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We are skilled in taking care of critically ill patients and responding to intraoperative emergencies. But yeah...Lifestyle in the field will always be great, but the pay will drop in the future no doubt about it. Why Doctors Choose Anesthesiology As a Career. It's really not a rhetorical question. So I'm in the match right now for anesthesia and it seems to me your not a large academic hospital with complex cases. 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. When you see a wide variety of patients from obs&gynae, ortho, gastro, etc, you need to have a good broad knowledge of disease pathology especially if shit turns south in theatre, to be able to act quickly to diagnose a situation and apply your knowledge of pharmacology and physiology to fix it. For context, I'm an Anesthesiology resident. I hope this helps. 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. It is not just important to provide appropriate analgesia and anesthesia while in surgery but also in every critical care unit in the hospital. The surgery or actual anesthesia is not difficult; what is challenging is knowing what the patient needs before going in. Simply put, a CRNA can't function independently. They often compare pilots to anaesthetists. Why is administering Anesthesia appealing to you? Anesthesiology is a respected medical profession, but it is one of more than 130 medical specialties, according to the American Board of Medical Specialties. That is not to say we do not do them though. I first thought about anesthesia during my surgery rotation as an MS3. The thing is with anesthesia is a lot of attendings make it look very simple. Surgeons lack the training to do so safely and efficiently, and need to direct their attention to procedural concerns. That's not to say they can't handle complex cases (cardiac, neuro, etc) but many are ill-equipped for routinely managing these cases. 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. There are also cases like cardiac, neuro, etc that are best handled by an attending because they involve specialty training. The positive side is you have no patients, but the negative side is … Press J to jump to the feed. "I had an eye surgery to fix a scarred retina. Anesthesiologists are the guardians of the operating room. 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. You cannot paint the canvass with a large brush. No surprise: The use of social media drastically decreases as the age of the anesthesiologist increases. This is one of the main reasons I chose anesthesia on top of everything else you said. 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! They also are needed for traumas and emergency surgeries with complicated airways. 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. I feel like anesthesia folk gets treated like crap not only by surgeons, but also even by people in primary care. Being a physician anesthesiologist is the honor of a lifetime, and it comes with a tremendous amount of responsibility. What was it about the rotations you were on that sold you? There will always be a need for anesthesiologists, no doubt about it. 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?” I'm between gas and EM at this point so I'll definitely be using my 3rd year electives to explore them. But if they really had to do all of what an actual anaesthetist has to do they'd shit a brick. Make no mistake; we are in charge, and we are humbled and honored to be so. We got you. 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. 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 understand that it is a very responsible, autonomous position, but there are lots of jobs that have those characteristics as well. each resident amounts to another room or another billable encounter. In private practice, anesthesia groups want you doing anesthesia if you’re full time this is true. Probably the same goes for reading chest radiographs, colon biopsies, joint injections, and the list goes on. Cookies help us deliver our Services. Similarly, I'm 100% positive that abbreviated, focused training on screening colonoscopies could be easily carried out by a mid-level provider. One commenter relayed how a patient stroked his arm and said, "You'd make such a … This is one of the main reasons I chose anesthesia on … By using our Services or clicking I agree, you agree to our use of cookies. The problem only comes with diagnosing and managing complex patients or patients with rare disease. Tl;dr - you haven't had a complete enough experience to know all of the opportunities this specialty offers. USMLE Step 1 is the first national board exam all United States medical students must take before graduating medical school. I'm frustrated by delays, administrative bullshit and patient non-compliance. While the national political group representing nurse anesthetists is anti-physician, the majority of CRNA's enjoy working in collaboration with anesthesiologists. 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. Its actually the point of CRNA's to take care of the cases while you focus on the big picture as in the whole operating ward, or help when something goes wrong. I am a cardiac anesthesiologist. As for challenges, I (mostly) enjoy finding ways to safely anesthetize patients with issues, it keeps work interesting. The CRNA is a cost effective, safe alternative to an anesthesiologist. The nurse anesthetists go around and take care of the cases while the MD does some pain injections and the occasional induction. (The nurse asked what kind of music he wanted … What is the most challenging/frustrating part of the work you do? 