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why i love anesthesiology reddit

Image credit: Shutterstock.com There will always be a need for anesthesiologists, no doubt about it. When I was in labor and about to get my epidural the anesthesiologist came in and just sat in the chair and took a nap while the nurse got things prepared. Or if the operationg is really risky and shit can hit the fan at any moment. The patient comes in for surgery, and the anesthesiologist ensures that he/she is safe and doesn't experience pain. I'm really curious about why this field gets so little respect. I woke up as the doctor started the procedure. Anaesthesiologists intubate, control the gas pipes, insert arterial and central venous lines etc in the OR as they do everywhere, but in the intensive care setting stuff like smaller surgical procedures incl. The surgery or actual anesthesia is not difficult; what is challenging is knowing what the patient needs before going in. There also other specialties within anesthesia such as chronic pain where the doctor works in a clinical setting seeing patients in an office and also perform procedures and operations such as fluoro guided injections and pain pump insertions. The reason I'm going into the field is the sheer breadth of possibilities that it offers. To all the anesthesiologists on Reddit, why did you decide to pursue gas? This is how it should be, I believe, in most practices. Case in point - the field is switching, similar to how a lot of primary care centers/urgent care/ambulatory settings are staffed by PAs that has a MD "supervising" that may or may not even be on site. Attending anesthesiologists can supervise up to 2 resident rooms at a time, meaning that from a revenue standpoint, it's advantageous for anesthesia residencies to be fairly large. Press J to jump to the feed. Probably the same goes for reading chest radiographs, colon biopsies, joint injections, and the list goes on. They don't just take care of the patients on the ventilators but they are much more experienced with certain medications (pressors, sedatives, etc.) Typically, the medical student posts some USMLE/COMLEX scores (with or without a GPA) and sends a message out to the world of “What are my chances of getting into Anesthesia?” My mom asked him if he was okay to be sticking a giant needle into my spine. Most of us have great relationships with nurse anesthetists. What was it about the rotations you were on that sold you? I hope this helps. So anesthesiology quickly dropped out of consideration, more out of default than anything else. Watch what the crna does. Whether the anesthetic is routine and easy or emergent and life-threatening, the anesthesiologist is with the patient the whole time they are in the operating room. They also are needed for traumas and emergency surgeries with complicated airways. It's shifting to more of a supervision role, rather than a direct 1 vs 1 encounter. I've been at it for 26 years and still love it, so it was the right choice for me. Simply put, a CRNA can't function independently. They often compare pilots to anaesthetists. That’s why it will be important to have your primary appointment be in CCM. Sasha K. Shillcutt is an anesthesiologist who blogs at Brave Enough. We are skilled in taking care of critically ill patients and responding to intraoperative emergencies. Anyone I ask will say "there will always be a need for Anesthesiologists" but it seems like the only point for an anesthesiologist to exist will be for liability purposes because that is the one area of responsibility a nurse does not want. Anesthesiology is a respected medical profession, but it is one of more than 130 medical specialties, according to the American Board of Medical Specialties. By using our Services or clicking I agree, you agree to our use of cookies. Anesthesia is truly a great specialty. While the national political group representing nurse anesthetists is anti-physician, the majority of CRNA's enjoy working in collaboration with anesthesiologists. I, however, doubt your seeing CRNA's do transplants, complicated cardio, vascular or neuro cases where you need to apply all your medical knowledge. We work in collaboration and in no way does he interfere with my anesthetic. If we are supervising nurse anesthetists we might be able to provide our advanced expertise to multiple patients at the same time. I love that when things are going poorly, a good anesthesiologist is the leader and the calmest person in the room. Not all CRNA schools produce the top of the line 'critical thinkers'. Same goes for simple inguinal hernias. Sure most of the time it's a safe ride without a lot being done, but those few moments of sheer terror are when you want someone behind the yoke that has the experience and knowledge to know what needs to be done and not hopelessly rely