should i do an anesthesia elective during internship?

[Multifidus]

Should I do an anesthesia elective during internship? I remembering asking on some interviews, and was told "no" for a variety of reasons, but mainly: "you'll be doing it for the rest of your life, do something else with elective time." That makes sense to me, but I wanted to see if any residents had an opinion. I just feel that an anesthesia elective may help me develop some IV and intubation skills that are definitely lacking. Thanks.

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[epidural man]

I think it depends on how they treat interns in the rotation. I would say do it because any month you can get a break from call, take it....regardless of the subject matter. Plus, if they don't watch interns closely, take off at 1300 and get a damn break for once.

Internship absolutely sucks!!!! It sucks a part of your soul, it kills a part of you and changes you forever and you are less of person afterwards. No one ever talks about this (except Samuel Shem in House of God) and probably won't admit it but it is certainly true. So if it is an easy rotation and a break from getting shat upon by floor nurses, then do it. To me, the subject matter isn't the issue - so when someone says "you'll be doing it the rest of your life....bla bla bla,,," i think that is a bunch of crap.

Just my opinion though....

 

[USAnesthesiaDoc]

For what it's worth, I did a transitional year which was a lot of ICU, some medicine, and some surgery. I had the opportunity to do one month of anesthesia, and thoroughly enjoyed it. I was also ahead of the game with my skills compared to my colleagues who had not done that starting in July of CA-1 year. It also reinforced to me that I had made the right decision and was a nice break from the other rotations.

 

[urgewrx]

NO. What will set you apart from the other residents is how much internal medicine you know. Take an elective like card, pneumo, IM ward, or icu. I don't even think you are allowed to do a month of Anesthesia, since it does not satisfy the Clinical Base requirements for the ACGME.

 

[epidural man]

Ya know,

After Urges posted, I have thought about it and changed my mind.

I agree. The fact that you will work 100+ hours/wk (and lie about it and report 80 hrs/wk) during your surgery months, work hard trying to coordinate (between the OT, PT, nutritionist, social worker, cardiologist and FP) placement for the multiple octogenerians you will discharge each day during your medicine months (which, by the way is a GREAT learning experience and thank goodness it takes most of your time), and spend hours standing next to the cardioligist watching him shoot fluoro images in the cath lab or figuring out E/A ratios in the echo lab- all the time talking to you about isotropy, chronotropy, lusitropy, dromotropy (things that anesthesiologists know nothing about) so you will be a 'ahead' of your collegues - the fact that you will get to do all this and much more should make your realize that you really should do an EXTRA rotation in ICU. In fact, you should ask to be on call Q3. You will be way ahead of your buddies when you start anesthesia.

I, like urges, have always felt that trying to be better than everyone else is really what counts. I have found that if my goal is not necessarily to make myself happy but to make sure I was more correct and smarter than everyone else, my life is much, much more fulfilling.

 

[Venus21pam]

Ya know,

After Urges posted, I have thought about it and changed my mind.

I agree. The fact that you will work 100+ hours/wk (and lie about it and report 80 hrs/wk) during your surgery months, work hard trying to coordinate (between the OT, PT, nutritionist, social worker, cardiologist and FP) placement for the multiple octogenerians you will discharge each day during your medicine months (which, by the way is a GREAT learning experience and thank goodness it takes most of your time), and spend hours standing next to the cardioligist watching him shoot fluoro images in the cath lab or figuring out E/A ratios in the echo lab- all the time talking to you about isotropy, chronotropy, lusitropy, dromotropy (things that anesthesiologists know nothing about) so you will be a 'ahead' of your collegues - the fact that you will get to do all this and much more should make your realize that you really should do an EXTRA rotation in ICU. In fact, you should ask to be on call Q3. You will be way ahead of your buddies when you start anesthesia.

I, like urges, have always felt that trying to be better than everyone else is really what counts. I have found that if my goal is not necessarily to make myself happy but to make sure I was more correct and smarter than everyone else, my life is much, much more fulfilling.

I think that's what I'm going to do - ask to have my call switched to Q2 (maybe that way instead of working 13 days without a day off I can pull like 24) and then ask if I can do an extra month of ward/clinic for an elective just because I want to improve my secretarial skills! 👍

 

[Gern Blansten]

I don't even think you are allowed to do a month of Anesthesia, since it does not satisfy the Clinical Base requirements for the ACGME.

You are allowed to do one month during your intern year. Anything beyond that has to be "paid back." That is how some programs are structured. They do up to 6 months of anesthesia their pgy-1 year, but they "pay it back" by doing other rotations deeper into their residency. The PGY-1 year has to be completely paid back before the start of the CA-III year. I believe those are the correct rules.

 

[bullard]

That sounds about right. Here at Northwestern, the categorical anesthesia interns do 10 months of medicine (ICU, wards, and a consult month) and then start anesthesia in May. We pay it back by doing two months of neuro ICU during CA-1 or 2 year.

