Richard Novak, MD is a Stanford physician board-certified in anesthesiology and internal medicine.Dr. The folks on the other side of the drapes looked a whole lot happier than the surgeons. That being said, I enjoy working with anesthesiologists and I frequently like to bounce ideas off of my MD friend at work. That emphasis isn't there in training CRNAs, NPs, PAs. So, why Anesthesia?? There will always be a need for anesthesiologists, no doubt about it. We can explain the surgical process to the patient and allay anxiety. Press J to jump to the feed. 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. Anesthesiology was a specialty I was always interested in, but seeing it performed at a high level in a setting with medically complex cases and patients is what convinced me to pursue it. Or if the operationg is really risky and shit can hit the fan at any moment. Similarly, I'm 100% positive that abbreviated, focused training on screening colonoscopies could be easily carried out by a mid-level provider. Anyway, my sappy entry about how much I love anesthesiology will come in the future. By using our Services or clicking I agree, you agree to our use of cookies. Simply put, a CRNA can't function independently. in my class, but no one listens to me. Why is administering Anesthesia appealing to you? What is most rewarding/enjoyable? 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… If you enjoy critical care and like the OR environment, you should give anesthesiology more thought. I was seriously considering Gas before this rotation, now it seems almost pointless. So someone, please, broaden my horizons. I rearranged my schedule to do an anesthesia rotation, fell in love with the specialty, and never looked back. 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. For example, the physician anesthesiologist must be ready to diagnose heart or lung problems that may complicate the patient’s surgery, and decide which medications are appropriate. I do believe that most CRNAs do not do major cases. 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. This is why you see so many NPs and PAs in the primary care setting seeing people with colds and headaches. I agree though it does seem like a very natural fit, and I think many european countries have it similar to you. 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. 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. 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. We take care of medical complications that arise after surgery or from the patient's pre-existing disease and treat postoperative pain and nausea. 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. each resident amounts to another room or another billable encounter. It will likely be a growing trend in all of medicine. I understand that it is a very responsible, autonomous position, but there are lots of jobs that have those characteristics as well. I, and hundreds of others, do this everyday. It is a decision based on years of study and practice; both of which are not held exclusively by anesthesiologists. By using our Services or clicking I agree, you agree to our use of cookies. On Reddit, a user asked anesthesiologists to post the funniest things people have said while under gas. Anesthesiologists are the guardians of the operating room. 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 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. I've rotated at a community hospital and at two university hospitals in anesthesia. I hope this helps. Being a physician anesthesiologist is the honor of a lifetime, and it comes with a tremendous amount of responsibility. One of the top-paying medical specialties, anesthesiology attracts far more applicants than available residency slots can accommodate. Good luck to everyone starting this rewarding journey in anesthesia training! I'd do anesthesia again. CRNAs have a long history in providing anesthesia care - generally for routine cases. I'm really curious about why this field gets so little respect. Part of an interview series entitled, “Specialty Spotlights“, which asks medical students’ most burning questions to physicians of every specialty. The positive side is you have no patients, but the negative side is … 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. As I explain to med students, anesthesiology is not a field that is easy to love. The same is true for medical school. There are also cases like cardiac, neuro, etc that are best handled by an attending because they involve specialty training. Hence why I thought it was vital to explain what we do. Yet due to competitive nature of the program and not wanting to face my prog. 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. But, everything you mention detracts from that (being in the OR). 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. Meaning that we can provide medical treatment for patients and provide unique value throughout all phases of surgical and procedural care. 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. That's really where the medical knowledge and training come to use. We insure that a patient is ready for discharge or is transferred to appropriate service in the hospital. The thing is with anesthesia is a lot of attendings make it look very simple. Maybe they have a bit of a inferiority complex, I really don't see the need for constant braggadocio. 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. In the long run, there also could be savings to the health care system if nurses delivered more of the care. The end is near!" Childbirth is an immensely stressful experience for the body, and having the skills to alleviate that trauma gives me a great sense of fulfillment. They also are needed for traumas and emergency surgeries with complicated airways. Under general anesthesia, they need me to be their voice because they can’t speak. USMLE Step 1 is the first national board exam all United States medical students must take before graduating medical school. I thought I wanted to do surgery and be in the OR. 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. 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. Image credit: Shutterstock.com They carry the trauma pager and the code pager and manage the codes, with the exception of those in the emergency room (sometimes). This is the part where critical thinking and the various skill sets learned in med school and residency come into play. If a hospital trains anesthesiologists it will most likely be run by anesthesiologists. They can do the same thing an attending can do (in the large majority of the case) for much less of a cost. It's shifting to more of a supervision role, rather than a direct 1 vs 1 encounter. When you need us, we are there. It seems so natural. 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. 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. That’s why it will be important to have your primary appointment be in CCM. One of the greatest honors I’ve achieved is becoming a board-certified anesthesiologist. To add to this, for bigger, more complex cases the anesthesiologist is more intimately involved. I'm between gas and EM at this point so I'll definitely be using my 3rd year electives to explore them. 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. By Carolyn Schierhorn Email Thursday, March 1, 2012 Wednesday, Feb. 27, 2019 Even though women comprised 47% of the US medical school graduates in 2014, only about 33% of the applicants for anesthesiology residency were women. Also you are needed in postop/preop, starting arterial lines, femoral blocs, etc. Putting together physiological/pharmacological data is not the hardest thing in the world to do. We are skilled in taking care of critically ill patients and responding to intraoperative emergencies. Work in collaboration with anesthesiologists be their voice because they involve specialty training anesthetists we might able... 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