The Anesthesiology "Personality" and Other Basic Inquiries

[wundabread]

I'm a 3rd year medical student with a few questions about Anesthesiology. I have a good feeling about it, and I've signed up to do a rotation early in my 4th year, but I'd like some input on a few topics.

1. What would you say is the "stereotypical personality" in Anesthesiology? I know these are by no means set in stone, but I think that most specialties have a personality type that seems particularly at home in a given area; who is that for Anesthesiology?

2. I'm an "on the go" type of guy; I liked surgery because I was always rushing around, but I wasn't so big on standing around holding retractors. I know that Anesthesiologists often have a substantial percentage of not-so-intense time to fill in the OR (along with a small but tasty portion of mayhem) but not having to stand around pretending you are interested in what the surgeon is doing and being able to put at least some of your attention on other things for a while should be much better for me. That said, how about the pace outside of the OR?

3. Finally, for those of you who have already matched, what would you consider to be the pros and cons? Particularly, do you worry about bordem, and do you get satisfaction out of the work you do? I hope that doesn't come across as crass, but these are some of the things I worry about.

I know these questions are quite basic, however Anesthesiology is not part of our core 3rd year rotations. The only time we are offered exposure is in the 4th year, and I just want to make sure I'm not totally off base in my assumptions.

Thanks in Advance,
Andy

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[md_student10021]

I'm an "on the go" type of guy; I liked surgery because I was always rushing around

I haven't done my anaesthesia rotation yet, but it sounds like anaesthesia might not be your field. They tend to sit around and read the paper for most of the operation, no?

 

[Gator05]

Sit around and read the paper? Right. They do. Sometimes.

Or, they're on their feet pushing liter after liter of fluid, fixing this, adjusting that, diagnosing this, treating that...honestly, it depends on the case. Bread and butter cases do lend themselves to easier anesthesia usually...but if you don't like bread and butter, then find an appropriate job, ie cardio, vascular, neuro or transplant.

 

[md_student10021]

Originally posted by Gator05
Sit around and read the paper? Right. They do. Sometimes.

Or, they're on their feet pushing liter after liter of fluid, fixing this, adjusting that, diagnosing this, treating that...honestly, it depends on the case. Bread and butter cases do lend themselves to easier anesthesia usually...but if you don't like bread and butter, then find an appropriate job, ie cardio, vascular, neuro or transplant.

thanks for the clarification. like I said, I haven't done anesthesia yet.

 

[CaliGirlDO]

To answer the original question...(with the attitudes evident in the previous replies being a great seg-way):

I've worked with a lot of anesthesiologists and they really don't have any one type of personality. The one thing they have in common is lacking a huge ego. I would have to say that I've seen most anesthesiologists put up with a lot of crap from various people, not just surgeons, and they let it roll off their back. I've also seen doctors who have been doing anesthesia for years miss intubations and step aside to let a colleague help out and have a shot at it. Of all doctors that I've worked with, they don't seem to get hung up on who gets the procedure done, as long as it gets done so the patient can be stable.

Aside from that, most anesthesiologists seem pretty mellow. Everyone has their own quirks. I'd say they definitely have a lot of dexterity and are good with their hands. They also are able to handle stressful situations well and think fast on their feet when things start to crash. You need to be the type of personality that can deal with it. There are those docs who went into the specialty to avoid dealing with talking to patients, and obviously they don't have the most outgoing personalities, but that has been changing as the pool of applicants changes too. I can tell you I am in no way shy.

Hope all this helps with your decisions.

 

[Gator05]

Some very interesting discussions in this thread! There are those who minimize patient contact in this field, no doubt about it.

But there are a few points to be made in the "patient contact" discussion. Namly, at 15 minutes per office visit for many specialties, is there really time to "connect" with the patient? With transient patient populations and changing insurance providers, are Americans able to remain with a single generalist for an extended period of time?

Recently had a family member admitted to a hospital; over 3 days, the physician spent <15 minutes total with this family member during this admission. It's a knee-jerk reaction to critique said physician. However, this fails to address the issues of why there was such little patient contact. Among other reasons, the physician was spread too thin in his HMO/PPO/Medicare/Medicaid-delegated responsibilities.

Some anest. specialties seem to require much more patient interaction pre and post-op; peds and OB come to mind, as well as critical care and pain management in terms of traditional patient contact. I'm still trying to figure out if these intense patient interactions of Anesthesiology are really less meaningful than those seen in the current practice of medicine in America. Only time will tell.

 

[beezar]

I think patient interaction in anesthesia can be more meaningful than in even medicine, depending upon the situation. Actually, some of the most grateful patients that I've met in med school were during my anesthesia rotations.

Think about it... surgery is not a stress-free thing, and patients are often very nervous. Anesthesiologists can play a huge role in comforting these patients before, during (ie: surgery on awake patients), and after an operation.

I think that good interpersonal skills and the ability to connect with a patient quickly is extremely important in anesthesiology, and very, very underrecognized.

If you don't like interacting with patients, anesthesia is definitely not the way to go... choose path or rads.

 

[Gator05]

beezar,

Without violating HIPAA....would very much enjoy hearing any such specific stories you might have about grateful patients!

 

[gasxchange]

a big part of the reason I went into anesthesia was the personality "types" I met in the field. to me it's important to be surrounded by people I consider like myself: smart but not too smart (i.e. eggheaded internists), laid back but not lazy (greedy day spa dermatologists), and serious but not totally uptight (surgeons take themselves way too seriously). of course there are always exceptions to all the above, but by and large anesthesia folks are as "normal" as it gets in medicine. I'm sure they are out there, but I've yet to meet an anesthesiologist I didn't get along with. after you do any field of medicine after 10 years it becomes repetitive and a little boring, so I don't worry about the "boredom" factor. besides, in what other field of medicine do you get paid to calmly sit while someone else is working for most of your job?

