Recommendation for away - pain vs CT vd peds

[soulcity]

Looking to do an away(to open up a region) but they only have availability for peds vs pain vs CT. I'm leaning towards pain so that it would give me some face to face time with an attending... any recommendations anyone ?

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[deleted875186]

Looking to do an away(to open up a region) but they only have availability for peds vs pain vs CT. I'm leaning towards pain so that it would give me some face to face time with an attending... any recommendations anyone ?

These sub specialties couldn’t be more different. You should probably only do the rotation your planning on applying for. I think you’ll interact with attendings in any field. I wouldn’t just assume you’d get more face time with pain attendings.

 

[anbuitachi]

they are all god awful. cardiac and peds cases are very specific and you will likely not get the opportunity to do much if anything. These cases will be staffed with residents/fellows and they will be doing everything. We occasionally get residents from other specialties rotating on peds, and we don't even let them intubate because anesthesiology residents only get so much opportunity to practice peds stuff unless its a heavy peds center so priority falls to us. And i doubt they'll let med students fudge around blowing veins in a kid when kid is being masked.

If i had to choose, probably cardiac > peds/pain They may let you put in IV and some other procedures if they are real chill. The downside is the day often starts earlier..
Pain is so different it's like doing a medicine rotation. And i didn't get much face time with attending on pain even as a resident but i'm sure this varies a lot from place to place

 

[abolt18]

they are all god awful. cardiac and peds cases are very specific and you will likely not get the opportunity to do much if anything. These cases will be staffed with residents/fellows and they will be doing everything. We occasionally get residents from other specialties rotating on peds, and we don't even let them intubate because anesthesiology residents only get so much opportunity to practice peds stuff unless its a heavy peds center so priority falls to us. And i doubt they'll let med students fudge around blowing veins in a kid when kid is being masked.

If i had to choose, probably cardiac > peds/pain They may let you put in IV and some other procedures if they are real chill. The downside is the day often starts earlier..
Pain is so different it's like doing a medicine rotation. And i didn't get much face time with attending on pain even as a resident but i'm sure this varies a lot from place to place

I did a CT anesthesia rotation as an away in my 4th year. They let me intubate, push meds, put in art lines, central lines, and put in double lumen tubes. It was an awesome rotation. I learned a lot and had a blast.

*Of note, I had experience, albeit limited, doing all of the above procedures before the rotation, so I believe this made them more comfortable with me doing them.

 

[AdmiralChz]

I did a CT anesthesia rotation as an away in my 4th year. They let me intubate, push meds, put in art lines, central lines, and put in double lumen tubes. It was an awesome rotation. I learned a lot and had a blast.

While nice, this is NOT the typical experience for a rotator. Usually the resident or fellow does most of it - a rotator would start by intubating and placing IVs, then maybe art lines by the end of the rotation. For peds, it would be even less if anything at all. The only way this situation would change is if a place doesn't have residents or fellows in which case it would be unlikely to allow away rotations for students but I guess you never know.

Once, when I was a CA-3, I scrubbed in with a medical student for a CVL. He swore he had done them before (he didn't mention it was only on a mannequin), and it was a very frustrating/scary experience for me as a supervisor. I won't be doing that again for some time unless I can really get some extensive 1-on-1 with a student for days and days. I'd reconsider if it was the ICU where we had plenty of time and (possibly) more space. Double-lumen tubes are a hard no, come back to me during CA-1 year.

Ideally a rotator would do some high-turnover ambulatory or outpatient anesthesia rotation where he or she would see lots of cases and get to do a whole bunch of stuff making it high yield. But most important is that you can sort of get in with one or two attendings and stay with them the whole month so they can get to know you, you can show some knowledge off, and potentially get a letter which can be quite challenging for anesthesia rotators.

 

[abolt18]

While nice, this is NOT the typical experience for a rotator. Usually the resident or fellow does most of it - a rotator would start by intubating and placing IVs, then maybe art lines by the end of the rotation. For peds, it would be even less if anything at all. The only way this situation would change is if a place doesn't have residents or fellows in which case it would be unlikely to allow away rotations for students but I guess you never know.

Once, when I was a CA-3, I scrubbed in with a medical student for a CVL. He swore he had done them before (he didn't mention it was only on a mannequin), and it was a very frustrating/scary experience for me as a supervisor. I won't be doing that again for some time unless I can really get some extensive 1-on-1 with a student for days and days. I'd reconsider if it was the ICU where we had plenty of time and (possibly) more space. Double-lumen tubes are a hard no, come back to me during CA-1 year.

Ideally a rotator would do some high-turnover ambulatory or outpatient anesthesia rotation where he or she would see lots of cases and get to do a whole bunch of stuff making it high yield. But most important is that you can sort of get in with one or two attendings and stay with them the whole month so they can get to know you, you can show some knowledge off, and potentially get a letter which can be quite challenging for anesthesia rotators.

I cannot contest that. I was surprised. But in their rotation expectations they specified that they wanted us to be doing central lines and art lines by the end of the month and that this was a more "procedural rotation" for 4th years. I was lucky that I had done them before a handful of times so they let me start doing them the first week.

If I was paired with a resident, I did less. If paired just with a fellow, I did way more.

I am not trying to say that this is what people should expect out of such a rotation. Only giving an example of how variable these rotations may be.

At my current institution, this would never ever happen. I had one cardiac attending say to me here that the only place a medical student has in the heart room is in the corner, not touching anything haha.

 

[Aether2000]

Would recommend CT. Pain is under fire from all sides right now and many pain physicians are in prison or have lost their licenses long term.