You are allowed to do one month during your intern year. Anything beyond that has to be "paid back." That is how some programs are structured. They do up to 6 months of anesthesia their pgy-1 year, but they "pay it back" by doing other rotations deeper into their residency. The PGY-1 year has to be completely paid back before the start of the CA-III year. I believe those are the correct rules.

 

[Gern Blansten]

That sounds about right. Here at Northwestern, the categorical anesthesia interns do 10 months of medicine (ICU, wards, and a consult month) and then start anesthesia in May. We pay it back by doing two months of neuro ICU during CA-1 or 2 year.

Only one month has to be paid back since you are allowed one month of anesthesiology during the intern experience.

 

[urgewrx]

The Clinical Base Year must include at least 10 months of clinical rotations, of which only one month, at most, may involve training in anesthesiology. These rotations include training in internal medicine or emergency medicine, pediatrics, surgery or any of the surgical specialties, critical care medicine, obstetrics and gynecology, neurology, family practice, or any combination of these. The remaining two months, at most, of the Clinical Base Year may be taken in electives or in specialties other than those listed above. If an accredited anesthesiology program offers this year of training, the Review Committee will verify that the content is acceptable. When the parent institution provides the Clinical Base Year, the anesthesiology program director must approve the rotations for individual residents, and must have general oversight for rotations on the services that are used for that Year.

 

[badgas]

The Clinical Base Year must include at least 10 months of clinical rotations, of which only one month, at most, may involve training in anesthesiology. These rotations include training in internal medicine or emergency medicine, pediatrics, surgery or any of the surgical specialties, critical care medicine, obstetrics and gynecology, neurology, family practice, or any combination of these. The remaining two months, at most, of the Clinical Base Year may be taken in electives or in specialties other than those listed above. If an accredited anesthesiology program offers this year of training, the Review Committee will verify that the content is acceptable. When the parent institution provides the Clinical Base Year, the anesthesiology program director must approve the rotations for individual residents, and must have general oversight for rotations on the services that are used for that Year.

The prelim IM program I am at is giving me 4 electives. The transitional program gets at least 6 electives. This is an established program that has produced many anesthesiologists. Are you talking about just categorical programs?

 

[urgewrx]

The prelim IM program I am at is giving me 4 electives. The transitional program gets at least 6 electives. This is an established program that has produced many anesthesiologists. Are you talking about just categorical programs?

That's for all the programs. You should be ok. Elective does not mean it does not count. As long as you are taking care of pts it will be ok. I guess radiology, pathology, or something similar will not count.

 

[junebugjohnson]

My vote is this:

If you can take any humane month (ie. no/minimal call, weekends off) other than anesthesia, do it. You won't have another chance to take derm, radiology or many other electives that may interest you. And I feel that an extra month of anesthesia before your CA1 year really won't help you all too much. Everyone's going to have a huge adjustment after internship.

If it's between anesthesia and another month of wards, etc, you should take anesthesia.

Bottom line is this: take advantage of any opportunity to catch up on rest and maintain sanity during internship. Doing an extra month of something hard isn't going to give a leg up on anyone come CA1.

 

[Bertelman]

NO. What will set you apart from the other residents is how much internal medicine you know. Take an elective like card, pneumo, IM ward, or icu. I don't even think you are allowed to do a month of Anesthesia, since it does not satisfy the Clinical Base requirements for the ACGME.

One extra month of IM wards is unlikely to increase your skillz or place you ahead of your colleagues. Either way, any benefit of an extra IM month will deteriorate to non-existent by the time you complete the program.

Do Anesthesia, for godsake. Obviously this depends on how your intern year is set up, but you are hopefully already set up with at least a cards month, maybe pulmo or even better a month or two of crit care. Is an elective month in Rads gonna help? You'll get to know your colleagues, and become familiar with the environment. When July 1 pops up, you'll hit the ground stumbling, rather than face-first.

 

[jennyboo]

Should I do an anesthesia elective during internship? I remembering asking on some interviews, and was told "no" for a variety of reasons, but mainly: "you'll be doing it for the rest of your life, do something else with elective time." That makes sense to me, but I wanted to see if any residents had an opinion. I just feel that an anesthesia elective may help me develop some IV and intubation skills that are definitely lacking. Thanks.

Anesthesia "elective" during your internship probably won't give you any real head start into your residency. You won't do enough procedures to get good at them or even barely familiar with them. As for learning "theory" or "head knowledge", either you'll know too much of the basics already for the elective (usually intended for non-anesthesia residents, after all) to learn anything insightful and you'll be bored, or you'll know nothing (join the rest of the world).

But as the first responder said, you work six days or 80 hours a week for most of your internship. If you do an anesthesia elective because it lets you get outta the hospital and go to the beach at 1pm, by all means do it -- that alone makes it worth the boredom of standing around in the operating rooms for yet another month of observing and doing nothing.

 

[epidural man]

that alone makes it worth the boredom of standing around in the operating rooms for yet another month of observing and doing nothing.

I agree. Anesthesia is very FUN and rewarding to DO, however, it is very boring to WATCH.