residency q

[coconut lime]

i am an m2 that's looking at anesthesiology as a potential career, but i just have some questions about the residency. i know that it's 4 years, but what does the 1st year of "internship" entail? what are the work hours like during the residency? how competitive is the residency, and what kind of board scores do you need? if anyone has any input/advice, i'd really appreciate it. thanks!

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[Skrubz]

anesthesia is currently 1+3 in terms of years. before you embark on 3 years of anesthesia training, you need a year of internship. this is typically prelim medicine, prelim surgery, or transitional but some others are acceptable (OB/gyne, peds, FP). the ACGME website has a link called "Program Requirements" where you can get a PDF that has the exact requirements. the intent of the internship year is to make sure that you have a foundation of basic clinical knowledge before you lock yourself in an OR behind a drape for 3 years. some programs provide that intern year (4-year/categorical programs) while others thumb their nose at you and tell you to go find one yourself (3-year/advanced programs). The ASA (at least I think it's the ASA...) is now promoting that all anesthesia residencies become 4 year programs where the clinical base year/internship is integrated; there is also a movement to increase the number of ICU months from 2 to 6 over the next few years.

as for hours, it varies. some programs brag about averaging 60 hours a week, while others have reputations for working residents like dogs. of course, the ACGME now limits residents to working 80 hours per week. i don't think most programs average more 70 or so hours per week tops. remember, anesthesia is one of the few, if not the only, residencies where you get your post-call day off (when you're in the OR. all bets are off in the ICU). in the OR, i would say your day typically starts between 6 and 630 in the morning, and ends anywhere from 3 to 6 on average, depending on the program.

as far as competitiveness, anesthesia is in the midst of an upswing. i would still say that it's middle-tier in terms of competitiveness though. i think rad onc, derm, ortho and ophtho (and rads this year) are more competitive. i have no idea what board scores you need these days...

 

[supahfresh]

anesthesia is one of the few, if not the only, residencies where you get your post-call day off

definetly not true. since the new 80 work week restriction, I have seen first-hand an OB/GYN and gen surgery programs send you home immediately post-call.

pick the specialty you like the most.

 

[Skrubz]

Originally posted by supahfresh
since the new 80 work week restriction, I have seen first-hand an OB/GYN and gen surgery programs send you home immediately post-call.

thanks for the correction, supahfresh. i wasn't aware ob/gyn and gen surg had become so humane. do you think this is now the norm for them?

 

[thegasman]

Also many programs with a four year curriculum are changing the traditional 1+3 format. A lot of places will have you do six months of anesthesia as an intern with six months of gen med etc. You would then fill out the rest of your intern months during your pg2-3 years. You wouldn't take step 3 until then or be able to moonlight outside in this situation I don't think.

 

[2ndyear]

Do you know what programs are integrated into 4 years? By integrated I mean more than 1-2 mo. of anesthesia. I know that Penn State is the only one that I came across interviewing this year, but it seemed really nice! They do 6 mo. in the first year.

 

[Skrubz]

the ones that i know (because i interviewed there) are:

chicago
UIC
U of C
northwestern
rush
loyola

california
UC davis

washington
UW
Virginia Mason

keep in mind that each of these programs offers both categorical (4 year) and advanced (3 year) positions, and not always in equal quantities.

for more programs, i'd recommend searching on FREIDA.

addendum
my bad, i didn't read your post carefully enough.

 

[2ndyear]

thanks for the list,
I meant more integrated though. I interviewed at UIC and Loyola, and sure, they both have 4 year programs but PGY-1 is still a basic internship with a month of anesthesia. I was wondering more about the programs that you do 6 months of anesthesia in your PGY-1 year. I think that these are few and far between right now but will become more common around 2007 or so if the ASA goes through with the Categorical only plan. Sorry about any confusion.

 

[thegasman]

Of the places I interviewed U Kentucky and U Virginia do six months of anes in the intern year. I think I heard USF may do this also. I'm not sure about others.

 

[gaslady]

There are disadvantages to having a program that allows you to do more than 1 or 2 months of anesthesia during internship. You have to go back and make up that time later on. I think that's a big deal and personally I am glad that I am getting the nonanesthesia training over with. I also think internship prepares you well for Step 3. The anesthesia board exam is supposedly one of the more difficult exams and requires a significant amount of preparation. You want to get Step 3 over with early on in residency so that you don't have to worry about it and can concentrate on anesthesia. Also some of these integrated programs may stagger the start dates of the various interns and CA 1 s. I think this kind of sucks because you miss the comraderie that the orientation brings at more traditional programs.
However, doing your internship at the same institution as your residency is a huge plus. There are reasons to do it at a different hospital, but I definitely favor doing at the same place.