Resident Lifestyle?

[ozzie20]

This has been talked about before, but a lot of the posts are dated, and some of the links are dead, anyone care to share about their typical week/days?

Being a new anesthesia intern this thread would give me something to look forward to.

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[coprolalia]

Sure.

1) The days are long and you get no respect from anyone.

2) You have crabby old attendings who boss you around.

3) You have patients that won't remember the goddamn brilliant job you did.

4) You have to take call and do all manner of b.s. cases at 3:00 AM that suddenly become "emergencies" because certain surgeons don't get enough block time during the week.

5) Outside the OR, you will only ever been seen as a commando who swoops in and fixes what's perceived to be some minor problem then leaves - no one actually thinks you're a real doctor.

6) You will have days where you want to go into the locker room to change your underwear after you've sh*tted your pants from the unexpected ST elevations or bradycardia or movement during a critical portion of the case or almost not being able to intubate someone, but no one will be there to give you a break.

7) Everyone will automatically assume that it's okay to call you by your first name. Even the patients. After all, you're not really a doctor, are you? (Did I mention that already?)

8) You will get sick of the fat, ugly, and/or geriatric nurses hitting on you, and the hotties going after the surgical residents.

9) You will get used to being asked to "stand by in case I can't get it" when called for intubations outside the OR.

10) Finally, no one will ever offer to help you, except your attending (which isn't always helpful) and maybe some surly anesthesia tech who'll immediately asked to be excused from the room once you've got the flash of blood from the art line.

Don't expect anesthesiology to be all champagne and roses. I see a lot of you guys coming here all excited (etc.) that you're starting your gas careers. That's great. But, there are moments when it really, really sucks. It's a lot of work, and it's exhausting most of the time (whether it's sweating it out during a ruptured AAA or sitting through some boring-ass 5-hour proctocolectomy where the surgeon won't even let you turn on music). It's not Easy Street like a lot of other disciplines (who have no real idea what we do) make it out to be. But, trust me. They'll give you the business for "selling out" in choosing anesthesia because you didn't really want to "work like a real doctor" or some other nonsense.

-copro

 

[pillowhead]

This has been talked about before, but a lot of the posts are dated, and some of the links are dead, anyone care to share about their typical week/days?

Being a new anesthesia intern this thread would give me something to look forward to.

CA-1 year has been slightly better in lifestyle insofar as I'm not being paged when I go home at the end of the day, I'm not up to my eyeballs in stupid social work/placement stuff, I go home by 7:30am post call, and I have more weekend time off. Can't discount any of that good stuff.

But I still put in about 70 hours last week. Stumbling in at 6am isn't fun either (my IM year was always 7am) and I NEVER leave before 4pm. My first solo call was brutal and painful and there were points in the night where I felt like I could just cry (NEVER felt like that on IM call. Plenty of painful moments, but not literally choking up). Attending looking at me like an idiot because I can't get the stupid central line. (Then attending tried and can't get it either.) Downright disrespect from a very small number of midlevels and indifferent dismissal from many. (Also some who are very helpful and very good to work with). Much more outside reading expected than was ever expected with internal medicine.

So, is it better than intern year? I guess overall it is, but there are plenty of times it doesn't feel like it. By the end of intern year, you should be feeling like a pro with 80-90% of floor admissions and calls. Then you get thrown into a whole new situation and get to feel like an intern all over again CA-1 year. Not trying to get you down, but I think there's a tendency to look towards anesthesia with very rose-colored glasses.

 

[climbingdocs]

Copro, you are such a grump, you need to be "called god" more often I think You gonna give us some positive aspects of anesthesia residency?

 

[Jeff05]

positive aspects of an anesthesiology residency

1. sometimes you get to make a difference (even though no one knows that you did)

2. it ends.

that's about it.

 

[2ndyear]

It ends and then as an attending you will:
1) Work harder than you ever did as a resident.
2) Still have to put up with the same BS from surgeons and their "emergency" 3 am butt pus that has to go NOW.
3) Not necessarily walk out of the hospital at 0730 like in residency post call.
4) Spend at least some time tied to a pager at home, waiting for it to beep.
5) Have no back up when you have the difficult airway at night.

