what should I do to be the best anesthesiologist possible?

[Ferdie]

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M4 here, anxiously awaiting the match, then a few months off and an intern year before finally getting back to what I really want to do...

For those of you who are already out there in your CA years, or practicing as attendings, what do you wish you would have done during the end of your 4th year and intern year to be better prepared? Read baby Miller? Read journals? Drink more tequila?

While I've got the time now, I want to do things to make me less incompetent later...

 

[badgas]

M4 here, anxiously awaiting the match, then a few months off and an intern year before finally getting back to what I really want to do...

For those of you who are already out there in your CA years, or practicing as attendings, what do you wish you would have done during the end of your 4th year and intern year to be better prepared? Read baby Miller? Read journals? Drink more tequila?

While I've got the time now, I want to do things to make me less incompetent later...

4th year - more tequilla. Intern year - survive. Not enough time for baby miller during intern year and when you get your tequilla opportunities, you take them. Seriously though, enjoy the rest of 4th year.

 

[Gas]

It's March already, so enjoy the last few months of being a med student. You have no responsibility, and you will miss that.

I don't know what kind of internship you are doing, but take your ICU and anesthesia months seriously. The rest of the time, just work hard, suck it up, and then it's on to anesthesia residency.

The biggest advice I can give you for internship is to take Step 3 and get it out of the way. It's one less thing to worry about when you are an anesthesiology resident.

 

[VentdependenT]

M4 here, anxiously awaiting the match, then a few months off and an intern year before finally getting back to what I really want to do...

For those of you who are already out there in your CA years, or practicing as attendings, what do you wish you would have done during the end of your 4th year and intern year to be better prepared? Read baby Miller? Read journals? Drink more tequila?

While I've got the time now, I want to do things to make me less incompetent later...

The fact that you are even thinking about how to make yourself a better doctor already puts you ahead of the curve. Congrats.

Grab a book that you are interested in (I dug Marino's ICU book intern year, and now) and get involved in interesting clinical situations. Thats about all you can do your intern year.

Other than that enjoy the hell out of your free time.

 

[Ferdie]

I suppose I could start reading my subscriptions to Anesthesiology and Jama, rather than letting them just pile up on the bookshelf...

 

[Bertelman]

I suppose I could start reading my subscriptions to Anesthesiology and Jama, rather than letting them just pile up on the bookshelf...

Ditch JAMA, nestle up to NEJM.

I haven't found more than one good article in any given Anesthesiology issue yet. You can clear that stack in an afternoon.

 

[cchoukal]

I agree that NEJM is WAY better than JAMA, and, for that matter, A/A is probably better for a student/resident than Anesthesiology. You shouldn't work too hard on anesthesia as an intern. That's your chance to learn as much medicine as you can, and that will serve you well. Reading about anesthesia now would just be out of context and none of it would really soak in. You've got your whole life ahead of you to read/learn more anesthesia. so, in short, I'll just echo what the others have said: have fun until intern year, learn as much medicine as you can as an intern, and when residency rolls around, read a little bit every day from a major text book, and keep up with the journals.

 

[lord_jeebus]

So glad to hear I'm not the only one who prefers NEJM and A&A...

JAMA goes straight from the mailbox to the trash chute these days...

 

[fascinoma]

For anyone with not enough time to read NEJM, they have an excellent podcast you can subscribe to. Listen 1 day a week on your morning or evening commute and you're set. Then read any articles you're really interested in later.

also, thanks for all the good advice!

 

[g3pro]

The New England Journal of Gobbledy-gook?

 

[SexPanther]

Ditch JAMA, nestle up to NEJM.

I haven't found more than one good article in any given Anesthesiology issue yet. You can clear that stack in an afternoon.

2nd this. You can also sign up for the resident E-bulletin from NEJM which sends an email of highlights/pearls every week from the new issue. Nice to have when you don't have the time to read the articles in depth. I'm not a huge fan of Anesthesiology, but it's free with the ASA membership.

Another journal I love is the Journal of Critical Care Medicine.

Enjoy your time before internship, your life will change drastically July 1st. If you do happen to peruse journal articles before then, you'd better have an alcoholic beverage in hand.

 

[Ferdie]

Enjoy your time before internship, your life will change drastically July 1st. If you do happen to peruse journal articles before then, you'd better have an alcoholic beverage in hand.

I do like to mix my work and play... 😀

Also, Jama has pretty pictures on the front, so I get my art history lesson in too. Really, that's the only part I've been reading. Art history, free with AMA membership...

 

[Dejavu]

I will put in a plug for "Anesthesiology, Problem-oriented Patient Management", by Yao and Artusio, as an additional reference. It breaks down several pt problems and the management thereof.
I also agree with learning as much Critical Care medicine as possible. You will use the concepts every day.

 

[TaiShan]

I do like to mix my work and play... 😀

Also, Jama has pretty pictures on the front, so I get my art history lesson in too. Really, that's the only part I've been reading. Art history, free with AMA membership...

JAMA has become my wife's favorite junk mail because of the little portion of cover arts.

 

[VentdependenT]

I will put in a plug for "Anesthesiology, Problem-oriented Patient Management", by Yao and Artusio, as an additional reference. It breaks down several pt problems and the management thereof.
I also agree with learning as much Critical Care medicine as possible. You will use the concepts every day.

Yao is definitely a rock star book.

Reed has an excelent and much more digestable "Clinical Cases in Anesthesia" textbook.

