I'm also a M4 in the match for anesthesia. I'm really curious about why this field gets so little respect. I do believe that most CRNAs do not do major cases. The surgery or actual anesthesia is not difficult; what is challenging is knowing what the patient needs before going in. When you need us, we are there. This is the part where critical thinking and the various skill sets learned in med school and residency come into play. That emphasis isn't there in training CRNAs, NPs, PAs. 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. Subreddit for the medical specialty dedicated to perioperative medicine, pain management, and critical care medicine. I understand that it is a very responsible, autonomous position, but there are lots of jobs that have those characteristics as well. Welcome to /r/MedicalSchool: An international community for medical students. In any case, when we supervise nurse anesthetists, we are always immediately available to render personal assistance. They can do the same thing an attending can do (in the large majority of the case) for much less of a cost. Press J to jump to the feed. This is how it should be, I believe, in most practices. 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. Childbirth is an immensely stressful experience for the body, and having the skills to alleviate that trauma gives me a great sense of fulfillment. What do you like about it? It will likely be a growing trend in all of medicine. 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. Putting together physiological/pharmacological data is not the hardest thing in the world to do. Anaesthetics is more complicated than people outside the field give it credit. "I had an eye surgery to fix a scarred retina. 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). The patient comes in for surgery, and the anesthesiologist ensures that he/she is safe and doesn't experience pain. Beyond the OR - Subspecialty-trained colleagues may take care of patients in the surgical intensive care unit post-operatively. The positive side is you have no patients, but the negative side is … That being said, there is a push towards CRNAs. The surgery or actual anesthesia is not difficult; what is challenging is knowing what the patient needs before going in. 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. Income, practice pattern, employment opportunities and … One of the top-paying medical specialties, anesthesiology attracts far more applicants than available residency slots can accommodate. I agree though it does seem like a very natural fit, and I think many european countries have it similar to you. 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. Press question mark to learn the rest of the keyboard shortcuts. That being said, I enjoy working with anesthesiologists and I frequently like to bounce ideas off of my MD friend at work. 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. Part of an interview series entitled, “Specialty Spotlights“, which asks medical students’ most burning questions to physicians of every specialty. Being a physician anesthesiologist is the honor of a lifetime, and it comes with a tremendous amount of responsibility. 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. 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. (It seems like somebody out there knows why they love it.) Anesthesiology: Keeping Patients Safe, Asleep, and Comfortable. I've rotated at a community hospital and at two university hospitals in anesthesia. Anesthesia is truly a great specialty. Also, when shit hits the fan in a normal case the crna calls the MD. Image credit: Shutterstock.com 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. No surprise: The use of social media drastically decreases as the age of the anesthesiologist increases. in my class, but no one listens to me. Remember, you are basing your view of CRNAs on where you work, or have trained. Subreddit for the medical specialty dedicated to perioperative … It's shifting to more of a supervision role, rather than a direct 1 vs 1 encounter. In fact, I might argue...similar analogy to surgery. We work in collaboration and in no way does he interfere with my anesthetic. Lastly, if you could do it all over and you were to stick with medicine, would you do gas again? Simply put, a CRNA can't function independently. 1. 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! But, everything you mention detracts from that (being in the OR). Similarly, I'm 100% positive that abbreviated, focused training on screening colonoscopies could be easily carried out by a mid-level provider. 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. I rearranged my schedule to do an anesthesia rotation, fell in love with the specialty, and never looked back. Sasha K. Shillcutt is an anesthesiologist who blogs at Brave Enough. For context, I'm an Anesthesiology resident. An Anesthesia Resident’s Perspective: From an interview with an anesthesia resident from the Emory University in Atlanta, Georgia. We can explain the surgical process to the patient and allay anxiety. 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. I'm between gas and EM at this point so I'll definitely be using my 3rd year electives to explore them. So you take that as your primary job. 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. 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. Maybe they have a bit of a inferiority complex, I really don't see the need for constant braggadocio. 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 was fed up as it made me a very impatient and angry person. Same goes for simple inguinal hernias. 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! I woke up as the doctor started the procedure. Most are capable of it, but they don't get the formal training and breadth of experience. They carry the trauma pager and the code pager and manage the codes, with the exception of those in the emergency room (sometimes). It's really not a rhetorical question. Feel free to ignore me, I'm just a dude with an opinion :-). Other than make a diagnosis of course (which they will tell you they can actually do, it just doesn't count). If … I was seriously considering Gas before this rotation, now it seems almost pointless. Meaning that we can provide medical treatment for patients and provide unique value throughout all phases of surgical and procedural care. You also need to keep in mind that the field of anesthesia extends far beyond the operating 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. It’s like being the best mix of an airline pilot with a doctor. Yet due to competitive nature of the program and not wanting to face my prog. We may run an Acute Pain Service managing epidural and continuous nerve block catheters, patient controlled analgesia devices, or consulting on patients with difficult to manage post-op pain. I, and hundreds of others, do this everyday. Great comment. So, why Anesthesia?? USMLE Step 1 is the first national board exam all United States medical students must take before graduating medical school. The anesthesiologists are a large presence and manage patients in the MICU, SICU, PICU, and any other ICU you can think of.