Procedures during PGY-1 year...

[SleeperHold]

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So I start anesthesia CA-1 in July, and looking back on my transitional year, I've done next to nothing in terms of procedures. On the other hand, it seems like other people who have done surgery prelims with SICU rotations have gotten a fair amount of lines and other experiences more relevant to anesthesia. Just wondering if programs are generally understanding of the discrepancy in first year training, or will I be shunned like the plague?

 

[bubalus]

Don't worry about it.

 

[Bougie]

When you start as a CA-1, most attendings assume you have zero knowledge and usually go to great, painful lengths about the "correct" way to do anything including taping the ETT. My advice is to say nothing and just nod yes even if you already have a pretty good idea about how to do a procedure. Also get info from upper level residents; I learned more practical info (i.e. how to get the damn Alaris pump to stop saying air-in-line) from them than the attendings when I started.

 

[VolatileAgent]

When you start as a CA-1, most attendings assume you have zero knowledge and usually go to great, painful lengths about the "correct" way to do anything including taping the ETT. My advice is to say nothing and just nod yes even if you already have a pretty good idea about how to do a procedure. Also get info from upper level residents; I learned more practical info (i.e. how to get the damn Alaris pump to stop saying air-in-line) from them than the attendings when I started.

yes.

and, eventually (and before you know it), you'll get to the point where you'll start to have equally painful "discussions" about what is actually the "correct way" to do the case.

 

[Gasboy07]

Yes - the nod and smile method works well. They usually work out very quickly where you're at then tailor advice accordingly. You never know when you might get a tip which makes life a whole lot easier.

In addition, if you let them know something you'd particularly like to learn they often seem to go out of their way to create opportunities for you... like when my patient looks like they "might" have a difficult airway and "might" be difficult to ventilate so we better do an awake fibreoptic.