Yet due to competitive nature of the program and not wanting to face my prog. The value of an anesthesiologist (US medical system) is that we are perioperative physicians. 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 CRNA is a cost effective, safe alternative to an anesthesiologist. First off, I am not trying to start a flame war here. 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. Lastly, if you could do it all over and you were to stick with medicine, would you do gas again? I love that when things are going poorly, a good anesthesiologist is the leader and the calmest person in the room. 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. I understand that it is a very responsible, autonomous position, but there are lots of jobs that have those characteristics as well. There will always be a need for anesthesiologists, no doubt about it. I hope this helps. We may be called upon to take care of patients in labor on the obstetric floor or assist with securing an airway elsewhere in the hospital. By using our Services or clicking I agree, you agree to our use of cookies. Image credit: Shutterstock.com Press question mark to learn the rest of the keyboard shortcuts. But, everything you mention detracts from that (being in the OR). By Carolyn Schierhorn Email Thursday, March 1, 2012 Wednesday, Feb. 27, 2019 Tl;dr - you haven't had a complete enough experience to know all of the opportunities this specialty offers. Not sure how common this joint field is elsewhere in the world. Every single one that I've met has the best sense of humor. The thing is with anesthesia is a lot of attendings make it look very simple. They often compare pilots to anaesthetists. I'd do anesthesia again. The end is near!" The nurse anesthetists go around and take care of the cases while the MD does some pain injections and the occasional induction. That’s why it will be important to have your primary appointment be in CCM. We can explain the surgical process to the patient and allay anxiety. As I explain to med students, anesthesiology is not a field that is easy to love. Press question mark to learn the rest of the keyboard shortcuts. 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. We got you. I woke up as the doctor started the procedure. Anesthesiology: Keeping Patients Safe, Asleep, and Comfortable. If the payors can get similar quality (which they likely do in the low-risk, very healthy populations) for a lower cost, it's hard to make an argument for paying a physician to do the work. Feel free to ignore me, I'm just a dude with an opinion :-). I was seriously considering Gas before this rotation, now it seems almost pointless. Why is administering Anesthesia appealing to you? The surgery or actual anesthesia is not difficult; what is challenging is knowing what the patient needs before going in. It is at the same time incredibly cerebral and extremely physical. I, and hundreds of others, do this everyday. They need me to act because they cannot protect themselves. This is why you see so many NPs and PAs in the primary care setting seeing people with colds and headaches. I thought I wanted to do surgery and be in the OR. It's shifting to more of a supervision role, rather than a direct 1 vs 1 encounter. I've rotated at a community hospital and at two university hospitals in anesthesia. The anesthesiologists are a large presence and manage patients in the MICU, SICU, PICU, and any other ICU you can think of. Remember, you are basing your view of CRNAs on where you work, or have trained. I first thought about anesthesia during my surgery rotation as an MS3. Not all CRNA schools produce the top of the line 'critical thinkers'. 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. I, however, doubt your seeing CRNA's do transplants, complicated cardio, vascular or neuro cases where you need to apply all your medical knowledge. In the middle of a case, even a MS3 at the end of a rotation can handle a straightforward one. Similarly, I'm 100% positive that abbreviated, focused training on screening colonoscopies could be easily carried out by a mid-level provider. A simple answer, from my perspective: wait until you see one of the cases headed very south. Being a physician anesthesiologist is the honor of a lifetime, and it comes with a tremendous amount of responsibility. This is important, since 1 anesthesiologist usually is in charge of 3-5 operations at the same time, so you cant lock yourself into 1 patient. We are anesthesiologists. One of the top-paying medical specialties, anesthesiology attracts far more applicants than available residency slots can accommodate. USMLE Step 1 is the first national board exam all United States medical students must take before graduating medical school. No surprise: The use of social media drastically decreases as the age of the anesthesiologist increases. When you need us, we are there. There is only so much a CRNA can do but if you're in a facility with a limited patient base and case load, you're not going to see where their ability falls short. The folks on the other side of the drapes looked a whole lot happier than the surgeons. 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. Anesthesiologists are the guardians of the operating room. I was fed up as it made me a very impatient and angry person. But if they really had to do all of what an actual anaesthetist has to do they'd shit a brick. Intraoperatively - Anesthesiologists may personally perform all or parts of an anesthetic plan. 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. As for challenges, I (mostly) enjoy finding ways to safely anesthetize patients with issues, it keeps work interesting. Part of an interview series entitled, “Specialty Spotlights“, which asks medical students’ most burning questions to physicians of every specialty. tracheostomy can be entirely up to the anaesthesiologists to perform. If a hospital trains anesthesiologists it will most likely be run by anesthesiologists. The problem only comes with diagnosing and managing complex patients or patients with rare disease. Please excuse the provocative title. Why Doctors Choose Anesthesiology As a Career. 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. My patients rely on me to be their personal physician during surgery. So, why Anesthesia?? I don't mean to be too cynical about this, but this issue is not isolated to Anesthesiology. This is how it should be, I believe, in most practices. I've been at it for 26 years and still love it, so it was the right choice for me. It will likely be a growing trend in all of medicine. 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. 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. I literally told my attending on my current pediatric rotation that my spouse and I are considering anesthesia. Even though women comprised 47% of the US medical school graduates in 2014, only about 33% of the applicants for anesthesiology residency were women. They also are needed for traumas and emergency surgeries with complicated airways. So anesthesiology quickly dropped out of consideration, more out of default than anything else. 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. 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. When these nurses tend to hand less complex cases (ASA1/2) of course it's going to seem simple. 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. 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. That's not to say they can't handle complex cases (cardiac, neuro, etc) but many are ill-equipped for routinely managing these cases. 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. 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 my class, but no one listens to me. What is the most challenging/frustrating part of the work you do? That is not to say we do not do them though. 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. I would suggest that your experience has been limited. 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. 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. Good luck to everyone starting this rewarding journey in anesthesia training! The reason I'm going into the field is the sheer breadth of possibilities that it offers. Surgeons lack the training to do so safely and efficiently, and need to direct their attention to procedural concerns. Childbirth is an immensely stressful experience for the body, and having the skills to alleviate that trauma gives me a great sense of fulfillment. I am a cardiac anesthesiologist. CRNAs have a long history in providing anesthesia care - generally for routine cases. I'm frustrated by delays, administrative bullshit and patient non-compliance. Other than make a diagnosis of course (which they will tell you they can actually do, it just doesn't count). Sasha K. Shillcutt is an anesthesiologist who blogs at Brave Enough. There are also cases like cardiac, neuro, etc that are best handled by an attending because they involve specialty training. I feel like anesthesia folk gets treated like crap not only by surgeons, but also even by people in primary care. 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. Has the best sense of humor floors of major medical centers there is very. My schedule to do surgery and be in CCM has really changed my perspective: wait until see... The opportunities this specialty offers to competitive nature of the line 'critical thinkers ' specialty training experience pain no does! 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