What should an anesthesia resident choose if they are...

[stimmed]

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1. not a speed demon
2. dislikes stressful situations (ie codes, super sick patients, ICU's)
3. does not want to do research
4. likes teaching


?

 

[michigangirl]

sounds ripe for an attending in an outpatient center at an academic institution. You may not be able to demand only outpatient at the get go, but after some time, if you prove yourself you can probably be.. You could work your way up to running the outpatient center or some significant admin role. I can't speak from experience on the other side, but I'm assuming academic outpatient stuff is not quite as "speedy" as PP. But folks who've done both (I have no PP experience) will have to weigh in.

 

[drccw]

1. not a speed demon
2. dislikes stressful situations (ie codes, super sick patients, ICU's)
3. does not want to do research
4. likes teaching
5. likes business

?

i recommend residency director....
or academics..

become the guru of something totally specific. so you are the end all be all of it... like PONV or something...
teach you residents to do all the research...

or go into chronic pain manaement...

FDW

 

[guitarguy09]

Pain?

 

[pgg]

1. not a speed demon
2. dislikes stressful situations (ie codes, super sick patients, ICU's)
3. does not want to do research
4. likes teaching
5. likes business

?

What level resident are you? If you're a CA-1 or even a CA-2, then
1) you'll get faster if you make daily specific efforts to be faster
2) you'll get more comfortable with those situations
3-4-5) many options

If you're a CA-3, it's a bit late to be thinking about this stuff. 🙂

Otherwise a clinical track academic position sounds like a good fit. Most academic attendings I've known could've (mostly) avoided the super sick crowd just by avoiding certain types of cases. There certainly isn't a lot of speed pressure, but you're probably outta luck on the business side unless by 'business' you mean 'admin/management' ...

And there's always pain, if you can put up with the patients.

 

[stimmed]

.

 

[pgg]

Near end of CA1 year. Slow and methodical by nature - being physically fast is possible for me if I really focus but it just requires that I make a conscious effort which is mentally draining. Or maybe It'll become second-nature with my super sick patients this coming year. We'll see!

The biggest thing that made me faster with procedures was to focus on economy of movement. Stupid little details that save a few seconds each but add up. For example epidurals ... there's really only one brief part of that entire procedure that needs to be done slowly - the needle driving and LOR. The rest there are lots of little things that can be done to minimize trips back and forth to the tray, moving and picking things up.
- grab all 3 betadine soaked sponges at once
- get the LOR syringe ready while the local is soaking in
- program & prime the pump while you're talking to / consenting the patient
- etc
I occasionally watch "slow" people do procedures and aside from just plodding along like they've got nowhere else to be, there's so much wasted movement turning to and from and back and forth between the patient and tray.

If you want to be faster, you will be. It seems most "slow" people just don't care about being fast, or they've developed their slow way of doing things and are set in their ways.

As for becoming comfortable with high stress situations - I guess I'll just have to see about that too! I'm skeptical because I don't like frenetic, confrontational atmospheres where everyone is panicking.

In the end you'll be at ease during codes because all the things that freak other people out - airway and meds and ACLS and hemodynamic manipulation - are what you do every day. Codes are like trauma, usually very formulaic and repetitive.

 

[imfrankie]

1. not a speed demon
2. dislikes stressful situations (ie codes, super sick patients, ICU's)
3. does not want to do research
4. likes teaching
5. likes business

?

Don't be too hard on yourself. You'll change a lot as residency progresses and after you work in practice for a bit also. Not to worry.

 

[PMPMD]

Sleep medicine?
http://forums.studentdoctor.net/showthread.php?t=810228

 

[proman]

As for becoming comfortable with high stress situations - I guess I'll just have to see about that too! I'm skeptical because I don't like frenetic, confrontational atmospheres where everyone is panicking.

Don't think that you have to panic in order to deal with a stressful case. In fact just the opposite is true. I remember one evaluation during residency where the attending wrote that he couldn't tell whether I truly understood how critical the patient was because I was calm 🙄

You're a CA1, at the end of your CRNA year. Wait until you've had cardiac/thoracic/vascular rotations before you relegate yourself to the ASA 1s getting plastic surgery.

 

[cfdavid]

Don't think that you have to panic in order to deal with a stressful case. In fact just the opposite is true. I remember one evaluation during residency where the attending wrote that he couldn't tell whether I truly understood how critical the patient was because I was calm 🙄

You're a CA1, at the end of your CRNA year. Wait until you've had cardiac/thoracic/vascular rotations before you relegate yourself to the ASA 1s getting plastic surgery.

That's one way of putting it.

