Updated Advice for New Grads going to MD-only practices?

[missiongirl]

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Anybody have updated or additional advice for us new grads out here who just finished anesthesia residency about to start our first MD-only jobs (where you do your own cases)? The Attendings at our residency programs have not been very helpful in giving practical advice because most have only been in Academics or had supervisory roles with CRNAs.

2 new grads I know of (me and a colleague) are going to MD-only practices (one of us is going to a group, one going as hospital employee) haven't had new grads in many years...anything in particular we should ask prior to starting, or should ask during hospital orientation? (besides location of difficult airway cart and what tools are on it, code cart, MH cart/kit, location of emergency drugs, bathrooms)...any equipment-specific orientation we should ask for, for liability/safety purposes?

Any additional suggestions as to how to make the transition from residency to private MD-only practice smoother are appreciated!

(I've read Jet's old post...anybody have anything to add?).

Thank you.

 

[Dejavu]

Yes, one minor thing.

Lay in the weeds for a few months feeling out how your group does things.

No one likes to hear from day one that "this is how we did things at the Mayo (or Cornell, or wherever)."

 

[sakr19680]

However you did things before forget it you do it there way, PERIOD!!!

 

[missiongirl]

Yes, one minor thing.

Lay in the weeds for a few months feeling out how your group does things.

No one likes to hear from day one that "this is how we did things at the Mayo (or Cornell, or wherever)."

Ok I appreciate that thought-we are going into unfamiliar territory (new hospitals, new culture, new people, possibly some different equipment, practicing on our own for the first time etc) anyway so I figured that 'lay in the weeds' approach would be good to feel out the systems there first. But I appreciate your saying it.

Anybody have any more advice on what they would tell a new grad if they were joining their MD-only group practice or as MD-only hospital employee besides "do things our way"?

 

[ssmallz]

Don't just blindly do what they do. Take their recommendations as you would any other provider. If you don't feel comfortable don't do it. They always do their lateral shoulders w/LMAs but you think this guy is too big....pop in a tube. They never do ISBs for shoulders, pop one in if you can get it done quick. You think you need an a-line for a case that they don't, do the a-line. It's your lisence, and your arse on the line and if $hit goes down, they're gonna look at you and say well you shoulda done XYZ. Understand that most of your collegues have been out of residency for 10+ years and don't keep up the material like Blade or the attendings on this site. It's much better to defend yourself as a new grad for being overly cautious then for getting into a situation and having the pt do poorly. Bottom line, don't delay the cases, take their advice like any other clinician, practice safely because at the end of the day make your own choices. Your first group will likely not be your last so don't sell out to a bunch of people that won't do the same for you.

 

[Jay K]

I've said it once and I'll say it again: If a surgeon, colleague, nurse or hospital administrator pushes you to do the wrong thing, you can always get a new job, but it's easier if you haven't killed someone.

I second laying low; Joining a group is like playing Survivor.

Try not to burn bridges.

Good luck and congratulations.

 

[pgg]

You're always happy to be there. Even for the 2 AM lap chole. If you didn't want to work, you wouldn't have put yourself on call. The only reason not to do a case is for genuine patient safety reasons. If a surgeon books a BS case at a ridiculous time, don't balk, just do the case and privately ask the seniors WTF is up with the 2 AM elective gallbladders.

We're a service specialty. You're competent and safe; in time this will be apparent to everyone and you'll get the credit and reputation you deserve. Early on, don't give the surgeons and other staff a reason to want to not want to work with you. You can do this without being a subservient doormat.

Most of this comes down to not being a whiny jerk who doesn't have an aversion to work, but it's surprising how many whiny lazy jerks are out there. In the locums world, they don't get invited back, and they don't get told why. I suspect in the partnership track world, they don't make the cut.