Specialities in Anesthesiology

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What type of training is necessary for specialization in pain management or pediatric anesthesiology? Is it typically a one-year fellowship?
 

Skrubz

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as far as i know, all anesthesia subspecialties are currently 1 year fellowships. i have heard rumors that the ABA may extend pain into a 2 year fellowship sometime down the road, however.
 

j_sde

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quick question... wonder if the 4th years or residents can help me out..

i'm doing a peds anesthesia rotation for my first block in 4th year (originally scheduled a general anesthesia but wasnt able to get that) home program. i wanted to use the home program rotation to get my feet wet on anesthesia, and get an idea of whether this is really the field i want to do.

but, now that i'm going to do a peds anesthesia prog.... will it still be a good representation of what an anesthesia residency is about? and a good representation of the anesthesia field itself so i can figure out if its for me? and also... will be be too different in pathology and procedures, thus making not being too helpful when i do my away general anesthesia electives? might be dumb quesitons.... but i'm thinking anesthesia comorbidity issues you commonly see in adult anesthesia will not be seen in the peds?

thanks for yoru inputs,
 

2ndyear

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It really depends on the hospital. If you do peds anesthesia at a big childrens hospital then you'll see peds all day. If it's scheduled to be peds anesthesia at a small place or one with an integrated childrens hospital, it's not uncommon for the attendings to work adult cases at least some of the time. A good deal of peds work is also off-site as kids need to hold still for a lot of imaging procedures and biopsies. You'll definately get your feet wet in peds anesthesia, as to whether it represents residency again depends on the program largely. You'll most likely see residents doing peds rotations though, and possibly fellows too. The pathology in kids is different and I think I had to read a lot more to understand what was going on. Take peds hearts for example, there's a lot of reading to do on what the lesions are and what the procedure is. I found that I got less procedures overall compared with adult. The attendings were less receptive to letting me try central lines and a-lines in kids. I did get plenty of peripheral IV practice though! And these are not easy to get in little ones.

I would say definately enjoy your peds rotation. It was rewarding to me and is one of the more scary fields within anesthesia, just because kids can go bad quick. When you on away rotations though, they generally expect that you know basically nothing. So any knowledge you picked up is just a bonus. If you want to impress them, it's more about attitude than how good you are at intubating and putting lines in. Anyone can learn that stuff, you just have to show that you're teachable and willing to try.
 

ThyroidAblation

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Originally posted by j_sde
quick question... wonder if the 4th years or residents can help me out..

i'm doing a peds anesthesia rotation for my first block in 4th year (originally scheduled a general anesthesia but wasnt able to get that) home program. i wanted to use the home program rotation to get my feet wet on anesthesia, and get an idea of whether this is really the field i want to do.

but, now that i'm going to do a peds anesthesia prog.... will it still be a good representation of what an anesthesia residency is about? and a good representation of the anesthesia field itself so i can figure out if its for me? and also... will be be too different in pathology and procedures, thus making not being too helpful when i do my away general anesthesia electives? might be dumb quesitons.... but i'm thinking anesthesia comorbidity issues you commonly see in adult anesthesia will not be seen in the peds?

thanks for yoru inputs,

I think it'll be a little different, j_sde. Procedure-wise, they usually use mask induction on children (vs. IV-induction in adults), and the IV is started afterwards. IV's are a LOT harder to start on kiddos, and you'll probably be using a straight blade for most of your intubations. You also have to be a lot more careful with fluids and air-bubbles, and there's the added dynamics of dealing with fussy kids and talking to mom. Thus, it's not the ideal preparation for an adult anesthesia away-rotation, but at the same time, what-you-know and whether you can slap the tube in blindfolded are only minor components of your evaluation (in my opinion). I would definitely enjoy your peds anesthesia month and not worry too much. You'll be fine.

Thyroid Ablation
 

BassDominator

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I actually got my feet wet with a peds rotation. Yes, adults are different, but I really enjoyed working with kids. Very cool anatomy and physiology.... and mom usually likes that med students have a lot of time to talk. Stick to the older/larger kids first and you should be okay.
 
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