 

[cajunmoon]

I was an internist for 7 years before opting for anesthesia. The exposure to a wide variety of patients during these 7 years gave me a long time to try to figure out what I wanted to do.

Right off, I would like to clarify that the one thing I found most gratifying through my 7 years was patient contact. Anesthesiology gives one the unique opportunity to reassure a patient and ensure his/her safety through the most traumatic experience of their lives. What could be more physiologically stressful & psychologically scary than having your chest/abdomen ripped open or your skull sawed off?

Most patients are extremely apprehensive before major surgery, and need to be made comfortable with more than just pre-meds. I am looking forward to patient contact & hope & pray I will make myself useful to others !!

And of course I am absolutely fascinated by the minute to minute complexity of physiological response brought about by the myriad pharmacological agents we use. Nothing could be more challenging or gratifying than that. The first time I saw a difficult intubation & sweat on the brow of one of the most competent & cool anesthesiologists I know, I was hooked to the adrenaline rush!!

I do not understand how some surgeons & most lay people (including my father-in- law, [ he thinks I am good for nothing, and took anesthesiology because I am a bum, and anyone who is worthwhile should be a neurosurgeon/cardiologist]) think that anesthesiology is mundane/boring & involves just gassing a person & then waking him up!!!

 

[circleK]

CaliGirlDO, beezar, cajunmoon Couldn't have said it better...exactly some of the main reasons I'm entering this field and planning on having a long, happy career. Good thread!

 

[emdoc21]

There is an element of routine in all specialtites. Anyone who thinks that all of anesthesia is boriing is uninformed. Part of the reason why some people think anesthesia is just sitting around is because anesthesiologists don't always look like they are doing something. There is a lot of physiology and manipulation of the physiology with pharmacology in anesthesia that requires thinking. Also, you are constantly monitoring the patient. Another reason why some may think anesthesia is routine is because there are a lot of routine cases done on healthy patients where there isn't as much that the anesthesiologist actively needs to be doing. There are some that just sit back and read the paper during these cases. It depends on what you like. As already stated in this thread there plenty of cases that will keep you busy throughout. I have a theory that anesthesiologists tend to be introverts, but I have nothing to back that up with.

Although anesthesiologists do have a variety of personalities, I think a common trait of many anesthesiologists is to want to know why things happen. This makes sense when you consider all the physiology you have to use on a daily basis. I don't think you need a love of pharmacology, b/c the number of drugs anesthesiologists actually use on a regular basis is quite limited compared to how many drugs are out there. As already mentioned in this thread another common trait is not needing external validation of what you do. The patients are generally considered to be the surgeon's patients and they tend to get more of the credit. In some institutions the surgeons really treat the anesthesiologists pretty poorly, but that varies a lot.

The patient interactions are short and intense. The patients are generally just as, if not more scared of the anesthesia than they are of the surgery. Some anesthesiologists go into the field b/c they don't want a lot of patient interaction i.e. they don't want to deal with social issues and long-term care. However, you do need to have good interpersonal skills b/c you have a very short time to get that person to trust you with their life. Anesthesiologists are patients' guardians; you take care of them when they can't take care of themselves. Sometimes that means protecting them from the surgeon b/c the surgeon's goal is to operate, but the anesthesiologists goal is to protect the patient.

In terms of time spend outside of the OR, there are preops and postops. Whose responsibility it is to do these varies by institution. Time outside of the OR for anesthesiologists is actually quite limited and busy. You are with the patient from preop to postop, unless someone else relieves you. There is prep beforehand that the surgeons have already done b/c they see them in the office. Surgeons can meet you in the OR and then leave once the patient is extubated. The anesthesiologist needs to stay with the patient until they sign them over to a nurse in recovery. On a busy day it can be difficult to get to the bathroom or have a drink between cases. That's why breaks are important. There will also be days with cancelled cases and delays when you will have more down time.

An obvious pro is the lifestyle. No one will ever call you at home to tell you that your patient has just come to the ER and you need to go see them. The field is very hands on b/c you do a lot of procedures, but it's also fairly intellectual. I personally don't enjoy primary care visits where you have noncompliant patients with multiple medical problems who don't check their blood sugar, exercise or watch their diet. I got bored of physicals and visits for low back pain and URI's during 3rd year. The only part of anesthesia where you'd have to deal with long-term care is pain management.

 

[beezar]

Originally posted by Gator05
beezar,

Without violating HIPAA....would very much enjoy hearing any such specific stories you might have about grateful patients!

Absolutely...

I met one patient in the preop area who was to undergo a valve replacement. She was grabbing the side rails of the bed, obviously anxious about the procedure. My reaction was to walk up to her and say, "you nervous?" She nodded her head. Then I said "it's ok to be nervous." and proceeded to explain what was going to happen and answered any questions I could.

I didn't think anything of it until my attending and I later saw the patient together. At the end of our talk, she thanked us, then turned to me, grabbed my hand, and said, "especially you. You are so kind. Thank you so much." Well, I was pretty surprised and happy, and it didn't hurt that I won some points with the attending...

Another patient I met actually on my psych rotation. We were being consulted for possible PTSD/panic disorder because he panicked on the OR table just prior to induction of anesthesia and the procedure had to be cancelled. He later underwent the operation without a hitch, and attributed this to his anesthesiologist. What had happened was the anesthesiologist went to see him the night before, slowly went through the entire induction process and answered all of his questions. You could tell the patient was very grateful to the anesthesiologist as he related the story, saying that he was very compassionate, and was the reason why he wasn't anxious at all the 2nd time around.

One of my surgery attendings had undergone a high risk C-section, and was understandably very anxious during the procedure. And she said that the most important person who helped her through the procedure was the anesthesiologist, who spoke to her and calmed her down the entire operation.

Those are just a few examples... there are many more! Anesthesiology is such a great field, and I would not hesitate to recommend it one bit to anyone considering it. I'm sure it's not for everyone, but then again, I don't see how it can' be...