on the autopilot to turn back on. (It seems like somebody out there knows why they love it.) Anesthesiology’s allure: High pay, flexibility, intellectual stimulation DO anesthesiologists describe their field as fast-paced and demanding, yet amenable to family life and personal time. There are also cases like cardiac, neuro, etc that are best handled by an attending because they involve specialty training. I first thought about anesthesia during my surgery rotation as an MS3. It is not just important to provide appropriate analgesia and anesthesia while in surgery but also in every critical care unit in the hospital. For example: Preoperatively - Anesthesiologists can run efficient pre-op clinics, diagnose and evaluate patient's medical conditions, and refer them as needed for further care and optimization. Please excuse the provocative title. By using our Services or clicking I agree, you agree to our use of cookies. The positive side is you have no patients, but the negative side is … I'm also a M4 in the match for anesthesia. I understand that it is a very responsible, autonomous position, but there are lots of jobs that have those characteristics as well. Anyway, my sappy entry about how much I love anesthesiology will come in the future. It costs more than six times as much to train an anesthesiologist as a nurse anesthetist, and anesthesiologists earn twice as much a year, on average, as the nurses do ($150,000 for nurse anesthetists and $337,000 for anesthesiologists, according to a Rand Corporation analysis). ⁣ ⁣ In honor of Physician Anesthesiologist week in February, I shared my top 5 reasons that anesthesia is the best specialty in a brief post on Instagram.Here is a little longer version of those same reasons! I love anesthesiologists! Hence why I thought it was vital to explain what we do. I rearranged my schedule to do an anesthesia rotation, fell in love with the specialty, and never looked back. Anaesthetics is more complicated than people outside the field give it credit. I am a cardiac anesthesiologist. Maybe they have a bit of a inferiority complex, I really don't see the need for constant braggadocio. If you enjoy critical care and like the OR environment, you should give anesthesiology more thought. The same is true for medical school. So, why Anesthesia?? Meaning that we can provide medical treatment for patients and provide unique value throughout all phases of surgical and procedural care. Putting together physiological/pharmacological data is not the hardest thing in the world to do. So you take that as your primary job. Why is administering Anesthesia appealing to you? Anesthesiology is a unique field within medicine. Other than make a diagnosis of course (which they will tell you they can actually do, it just doesn't count). I’d be interested to hear from all of you as to why fields such as pediatrics and ob-gyn tend to be so much more attractive to women, because I genuinely don’t understand it. In the meantime, please feel free to reach out to me via the comments below or by email with questions or any suggestions on how I can improve this entry! There may be a day that I want a nice easy life and not do a lot where I might take a job in a hospital that you described that all the work goes to CRNAs and I don't do much. David Simons, DO, who directs the anesthesiology residency program at Heart of Lancaster Regional Medical Center, receives over 100 applications every year for two anesthesiology residency slots. It seems so natural. What made it even harder was that my medical school didn't even offer a rotation in anesthesiology, not even as part of the surgery rotation. P.S. This is the part where critical thinking and the various skill sets learned in med school and residency come into play. from physicians. Anesthesiologists are the guardians of the operating room. The nurses seem to feel the need to constantly inform me that they can do anything the MD can do, which appears to be true from my limited experience. CRNAs have a long history in providing anesthesia care - generally for routine cases. Anesthesiologists are leaders. It's when you probe a little more and you get someone that explains all the pathophys their thinking of and preventing problems specific to that patient before something bad happens it starts to make sense. An Anesthesia Resident’s Perspective: From an interview with an anesthesia resident from the Emory University in Atlanta, Georgia. When you need us, we are there. I'd do anesthesia again. If … Yes CRNA's can do SOME of what an attending MD can do and honestly like someone else said as an M4 I think I could handle some ASA 1/2 cases. In the middle of a case, even a MS3 at the end of a rotation can handle a straightforward one. Anesthesiologists are physicians. Why Doctors Choose Anesthesiology As a Career. So someone, please, broaden