 

[cleansocks]

Don't think that you have to panic in order to deal with a stressful case. In fact just the opposite is true. I remember one evaluation during residency where the attending wrote that he couldn't tell whether I truly understood how critical the patient was because I was calm 🙄

You're a CA1, at the end of your CRNA year. Wait until you've had cardiac/thoracic/vascular rotations before you relegate yourself to the ASA 1s getting plastic surgery.

I had a similar evaluation in the first half of my ca1 year! But he phrased it more negatively, saying he couldn't tell if I was "all there," wouldn't trust me to do a basic case on my own if he was too busy to help out, and told my program director about it! I took a little too long (5-10 seconds) for the attending's comfort to recognize laryngospasm. Hadn't seen it before! So i got hip-checked and reached for the prop/succ for him instead. Awkward working with that guy now!

 

[jennyboo]

Pathology.

 

[stimmed]

Pathology.

6. Dislikes dead people.

 

[IlDestriero]

sounds ripe for an attending in an outpatient center at an academic institution. You may not be able to demand only outpatient at the get go, but after some time, if you prove yourself you can probably be.. You could work your way up to running the outpatient center or some significant admin role. I can't speak from experience on the other side, but I'm assuming academic outpatient stuff is not quite as "speedy" as PP. But folks who've done both (I have no PP experience) will have to weigh in.

Our Academic ASCs are full speed, attending only, and with experienced OR and PACU nurses. We blast through as many cases as possible and still go home early. It's like my pre academia days.😍 ASC duty is a perk for staff able to keep up with the pace, and with the experience to be trusted working alone in an environment where no physician help is available (excepting the surgeon) in an emergency. It is very uncommon for new hires to go there for several years, and the spots are coveted. I love the break from the usual grind and go 2-3 times a month.
Sometimes we're alone, sometimes there is another MD there with a second OR, either way, no one is coming to help if you've got problems.
Several staff have no interest in the high speed turnover, several are not a good fit for being alone, and a couple reacted poorly to crises and were kicked back to the mothership. There are also a couple senior folks who don't want to teach or supervise anymore, and don't want case after case of ASA3+ kids, so they go out more often or exclusively.

 

[stimmed]

Our Academic ASCs are full speed, attending only, and with experienced OR and PACU nurses. We blast through as many cases as possible and still go home early. It's like my pre academia days.😍 ASC duty is a perk for staff able to keep up with the pace, and with the experience to be trusted working alone in an environment where no physician help is available (excepting the surgeon) in an emergency. It is very uncommon for new hires to go there for several years, and the spots are coveted. I love the break from the usual grind and go 2-3 times a month.
Sometimes we're alone, sometimes there is another MD there with a second OR, either way, no one is coming to help if you've got problems.
Several staff have no interest in the high speed turnover, several are not a good fit for being alone, and a couple reacted poorly to crises and were kicked back to the mothership. There are also a couple senior folks who don't want to teach or supervise anymore, and don't want case after case of ASA3+ kids, so they go out more often or exclusively.

So no residents? What makes it academic? What's an ASC? Ancillary service center?

 

[geogil]

So no residents? What makes it academic? What's an ASC? Ancillary service center?

Ambulatory surgery center.

Il D can correct this, but an academic ASC is affiliated with a university hospital.

 

[DO Anes]

1. not a speed demon
2. dislikes stressful situations (ie codes, super sick patients, ICU's)
3. does not want to do research
4. likes teaching
5. likes business

?

Community College English teacher.

 

[IlDestriero]

Ambulatory surgery center.

Il D can correct this, but an academic ASC is affiliated with a university hospital.

Correct. There are trainees at the big house, not the ambulatory surgery center cash cows in the wealthy suburbs.😉 You get the same faculty, but none of the hassles of being at the big slow moving monster. They actually want to expand the concept over the next decade or so and develop a couple day hospitals with overnight capacity for healthy kids and transform the main hospital into, for the most part, a giant ICU/step down for sick kids. Sign me up for the former. Some other Children's hospitals have already started doing this, beyond just a few ASCs.

 

[cfdavid]

Community College English teacher.

When I get "grass is greener" syndrome, I'll sometimes reflect on what it would be like being a college (university preferably) liberal arts professor. I have this vision in my head where I'm strolling into my first class at 7:45 a.m., Starbucks in hand, wearing corduroys and a casual button down shirt. Completely stress free. Lecturing to a roomfull of early twenties hotties! O.k., back to reality.....

 

[BeddingfieldMD]

For better or worse, my memories of college and what the average [insert any liberal arts field here] professor did on a daily basis seem pretty much in line with what you've described. I'm sure there's a lot of research that goes behind the scenes, but once you're tenured, you're set. And all the grunt work is dished out to the PhDs, of course.