 

[Gator05]

I was following an anesthesiologist at a VA hospital this past summer. As one of the patients was being rolled to the OR, the patient reported feeling quite nauseas. Rather than just push him into the room, the anesthesiologist stopped the patient's bed, put the side rail down, helped him to sit up. Then he picked up an emesis basin, put his arm around the patient and held the basin for the patient until the feeling passed.

It was a simple act of compassion.

Now when I hear others talk about using anesthesiology to escape patient contact, or about poor patient interaction in anesthesiology, I laugh. I'm convinced that such contact has less to do with your specialty, and more about why you went into medicine in the 1st place.

 

[painres]

An obvious pro is the lifestyle. No one will ever call you at home to tell you that your patient has just come to the ER and you need to go see them. The field is very hands on b/c you do a lot of procedures, but it's also fairly intellectual. I personally don't enjoy primary care visits where you have noncompliant patients with multiple medical problems who don't check their blood sugar, exercise or watch their diet. I got bored of physicals and visits for low back pain and URI's during 3rd year. The only part of anesthesia where you'd have to deal with long-term care is pain management. [/B]

Amen brother.

 

[wundabread]

Thanks all for the great replies.

I'd still like to hear more about the pros and cons, as it's clear that every field has them and it's all about finding pros you love and cons you can live with.

I'd really like to hear more from painres about pain management and the pros and cons of that. The idea of spending 2 days/wk in pain clinic, .5 to 1 day/wk of interventional pain procedures, and 2 days/wk of OR anesthesia seems like a very appealing schedule for it's variety.

Thanks again, and please keep your thoughts coming.

 

[painres]

Wundabread, Im actually an anesthesiology resident, not in a pain fellowship yet. Let me list some of the pros and cons of general anesthesiology that I can think of.

Pros:
1.) Great residency lifestyle,50-60 hour weeks, days off following call, 2-4 weekends off a month.
2.) Short patient interactions, but usually positive, as another said.
3.) Vibrant environment, in and out of the OR, working with different Docs all the time, around different nurses, this can be a very cool field if you like to socialize with your peers.
4.) On any given day, you never know what kind of case you might be assigned to.
5.) Theres nothing better than taking someones pain away, in seconds flat, it tends to make you feel good too.
6.) Potential for specialization, pain, critical care.
7.) No overhead ( unless you run a pain clinic)
8.) Not as much hipaa to deal with as some other specialties
9.) Not as much paperwork as other specialties, and virtually no pseudo-social work like the primary care fields
10.) Great post residency lifestyle. A friend of mine finished one year ago, and made $380K his first year out, with most weekends off. This is not uncommon, especially in the south, where you can live very well on this amount of money.
11.) If you like phys, then this is the specialty for you.

Cons:
1.) Long cases can get boring.
2.) When things go bad, they REALLY go bad, you had better be able to think on your feet.
3.) If you can fix things quickly, you can screw them up just as fast.
4.) Fairly large number of malpractice lawsuits.
5.) High drug addiction rate. Stay away from the fentanyl

There are other pros and cons, but this is a good list. Hope it helps, I think this is an awesome field.

 

[GeneralTso]

How many pain fellowship slots are there and whats the deal on their competitiveness.

 

[wundabread]

painres, thanks for your insight.

Another couple of questions that came to mind:

1) Thinking or Flow-Charts?
Some people that I have talked to have said that they were turned off by the "algorithmic" nature of Anesthesiology.

I know that most (all?) doctors follow an algorithm for treatment of all kinds of stuff, but does this hold more true for anesthesiology than most other fields?

There are accepted protocols for dealing with OR situations and then apparently in pain clinic due to liability you must follow the same flow with each patient (much more so than your average internist), because why did you give Mr. X opiates and not give them to Ms. Y?

I know that there is a lot of thought behind how those algorithms are put together, but is the "thinking on your feet" real problem solving or is it recalling the algorithm?

I hope this didn't come off as an attack on the field; I really want to believe that this is not the case. Please help quell my doubts!

2) Dealing with crap.
How much autonomy is there? How about having to put up with stupid hospital administrators who aren't looking out for the patient but instead for the bottom line? When you (or your group) are hired by a hospital you have to play by their rules, do you not?

And then there's the surgeons, who sometimes see you as someone who is there to work for them so they can do their thing. They want it to be *their* OR, leading to some of the silly "passive-agressive" stuff by anesthesiology (I'm sure we've all heard about this) just to piss the surgeons off.

Bottom line, how much autonomy does the Anesthesiologist have in determining how and with who they spend their day? How about in deciding how to handle each patient, vs having the hospital administrators tie their hands?

I don't put up with other people's crap very well, and I don't think anyone else should either. I also put a high value on autonomy. However, in this day and age of health care, perhaps the best we can manage is keeping it to a minimum.

Anyway, sorry to bring up such downers but these things have been on my mind recently and I really want to make the most informed choice possible as 4th year is almost upon me.

Thanks!

 

[painres]

Wundabread, Wow, you have a lot of questions, no I dont take it personally, buy honestly with many anesthesiologists youll find its very hard to offend them As far as algorithms youll find that the best anesthesiologists dont really use them, as much as they use their understanding of physiology, the subtle dif. of the drugs, and the nature of the patient and the given comorbidities. For patient x with problems a, b, and c, who becomes hypertensive, there will be 5 or more drugs that could be used to lower HTN but they will each have subtle differences in how they act, as well as in the side effects that they produce in a given situation, the speed and degree with which they accomplish the desired effect. Algorithms will only get you so far before the art of anesthesiology is needed to perform the best care possible for the patient.
As for autonomy, I guess it depends on the institution when in private practice as far as management goes, but as far as the surgeon is concerned he does the surgery and you do the anesthesiology, and neither of you tells the other how to do his or her job. Now, I have seen times when the surgeon tried to tell the anes. how to perform anes. for a given case, say the surg. wanted gen. anes. and the anes. thought that it was more safe to do a regional block. In this case the anes. overules the surgeon, hands down. You went to school for one thing, he or she for another. If you let him push you around its your fault for letting them, and they will try, they are surgeons and they are used to getting their way.