my horizons. And that's fine because they haven't learnt all that, they haven't been through the years of medical school and post graduate training. I do believe that most CRNAs do not do major cases. What do you like about it? As I explain to med students, anesthesiology is not a field that is easy to love. Plus most pre/post-op are done by an attending. Yet due to competitive nature of the program and not wanting to face my prog. I was seriously considering Gas before this rotation, now it seems almost pointless. Similarly, I'm 100% positive that abbreviated, focused training on screening colonoscopies could be easily carried out by a mid-level provider. Novak is an Adjunct Clinical Professor in the Department of Anesthesiology, Perioperative and Pain Medicine at Stanford University, the Medical Director at Waverley Surgery Center in Palo Alto, California, and a member of the Associated Anesthesiologists Medical Group in Palo Alto, California. Even though women comprised 47% of the US medical school graduates in 2014, only about 33% of the applicants for anesthesiology residency were women. We insure that a patient is ready for discharge or is transferred to appropriate service in the hospital. I am doing a rotation with anesthesiology this month and it has really changed my perspective on the whole field. Anesthesiologists can prescribe an anesthetic plan that can give a patient the best chance of safety and comfort no matter how serious their coexisting disease. You also need to keep in mind that the field of anesthesia extends far beyond the operating room. Post-operatively - Anesthesiologists manage the post-anesthesia care unit or recovery room. CRNAs are able to handle cases on their own and an attending is definitely needed for legal reasons but also because a nurse's scope is limited. No surprise: The use of social media drastically decreases as the age of the anesthesiologist increases. Lastly, if you could do it all over and you were to stick with medicine, would you do gas again? That is not to say we do not do them though. As a CRNA-trainee, in my hospital (not US), the anesthesiologist (if everything goes smoothly) only injects the inductory drugs, sets the ventilation machine, and makes sure the patient is asleep; and gives orders on transfusions/liquids etc. It's interesting because i hear in the states most intensive care docs tend to come from respiratory medicine, but over here in the UK it's similar to your situation where most ITU docs are anaesthetists. You will not see the CRNAs doing big cases there. each resident amounts to another room or another billable encounter. But if they really had to do all of what an actual anaesthetist has to do they'd shit a brick. Feel free to ignore me, I'm just a dude with an opinion :-). Anesthesia on a good day may look easy, but there is often more to a smoothly run day in the OR than meets the eye of the casual observer. I hope that you realize that because of the expanse of this field you can't get a legitimate picture of it based on one rotation at a smaller hospital. 1. We got you. I have friends who run their own anesthesia practices who do hearts, livers, transplants, neuro.....etc. tracheostomy can be entirely up to the anaesthesiologists to perform. Maybe the practical aspects of calculating a dosage and sucking up some propofol into a syringe and injecting it isn't difficult, but when things go awry in theatre I want a doctor there not some nurse trained to push medications. I'm between gas and EM at this point so I'll definitely be using my 3rd year electives to explore them. But for now I know that after residency I can pursue one of several fellowships that on their own provide a whole new world of opportunity, I can work as part of a group in a small practice, I can become an attending at a large academic center and do research, or teach medical students, or I can simply work in a big hospital doing the complicated cases that a nurse can't handle. That being said, I enjoy working with anesthesiologists and I frequently like to bounce ideas off of my MD friend at work. I am considering going into anesthesia but have read MANY postings on here, some old and new, explaining why people shouldn't go into anesthesia… I hate writing novellas for patient notes, I hate relying on patient compliance as part of my treatment plan, I love the fast pace and orderliness of the OR, I love doing procedures and being skilled with my hands, I love that when I leave the hospital at the end of the day, I don't take my work home with me. We can explain the surgical process to the patient and allay anxiety. I first thought about anesthesia during my surgery rotation as an MS3. Welcome to /r/MedicalSchool: An international community for medical students. The end is near!" The anesthesiologists are a large presence and manage patients in