No matter how much residency sucks, suck every ounce of training out of it that you can. When you're done, you're done. No attending to back you up, nobody to save your butt if you screw up. It's the real deal out there and you have to come out strong and with your head on straight to make it.

 

[loveumms]

Positives:

- You will save some lives. You might not get a pat on the back, or recognition from anyone. You will know you did a good job.

- People are glad when you show up. Believe me, other disciplines rely on us more then they want to admit. Some of their ABCs begin with A- anesthesia.

- You get to make critical decisions and then watch the outcome.



Of course there are many negatives. This is residency people. I especially hate the second add on at 4pm that you know is going to make you get home late. Unfortunately, that is part of this deal we signed up for. I try to look at every case as an opportunity to learn.

 

[coprolalia]

No attending to back you up, nobody to save your butt if you screw up.

That's not entirely true. Ask any of the attendings here.

-copro

 

[ozzie20]

from the sounds of it, everything sucks in anesthesia, and it won't get any better when you're an attending? that about the jist of it?

 

[Bougie]

Wow!!!! What a bunch of whiney losers. Suck it up people and cut the B.S.

Just look across the screen at your surgical colleagues and realize how good you have it.
My PGY-4 counterpart on the liver transplant service:

Monday:
0500 round on floor patients
0600 round on ICU patients
0700 liver transplant
1400 round on ICU patients
1500 liver bring back bleed
1900 call all 5 transplant attendings and update
2100-0500 on call in hospital

Tuesday:
0500 round on floor patients
0600 round on ICU patients
0700 clinic
1700 round and update attendings
1800 go home??....nope...transplant coming in
2000 liver transplant
0300 crash in call room

Wednesday
0500.....

Yes we don't get the most respect, but do I really care about scrub techs and nurses kissing my rear??? No!

Yes we work hard and have late cases. So what! You're a doctor. Jiffy lube is hiring if you can't cut it.

Yes patient's don't know who we are or how we saved their lives. So what! If you need constant love and admiration, go buy a puppy.

We have a very cool specialty. We get to do cool procedures, make critical decisions, make a lot of money, and don't have to deal with a lot of crap that other docs have to (clinic, patients calling you on weekends). So cut the moaning and groaning.

 

[jetproppilot]

Wow!!!! What a bunch of whiney losers. Suck it up people and cut the B.S.

Just look across the screen at your surgical colleagues and realize how good you have it.
My PGY-4 counterpart on the liver transplant service:

Monday:
0500 round on floor patients
0600 round on ICU patients
0700 liver transplant
1400 round on ICU patients
1500 liver bring back bleed
1900 call all 5 transplant attendings and update
2100-0500 on call in hospital

Tuesday:
0500 round on floor patients
0600 round on ICU patients
0700 clinic
1700 round and update attendings
1800 go home??....nope...transplant coming in
2000 liver transplant
0300 crash in call room

Wednesday
0500.....

Yes we don't get the most respect, but do I really care about scrub techs and nurses kissing my rear??? No!

Yes we work hard and have late cases. So what! You're a doctor. Jiffy lube is hiring if you can't cut it.

Yes patient's don't know who we are or how we saved their lives. So what! If you need constant love and admiration, go buy a puppy.

We have a very cool specialty. We get to do cool procedures, make critical decisions, make a lot of money, and don't have to deal with a lot of crap that other docs have to (clinic, patients calling you on weekends). So cut the moaning and groaning.

HAHAHAHAHAHAHAHAHAHAHAHAHHA
i can't stop laughing....go buy a puppy....
HAHAHAHAHAHA

 

[foxtrot]

Sure.

1) The days are long and you get no respect from anyone.

2) You have crabby old attendings who boss you around.

3) You have patients that won't remember the goddamn brilliant job you did.

4) You have to take call and do all manner of b.s. cases at 3:00 AM that suddenly become "emergencies" because certain surgeons don't get enough block time during the week.

5) Outside the OR, you will only ever been seen as a commando who swoops in and fixes what's perceived to be some minor problem then leaves - no one actually thinks you're a real doctor.

6) You will have days where you want to go into the locker room to change your underwear after you've sh*tted your pants from the unexpected ST elevations or bradycardia or movement during a critical portion of the case or almost not being able to intubate someone, but no one will be there to give you a break.