Hope this helps.

 

[wundabread]

Yeah, I guess I have a lot of questions. I'm trying really hard to make the most educated decision possible. I'm feeling a bit overwhelmed as the notion that I really do need to narrow down my specialty choices is settling in.

Thanks for making that process much easier; all the input here has been tremendously helpful.

I wanted to reaffirm that autonomy is par for the course, and not a luxury.

Thanks again.

 

[Krony]

I've really enjoyed this thread - it's furthered an early developing interest in anesthesiology. I'll be starting medical school this fall and was hoping that someone could offer any advice regarding good things to be involved with for a medical student pondering a future in anesthesiology. In the pursuit of any residency program I'm well aware of the importance of good board scores, grades, and letters of recommendation - are there any additional specific things that one might suggest, however, that would accomplish the dual purposes of increasing one's competitiveness for a residency in anesthesiology and providing one with a better sense as to what the field entails? (for example...research in the field...special types of selectives that might be different from a standard anesthesia rotation...etc.)

Something else I'm curious about...for the past few years I've worked for an ophthalmologist, and among other things I schedule his surgeries. Each week I fax a number of marginally legible to highly illegible H&Ps and EKGs presumably (so I've been told) that the anesthesiologists will review. It is apparent that treatment by anesthesiologists during a procedure will in part be affected by the patient's medical history - if there turns out to be a relevant omission by the primary care physician or an item that the anesthesiologist overlooked perhaps due to poor penmanship, does the liability fall strictly on the surgeon and/or anesthesiologist? (I know the surgeon at least in this case rarely even looks at these items. It also seems clear that the surgeon would never tolerate an anesthesiologist wanting to postpone a procedure because some scrawl on the H&P could not be read.) Perhaps I've misunderstood something and perhaps the preoperative H&P falls more in the category of a preop filter by the primary care doctor and the surgical center just has to have a copy to prove that it was done (or that the patient was "cleared" for surgery). Granted 90% of these H&Ps are for cataract surgery, but I imagine that similar issues of legibility exist for more involved procedures as well.

Thanks in advance for any comments.

-Krony

 

[CaliGirlDO]

It's great that you're interested in anesthesiology thanks, in part, to the comments and descriptions provided in this forum. But you should keep in mind that this forum is mostly populated by people who have done their 3rd year rotations and for one reason or the other found they fit into that anesthesia "personality" and found that the field offered them what they wanted in medicine.

Now that I'm a few weeks from graduation and the rest of my class has matched into their respective specialties....I can say that it is quite interesting where people ended up. There were those who were gung-ho for one specialty and all of a sudden switched to something else along the way. There are very few who set out for one specialty and actually stayed true to that desire and got in. I think that's more the norm nationally from that I've read on statistics.

That being said, I think the best strategic advice is to have a set of things that you're interested in and keep it in the back of your mind. Then as you go through your core rotations you can gradually eliminate things that just are NOT you. For now, just focus on your classes,especially pharmacology and physiology, and doing well on boards for your first two years. If there are any opportunities to do research or other extracurricular related activities, go for it....but make sure you're doing well in your other classes!!! I remember program directors who are more interested in knowing that you're a well-rounded student than seeing that you've spent four years focused on anesthesia. It's just one of those fields that the more you know about medicine, the better. Do well on your clinical rotations, obviously! I suppose if you're going for those upper-crust residencies, you should try to be more of a gunner. But if you're just trying to find a decent anesthesia residency like most of us, that should get you in.

Believe me, I didn't originally want anesthesia..I discovered it along the way and I definitely don't feel that there really was much more I could do during medical school to better my chances of getting in. Good luck!

 

[gasmanwannabe]

Hey out there
i am finishing up my 3rd year, and have had fields in my mind, especially after how painful 3rd year was. But i must admit, after reading this thread, i am sold on anesthesia. After reading the descriptions, i'm sitting back and thinking....ok, this is me...everything you guys have said, from the type of people -thanx gasexchange - to why you love it. Thanx to all of you. and please, keep replying with your thoughts.....they fuel to inspire

 

[emdoc21]

Something else I'm curious about...for the past few years I've worked for an ophthalmologist, and among other things I schedule his surgeries. Each week I fax a number of marginally legible to highly illegible H&Ps and EKGs presumably (so I've been told) that the anesthesiologists will review. It is apparent that treatment by anesthesiologists during a procedure will in part be affected by the patient's medical history - if there turns out to be a relevant omission by the primary care physician or an item that the anesthesiologist overlooked perhaps due to poor penmanship, does the liability fall strictly on the surgeon and/or anesthesiologist? (I know the surgeon at least in this case rarely even looks at these items. It also seems clear that the surgeon would never tolerate an anesthesiologist wanting to postpone a procedure because some scrawl on the H&P could not be read.) Perhaps I've misunderstood something and perhaps the preoperative H&P falls more in the category of a preop filter by the primary care doctor and the surgical center just has to have a copy to prove that it was done (or that the patient was "cleared" for surgery). Granted 90% of these H&Ps are for cataract surgery, but I imagine that similar issues of legibility exist for more involved procedures as well.

There is no such thing as being "cleared" for surgery. The appropriate statement is that the patient is at acceptable risk or average risk for surgery. To say they are cleared would be the same as saying that there is no risk of getting into a car crash when driving, i.e. the risk is small and can be reduced through proper preventive measures, but can never be completely eliminated. It is the anesthesiologist's responsibility to ensure that the patient can tolerate the surgery. The primary doc may see them and "clear" them, but if something goes wrong in the OR it is ultimately the anesthesiologists responsibility. However, if this happens, a resulting lawsuit would likely include all parties involved. If there is sufficient reason, the anesthesiologist can and will postpone the surgery in order to gather more information. Unfortunately when this happens it delays the OR and the surgeons won't like it. Illegible preop paperwork or missing paperwork is a constant problem for anesthesiologists. This is why it is important for anesthesiologists to have a solid basis of medical knowledge in order to be able to evaluate a patient themselves.

