disappointed in rotation

[gclax30]

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I've just finished my first week of a 3rd year anesthesiology rotation and I have to say I am VERY disappointed so far. I am very interested in this field and really wanted to learn everything I could about it during these 2 weeks but so far it has been a big let down. I'm really hoping that it is just this particular preceptor and hospital because I've been reading some great posts lately about why everyone has gone into anesthesiology and it sounds like a great fit for me.

Basically we show up at 7:00 a.m. and check out the schedule for the day, go around and do a few intubations, maybe a central line or art line, hang out and read in the OR dept for hours in between, go to lunch, maybe another intubation, then go home by 2:00. Once we intubate the patient my doc leaves the room and mentions nothing about how to manage him DURING OR AFTER the surgery (which I gather is kind of important?) 😱. So now I can either tag along with him or stay in the room and try and get the CRNA to teach me something, which few are willing to do and rightfully shouldn't have to do. And then he says we can go watch any interesting surgery we want and takes off, but I really want to learn some freaking anesthesiology!!! Atleast go over some physiology, something!

I want to learn the principles of anesthesia and why we do the things we do, not just HOW to do them. I don't want to just turn knobs and push buttons and intubate. And I did tell him that I'm interested in pursuing this field, hoping he would kind of take me under his wing and show me some stuff, and his reply was "oh, ok, well there is a good job market right now".

Any suggestions? I only have one more week and I don't want to totally write off this specialty on account of a crappy rotation. How can I maximize my remaining time? Thanks.

 

[zippa]

It doesn't seem like you are taking the initiative and asking him/her questions.

 

[jetproppilot]

I've just finished my first week of a 3rd year anesthesiology rotation and I have to say I am VERY disappointed so far. I am very interested in this field and really wanted to learn everything I could about it during these 2 weeks but so far it has been a big let down. I'm really hoping that it is just this particular preceptor and hospital because I've been reading some great posts lately about why everyone has gone into anesthesiology and it sounds like a great fit for me.

Basically we show up at 7:00 a.m. and check out the schedule for the day, go around and do a few intubations, maybe a central line or art line, hang out and read in the OR dept for hours in between, go to lunch, maybe another intubation, then go home by 2:00. Once we intubate the patient my doc leaves the room and mentions nothing about how to manage him DURING OR AFTER the surgery (which I gather is kind of important?) 😱. So now I can either tag along with him or stay in the room and try and get the CRNA to teach me something, which few are willing to do and rightfully shouldn't have to do. And then he says we can go watch any interesting surgery we want and takes off, but I really want to learn some freaking anesthesiology!!! Atleast go over some physiology, something!

I want to learn the principles of anesthesia and why we do the things we do, not just HOW to do them. I don't want to just turn knobs and push buttons and intubate. And I did tell him that I'm interested in pursuing this field, hoping he would kind of take me under his wing and show me some stuff, and his reply was "oh, ok, well there is a good job market right now".

Any suggestions? I only have one more week and I don't want to totally write off this specialty on account of a crappy rotation. How can I maximize my remaining time? Thanks.

Find a resident to hang out with.

Shadow ONE resident for the whole week. get there when he(she) gets there at 0600 or whatever. You'll come outta next week with a better picture if you get to know a resident in the program.

YOU: "Dude, mind if I hang out with you this week? I'd like to come in tomorrow when you get here so I can get a better feel of this gig."

RESIDENT: "Sure. I set my room up around six-thirty so meet me in OR number eight tomorrow morning."

Residents usually get to the OR in the AM to set up around 0615-0630 so if the resident doesnt offer this, ask if you can come in at that time. Then stick to him for the whole day.

Stay later. You don't have to leave at 2.

During my residency, I remember a 3rd year student who got there early and stayed late every day of his 3rd year rotation, then got there early and stayed lated EVERY DAY of his 4th year elective rotation. His name was Raj. He worked more hours than we did during his med-student-time in anesthesia.

Dude had an anesthesia residency slot secured at Tulane before he even graduated from med school.

Life is short.

Make an impact.

Good luck.

 

[cfdavid]

Man, that's too bad. Those types of preceptors seem like a big part of the problem in anes. Those sloths should just step out of the way if they're going to be like that.

I'll be spending all next week in the OR. I'll be hanging with surgeons, but my main motive was to get a handle on anesthesia (this hospital doesn't have anes residents though, so I'm officially shadowing surgical residents/attendings). I'm geeked about it, cause I'll be getting some good, general, OR time in.