7) Everyone will automatically assume that it's okay to call you by your first name. Even the patients. After all, you're not really a doctor, are you? (Did I mention that already?)

8) You will get sick of the fat, ugly, and/or geriatric nurses hitting on you, and the hotties going after the surgical residents.

9) You will get used to being asked to "stand by in case I can't get it" when called for intubations outside the OR.

10) Finally, no one will ever offer to help you, except your attending (which isn't always helpful) and maybe some surly anesthesia tech who'll immediately asked to be excused from the room once you've got the flash of blood from the art line.

Don't expect anesthesiology to be all champagne and roses. I see a lot of you guys coming here all excited (etc.) that you're starting your gas careers. That's great. But, there are moments when it really, really sucks. It's a lot of work, and it's exhausting most of the time (whether it's sweating it out during a ruptured AAA or sitting through some boring-ass 5-hour proctocolectomy where the surgeon won't even let you turn on music). It's not Easy Street like a lot of other disciplines (who have no real idea what we do) make it out to be. But, trust me. They'll give you the business for "selling out" in choosing anesthesia because you didn't really want to "work like a real doctor" or some other nonsense.

-copro

This is one of the most accurate descriptions of an anesthesia residency that I have seen (coming from someone who has finished their residency). Don't forget that you get to take 2 sets of extremely difficult boards and spend thousands of dollars preparing for them when you make as much as a McDonald's manager (maybe a little more).
I love it!!!

 

[LostTommyGuns]

CA-1 year has been slightly better in lifestyle insofar as I'm not being paged when I go home at the end of the day, I'm not up to my eyeballs in stupid social work/placement stuff, I go home by 7:30am post call, and I have more weekend time off. Can't discount any of that good stuff.

Amen. Pillowhead is also right that it is much harder than IM because what you do directly affects the patient in an imminent and potentially life-threatening way - combine that with awesome academic surgeons and their sometimes brutal attempts at exsanguinating your patient and it makes for some interesting times.

Personally I think it is important to 1. Never let 'em see you sweat. 2. Always be smiling/in a good mood no matter how pissed you are - if someone is going to beat you down they want you beaten down not smiling, don't let them win. 3. Realize that as a wise CA-3 once said "As long as they can't figure out how to stop time from moving forward, you're set."

 

[ozzie20]

I guess my question wasn't so much what you liked/didn't like about your residency but more of a "what is your schedule like" from a day to day and weekly basis, like what bougie wrote, but for anesthesia residents. Anyone care to write on that?

 

[LostTommyGuns]

It varies depending on what rotation you're on etc, but I'm guessing you're asking about General OR which is most/much of CA-1 year...

Come in between 0600-0645 depending on whether there is conference/grand rounds and how complicated the cases are to set-up
See patient by 0700
In OR by 0730
Usually get 10-15min break in AM around 0900 - hopefully.
Lunch for 30min between 1100-1300
Sometimes 15min afternoon break 1400-1500 - usually by this time cases are getting shifted around and enough people are done that you get some form of break on average...
The rest of the day is: finishing your assigned cases, relieving CRNAs, pre-call residents, doing any preops not done earlier... Out by 1600-1800 usually, very rarely earlier and sometimes later.

Bear in mind that this is like trying to explain how to get to drive to work - I can tell you the route but not traffic conditions, when you're going to hit stoplights, whether some raging drunk is going to T-bone you, whether you're going to be pulled over by the police or run into a thunderstorm... To me the days are a mix of waiting in traffic followed by moments of pedal to the metal highway driving.

I like analogies

 

[GassiusClay]

How much call once your part of the regular call schedule? Starting out we only do a couple per month but after next month, we will be part of the pool.

How often are you guys CA-2 and 3s on call during the month?

 

[OB1🤙]

Bear in mind that this is like trying to explain how to get to drive to work - I can tell you the route but not traffic conditions, when you're going to hit stoplights, whether some raging drunk is going to T-bone you, whether you're going to be pulled over by the police or run into a thunderstorm... To me the days are a mix of waiting in traffic followed by moments of pedal to the metal highway driving.

I like analogies

Well said, my friend.