Spouse of EMdoc, an MS 4

 

[RochesterCA2]

I couldn't resist replying to this thread - I even had to go register and everthing (tongue in cheek). First off, congratulations to all of you who are considering anesthesia as a profession. You are making a great choice at a great time! I wish you all the very best of luck. From what I have read most of you have nothing to worry about.
I am a PGY2 aka CA1 at the University of Rochester. I did my medical school training at the Kirksville College of Osteopathic Medicine and my undergrad at the U of Utah. I am right now lazying the night away on OB-Anesthesia call. See what you have to look forward to?
When I saw this thread I knew I had to comment. You see I once wondered the same thing, and over the past twenty one months I have made some observations and come to some preliminary conclusions about the "Anesthesia Personality". When I say that I am refering to the personality type who really does well in our field; these are what I call the anesthesia personality - I can also comment on who might not do so well. The whole package is what makes them seem so down-to-Earth and "normal" .So here it goes.
First and foremost is Empathy. You need to have (or learn very quickly) the ability to read what people are feeling and to a lesser extent, what they're thinking. Not just with your patient, but with the surgeon and the nursing staff as well. I know this sounds crazy, but I have done some very informal surveys of other docs- those who really excel - and it has been surprising how many have developed this trait (or been born with it). This is the NOT FLIGHTY trait. They are really paying close attention.
Next is Detail Orientation. Now I won't say you have to be anal-retentive, because very few good anesthesiologists are. But you have to be able to identify what's important and not cut corners. Not surprisingly it's the little things that cause big problems. You will notice that good anesthesiologists are pretty particular about how they do their job; and at first glance it may seem quirky or just plain weird. Everybody is a little different here, but the point is they have a routine so they don't have to think about it. It's called the KISS theory (Keep It Simple Stupid!). This trait is what makes others view him/her as eccentric - you'll hear that a lot.
On to Humility. I'm not talking about walk-all-over-me humble, but rather recognizing that you don't know everything and being willing to admit that fact. Sort of the anti-surgeon mentality.
Then there is Quiet Confidence. This goes along with the humility thing. Never so much confidence that he/she comes across cocky, but just enough so that everyone in the room is relaxed but not threatened (read surgeons).
Lastly is Not Easily Offended. You have all seen how anesthesiologists can be treated. Some of you have probably had a taste of it even. The anesthesia personality is content in knowing that they love what they do and realizes that the guy on the other side of the drape probably isn't and doesn't.
So there it is. It explains why this personality type is easy to get along with and makes a great friend. Of course not every anesthesiologist possesses all of these traits. As a matter of fact a small minority probably does. But you will see that the good ones possess most, if not all, in varying degrees.
The personality that doesn't do well in anesthesia is one who has none of these traits; or worse possesses the opposite characteristic - self centeredness, over-confidence, easily offended, or cuts corners/impatient.
While I am not one, I see a lot of former engineers who really do well in anesthesia. Not sure if it's the "how do things work" mentality or if it's their attention to detail that makes them fit so well.
Anyway, sorry this turned into a thesis. Hope it helps someone. I think my email is supposed to show up with my post. I'd be happy to respond to any questions, but would prefer not to be flamed...it's just my opinion/observation and of course I could be way off in left field. Good luck to each of you. DGrimes

 

[wundabread]

Thanks man, always good to hear some more feedback, esp. from someone who knows what they are talking about.

I'm getting a really good feeling about Anesthesiology the more I learn about it. I think all that is left for me is to try it for a month and see if it's what I think it is.

I like that anesthesiology has a strong foundation in internal medicine/physiology and that it's largely procedure-oriented. I also like the fact that it seems pretty minimal on scut. What I want is to go in early and bust my ass in a job that will keep my on my toes both physically and mentally, occasionally juice up my adrenal glands, and then go home at a reasonable time and do my own thing. Work hard, play hard.

 

[powermd]

Originally posted by wundabread
Thanks man, always good to hear some more feedback, esp. from someone who knows what they are talking about.

I'm getting a really good feeling about Anesthesiology the more I learn about it. I think all that is left for me is to try it for a month and see if it's what I think it is.

I like that anesthesiology has a strong foundation in internal medicine/physiology and that it's largely procedure-oriented. I also like the fact that it seems pretty minimal on scut. What I want is to go in early and bust my ass in a job that will keep my on my toes both physically and mentally, occasionally juice up my adrenal glands, and then go home at a reasonable time and do my own thing. Work hard, play hard.

I agree with this post. I'm a third year circling ever closer to anesthesia. I too love the strong internal medicine base, physio/pharm, as well as a deep understanding of surgical medicine. I like the procedure-orientation, the early in/out lifestyle, and the close connections made with anxious patients. I'm set to do some rotations this fall and I'm very excited!

 

[stanMD]

I was wondering if there is anyone here who has decided to do a fellowship in pain. Before med school, I worked in an OR and thought from day 1 that anesthesia was for me. Before I left the OR, I met a resident who was going to Harvard for a pain management fellowship. I wish I could have asked him more questions. If there is anyone out there interested in pain, could you fill me in on the differences in practice, lifestyle, etc. from the regular OR anesthesia.

I concure that Anesthesiologists are by far the most kick ass of any physicians out there. They are laid back, approachable, and most have other hobbies and interests outside of the hospital. ie. mountain bikers, triathletes, pilots, and... ahh... parent. For the most part, there was very little arrogance and a lot teamwork demonstrated by all.

