Hi Everyone, I've been off the forums for awhile. Busy with internship. I just wanted to post a couple of things I've noticed this year concerning the need for anesthesiologists. I just finished 3 months of Surgery (Transitional year) and got to know many of the community surgeons, intensivists, and anesthesiologists. After these 3 months, I feel more secure then ever about anesthesiology's future. For example: 1. Just about every surgeon I've met (especially the CT, Vascular, and Neurosurgeons) expressed a strong desire to have an anesthesiologist present for their cases. Most of them had been burned to many times by working with CRNA's. Frankly, they said their patients were for the most part too sick for anyone but another physician to be taking care of them in the OR. 2. The rapidly expanding field of TEE is dramatically changing CT and vascular surgery. This is not just for valve surgery, since many unexpected intraoperative occurences are being detected by TEE. Examples of these are rare things such as ventricular thrombus formation to common things like volume depletion. I don't know any CRNAs who are adept echocardiographers. 3. The true skills of the anethesiologist really show through in the emergent cases, which many people not in the field forget entirely. In my minimal 3 months of general surgery, we took some really sick people to the OR. I'm talking about people who are in DIC, renal failure, septic and hypovolemic shock, with heaps of necrotic bowel and just a day or two out from major anterior wall MI's. The funny thing is, until you actually get into the field (surgery or anesthesia), you don't really notice how often these presentations actually are. Not to mention those with the above problems, plus being 5'0", 250 lbs, and major pulmonary hypertension. The hospitals know this and that's why they want anesthesiologists available 24 hrs a day. The major medical center/trauma center here just made it mandatory that all anesthesiologists with attending priviledges take in house call on a scheduled basis, or lose their priviledges. They already had in house CRNAs. Anyway, I could go on for awhile but I'll stop now. I guess the impression I've been getting during internship, is that the future of anesthesia is very bright, as long as you don't mind taking care of sick people and working hard. Bye the way, internship is a blast so far.