So You Want to Be an ANESTHESIOLOGIST [Ep. 12]

Brief Summary

This video provides a comprehensive overview of anesthesiology, covering the roles and responsibilities of anesthesiologists, the path to becoming one, subspecialties within the field, and the pros and cons of choosing this career. It emphasizes the importance of vigilance, quick decision-making, and a strong understanding of physiology and pharmacology.

• Anesthesiologists are the patient’s "guardian angel" during surgery, responsible for maintaining stable vitals and ensuring patient safety.
• The field offers a good work-life balance compared to other specialties.
• Subspecialties include regional anesthesiology, cardiac anesthesiology, chronic pain management, and pediatric anesthesiology.

What is Anesthesiology?

Anesthesiology involves caring for patients before, during, and after surgery, acting as their "guardian angel" to ensure their safety. Anesthesiologists maintain stable vitals, hemodynamic status, and an open airway for patients. They administer drugs and make adjustments to keep vitals consistent, and manage breathing through endotracheal tubes connected to ventilators. Pre-operatively, they assess patient safety, checking for conditions that could lead to complications like aspiration. Post-operatively, they ensure safe recovery and manage pain. Despite stereotypes, anesthesiology requires constant vigilance and the ability to handle high-intensity situations, demanding mastery of physiology, pharmacology, observation, and clinical judgment.

How to Become an Anesthesiologist

After medical school, anesthesiology residency is a 4-year program. The first year is a standard intern year with rotations through various specialties. Anesthesia training begins in the second year (PGY-2), referred to as CA-1 (clinical anesthesia year). There are categorical programs where all 4 years are at the same institution, including either a medicine or surgical intern year. Medicine intern years offer lighter hours and valuable insight into managing cardiopulmonary status, pain, and glucose levels. Surgical intern years provide insight into surgical practices. Advanced programs involve a separate transitional year (TY) for the intern year, which includes a mix of medicine, surgery, electives, and research, and is considered an easier intern year. Anesthesiology is now less competitive, with average Step 1 and Step 2CK scores being 232 and 244, respectively. Residency hours are generally more relaxed, with 55-65 hour work weeks, and attending physicians typically work 40-50 hours a week.

Subspecialties within Anesthesia

After anesthesiology residency, there are several 1-year fellowships available. Regional Anesthesiology and Acute Pain Medicine involves procedures like ultrasound-guided nerve blocks and managing pain in post-operative patients. Cardiac Anesthesiology is for those who enjoy intense cases like open-heart surgery, involving techniques like single-lung ventilation. Chronic Pain Management involves seeing patients in clinic, prescribing analgesics, and administering injections, with high compensation. Neuroanesthesiology is for those interested in complex cases where patients may need to be awake during surgery to test brain functions. OB Anesthesiology is often female-dominated, involving managing C-sections and providing rewarding experiences with healthy babies and happy mothers. Pediatric Anesthesiology is for those who love working with children, assisting with both major and minor procedures, requiring special equipment and understanding of pediatric physiology. Critical Care Anesthesiology involves managing patients in the ICU, often those recovering from major surgery or suffering from severe infections or trauma.

What You’ll Love About Anesthesiology

Anesthesiology is one of the ROAD (radiology, ophthalmology, anesthesiology, and dermatology) lifestyle specialties, offering high compensation and a good work-life balance. Anesthesiologists typically work regular 9-to-5 hours and are completely off when not working, without the need to carry a pager. The field avoids clinic work, unless pursuing chronic pain management. It is a great option for those who love the OR but do not want to be surgeons, fostering a sense of camaraderie with the surgical team.

What You Won’t Love About Anesthesiology

Anesthesiologists are often unsung heroes who do not receive the recognition they deserve, with gratitude typically directed towards the surgeon. They may be seen as sidekicks to the surgeon. The field involves high-stress situations requiring quick decision-making, where a patient’s life is in your hands. Mid-level encroachment by CRNAs seeking independent practice rights is a growing concern, potentially decreasing employment opportunities for anesthesiologists, though opportunities still exist for complex cases requiring a physician’s expertise.

Should You Become an Anesthesiologist?

Anesthesiology may be a good fit for those who loved physiology and pharmacology, enjoy working with their hands, gravitate toward high-stress situations, and value work-life balance. If you love the OR and want it to be the focus of your life but are comfortable with surgeons taking the lead, anesthesiology is a viable option. Those who crave the spotlight may not be happy in this field. While less competitive than some specialties, getting into a strong residency program is still challenging.