When I get "grass is greener" syndrome, I'll sometimes reflect on what it would be like being a college (university preferably) liberal arts professor. I have this vision in my head where I'm strolling into my first class at 7:45 a.m., Starbucks in hand, wearing corduroys and a casual button down shirt. Completely stress free. Lecturing to a roomfull of early twenties hotties! O.k., back to reality.....

 

[stimmed]

Community College English teacher.

ooooh ZING!

Actually that sounds really nice, though I'd prefer some palatial, sprawling campus and smart 20yo's.

 

[cfdavid]

For better or worse, my memories of college and what the average [insert any liberal arts field here] professor did on a daily basis seem pretty much in line with what you've described. I'm sure there's a lot of research that goes behind the scenes, but once you're tenured, you're set. And all the grunt work is dished out to the PhDs, of course.

Being an expert on one small segment of European history (or whatever).....
Maybe writing a book or something... Going on "field trips" to investigate historical sites or some jazz like that....(really just drinking wine in the French countryside....).

Come back to your cozy little "Tudor" home just off campus. Ofcourse the campus would be one with lots of old buildings, lots of ivy etc. Hell, I think I might just need to take up pipe smoking since that seems it would go great while reading next to the fireplace.....(which is essentially your job, no?)

Teachin a coupla classes per day..... Talkin about a bunch of BS all day long.... Philosophizing.... Existing in a state of near immunity (hell, let's just call it bliss) from the economic realities of the real world.....

O.k. Enough is enough! Back to reality.

 

[IlDestriero]

Being an expert on one small segment of European history (or whatever).....
Maybe writing a book or something... Going on "field trips" to investigate historical sites or some jazz like that....(really just drinking wine in the French countryside....).

Come back to your cozy little "Tudor" home just off campus. Ofcourse the campus would be one with lots of old buildings, lots of ivy etc. Hell, I think I might just need to take up pipe smoking since that seems it would go great while reading next to the fireplace.....(which is essentially your job, no?)

Teachin a coupla classes per day..... Talkin about a bunch of BS all day long.... Philosophizing.... Existing in a state of near immunity (hell, let's just call it bliss) from the economic realities of the real world.....

O.k. Enough is enough! Back to reality.

That's great for the trust fund crowd. $60k a year as an Asst professor of Early European Architecture ain't goin' to get you far. Nor is the $6/book you'll get on your textbook that you spent 1000 hours writing.

 

[geogil]

That's great for the trust fund crowd. $60k a year as an Asst professor of Early European Architecture ain't goin' to get you far. Nor is the $6/book you'll get on your textbook that you spent 1000 hours writing.

And the fact that jobs are SCARCE. Schools are churning out waaay more liberal arts PhD's than university faculty positions available. You might be cranking out papers and books just hoping and praying to get tenured and you'll still only be making a fellow's salary for a looong time.

Yup, dim though the future in medicine is, I don't regret my decision to forgo a history PhD in favor of doing anesthesiology.

 

[pgg]

Teachin a coupla classes per day..... Talkin about a bunch of BS all day long.... Philosophizing.... Existing in a state of near immunity (hell, let's just call it bliss) from the economic realities of the real world.....

O.k. Enough is enough! Back to reality.

I would think a liberal arts PhD would be uniquely vulnerable to the economic realities of the real world.

I mean, there are a lot of them, and only so many Starbucks out there ...

 

[cfdavid]

That's great for the trust fund crowd. $60k a year as an Asst professor of Early European Architecture ain't goin' to get you far. Nor is the $6/book you'll get on your textbook that you spent 1000 hours writing.

Geez... Did you HAVE to rain on my parade. I much prefer my "alternate" reality...

 

[chocomorsel]

Geez... Did you HAVE to rain on my parade. I much prefer my "alternate" reality...

So did I man, so did I. When the alarm goes off in the morning, I ask myself, why, why, why. Why the hell can't we start at 9 am instead of 0730.

 

[urge]

sounds ripe for an attending in an outpatient center at an academic institution. You may not be able to demand only outpatient at the get go, but after some time, if you prove yourself you can probably be.. You could work your way up to running the outpatient center or some significant admin role. I can't speak from experience on the other side, but I'm assuming academic outpatient stuff is not quite as "speedy" as PP. But folks who've done both (I have no PP experience) will have to weigh in.

Where I work mostly the junior guys who can do blocks & healthy peds get shipped over to the ASC. Some like it some not. The guys who do the really sick patients have never been to the ASC.