The way I see it is how one decides to practice is up to the individual attending. Some of the sloths will choose to just get by, like the employee-type mentality that MilMD has elaborated on. Others, like many of the attendings on this forum, will choose to practice entirely different, as you will be able to do down the road.

You can be the guy/gal that takes ownership of cases. The one that is the true knowledge sink that people rely on and respect. The one that shows leadership and that enjoys teaching (when appropriate). The one that drops back into the various rooms (in an ACT model) often, thereby staying on top of his/her cases and projecting a prescence of professionalism and security.

Perhaps this is all idealistic, but my experiences are that in ANY job, one can merely get by, or one can choose to excel. The attending that you've described is not taking advantages of all of the above OPPORTUNITIES available to him. That's a shame, and very well may be unacceptable in the near future.

I had a buddy in college who's dad was the chief of anesthesiology at a decent sized community hospital. According to my pal, his dad was ALWAYS reading up on cases, watching videos related to the field, and just being proactive w/r/t his career. That's why he was the chief, and very well respected. He made the choice to be that way.

 

[ideas]

I've just finished my first week of a 3rd year anesthesiology rotation and I have to say I am VERY disappointed so far. I am very interested in this field and really wanted to learn everything I could about it during these 2 weeks but so far it has been a big let down. I'm really hoping that it is just this particular preceptor and hospital because I've been reading some great posts lately about why everyone has gone into anesthesiology and it sounds like a great fit for me.

Basically we show up at 7:00 a.m. and check out the schedule for the day, go around and do a few intubations, maybe a central line or art line, hang out and read in the OR dept for hours in between, go to lunch, maybe another intubation, then go home by 2:00. Once we intubate the patient my doc leaves the room and mentions nothing about how to manage him DURING OR AFTER the surgery (which I gather is kind of important?) 😱. So now I can either tag along with him or stay in the room and try and get the CRNA to teach me something, which few are willing to do and rightfully shouldn't have to do. And then he says we can go watch any interesting surgery we want and takes off, but I really want to learn some freaking anesthesiology!!! Atleast go over some physiology, something!

I want to learn the principles of anesthesia and why we do the things we do, not just HOW to do them. I don't want to just turn knobs and push buttons and intubate. And I did tell him that I'm interested in pursuing this field, hoping he would kind of take me under his wing and show me some stuff, and his reply was "oh, ok, well there is a good job market right now".

Any suggestions? I only have one more week and I don't want to totally write off this specialty on account of a crappy rotation. How can I maximize my remaining time? Thanks.

Do you just show up at 7am or do you get there early to practice starting IVs and such? I think you need to just latch onto a preceptor that lets you do a lot and ASK him can he show you how a postop check should be done, etc. Have you asked to take call with your preceptor? Just try and live like s/he does for your 4 week rotation so you can see if you really like it.

 

[Coastie]

Not every resident is a born teacher.

Find one who is. Find out who loves to teach as an attending, who also allows hands on stuff.

Show some interest..Help anyway you can, and balance it all out by being a cool dude, not a pest.

It's sometimes really confusing as a med student to do an Anesthesiology rotation because it is very foreign in many ways to your other rotations...but if you find the right mix of people and you play your cards just right, it will end up being the best rotation you'll ever have, even if you end up falling in love with OB/GYN..

Good Luck

I've just finished my first week of a 3rd year anesthesiology rotation and I have to say I am VERY disappointed so far. I am very interested in this field and really wanted to learn everything I could about it during these 2 weeks but so far it has been a big let down. I'm really hoping that it is just this particular preceptor and hospital because I've been reading some great posts lately about why everyone has gone into anesthesiology and it sounds like a great fit for me.

Basically we show up at 7:00 a.m. and check out the schedule for the day, go around and do a few intubations, maybe a central line or art line, hang out and read in the OR dept for hours in between, go to lunch, maybe another intubation, then go home by 2:00. Once we intubate the patient my doc leaves the room and mentions nothing about how to manage him DURING OR AFTER the surgery (which I gather is kind of important?) 😱. So now I can either tag along with him or stay in the room and try and get the CRNA to teach me something, which few are willing to do and rightfully shouldn't have to do. And then he says we can go watch any interesting surgery we want and takes off, but I really want to learn some freaking anesthesiology!!! Atleast go over some physiology, something!

