one month of proctoring, even if every surgeon thinks you should be able to learn it in a month. Practice makes perfect. If you're still struggling, seek out an attending that you trust and try to work with them more and have them really try to help you improve your skills.

    This is why I miss academics. I actually enjoy teaching. Wish I could help you first hand.
     
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  11. creechy

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    I stand corrected.
    Your a..... Oops, I mean you're a douche.
     
  12. Consigliere

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    That's better. Good luck with residency and better luck when you're done.
     
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  13. Shinkansen

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    CA-1 here as well, been on my own in the OR for a week now. Feel much better every week about what I'm doing. Big complicated cases are scary, but the basic ones are becoming less scary. I still keep propofol in line though, more just to keep my heart rate down...
     
  14. creechy

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    Been done.
    Board certified.
    Good job in major metro area.

    How about you stop raining on parades and try to be content with life. Good luck with that.
     
  15. Consigliere

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    Already am. Thanks for playing.
     
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  16. Doctor4Life1769

    Doctor4Life1769 **tr0llin, ridin dirty**
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    There ought to be more attendings like you who enjoy teaching in academia.
     
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  17. Docuronium

    Docuronium ASA Member
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    Really though? You're almost the angriest person on this board.
     
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  18. Crayola227

    Crayola227 The Oncoming Storm
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    Just on casual perusal of @Consigliere , I'm gonna have to say no, they're not. They're not even the most jaded. They are pretty jaded. Having a 700k salary and trying to talk you guys off the specialty? I would definitely consider the words of someone with such a seemingly attractive job why they don't recommend it. I would also listen to @Twiggidy since he seems to like the profession.

    @Law2Doc is much meaner. Real cutting. Don't often agree with him but he has a sharp mind. I don't think of him as angry, but the way that he talks about his approach to training, I would fear his wrath, so maybe angrier.

    @Doctor Bob Just look up threads about resident suicide and you'll see that in comparison Consigliere is definitely looking out for you.

    Note to everyone here: I mean this in a jesting manner. If it hurts your feelings let me know I'll edit my post
     
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    #18 Crayola227, Jul 31, 2015
    Last edited: Jul 31, 2015
  19. Consigliere

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    There's the key, kid. I'm the happiest cat in the OR in "real" life. Seriously. I make sick cash and don't work for 2.5 months a year. Have a beautiful family with 4 great kids, great wife, great life. Don't believe the hype. The speciality of anesthesiology IS dying a fast death though; no amount of optimism and "Zip-A-Dee-Do-Dah" whistling is gonna change that.
     
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    #19 Consigliere, Jul 31, 2015
    Last edited: Aug 1, 2015
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  20. nimbus

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    Agree. Anesthesia is currently a great gig. It's never been better during my 20 year career. However, there is currently a huge and unprecedented shift in anesthesia revenues being funneled to corporate overlords.

    Will it ever shift back? The only way I see that happening is if a massive shortage of anesthesiologists develops. Even then, the specialty will have been corporatized and they will always take a cut.
     
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  21. yangsc

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    that's scary.. what exactly do you mean? will i hate myself in 10 years if i apply anesthesia this year?
     
  22. Consigliere

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    Depends on how much self loathing you currently have.
     
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  23. Docuronium

    Docuronium ASA Member
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    Is there a way we can have a single thread without one of you guys coming in and talking about how bad it's gonna be? Can we have just one nice thing?
     
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  24. bkell101

    bkell101 UDGRAD
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    For ca-1's....don't sweat the procedural skills, with time you could teach a monkey most of it...your technical skills will develop. Don't worry about missed airways or lines at this point. Focus on understanding what you are doing and why you are doing it. Understand how your patients comorbidities and the planned procedure are going to effect your pre/intra/post operative management. Ask questions, read, be eager and easy to teach. Take ownership of your patients. Focus on becoming a great doctor/consultant and not a proceduralist. Nobody cares if you blow the Aline on your first attempt, because we have all been there. If you haven't looked up your patients the night before and haven't read about the procedure at hand, then that's a whole different story...
     
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  25. Twiggidy

    Twiggidy ASA Member
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    This is a good point. When you get to written and oral boards, the questions won't be, "How do you intubate?" or "Show me how to do a central line." It's all understanding anesthesia and how they affect patients with different diseases and what you're going to do to deal with it.
     

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