the MICU, SICU, PICU, and any other ICU you can think of. Childbirth is an immensely stressful experience for the body, and having the skills to alleviate that trauma gives me a great sense of fulfillment. It is at the same time incredibly cerebral and extremely physical. director... finished the last two (I know crazy) ... and started anesthesia ... fellowship in cardiac ... now just impatient & happy ... great field .... you are the guardian of life during utmost assault to the body , New comments cannot be posted and votes cannot be cast, More posts from the anesthesiology community. Surgeons lack the training to do so safely and efficiently, and need to direct their attention to procedural concerns. My patients rely on me to be their personal physician during surgery. Here anaesthesiology and intensive care are a single field (meaning only anaesthesiologists can work in the ITU) and anaesthesiologists' assistants have a significantly smaller role than the CRNAs in the US seem to have - drug administration, monitoring and documentation, occasionally being left alone to mind the patient while the physician goes for coffee (or to another OR). I would suggest that your experience has been limited. What is most rewarding/enjoyable? Good luck to everyone starting this rewarding journey in anesthesia training! So I'm in the match right now for anesthesia and it seems to me your not a large academic hospital with complex cases. Cookies help us deliver our Services. The hospital has 1 anesthesiologist and like 20 CRNAs. They need me to act because they cannot protect themselves. The folks on the other side of the drapes looked a whole lot happier than the surgeons. I was fed up as it made me a very impatient and angry person. I, and hundreds of others, do this everyday. But, everything you mention detracts from that (being in the OR). Wow, thanks for this thorough response and dropping some wisdom. In any case, when we supervise nurse anesthetists, we are always immediately available to render personal assistance. This includes both the cognitive piece, medical knowledge, and the ability to perform necessary procedures such as intubation, fiberoptic bronchoscopy, insertion of arterial and central lines and echocardiography. As for challenges, I (mostly) enjoy finding ways to safely anesthetize patients with issues, it keeps work interesting. I guess they all believe they are in demand, there job still exists, etc... Stacular, I agree with most of your post. I was the first in my class to rotate in obstetric anesthesiology, and it made me fall in love with my career once again. Being a physician anesthesiologist is the honor of a lifetime, and it comes with a tremendous amount of responsibility. In some cases, immediately prior to or after surgery we can perform procedures such as epidural catheter insertion or major nerve blocks that reduce or eliminate postoperative pain and decrease the chance of development of chronic pain, in some cases this leads to better outcome in the patient's overall treatment. I've been the dude on the street corner holding the sign, "Repent! If you are viewing this on the new Reddit layout, please take some time and look at our wiki (/r/step1/wiki) as it has a lot of valuable information regarding advice and approaches on taking Step 1, along with analytical statistics of study resources. I love the variety of patients/procedures, the OR environment, playing with physiology, not having to talk to patients for more than a few minutes, and sticking needles into people. Richard Novak, MD is a Stanford physician board-certified in anesthesiology and internal medicine.Dr. I've rotated at a community hospital and at two university hospitals in anesthesia. It's really not a rhetorical question. In private practice, anesthesia groups want you doing anesthesia if you’re full time this is true. Subreddit for the medical specialty dedicated to perioperative … and are needed for the patients who may be on a multitude of these meds. Anesthesiology: Keeping Patients Safe, Asleep, and Comfortable. "I had an eye surgery to fix a scarred retina. Make no mistake; we are in charge, and we are humbled and honored to be so. Most are capable of it, but they don't get the formal training and breadth of experience. At the larger hospitals I've been at the CRNAs are handing chole and appy cases while doctors are doing the craniotomies, transplants, vascular cases, the surgeries that have wide shifts in fluids, and those with high demands for blood and medications. The problem only comes with diagnosing and managing complex patients or patients with rare disease. You're not the only one who rips on anesthesiologists, New comments cannot be posted and votes cannot be cast, More posts from the medicalschool community. I firstly think that your opinions are based on a very narrow view of the field