 

[Bertelman]

JAMA has become my wife's favorite junk mail because of the little portion of cover arts.

Don't discount the poetry!

Ode to the Gall Bladder

once green,
bile filled

now thine stones
are filmed

no longer
in a belly

you are
quite simply,



smelly

 

[swpm]

I will put in a plug for "Anesthesiology, Problem-oriented Patient Management", by Yao and Artusio, as an additional reference. It breaks down several pt problems and the management thereof.
I also agree with learning as much Critical Care medicine as possible. You will use the concepts every day.

Yao's got a nice book, but the OP's a med student who's still got a year of intern purgatory ahead.

IMHO, his time would be far better spent reading one basic text (Baby Miller or M&M), plus books that will serve him well as an intern (Marino leaps to mind). Anything beyond the basics at this point is likely to be low yield and will stick like Teflon.

 

[militarymd]

Ditch JAMA, nestle up to NEJM.

I haven't found more than one good article in any given Anesthesiology issue yet. You can clear that stack in an afternoon.

Very true...and very sad.

 

[Bertelman]

Very true...and very sad.

Unless, of course, you are interested in understanding how sevo attenuates the ACh receptor in BR3DY knockout mice in hyperbaric, hypothermic conditions.

Or how that effect can be salvaged by concomitant pulse insulin infusion when co-mediated by the transbronchial administration of a poly-C tetramer...in a mouse model

 

[nociceptor]

M4 here, anxiously awaiting the match, then a few months off and an intern year before finally getting back to what I really want to do...

For those of you who are already out there in your CA years, or practicing as attendings, what do you wish you would have done during the end of your 4th year and intern year to be better prepared? Read baby Miller? Read journals? Drink more tequila?

While I've got the time now, I want to do things to make me less incompetent later...

Get your name in this book. that would make you the complete anesthesiologist

don't listen to me. I am a PGY1 and not a good one at that.

 

[Bougie]

Stay drunk and bang as many broads as possible for the rest of your 4th year. There is no better time in life other than freshman year of college.

Intern year, forget about learning anesthesia unless you are on an anesthesia elective. You have 3 years to do that. If you feel you must, get through a few chapters in Morgan Mikhail (IV anesthetics, inhaled anesthetics, muscle relaxants, airway, monitoring). Learn from your rotations especially cards and ICU. Do as many procedures as possible. Make friends with attendings, surgical/medical residents, and even nurses. This will pay off huge for you in later years, trust me.

 

[loveumms]

I second Vents suggestion to read Marinos ICU book. It covers so many topics that are important to not only anesthesia and critical care but also medicine in general. I read some of this as a med student but, this year on my ICU rotation it really made sense of hemodynamics, cardiac and pulmonary physiology. Plus, it's an easy read.

Another suggestion - I don't know if anyone else would agree but, if you are doing a med/surg year, I would advise against doing an elective in anesthesia. Even though that is what you ultimately want to do (and hopefully enjoy immensely), you will get enough anesthesia in your last three years. Do an elective in cards/pulm so you can become a pro at EKGs/cardiac management or pulm management since this will become important to your everyday life as an anesthesiologist.

Finally - like everyone else has said - ENJOY the last few months of freedom. Read some books for enjoyment, relax a lot (aka sleep in often) and hang out with family and friends. Once you start internship you will be very busy and will look back on the days of fourth year with yearning.

Good luck in the match!

 

[Ferdie]

Thanks for the advice guys. I'm going to cough up the $80 for that ICU book, and read that instead of Baby Miller (I've already read a bit of that anyway, and yeah, it probably won't help me too much during all those months of medicine...)

 

[Laurel123]

I would say sleep, relax and have a good time in your fourth year of medical school. You have a long exhausting road ahead of you, and the last you want is to be burnt out. Enjoy the stress free days before they are gone forever. I find reading anesthesia without being able to be in the OR to administer anesthesia is like reading a phone book without having a telephone in front of you to call people - it is very boring, impossible to remember and a little useless.

I suppose if you are itching to read something education, I do like the idea of getting the Marino book. You will be able to use it as an intern as well as broaden your anesthesia knowledge.

My last month of intern year, I had some pathology elective. So I decided to read a little Baby Miller. When I took the AKT two weeks into my PGY1 year I got the lowest score in my class - it was like 15 percentile or something. I probably could have answered all c's and did better. By the time I took the AKT the next year, I was able to essentially pass the boards because finally what I was studying could be applied and it all came together!

Good luck, enjoy residency - it's actually a pretty good time.

 

[fakin' the funk]

I find reading anesthesia without being able to be in the OR to administer anesthesia is like reading a phone book without having a telephone in front of you to call people - it is very boring, impossible to remember and a little useless.

nice!

 

[seinfeld]

Just keep asking yourself " what can i do to be the best" the rest will fall into place

 

[GuP]

Did the Marino ICU text change much from 2nd to 3rd edition? I have the secon edition and am wondering if it's wise to shell out $ for the newer edition.

 

[pgg]

Did the Marino ICU text change much from 2nd to 3rd edition? I have the secon edition and am wondering if it's wise to shell out $ for the newer edition.

Yes, it changed a lot. 2nd edition was 1997. I was an undergrad then, and people were using 15 cc/kg tidal volumes to treat ARDS. May as well have been the dark ages.

CCM has seen quite a few major, practice changing studies published in the last decade. If anything, the 3rd edition is already dated in a some areas. The 2nd edition is thoroughly obsolete.