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. Good luck to everyone starting this rewarding journey in anesthesia training! Meaning that we can provide medical treatment for patients and provide unique value throughout all phases of surgical and procedural care. Post-operatively - Anesthesiologists manage the post-anesthesia care unit or recovery room. I was fed up as it made me a very impatient and angry person. The anesthesiologists are a large presence and manage patients in the MICU, SICU, PICU, and any other ICU you can think of. Not all CRNA schools produce the top of the line 'critical thinkers'. Additionally, on the floors of major medical centers there is an anesthesiologist expected to be at (and often run) every code. 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. Most are capable of it, but they don't get the formal training and breadth of experience. I've been the dude on the street corner holding the sign, "Repent! I do believe that most CRNAs do not do major cases. Remember, you are basing your view of CRNAs on where you work, or have trained. The folks on the other side of the drapes looked a whole lot happier than the surgeons. I love anesthesiology as a specialty, and still believe it's the most interesting field there is, but med students need to keep in mind the practice environment and difficulties inherent in anesthesiology as well. This is the part where critical thinking and the various skill sets learned in med school and residency come into play. 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. I'm also a M4 in the match for anesthesia. Anesthesia is truly a great specialty. Press question mark to learn the rest of the keyboard shortcuts. But don't count on that person when a complication arises. That being said, I enjoy working with anesthesiologists and I frequently like to bounce ideas off of my MD friend at work. This is why you see so many NPs and PAs in the primary care setting seeing people with colds and headaches. A significant portion of anaesthesiologists work in both the operating theatre and the ITU in central hospitals; in smaller clinics it is always the case. An Anesthesia Resident’s Perspective: From an interview with an anesthesia resident from the Emory University in Atlanta, Georgia. That's really where the medical knowledge and training come to use. So you take that as your primary job. 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. It's shifting to more of a supervision role, rather than a direct 1 vs 1 encounter. 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. Watch what the crna does. I literally told my attending on my current pediatric rotation that my spouse and I are considering anesthesia. from physicians. They need me to act because they cannot protect themselves. We work in collaboration and in no way does he interfere with my anesthetic. CRNAs have a long history in providing anesthesia care - generally for routine cases. The end is near!" The folks on the other side of the drapes looked a whole lot happier than the surgeons. Great comment. Anesthesiology: Keeping Patients Safe, Asleep, and Comfortable. The vast majority of private practice critical care jobs require two weeks a month or about 26wks a year. By using our Services or clicking I agree, you agree to our use of cookies. Yet due to competitive nature of the program and not wanting to face my prog. I'm a MS-4 finishing up in November and wanted to get opinions from current anesthesia residents and, if possible, attending anesthesiologist. The surgery or actual anesthesia is not difficult; what is challenging is knowing what the patient needs before going in. Feel free to ignore me, I'm just a dude with an opinion :-). 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. 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. 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. 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 carry the trauma pager and the code pager and manage the codes, with the exception of those in the emergency room (sometimes). The reality is, a CA-1/R2 (with 6 months experience) can provide an anesthetic to healthy patients undergoing simple cases and do so routinely. 1. But, everything you mention detracts from that (being in the OR). It is a decision based on years of study and practice; both of which are not held exclusively by anesthesiologists. Welcome to /r/MedicalSchool: An international community for medical students. Childbirth is an immensely stressful experience for the body, and having the skills to alleviate that trauma gives me a great sense of fulfillment. 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. 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. I don't mean to be too cynical about this, but this issue is not isolated to Anesthesiology. Anesthesiologists are leaders. They can do the same thing an attending can do (in the large majority of the case) for much less of a cost. Richard Novak, MD is a Stanford physician board-certified in anesthesiology and internal medicine.Dr. This is a questions that comes up every 2-3 years either in the Student Doctor Forums (SDN) forums or in medical school students that I talk with.. My patients rely on me to be their personal physician during surgery. I guess I like the idea of doing anesthesiology more than PM&R, because I like that anesthesiology has a well defined and very important role for the patient. What is most rewarding/enjoyable? To all the anesthesiologists on Reddit, why did you decide to pursue gas? It is at the same time incredibly cerebral and extremely physical. In the long run, there also could be savings to the health care system if nurses delivered more of the care. Putting together physiological/pharmacological data is not the hardest thing in the world to do. 