 

[drusso]

Originally posted by stanMD


I concure that Anesthesiologists are by far the most kick ass of any physicians out there. They are laid back, approachable, and most have other hobbies and interests outside of the hospital. ie. mountain bikers, triathletes, pilots, and... ahh... parent. For the most part, there was very little arrogance and a lot teamwork demonstrated by all.

You obviously have not met a physiatrist...now THAT's laid back!

 

[muchogas]

As I sit here trying to muster the interest in studying for my last shelf exam of m3 year (peds), I am amazed at all the posts on this thread, and just how helpful they are. I have been thinking about anesthesia for a while now, and have started to gravitate more and more towards it. Unfortunately, like many of those out there who contemplate such a career, it is full of accusations/disapprovals by known physicians in other field and lay people. I myself have an interventional cardio as a father who frowns on anesthesia. Regarldless of that, I agree with all that was said. If I have learned anything as a med student in my m3 year is that humility is key, as we never will know everything, but integrity and self worth are just as important. Tact is the word for the day, as we all deal with crappy attendings, and even residents and staff who for some reason have their panties in a bind and try to slam whomever they can. The anesthesiologist, for their cool headed nature and pleasant resolve seem like easy targets. Glad to know they are not, and that all that truly matters in this life in medicine is being happy, being sure of who you are, and knowing that you come to work, kick ass, and then go home fulfilled regardless of the profession. I like anesthesia, cant wait to do my rotations, and most of all hope it inspires me like it has seemed to inspire so many. Thanks for all your comments, and I hope I have not bored you with what I now think is a post that lost its initial intention.

 

[Gator05]

Mucho,

Thanks for a great post. Aside from anesthesiologists, the pediatricians (and their subspecialists) I've encountered, in my very humble (and continually learning) opinion, run right up there with anesthesiologists in terms of personality. So I think the timing of your post deserves some special recognition.

A good friend of mine summed up much of the anti-anesthesiology sentiment according to his observations: people just don't seem to understand what an anesthesiologist does. I think "people" in this case also extends to physicians, in some cases more than the patients themselves.

 

[apma77]

I wanted to second the notion that anesthesiology is a great field.
LIke radiology it has gained popularity. I remember when people use to put down radiologists and say how they lack patient contact and are stuck in a dinghy room with no excitement yada yada yada..now some of these same people wish they had the lifestyle.
LIkewise, Anesthesia is a great field with great incoming talent since the field has now become competitive. Surgeons use to treat anesthetists like crap but those days are quickly coming to an end....the guy behind the drapes running the gas is making more money!!

I initially thought i wanted to be a surgeon but the malignant personalities in surgery really swayed my interest away and i knew that i never wanted to be a part of that crowd. Most people now turning to anesthesia are very competitive in med school and it is becoming difficult to match in good programs.

goodluck to you all contemplating a anesthesiology career!

 

[chicamedica]

WOW!! All I can say after reading this thread. . .wow. . .

I'm early in my MS-3 year still (only had IM, Fam med, EM, Ophtho, and ENT rotations so far), and have been relatively undecided. For me the two most important criteria for a specialty is FRIENDLINESS among colleagues and brainwork.

I'd been interested in EM throughout 1st and 2nd years, then 2 wks ago during my ED week, the more shifts I worked I realized that EM was totally not me. I enjoyed the brainwork and the collegiality of my IM rotation, and although I truly hate the stupid scutwork like having to tell a nurse for the 100th time to draw a certain important lab, I was truly considering IM until today. I also love the excitement and the "saving the pt" feeling of critical care.

I know Fam med nor any of the outpatient clinic-type specialties are NOT for me. They get painfully boring. Ophtho is better than ENT boredom-wise, but I noticed that there is quite a bit of "hierarchiness" in ophtho, which I didn't like (I prefer collegiality among fellow colleagues--attendings, residents, etc).

So anyway, during my ENT and ophtho weeks, I got to spend some time in the OR watching the boring ENT and eye surgeries. For all of those cases, it was so much more interesting to watch the anesthesiologists at work, and I personally witnessed the warmth and compassion of their personalities. Although in my IM rotation I was lucky to have several teams with such people, I've also gotten stuck with just as many bitter and insensitive IM residents and attendings. Anesthesia seems to have more of the former rather than latter.

I'd been avoiding considering gas as a specialty mostly b/c I was hesitant about dealing with those nasty egofilled surgeon types (although I've met some nice surgeons too). But after reading this thread I realize my personality fits exactly what you guys mentioned. I CAN take a lot of crap and yet still want to keep things cool and friendly. I always question myself and admit when I'm wrong and LEARN from my mistakes or sthg I didn't know, and I love to be around the same kind of people. If I'm wrong, I NEED to know that AND to find out what is RIGHT. That is a group of people that I can learn the most with and have incredible teamwork with. Although I believe this kind of attitude SHOULD be present in all fields of medicine, sadly it probably only present in 1 or 2 fields (gas and maybe peds). Otherwise, the patient at risk, as obviously the pt is not the priority if one's ego and pride is.

I hate fields that expect you to show-off and that are full of people who act defensive at every moment they feel they might "look dumb". I just worked with a surgical subs resident who switched from IM who was exactly like that. Even worse, whenever he thought he looked stupid he would defend himself at the expense of a colleague, even though the colleague did things the right way and HE was the wrong one.

Anyway, as of today I'm officially considering anesthesiology as my future specialty. I truly can't wait to work with such awesome people with genuinely kind hearts.

p.s. and I can do CC with anesthesia too!!!

 

[UTSouthwestern]

As a side note, I spent 5 days at the ASA in San Franscisco and got to talk with a number of PD's and politicos. One thing that stood out in those conversations is a trend toward recruiting more residents interested in critical care. At one point, anesthesiology had 60+% of the members of the American Society of Critical Care and were its original founders. It is now down to 10% and a strong push is being made by anesthesiology to reclaim the majority of those positions. In general, the focus was on reclaiming and reinforcing our presence in a number of our subspecialties where we have trained other physicians to be a part of.