I want to learn the principles of anesthesia and why we do the things we do, not just HOW to do them. I don't want to just turn knobs and push buttons and intubate. And I did tell him that I'm interested in pursuing this field, hoping he would kind of take me under his wing and show me some stuff, and his reply was "oh, ok, well there is a good job market right now".

Any suggestions? I only have one more week and I don't want to totally write off this specialty on account of a crappy rotation. How can I maximize my remaining time? Thanks.

 

[dhb]

I want to learn the principles of anesthesia and why we do the things we do, not just HOW to do them. I don't want to just turn knobs and push buttons and intubate.

As a med student your exposure to anesthesia is generally limited so sometimes it's hard to get a discussion going on any given topic and this might be perceived as a lack of interest if the attending isn't proactive with you.
So if you don't just want to turn knobs you should be asking why the knobs are being turned there is a reason behind everything that happens in the interaction between the anesthesiologist, the patient and the or environment so to get things started you should ask the resident/attending about his/her though process behind everything that he/she is doing: why the pulse ox first? why the electrodes in that position? why this amount of flow on the machine etc etc... (without being pesky 😀 if you don't get answers then you should find another teacher pronto)

How can I maximize my remaining time?Thanks.

Stick around later life in the hospital isn't the same after 5pm 😀

 

[militarymd]

WVU anesthesiology program is in trouble...they're looking for a new chair...it's in shambles...probably explains your rotation.

 

[gclax30]

Man, that's too bad. Those types of preceptors seem like a big part of the problem in anes. Those sloths should just step out of the way if they're going to be like that.

I'll be spending all next week in the OR. I'll be hanging with surgeons, but my main motive was to get a handle on anesthesia (this hospital doesn't have anes residents though, so I'm officially shadowing surgical residents/attendings). I'm geeked about it, cause I'll be getting some good, general, OR time in.

The way I see it is how one decides to practice is up to the individual attending. Some of the sloths will choose to just get by, like the employee-type mentality that MilMD has elaborated on. Others, like many of the attendings on this forum, will choose to practice entirely different, as you will be able to do down the road.

You can be the guy/gal that takes ownership of cases. The one that is the true knowledge sink that people rely on and respect. The one that shows leadership and that enjoys teaching (when appropriate). The one that drops back into the various rooms (in an ACT model) often, thereby staying on top of his/her cases and projecting a prescence of professionalism and security.

Perhaps this is all idealistic, but my experiences are that in ANY job, one can merely get by, or one can choose to excel. The attending that you've described is not taking advantages of all of the above OPPORTUNITIES available to him. That's a shame, and very well may be unacceptable in the near future.

I had a buddy in college who's dad was the chief of anesthesiology at a decent sized community hospital. According to my pal, his dad was ALWAYS reading up on cases, watching videos related to the field, and just being proactive w/r/t his career. That's why he was the chief, and very well respected. He made the choice to be that way.

Thanks for the responses everyone. I do take the initiative to ask questions, but it is hard when my preceptor leaves the room 8 seconds after the patient is intubated and is nowhere to be found until the next case. I ask the CRNAs because they are the only ones around and all I get is a simple two line answer that I could have found in my pocket anesthesiology book. I've asked all about the induction process, intubation, what the differences are between the inhaled agents, how to start waking them up, when to extubate, etc. and it just seems like I'm wasting my breath. I learned more anesthesia from pharm lectures last year. There are no residents and the other gas docs there don't take students and won't even let us in the room because it is "too crowded" 👎. So anyway, hoping things turn around a bit next week. Thanks again.

 

[dhb]

well it seems like you should try rotating somewhere else...👎

 

[Masseter Spasm]

Sounds like a poor location for an anesthesia rotation. I would not dismiss anesthesia yet. If anesthesia is a required rotation at your school, it may be that there is simply not enough room for students at the desirable sites. (It sounds like you are rotating at a small community hospital with a department of anesthesia that places a low priority on education.) I would try to do a fourth year elective at a different site. Talk to other students who enjoyed their rotation and identify a desirable site for your elective rotation. Or consider doing an away elective.

Also recognize that expectations on anesthesia rotations may be different than your other rotations. During Medicine and Surgery medical students are often kept busy doing the work that no one else wants to do (H & P's, retracting, rectal exams, etc.) Anesthesia is at times a very time urgent environment in which alot needs to be accomplished successfully in a short period of time. Some anesthesiologists are better at getting students involved than others. (Often it is easier to simply do the sequential tasks in anesthesia oneself than to delegate them to others.)

