How to best approach CA-1 year?

[invitro]

Hey. I'm going to be a CA-1 this year at a good academic program (in less than a month!). I read through a couple of posts that people made about reading suggestions etc.

I am steadily getting through M+M. My goal is to know the first fifteen chapters well before I start on July 1st. Is this a good goal? Sorry, but I looked through Baby miller (the 2007 edition) and I found it just wasn't as readable.

How much of intern year (medicine wise) is useful as a resident? I wouldn't say I was the weakest medicine intern, but I still sometimes have trouble with my clinical judgement at times....this kind of frustrates me.
I heard a couple of CA-1 residents tell me that intern year was essentially not very useful for anesthesiology, and that you have to learn an entirely different skill set/base of knowledge. This heartens me as my medicine background is somewhat adequate at best, but I wonder if this is true?

Finally, most importantly, how should I approach residency? I know this a stupid question but I just need some of you confident CA-2's and CA-3's to tell me some tips.

I copied a portion of a post UT Southwestern made a few years ago about becoming a chief resident...I think some of his posts are very thought-provoking.

So does it help[To be chief resident]? Definitely. Should you campaign to get the position? Hell no. Every resident should work with the diligence and enthusiasm that would make them candidates for the position, but what will separate you from the pack is your willingness to go the extra mile and help your fellow residents and program whenever there is a need and even when there isn't a need. Recognition comes through merit and service, not backstabbing, politicking, or machinations. I have seen a couple of people in other residencies do the latter and claim the position but all that does is create a chief resident without the ability or backing of the residents to lead.

I always wanted to help and do extra work because I loved the extra opportunities to gain experience and even just watch other people in action to learn their secrets. You can also separate yourself from the pack by being lazy, showing up late, not being prepared, and having a me first/the world is against me attitude. YOU CANNOT JUST TURN OFF LAZINESS AND SUDDENLY BECOME AN ACHIEVER. You slack off early in your residency and not only does it become hard to deviate from your wayward path, but it is also hard to shake off the label of lazy/stupid/dangerous resident.

In the end, I desperately want to be the confident CA-3 (chief or not) that residents look up to and attendings trust. My overall question to you guys is how do I reach that goal in the most efficient manner?

invitro

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[VentdependenT]

Approach it like you would your intern year. Learn from the residents and attendings who strike you as good anesthesiologists. Ask em all the questions you can think of that are relevent. There is no question too stupid during the first half of CA-1 year. I didn't know how to prime a friggen IV or work the stop cock correctly. Seriously.

Most important; don't be lazy, help out (even if its just helping a fellow anes resident slap on monitors or push the patient down the halll), be ON TIME, and don't bitch. If you have those four things down you'll be a good resident. Seriously.

The clinical stuff will come. Believe me. You'll even get all cocky at some point then you'll get burned, or almost burned, and then you'll relize how little you know. So don't sweat not knowing stuff. There are points where all of us feel inadequate at times. Except for maybe military, jet, and noyac. Bastards.

As far as intern year goes, yeah, there is some helpful stuff there but its all in how you incorporate it. I think gettin through those chapters of M&M will put you wayyyyyyy ahead of the curve.

 

[invitro]

Hey, thanks for the reply vent, and congrats on getting that chief spot. I know you will be a great chief to your junior residents.

-invitro

 

[Masseter Spasm]

"In the end, I desperately want to be the confident CA-3 (chief or not) that residents look up to and attendings trust."--Invitro

Start with knowledge. Keep reading. Try to finish M&M by the end of your CA-1 year. Then move on to something else like Barash or Miller. You would be surprised how many people can get through the day without knowing much about their patients or anesthesia while in the protected environment of a residency.

Anesthesia attendings trust residents that look prepared. (A resident who understands the patient, procedure, and anesthetic technique.)

Accumulate experience. Anesthesia is a team sport in large hospitals. When you finish your cases ask the board runner if he/she needs help with anything else. If your cases are delayed see what else is going on. (Maybe someone needs help with a regional block or a difficult intubation.) If you were making the OR schedule for the next day how would you make case assignments? Would you give the sick patients and complex procedures to a resident who disappears everyday at 3 p.m. or the resident who you can always trust when things get crazy? Some residents always seem to be in the middle of the action by virtue of being hard-working and agreeable.

If you try to approach residency as your time-limited opportunity to learn and gain experience you will do well. If you approach residency as just a job your time will be wasted. I appreciate that their is a temptation to resist the system, but keep in mind that most marginal residents become marginal anesthesiologists. The attitudes/habits that you adopt now will stay with you when you go out to practice on your own.