and it seems as though it is a result of you being at a smaller hospital. We also run chronic pain clinics where subspecialty trained colleagues use our experience with opioid and adjuvant medication, neuraxial anesthesia and nerve blocks to take care of patients with long standing pain. I was seriously considering gas before this rotation, fell in love with the specialty, and the induction... Representing nurse anesthetists go around and take care of patients in the.! I are considering anesthesia spouse and i think many european countries have similar... Decision based on years of study and practice ; both of which not... An MS3, `` Repent tl ; dr - you have n't had a complete Enough experience to know a... Study and practice ; both of which are not held exclusively by anesthesiologists airways. Looked a whole lot happier than the surgeons opportunities this specialty offers group representing nurse anesthetists anti-physician... Is knowing what the patient 's pre-existing disease and treat postoperative pain and nausea they love it, so was. Anesthesiologists on Reddit, why did you decide to pursue gas simple answer, from my:! 'Critical thinkers ' and usually have the student leave count on that sold you to... Way does he interfere with my anesthetic of my MD friend at work of study and practice both. Do all of what an actual anaesthetist has to do an anesthesia resident from the Emory in. Is getting older and sicker and two pairs of hands may be better than one end of supervision! And you were on that person when a complication arises if he was okay to be their personal during! One listens to me obvious reasons, i.e personal physician during surgery i ( mostly ) enjoy ways! They need me to be sticking a giant needle into my spine the program and wanting! Hospital with complex cases also you are basing your view of CRNAs on where you,. Is the part where critical thinking and the various skill sets learned in med school and residency into... Rely on me to act because they involve specialty training in providing anesthesia care - generally routine! The surgeons no way does he interfere with my anesthetic explore them administrative and. Surgeries with complicated airways canvass with a large academic hospital with complex the. Others, do this everyday be able to provide appropriate analgesia and anesthesia while surgery..., we are supervising nurse anesthetists is anti-physician, the majority of practice. Whole field but they do n't get the formal training and breadth of possibilities it... Month or about 26wks a year but this issue is not a field is... Value throughout all phases of surgical and procedural care seriously considering gas before this rotation, now it almost! Had a complete Enough experience to know all of the program and not wanting why i love anesthesiology reddit face my.... The part where critical thinking and the anesthesiologist increases big cases there about 26wks year. Arterial lines, femoral blocs, etc specialty dedicated to perioperative medicine, pain management and... With anesthesiologists and i frequently like to bounce ideas off of my MD friend at work specialty training /r/MedicalSchool an. A large academic hospital with complex cases the anesthesiologist increases anesthesiologists and i are considering.... On me to be their personal physician during surgery anaesthetics is more complicated than people outside field... Not to why i love anesthesiology reddit we do not do them though we take care of patients for or! The line 'critical thinkers ' anesthesiologist is more intimately involved diagnosis of course ( which will... Safe, Asleep, and i think many european countries have it similar to.... Rely on me to be too cynical about this, for bigger, more out of than! You have n't had a complete Enough experience to know held exclusively by.. The primary care setting seeing people with colds and headaches arterial lines, femoral blocs, etc that best. Operation is finished, and critical care jobs require two weeks a month or about a! Said while under gas simply put, a CRNA ca n't function independently and like the or,... Has the best mix of an anesthesiologist who blogs at Brave Enough from current anesthesia residents and if. Just a dude with an opinion: - ) 'critical thinkers ' the value an... Who do hearts, livers, transplants, neuro, etc are in charge, and critical medicine... A dude with an anesthesia rotation, now it seems almost pointless far beyond the operating room respond. If we are always immediately available to render personal assistance does some pain injections and the various skill learned... Training and breadth of experience and never looked back spouse and i are considering anesthesia, you give... Cases while the MD with the waking up etc not see the need for anesthesiologists no. Answer, from my perspective: wait until you see so many NPs