For your last week try to locate someone who gets you involved even if it seems mundane. (Can you turn to sevo to 2%, Can you mask this patient while I put in an I.V., Do you want to put in an IV?, etc.) At least try to find someone who thinks outloud. ("When I place an LMA I leave the cuff inflated because...")

Keep reading, Ask alot of questions, and continue to show interest. Sooner or later your persistance will pay off.

 

[proman]

Sounds like you're rotating with a private group. Right? I did my first month with a private group and felt the same way. There were advantages (ie more intubations) but to be honest, most CRNAs are intimidated by medical students. You won't learn much from them and they don't represent the medical specialty. My second month was at Wake Forest. Completely different experience. While I didn't get to do as many intubations, I got to be a part of the cases, and the teaching. So, make sure you do a rotation at a good residency program before you drop the specialty.

 

[apma77]

the poster seems to be another pain in the a$$ medical student which we all dread..they feel they are owed constant attention and pampering

for gods sakes grow up and come out of the womb😱

 

[amyl]

WVU anesthesiology program is in trouble...they're looking for a new chair...it's in shambles...probably explains your rotation.

care to share the details? it is/was pretty high on my list? I thought they just came off probation and everything was headed in the right direction?

 

[badgas]

care to share the details? it is/was pretty high on my list? I thought they just came off probation and everything was headed in the right direction?

I think that things are improved there. Trisomy... any thoughts??

 

[militarymd]

care to share the details? it is/was pretty high on my list? I thought they just came off probation and everything was headed in the right direction?

They're looking hard to find a chair...

They're looking hard to find warm bodies....

One of my partners was hired a few years back to be assistant chair....they lost my partner to me by being stupid...and now they're trying to get my partner....

and it's not happening....They have issues....beyond just on probation.

 

[Trisomy13]

WVU anesthesiology program is in trouble...they're looking for a new chair...it's in shambles...probably explains your rotation.

With all due respect MilMD, please do not post misinformation. There has been a tumultuous period recently, but WVU has a chairman - David Wilks, MD. From what I understand he was previously at U New Mexico and helped turn that program around when it was in trouble. There is still a search for additional faculty but there have been several recent hires and more interviewing (saw a peds guy in the lounge today interviewing). We recently (two weeks ago) opened a brand new 20-bed PACU. ORs are state-of-the-art - cameras, flat screens, etc.

The program is on probation for issues that have been largely resolved, with the RRC review extended to April 2008. We expect positive results. While we have some hurdles to overcome to become a top-notch program, we are far from being "in shambles". If you want to bring up other issues please do and I'll do what I can to answer them.

 

[me454555]

the poster seems to be another pain in the a$$ medical student which we all dread..they feel they are owed constant attention and pampering

for gods sakes grow up and come out of the womb😱

Teaching and pampering are 2 different things. Don't you remember what it was like to be a medical student? Your thrown into an environment where you know absolutely no one and nothing about the subject. You have no clue what to do and they expect you to know everything. Having a good preceptor can make or break a rotation. There is nothing wrong with a little one on one teaching and that seems to be the problem in the medical field in general. If you don't wanna teach, don't go to an academic hospital. Seems pretty strait foward but I can't tell you how many rotations I went to where the preceptors would just go about their business and I felt like an endentured servant doing busywork w/out getting paid or taught. It really makes for a horrible rotation

 

[Berg]

I would just like to point at that the original poster goes to WVSOM (West Virginia School of Osteopathic Medicine), not WVU SOM. Original poster was talking about a completely different school as those that replied.

 

[militarymd]

With all due respect MilMD, please do not post misinformation. There has been a tumultuous period recently, but WVU has a chairman - David Wilks, MD. From what I understand he was previously at U New Mexico and helped turn that program around when it was in trouble. There is still a search for additional faculty but there have been several recent hires and more interviewing (saw a peds guy in the lounge today interviewing). We recently (two weeks ago) opened a brand new 20-bed PACU. ORs are state-of-the-art - cameras, flat screens, etc.

The program is on probation for issues that have been largely resolved, with the RRC review extended to April 2008. We expect positive results. While we have some hurdles to overcome to become a top-notch program, we are far from being "in shambles". If you want to bring up other issues please do and I'll do what I can to answer them.

YOu have first hand info...I'm only repeating what I was told.

 

[bigdan]

Life is short.

Make an impact.

Good luck.

Jet - this should be on a T-shirt somewhere. Truer words have not been spoken (or typed).

dc