Philosophies and Economic Practicalities in Anesthesiology Education

[Gator05]

In talking with the graduating MS4's at our institution about their interview experiences, there seem to be 2 camps among the residency programs out there:

The first is a work-based program, whereby the majority of your education is via pure experience. Learning is not by reading in these cases, but by doing. It's pointed out that anesthesiology IS a procedural specialty, and as such is best learned by doing rather than reading. Days in these programs are long (>12-14 hours), but the clinical experience immense.

The second is a more-relaxed work schedule, with emphasis placed on having time to read rather than pure OR-time. There is, after all, a great amount of practical basic-science material in anesthesiology, and procedures should become routine after the n-th time.

It gets more complicated; are the work-based programs truly treating you to educational cases? Doing eyeballs for 12 hours late in CA2 year may not be as helpful as an hour or 2 at home reading up on topic X. This may also be a sign of the hospital using residents to enhance its profit margin. In the opposite direction, how appropriate is it for a program NOT to run a heart room daily, or to force residents to double up on cases? Is there a clinically relevant penalty on your education for getting home at 4pm each day?

Looking for comments from senior members on these issues, as there seem to be some fundamental differences amongst the program directors out there!

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[BassDominator]

All the top programs will work you hard. The better the program, the more complex the cases and the better the learning experience. Sure, some might argue you'll probably never see most of these cases in private practice, but it still prepares you better for the boards and any surprises in the future.

Personally, I learn better from doing.... and then reading about it. I would hate to get a question on my boards or a patient with something I've only read about in a book.

Honestly, no program will really work you that hard.... most don't come close to the 80 hour rule, with the exception of the ICU. Even at the most hardcore programs, you're only working 60-65 hours a week (which still beats the heck out of most other specialties).