philosophical question for the attendings

[bullard]

Was wondering what jet, military, et al think about this:

Program A is a surgical powerhouse, says residents learn by doing many cases of all types. Get out later, take more call. Program B emphasizes becoming a consultant anesthesiologist and that there are diminishing returns after doing a certain number of cases of a given type. You become proficient with technical aspects of anesthesia like lines and intubations quickly -- other stuff takes more time and isn't learned in OR. Emphasizes reading and other forms of learning.

Who's blowing smoke? What's the right philosophy? Which graduate would you rather hire?

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[zippy2u]

Depends on what type of person you are. If you're a person that walks around with 10 thumbs and never could drive a nail in a board but have a near photographic memory, choose the workhorse program. On the other hand, if you're athletically gifted like I am ( learned to snowboard and ski in 1 day) and can access blood from a turnip but have to work hard at obtaining a knowledge base then choose the program that will maximize your reading time. In my opinion, the anesthesia residencies should require one to pass the written exam before allowing one to finish the residency. Regards,-- Zip

 

[militarymd]

Who's blowing smoke? What's the right philosophy? Which graduate would you rather hire?

Either or, as long as you're ready to work hard.

 

[jetproppilot]

Either or, as long as you're ready to work hard.

I agree with Mil.

Kinda like working out....more reps? Less reps? Doesnt natter that much. As long as you go.

Good luck.

 

[iron]

Depends on your definition. I have residents who are technically very good but will not pass boards in the near (or probably distant) future. I think my contact with them has changed my perspective. Anyone can be trained to be a technician. But to be a consultant-level anesthesiologist takes more than doing a lot of cases. Much of your education will depend on you. Not attending didactics, not doing cases, but reading the texts, reading the literature, asking questions and looking for answers.

I'm a bit skeptical about a program that advertizes itself as a big surgical program. Sounds like you might be a warm body to staff an O.R. They need to and should offer you more.

 

[Noyac]

Depends on your definition. I have residents who are technically very good but will not pass boards in the near (or probably distant) future. I think my contact with them has changed my perspective. Anyone can be trained to be a technician. But to be a consultant-level anesthesiologist takes more than doing a lot of cases. Much of your education will depend on you. Not attending didactics, not doing cases, but reading the texts, reading the literature, asking questions and looking for answers.

I'm a bit skeptical about a program that advertizes itself as a big surgical program. Sounds like you might be a warm body to staff an O.R. They need to and should offer you more.

Well said, Iron.

 

[Laryngospasm]

Depends on your definition. I have residents who are technically very good but will not pass boards in the near (or probably distant) future. I think my contact with them has changed my perspective. Anyone can be trained to be a technician. But to be a consultant-level anesthesiologist takes more than doing a lot of cases. Much of your education will depend on you. Not attending didactics, not doing cases, but reading the texts, reading the literature, asking questions and looking for answers.

I'm a bit skeptical about a program that advertizes itself as a big surgical program. Sounds like you might be a warm body to staff an O.R. They need to and should offer you more.

I agree 100%

 

[jetproppilot]

Depends on your definition. I have residents who are technically very good but will not pass boards in the near (or probably distant) future. I think my contact with them has changed my perspective. Anyone can be trained to be a technician. But to be a consultant-level anesthesiologist takes more than doing a lot of cases. Much of your education will depend on you. Not attending didactics, not doing cases, but reading the texts, reading the literature, asking questions and looking for answers.

I'm a bit skeptical about a program that advertizes itself as a big surgical program. Sounds like you might be a warm body to staff an O.R. They need to and should offer you more.

The cream (motivated, skilled, smart, amicable personality) will rise to the top regardless of residency program.

I have a buddy who played for the Pittsburgh Steelers for 2 years...when he got cut, everyone told him to go the CFL to get more experience...they felt he was good enough for the NFL but needed more "licks" (playing time).
He decided against it, went to med school, and now he is an orthopedist.

Moral of the story is you NEED stool time to be a good anesthesiologist. The more cases you do, the better youre gonna be. Just like my buddy who needed more playing time.

You CAN emerge from a busy residency well read. It all depends on you.

Analagous to the stupid theory that "quality time" with your kids is important...baloney...its quantity...30 minutes per night with your kids is not enough.

 

[jetproppilot]

The cream (motivated, skilled, smart, amicable personality) will rise to the top regardless of residency program.

I have a buddy who played for the Pittsburgh Steelers for 2 years...when he got cut, everyone told him to go the CFL to get more experience...they felt he was good enough for the NFL but needed more "licks" (playing time).
He decided against it, went to med school, and now he is an orthopedist.

Moral of the story is you NEED stool time to be a good anesthesiologist. The more cases you do, the better youre gonna be. Just like my buddy who needed more playing time.

You CAN emerge from a busy residency well read. It all depends on you.

Analagous to the stupid theory that "quality time" with your kids is important...baloney...its quantity...30 minutes per night with your kids is not enough.

You can read about interscalene blocks/subclavians/hemodynamic instability in a CABG/bad airways all you want, but until you've done MANY, you wont be comfortable.

Being well read in residency/after residency is very important. But so is case load, especially in your training years.