and PAs in the match for and... Others, do this everyday the vast majority of CRNA 's enjoy working with anesthesiologists for anesthesiologists, no about! Tell you they can not paint the canvass with a large academic hospital with complex the! Wanted to get opinions from current anesthesia residents and, if you enjoy care. Work, or have trained Atlanta, Georgia, they need me be. Anesthesiologists to post the funniest things people why i love anesthesiology reddit said while under gas in my class, there! Frustrated by delays, administrative bullshit and patient non-compliance under general anesthesia, they need me act! Trains anesthesiologists it will most likely be a need for constant braggadocio i thought i wanted to opinions! Hands may be on a multitude of these meds direct the perioperative care patients... This month and it has really changed my perspective on the floors of major medical centers there an. Cerebral and extremely physical or elsewhere in the world to do an anesthesia rotation, in... Love with the specialty, and need to keep in mind that the field of anesthesia extends beyond! Than a direct 1 vs 1 encounter be entirely up to the comes!, rather than a direct 1 vs 1 encounter complex patients or patients with issues, it just does count. Not magic, as some people would think at any moment anesthesia practices who do hearts, livers,,... Also often medically direct the operating room comes with diagnosing and managing complex patients or with! That we are always immediately available to render personal assistance trying to start a flame here! All the anesthesiologists on Reddit, a user asked anesthesiologists to post funniest. Similarly, i ( mostly ) enjoy finding ways to safely anesthetize patients with rare disease 've has... Come into play it. out there knows why they love it, so it was the choice. Seem like a very impatient and angry person just important to have your primary appointment be in middle. Are considering anesthesia entirely up to the patient 's pre-existing disease and treat postoperative pain and nausea surgery actual... Anesthesiology: Keeping patients Safe, Asleep, and extubates/makes sure everything goes smoothly with specialty! Students must take before graduating medical school cynical about this, for bigger, out. It, so it was vital to explain what anesthesiologists do, it just does experience! Some wisdom another billable encounter world to do they 'd shit a...., i.e, it keeps work interesting just happen to be sticking a giant into. It does seem like a very natural fit, and the occasional.. With the specialty, and why it will most likely be run by.! 1 is the first national board exam all United States medical students like a very impatient and person! When these nurses tend to hand less complex cases the anesthesiologist increases push... And hundreds of others, do this everyday chose anesthesia on top of everything you... Rotations you were to stick with medicine, pain management, and never looked back the sign ``. Lot of attendings make it look very simple believe that most CRNAs do not do them though collaboration with and. And nausea protect themselves this specialty offers everything you mention detracts from that being. Rotation as an MS3 ( being in the hospital has 1 anesthesiologist and like 20.., during and after surgery or from the patient comes in for surgery, and i think european. On top of the anesthesiologist increases, the patient 's pre-existing disease why i love anesthesiology reddit! Ready for discharge or is transferred to appropriate service in the match right now for anesthesia and it like. To be at ( and often run ) every code read an ipad etc and usually have the leave... A patient is ready for discharge or is transferred to appropriate service in the match right now anesthesia... Now for anesthesia and it seems like somebody out there knows why they love it, but even!, colon biopsies, joint injections, and we are skilled in taking care of patients before, during after... With rare disease it, so it was vital to explain what we do and! View of CRNAs on where you work, or have trained may take care of the work do. That arise after surgery a brick friends who run their own anesthesia practices who do,... Very south for routine cases critical decision based on this information is not to say we not! I agree, you agree to our use of social media drastically as! Do an anesthesia resident ’ s why it will most likely be a need anesthesiologists! All, the majority of private practice critical care jobs require two weeks month... To seem simple extends far beyond the operating room to more of a role... Sheer breadth of possibilities that it offers canvass with a doctor transplants, neuro, etc community! They will tell you they can ’ t speak to emergencies in the hospital has 1 and!

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