 

[irisheyes]

This has been a most inspiring read....thank you!! I a only beginning my medical education but have three sisters who are in nursing ( midwife, nurse-lecturer, and ER nurse respectively) They have all been in practice for over 7 years and all concur that anesthesia doc's are the cream of the crop!!. Although I will obviously keep my options open until I get through my clinicals I really do believe that I would love this field. Physiology is intriguing to me ( a mini-universe, so to speak), and I am a laid back kind of guy who enjoys skydiving, playing guitar, diving and advancing my knowledge of what makes us all tick ( ie. humanity). Anyway, according to my siblings it has been the anesthesiologists who are the often eccentric, yet highly competent, laid back professionals who have the best way of life, the best outlook, the best monetary reward, etc. In fact they classify anesthesiologists as being in a league of their own with regard to their thinking on their feet and their understanding of the working of the body, not to mention their ability to walk up to a patient and locate a vein that an intern has spent fifteen minutes searching for!. I really cannot wait to rotate through this field.You guys are the cool, knowledgable, approachable old guys of medicine Everything I have read in this thread is making me think I would really enjoy it. Good luck to all of you!!

 

[SurgGal128]

This is a great thread!!! I just wanted to comment on my personal experience. I actually have a different experience with anesthesiologists because I was a surgical tech before I went to med school. I have seen it from a nursing standpoint and have nothing but respect for anesthesiologists. I have always wanted to go into medicine to be a surgeon, and after many years of working in surgery, I found that anesthesia fits my personality better (let alone the awesome lifestyle!).

First off... as others have posted, anesthesiologists tend to be calm and collected (until things go horribly wrong), but they are still very methodical and decisive. They also tend to be very personable and no ego (and definitely they don't mind letting a colleague help out with a difficult central line or airway!).

About the "sitting reading the paper thing", there are moments of that, but it depends on the specialty. I scrubbed a lot of emergency cases (AAA ruptures, brain tumors, cerebral aneurysms, septic bowels) and those anesthesiologists were constantly in the room monitoring the pts every breath, heart beat, fluid response- and to me, that is so fascinating.

So... my physio background made me realize how much I love that anesthesia mixes the science of medicine with the personal touch that is so important.

I am actually highly considering anesthesia because of the social interaction with patients. Especially pediatric anesthesia where the kids are so terrified of just seeing everyone in blue masks and hats... to me it's very rewarding. I have seen countless patients that appreciate and thank the anesthesiologist for their warmth and comfort... especially if they wake up pain and nausea free! It is also important to be there for awake pts, such as those who require a spinal... it is more patient interaction that people think. And as a side note- a good anesthesiologist is hard to tell from a CRNA they are so good with patients!!!

 

[secretasianman]

And as a side note- a good anesthesiologist is hard to tell from a CRNA they are so good with patients!!!

hahahaha .

 

[coprolalia]

And as a side note- a good anesthesiologist is hard to tell from a CRNA they are so good with patients!!!

hahahaha .

Yeah, WTF was that supposed to mean?

This thread is six years old! Why was it resurrected again?

-copro

 

[pgg]

This thread is six years old! Why was it resurrected again?

Maybe she was trying to set a forum record for oldest thread raised from the dead? Gonna go look for something older to bump now ...

 

[WholeLottaGame7]

Did they even have the interwebs back in 2003?

 

[Narcotized]

The Anesthesiologist Personilty: Typically very mathematical, organized, thorough, and controlloing often to the point of anal (see 150 posts written about sepsis in the OR over a 4 hour span . I plead guilty to the above traits. Maybe it drives people crazy in real life sometimes, but just like the pilot of your plane, it's the personality type you want in charge of your life during surgery.

Often I don't see this same attention to detail in many crnas (not all, but yes many). Sorry midlevels, not picking a fight with you; just being honest, and you know what I mean if you are honest too. One refused to preoxygenate, called it a waste of time, and instead of just doing it to make life easy, picked a fight with me over it every time till I told the head crna I don't feel safe with this guy and wouldn't work with him. Another I saw twice wheel the patient in, flip on the machine, and off to sleep he/she went. True stories.

Anesthesiologists tend to also focus on hobbies, families, and other things outside of work, often not seen with other specialists. Typically not as malignant as other specialists, but the exception is that some academic anesthesiologists can be some of the largest d-bags you'll ever come across in your lifetime. In private practice most seem to be very nice guys.

The downside to the anesthesiologist personilty is often no vertebrae whatsoever and just basically a weak personalilty. If you have a strong personality and have no desire to abuse those below you yet won't take unfair abuse from above, you will hate residency, as I can tell you I positively hated every single day of my residency. But I wouldn't have it any other way. I'd rather sell doughnuts on street corner than sit there like a wounded puppy while some a-hole treats you with complete disrespect.

The anesthesiologist weak personality tends to cause problems in our field. Surgeons kick us around. crnas kick us around. There is constant pressure to conform. If you get in a situation where other anesthesiologists let the crnas run the show, you become the problem when you tell them to preoxygenate even if they don't want to. You become too difficult to work with when you tell the crna to do a machine check before the day, and to not just flip a switch then followed by pushing propofol. I was also told by one anesthesiologist higher-up to let the surgeons vent at me no matter how excessive they get, even if they are completely wrong; that I should let off steam with my colleagues, but not ever talk back to the surgeon. Sorry, again I'll opt for selling doughnuts on the street corner first.

As nuts as surgeons can be, they tend to stick together and protect their own. One attending wanted both myself and a surgery resident to stay inhouse busy for 48 straight hours. I eventually went home a little early and reported the incident to my department. The outcome, "I needed to keep my mouth shut." When surgery faculty found out what happened, the program head went on a mission to get rid of this anesthesia attending. To this day I'll hand wash that surgeon's car for free anytime if he ever asks, and I will never recommend my anesthesia program to anybody unless I really dislike them.