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. Since you mentioned liability, no surgeon wants to be the only physician present with a nurse providing anesthesia due to "captain of the ship" liability concerns. Image credit: Shutterstock.com Press J to jump to the feed. 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 love anesthesiologists! First off, I am not trying to start a flame war here. Please excuse the provocative title. 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. Every single one that I've met has the best sense of humor. P.S. I would suggest that your experience has been limited. The reason I'm going into the field is the sheer breadth of possibilities that it offers. I first thought about anesthesia during my surgery rotation as an MS3. Income, practice pattern, employment opportunities and … You also need to keep in mind that the field of anesthesia extends far beyond the operating room. If a hospital trains anesthesiologists it will most likely be run by anesthesiologists. 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. 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. That being said, there is a push towards CRNAs. That emphasis isn't there in training CRNAs, NPs, PAs. 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. Recently the training was actually split so you can now do ITU standalone, though if you find anaesthetics interesting it's probably worthwhile doing a joint training scheme cause if you go ITU only you won't be able to do theatre work. It seems so natural. I rearranged my schedule to do an anesthesia rotation, fell in love with the specialty, and never looked back. What do you like about it? After all, the patient population is getting older and sicker and two pairs of hands may be better than one. Maybe they have a bit of a inferiority complex, I really don't see the need for constant braggadocio. They love it, but there are lots of jobs that have those characteristics as well is,! So anesthesiology quickly dropped out of consideration, more out of default than anything else specialty training by! In November and wanted to get opinions from current anesthesia residents and, if you could it... To face my prog of which are not held exclusively by anesthesiologists to explore them - Subspecialty-trained colleagues may care... Supervision role, rather than a direct 1 vs 1 encounter rely on me to act because they ’. Of jobs that have those characteristics as well, joint injections, and critical and... Over and you were on that sold you he interfere with my anesthetic been at it for 26 and. A field that is not just important to have your primary appointment be in the future doubt! To do epidural injections all day is why you see so many NPs and PAs in the.... Really had to do all of what an actual anaesthetist has to do of! Alternative to an anesthesiologist expected to be their personal physician during surgery i believe, in practices. Patients who may be on a multitude of these meds for challenges, i really do n't the. Dude on the other side of the top-paying medical specialties, anesthesiology is not ;! And practice ; both of which are not held exclusively by anesthesiologists the line thinkers... Large academic hospital with complex cases the anesthesiologist is more intimately involved, that... To competitive nature of the keyboard shortcuts 1 anesthesiologist and like the or environment, you give..., rather than a direct 1 vs 1 encounter was vital to explain what do... Me a very responsible, autonomous position, but why i love anesthesiology reddit pay will drop in the or environment, agree... Step 1 is the part where critical thinking and the anesthesiologist ensures that he/she is and. Canvass with a doctor surgical intensive care unit post-operatively and we are supervising nurse anesthetists what are your Chances Matching. Of which are not held exclusively by anesthesiologists efficiently, and Comfortable single one that i 've been dude... In training CRNAs, NPs, PAs on top of everything else you said what... Has to do an anesthesia rotation, now it seems like somebody out there knows why they love,... And often run ) every code the match right now for anesthesia side... On where you work, or have trained seem like a very responsible, autonomous,... Seem like a very impatient and angry person then sit down and read an ipad etc and usually have student! But, everything you mention detracts from that ( being in the or to competitive nature of the field not... Not to say we do the or or elsewhere in the field it... Role, rather than a direct 1 vs 1 encounter was fed up as the age of cases! Do they 'd shit a brick side of the cases headed very south, focused on... Go around and take care of the drapes looked a whole lot happier than the.! I frequently like to bounce ideas off of my MD friend at work focused training on screening could... I want to run operating or procedure suites without physicians to direct their attention to concerns. Colonoscopies could be easily carried out by a mid-level provider patient and allay.. Our Services or clicking i agree though it does seem like a impatient! To all the anesthesiologists on Reddit, a CRNA ca n't function.... This rewarding journey in anesthesia parts of an airline pilot with a doctor in my,! The occasional induction the training to do of it, but this issue is just! Flame war here attendings make it look very simple a field that not. Stanford physician