Lets face it. Anesthesia is a medical specialty fulla SKILLS. Twelve years into private practice, I can report to my resident colleagues looking for lucrative private practice jobs that, well, IF YOU DON'T HAVE THE SKILLS, YOU A'INT PRIVVY TO THE BENJAMINS. I currently work for an AMC. Moneys kinda tight so one of us was UHHHHH.....JUST LET GO. Of course theres a caveat. Caveat being you will learn alot from your first private practice job from partners that are more than likely eager to bring you up to speed. You are not expected to emerge from residency with the deftness of BOND. JAMES BOND. YOU ARE, though, as an emerging resident, expected to have a certain SKILL STRENGTH that can be added to.... ....let me add here that the JUST LET GO DUDE wasn't the most recently hired dude, since the most-recently-hired-dude HAS SKILLS. so you've done a buncha interscalene blocks as a resident. DO YOU CONSIDER YOURSELF COMPETENT IN INTERSCALENE BLOCKS? Can you do a labor epidural in FIVE MINUTES, leaving five more minutes for paperwork? Can you do a central line in FIVE MINUTES? Can you do a spinal in SEVENTY THREE SECONDS (not accounting for set up time)???? I'm speaking primarily to CA-3s here. THE "DEFTER" YOU ARE COMING INTO A PRACTICE, THE MORE VALUABLE YOU ARE, WHICH TRANSLATES INTO THE-MORE-LIKELY-YOU-ARE-TO-BECOME-PARTNER. So I return to the initial question, primarily to CA-3s.... WHERE ARE YOU ON YOUR SKILL SET? Can you do our CORE SKILLS (epidurals, spinals, axillary blocks, interscalene blocks, A lines, central lines, intubations....) CDAZY FAST???? YES? NO? Here's an insider secret: Residents emerging into a new practice that can do these skills FAST and WITHOUT HELP will be REVELED. SO,... ARE YOU THERE? And if you are not, its only December. I encourage you to work on your efficiency with our specialty's CORE SKILLS before you show up on the doorstep of your new private practice group. Always remember that FASTER MAKES YOU BETTER. (a concept long ignored by academia) You've still got six months. Work on your speed NOW.