Overall I think the anesthesiologist personility makes them very easy to get along with and likeable, but I'd like to see more assertiveness. Assertiveness is a positive trait and simply means sticking up for what is right. It is not synonomous with aggressive.

 

[Masseter Spasm]

Did they even have the interwebs back in 2003?

Yes, there was an internet in 2003. Al Gore invented it.

 

[canjosh]

hahaha. Didn't he win a Nobel prize for that accomplishment??

 

[coprolalia]

Overall I think the anesthesiologist personility makes them very easy to get along with and likeable, but I'd like to see more assertiveness. Assertiveness is a positive trait and simply means sticking up for what is right. It is not synonomous with aggressive.

Yeah, I've heard this a different way...

"You gotta pick and choose your battles.

The first d-bag that told me that was so spineless I thought that he must've been some quirk of evolution. Yeah, pick and choose your battles... doesn't mean you should never pick a fight, like this guy thought.

I'm with you, though, Narcotized. The problem with the new system, though, is not if you are assertive, but rather how you are assertive. Frankly, I spent a good portion of residency being angry and addressing things I thought were stupid, pointless, redundant, scary, reckless, dangerous, inefficient, wasteful... etc.

After you try to point this out a few times to people politely, you quickly figure out that politeness gets ignored.

But...

It took me almost my entire residency to realize this fact: no one cared what I thought.

I was just another resident, like the hundreds that had come before me, who was going to do his training and then leave. It didn't matter that I was good. It didn't matter that my ideas were good. It didn't even matter whether I was right or wrong. That wasn't the point.

They simply didn't care what I thought.

Being angry and vociferous... sure, it got me noticed. But, not in a good way.

I started to come here instead.

And, that's my point. I had no power. So, because I had no power, I was easily ignored and, instead, remembered as the angry-guy-who-was-probably-right-most-of-the-time-but-no-one-cares-what-he-thinks-because-nothing-he-says-is-going-to-change-anything-anyway.

Therefore, I hear you about the spineless comment. A lot of the time, there's just no point at picking a fight or choosing a battle that, ultimately, isn't going to do anything for you or change anything or get you anywhere... except the reputation of being "difficult to work with".

Now, I'm just biding my time. I'm collecting a decent paycheck, and I'm taking a lot of notes. I'm observing and figuring out those things I don't like and what I do like. I work within my own sphere of control - my patient and my immediate surroundings - and I will protect that domain for now. Everything outside of that, I don't worry about.

If I have a conflict (say, with a CRNA), I try to be Socratic about it. "You didn't pre-oxygenate? Whaddaya think that patient's FRC is? What's going to happen if you can't get the tube in right away?"... or... "You didn't check the machine? Ever had an o-ring fail? What if the vent doesn't switch on when you flip the switch over from manual to ventilate?"

You just keep asking those things. And, you take notes. Someday you'll be right, and you won't even have to say "I told you so". People will notice. And, you'll start to get more power. Once you have that power, you can use it to affect change.

You want to bitch about stupidity, stupid people, and stupid things you have to endure... you want to pick fights and unload (be it on some ignoramus who doesn't understand the difference between an "MDA" and a CRNA, or a purported colleague who's trying to reinvent the wheel regarding some tested and proven methodology trying to show everyone in the process how much smarter he is by uncorking the journal-diarrhea bung)? Come here and do it. It's much easier, and much safer for your career.

-copro

 

[Narcotized]

It took me almost my entire residency to realize this fact: no one cared what I thought.

Oh I learned that pretty quick into residency, lol. I learned from 16 years as an ER physician that it makes no difference who is right or wrong, it just matters who is more important (and the ER doc is of least importance in the hospital doctor rankings). That gave me a head start figuring out just how low I was as a CA-1 resident. Even CA-2s wouldn't let me show them what they were missing on say a CXR or EKG because I was lower in the anesthesia ladder and couldn't possibly teach them something. Pretty ridiculous. And pointing out something an attending might learn from? Forget it.

I love what you said about "pick your battles" coming from people that never picked a single battle in their entire life, lol. Pretty funny, so often true.

 

[error404]

Any chance that SurgGal just brought up CRNAs because it was the only way to get this thread going again?

Not that the whole thing doesn't give me the warm fuzzies...

 

[WholeLottaGame7]

Any chance that SurgGal just brought up CRNAs because it was the only way to get this thread going again?

Not that the whole thing doesn't give me the warm fuzzies...

Personally, I thought that was one of the best backhanded compliments I've seen. So genuinely positive-sounding, yet so cruel and well-aimed. Alas, it was all for naught, as somehow we as a community declined to take this particular bait.

 

[prism74]

As nuts as surgeons can be, they tend to stick together and protect their own. One attending wanted both myself and a surgery resident to stay inhouse busy for 48 straight hours. I eventually went home a little early and reported the incident to my department. The outcome, "I needed to keep my mouth shut." When surgery faculty found out what happened, the program head went on a mission to get rid of this anesthesia attending. To this day I'll hand wash that surgeon's car for free anytime if he ever asks, and I will never recommend my anesthesia program to anybody unless I really dislike them.

Overall I think the anesthesiologist personility makes them very easy to get along with and likeable, but I'd like to see more assertiveness. Assertiveness is a positive trait and simply means sticking up for what is right. It is not synonomous with aggressive.

As a former PA for a private anesthesia group that serviced a community hospital (my job was to handle all the preop assessments), the docs I worked with and I would often discuss this kind of thing -- the gist of this is simply that, unfortunately, without the cases that the surgeons bring, there aren't any patients to put to sleep, so the practice loses business, the hospital loses business, etc., hence the need to "keep the surgeons happy." Ridiculous at times, but an unfortunately high level of diplomacy required in dealing with these kinds of situations.

 

[Dawkter]

Great thread, especially for those of us looking to anesthesia for our future careers. A fun read