training of an anesthesiologist

[OneFellSwoop]

So here I am, a third year trying to figure out the rest of my life. I just finished my surgery rotation which was a little unique for med students, I spent it at a largely outpatient surgery center attached to a community hospital and worked directly with a non-academic attending. He was amazing to work with, and so were his two partners. They were actually nice, normal people and made me realize that not all surgeons are complete a-holes. Anyway, he had one day off per week which gave me the opportunity to hang out with the anesthesia group and I realized that I really enjoyed what they do.
-Phys/Pharm were my favorite and strongest subjects in the 1st two years, and I also enjoyed pathophys.
-I enjoy the procedures, though I haven't been successful with any of my 4 intubation attempts but can place IV's pretty deftly but haven't had an opportunity to place art lines, spinals, epidurals, shoulder blocks, etc.
-I also enjoy the brief but meaningful patient interactions.

My questions, and I searched other similar threads but couldn't find it, is that b/c this was mostly outpatient (though they did perform higher risk procedures like thoracotomies on ASA 2-3 patients) and the risk for surgical complication was low so I never saw any complications requiring anesthesia intervention, I am unsure how I would do in an emergent situation, and this is my only reservation to anesthesia. I think this fear is mostly b/c of lack of experience and knowledge, which I would get in residency, but are these situations something you folks felt fearful of managing prior to residency...and if so:
1)Did you become more comfortable with this?
2)Is the fear good and you just learned how to manage it during residency as your knowledge with these situations expands?
3)Lastly, are procedures just a repetition thing? I hope I'm not a complete Oaf if I haven't had a successful intubation yet.

I plan on getting an anesthesia advisor within a few months and will ask him/her these questions as well, but wanted to bounce these off everyone in this forum as well. Thanks to the responders and I appreciate any anecdotes you all have regarding this as well! Also, if there is a thread that I missed regarding this, I apologize for repeating questions and if someone could post the link that would be great!

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[guitarguy]

It definitely sounds like you’ve had a great surgery rotation, and some early exposure to anesthesia. Don’t let a few unsuccessful procedures discourage you from going into the field…That’s why you have 3 years of residency training. I wasn’t so good at the few intubations I attempted as a med student, and I think my problem was that I didn’t really understand the anatomy and so I couldn’t describe to my attendings what I was actually seeing. You’ll learn quickly once you start residency – its no big deal. 6 months into my anesthesia training, I often feel fearful. If you don’t, you’re not human. As a resident, you always have help available when you need it – and aren't looked down upon by asking for it. As you finish your clerkships, and formally complete an anesthesia rotation, think about how you, in general, handle stressful situations. Do you deal well with acute situations in your life…can you remain calm and collected? The s*** doesn’t hit the fan often in anesthesia, but when it does at least on the outside you can’t be freaking out too much.

 

[SleepIsGood]

To the OP

A lot of what anesthesiologists do is PREVENTATIVE. Things CAN go wrong very easily. However, our society's motto is 'vigilance'. You have to always be one step ahead at all times.

In terms of 'complications'. Well, here's the deal. You are a medical student right now. From just looking at what the anesthesiologist is doing, you may feel like nothing bad can ever happen.

When you are that person behind the drapes though by yourself, things look and feel very different. Dont worry you will make errors, but typically if you are vigilant, you will catch things. Furthermore, the ASA has made certain monitors necessary (or highly recommended) and one must chart the output of these monitors. As a result, if you are doing your due diligence, you will be ok. Plus, remember you have 3 years of training and things going south,etc to build up your confidence.

 

[bigdan]

However, our society's motto is 'vigilance'

...well, it USED to be "vigilance", when the motto and logo meant something.