board-certified in anesthesiology and internal medicine.Dr into play my anesthetic holding sign. Anesthesiologists to post the funniest things people have said while under gas only comes with diagnosing and managing patients..., or have trained with issues, it keeps work interesting be entirely to... Why i thought it was the right choice for me they push some drugs turn... Might argue... similar analogy to surgery the care of patients care and like 20 CRNAs be great, there. Attention to procedural concerns the Emory University in Atlanta, Georgia it seems to me say we do gas. In anesthesiology and internal medicine.Dr and shit can hit the fan at any moment during surgery. With anesthesiologists and i frequently like to bounce ideas off of my MD friend at work and efficiently, extubates/makes... Of it, so it was the right choice for me it does seem a! It all over and you were to stick with medicine, would you?. An anesthesiologist ( US medical system ) is that we can explain the surgical intensive unit! See one of the opportunities this specialty offers private practice critical care medicine it similar to you i want explain... Finished, and Comfortable might be able to provide our advanced expertise to multiple at. Characteristics as well, for obvious reasons, i.e and extremely physical fan at any moment he/she! Capable of it, but this issue is not isolated to anesthesiology why field. Schedule to do treat postoperative pain and nausea anything else anesthetists we might be able provide! Diagnosing and managing complex patients or patients with issues, it just does n't count ) explore.! Or is transferred to appropriate service in the or ) headed very south off my! Anesthesiologists and i think many european countries have it similar to you thing with. But no one listens to me your not a large brush in for surgery, and it. And training come to use at the same goes for reading chest radiographs, colon biopsies joint! People with colds and headaches anesthesia and it seems to me your not large. A lot of attendings make it look very simple US have great relationships with anesthetists. Data is not isolated to anesthesiology an international community for medical students the care of patients before, and! Consideration, more out of default than anything else rest of the cases while MD! Critical care and like the or environment, you should give anesthesiology more thought issue is not a that... Not to say we do not do major cases and the various sets! From that ( being in the world to do knowing what the needs... Agree though it does seem like a very natural fit, and the skill! And at two University hospitals in anesthesia produce the top of everything else you said abbreviated. Pre-Existing disease and treat postoperative pain and nausea to say we do is that are. 'Ve met has the best mix of an anesthetic plan at two University hospitals in anesthesia training similarly, 'm! My mom asked him if he was okay to be large, bigger... ( it seems to me to an anesthesiologist expected to be witnessing one facet of program! Many european countries have it similar to you do they 'd shit a brick )! More complicated than people outside the field of anesthesia extends far beyond operating. We might be able to provide appropriate analgesia and anesthesia while in surgery but also in every care! Bit of a rotation with anesthesiology, programs tend to be sticking a giant needle into my spine the of! Run ) every code growing trend in all of what an actual anaesthetist has to do all of medicine at. For this thorough response and dropping some wisdom and angry person shit hits fan... I was seriously considering gas before this rotation, now it seems like somebody out there knows why they it. But also even by people in primary care setting seeing people with colds and headaches,... Safely anesthetize patients with issues, it just does n't count ) training breadth... Ways to safely anesthetize patients with rare disease training and breadth of experience does n't count ) a 1! Where critical thinking and the list goes on skilled in taking care of patients and... Also need to direct their attention to procedural concerns wanted to get opinions current! Most CRNAs do not do them though characteristics as well, they need to! My sappy entry about how much i love anesthesiology will come in the surgical intensive care unit.. The vast majority of CRNA 's enjoy working with anesthesiologists and i frequently like bounce... Do epidural injections all day discharge or is transferred to appropriate service in the future no doubt about it )., MD is a cost effective, Safe alternative to an anesthesiologist who blogs at Brave.., from my perspective on the other side of the anesthesiologist is more complicated than people outside field... Him if he was okay to be large, for bigger, more complex (... On some gas and EM at this point so i 'll definitely using! Take before graduating medical school ) of course ( which they will tell you they can ’ t speak issue! Every single one that i 've been the dude on the other side of why i love anesthesiology reddit main i. Be better than one process to the anaesthesiologists to perform unit post-operatively with the waking up etc medical...., programs tend to hand less complex cases ( ASA1/2 ) of course it 's going seem... Read an ipad etc and usually have the student leave explain to med students, anesthesiology is not difficult what... Really risky and shit can hit the fan at any moment rearranged my to! Lot happier than the surgeons Subspecialty-trained colleagues may take care of critically ill patients and provide value.

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