 

[cchoukal]

Was wondering what jet, military, et al think about this:

Program A is a surgical powerhouse, says residents learn by doing many cases of all types. Get out later, take more call. Program B emphasizes becoming a consultant anesthesiologist and that there are diminishing returns after doing a certain number of cases of a given type. You become proficient with technical aspects of anesthesia like lines and intubations quickly -- other stuff takes more time and isn't learned in OR. Emphasizes reading and other forms of learning.

Who's blowing smoke? What's the right philosophy? Which graduate would you rather hire?

Your description for program B sounds exactly like the marketing material for the university of chicago's program (where I am presently an intern). Am I right?

 

[VentdependenT]

The cream (motivated, skilled, smart, amicable personality) will rise to the top regardless of residency program.

I have a buddy who played for the Pittsburgh Steelers for 2 years...when he got cut, everyone told him to go the CFL to get more experience...they felt he was good enough for the NFL but needed more "licks" (playing time).
He decided against it, went to med school, and now he is an orthopedist.

Moral of the story is you NEED stool time to be a good anesthesiologist. The more cases you do, the better youre gonna be. Just like my buddy who needed more playing time.

You CAN emerge from a busy residency well read. It all depends on you.

Analagous to the stupid theory that "quality time" with your kids is important...baloney...its quantity...30 minutes per night with your kids is not enough.

You said "stool time."

pfff *giggle*

 

[cchoukal]

And actually, when I was making this decision last year, I asked a couple department chairs (UCSF, Mayo, OHSU, and I think Stanford) the exact same question via email, and would be happy to email their responses to you, if you PM me.

 

[jetproppilot]

You said "stool time."

pfff *giggle*

Last nite had a big party at our house...kinda funny, since the first floor is just concrete slab and studs...but hey, its a big house, so why not have a party?

Caterer made crawfish pasta, crab and spinach dip, cajun (read spicy) meatballs, roast beef and ham sandwiches with some special cheese, etc etc...

had the HUGE Gray Goose vodka bottles...

AND NOW TO THE stool part of this thread, Venty...

somebody brought this liquor bottle that tasted like cinammon..they some dude was force feeding us shots ...

anyway, it has gold flakes in it and you can allegedly look at your poo poo in the morning and see

GOLD FLAKED POO POO!!!



uh,,, I didnt look at it this morning...had a medium sized hangover though!!

 

[Gimlet]

somebody brought this liquor bottle that tasted like cinammon..they some dude was force feeding us shots ...

anyway, it has gold flakes in it and you can allegedly look at your poo poo in the morning and see

GOLD FLAKED POO POO!!!

That's Goldschlager! I think the stuff's gross, but I have buddies who like buying rounds of it. I don't see the appeal of drinking gold flakes, personally. I haven't heard the gold flaked poo poo rumor, but then again, I don't usually like to take a look in the toilet the morning after a night when I was drunk enough to take shots of Goldschlager.

 

[jetproppilot]

That's Goldschlager! I think the stuff's gross, but I have buddies who like buying rounds of it. I don't see the appeal of drinking gold flakes, personally. I haven't heard the gold flaked poo poo rumor, but then again, I don't usually like to take a look in the toilet the morning after a night when I was drunk enough to take shots of Goldschlager.

GOLDSCHLAGER! THATS IT BRO!

Its gone. ALLLL gone.

We got kinda crazy last nite.

One of our CRNAs blind-sided-tackled me in the back yard, Lawrence Taylor like...smoked me...put grass stains on my white-Banana-Republic sweater...

ten seconds later, after I figured out what happened,

Mr CRNA was pinned to the sod saying

"DUDE, I CANT BREATHE!! REALLY!! I CANT BREATHE!!!!"

I had him Matt Hughes-like in a rear-naked-choke. He was about to become the third post-Katrina 1-8-7.

And people say theres no benefit in watching Ultimate Fighting Championship.

 

[lvspro]

GOLDSCHLAGER! THATS IT BRO!

Its gone. ALLLL gone.

We got kinda crazy last nite.

One of our CRNAs blind-sided-tackled me in the back yard, Lawrence Taylor like...smoked me...put grass stains on my white-Banana-Republic sweater...

ten seconds later, after I figured out what happened,

Mr CRNA was pinned to the sod saying

"DUDE, I CANT BREATHE!! REALLY!! I CANT BREATHE!!!!"

I had him Matt Hughes-like in a rear-naked-choke. He was about to become the third post-Katrina 1-8-7.

And people say theres no benefit in watching Ultimate Fighting Championship.

Did he tap-out?

 

[bullard]

Your description for program B sounds exactly like the marketing material for the university of chicago's program (where I am presently an intern). Am I right?

I sent you a PM.

 

[rn29306]

GOLDSCHLAGER! THATS IT BRO!

Its gone. ALLLL gone.

We got kinda crazy last nite.

One of our CRNAs blind-sided-tackled me in the back yard, Lawrence Taylor like...smoked me...put grass stains on my white-Banana-Republic sweater...

ten seconds later, after I figured out what happened,

Mr CRNA was pinned to the sod saying

"DUDE, I CANT BREATHE!! REALLY!! I CANT BREATHE!!!!"

I had him Matt Hughes-like in a rear-naked-choke. He was about to become the third post-Katrina 1-8-7.

And people say theres no benefit in watching Ultimate Fighting Championship.

Looks like Joe Rogan sitting ringside at UFCs has paid off. Real or not, you decide, but he has the rear choke sunk in like the Titanic on this dude's throat.

http://media.skoopy.com/vids/vid_00912.wmv