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. Surgeons lack the training to do so safely and efficiently, and need to direct their attention to procedural concerns. 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 is not just important to provide appropriate analgesia and anesthesia while in surgery but also in every critical care unit in the hospital. As for challenges, I (mostly) enjoy finding ways to safely anesthetize patients with issues, it keeps work interesting. That's really where the medical knowledge and training come to use. 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. 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 some cases, immediately prior to or after surgery we can perform procedures such as epidural catheter insertion or major nerve blocks that reduce or eliminate postoperative pain and decrease the chance of development of chronic pain, in some cases this leads to better outcome in the patient's overall treatment. 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. I was seriously considering Gas before this rotation, now it seems almost pointless. 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. 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. Even though women comprised 47% of the US medical school graduates in 2014, only about 33% of the applicants for anesthesiology residency were women. Every single one that I've met has the best sense of humor. 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. CRNAs have a long history in providing anesthesia care - generally for routine cases. Anesthesiologists are leaders. My mom asked him if he was okay to be sticking a giant needle into my spine. If a hospital trains anesthesiologists it will most likely be run by anesthesiologists. In any case, when we supervise nurse anesthetists, we are always immediately available to render personal assistance. Image credit: Shutterstock.com The hospital has 1 anesthesiologist and like 20 CRNAs. 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. Meaning that we can provide medical treatment for patients and provide unique value throughout all phases of surgical and procedural care. What is most rewarding/enjoyable? We can explain the surgical process to the patient and allay anxiety. Post-operatively - Anesthesiologists manage the post-anesthesia care unit or recovery room. Anesthesiology is a unique field within medicine. In private practice, anesthesia groups want you doing anesthesia if you’re full time this is true. I literally told my attending on my current pediatric rotation that my spouse and I are considering anesthesia. It’s like being the best mix of an airline pilot with a doctor. 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. and are needed for the patients who may be on a multitude of these meds. Press question mark to learn the rest of the keyboard shortcuts. Also, when shit hits the fan in a normal case the crna calls the MD. But don't count on that person when a complication arises. 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. Income, practice pattern, employment opportunities and … Wow, thanks for this thorough response and dropping some wisdom. But, everything you mention detracts from that (being in the OR). Or if the operationg is really risky and shit can hit the fan at any moment. My patients rely on me to be their personal physician during surgery. After all, the patient population is getting older and sicker and two pairs of hands may be better than one. Simply put, a CRNA can't function independently. You will not see the CRNAs doing big cases there. In the long run, there also could be savings to the health care system if nurses delivered more of the care. Anesthesia is truly a great specialty. The same is true for medical school. This is why you see so many NPs and PAs in the primary care setting seeing people with colds and headaches. I've been at it for 26 years and still love it, so it was the right choice for me. Anaesthetics is more complicated than people outside the field give it credit. I was fed up as it made me a very impatient and angry person. Tl;dr - you haven't had a complete enough experience to know all of the opportunities this specialty offers. Anesthesiologists also often medically direct the operating room and respond to emergencies in the OR or elsewhere in the hospital. So I'm in the match right now for anesthesia and it seems to me your not a large academic hospital with complex cases. 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. I agree though it does seem like a very natural fit, and I think many european countries have it similar to you. Making a critical decision based on this information is not magic, as some people would think. Please excuse the provocative title. What is the most challenging/frustrating part of the work you do? So you take that as your primary job. If … What do you like about it? Press J to jump to the feed. I love that when things are going poorly, a good anesthesiologist is the leader and the calmest person in the room. I've been the dude on the street corner holding the sign, "Repent! 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. That emphasis isn't there in training CRNAs, NPs, PAs. I feel like anesthesia folk gets treated like crap not only by surgeons, but also even by people in primary care. The CRNA is a cost effective, safe alternative to an anesthesiologist. I have friends who run their own anesthesia practices who do hearts, livers, transplants, neuro.....etc. Remember, you are basing your view of CRNAs on where you work, or have trained. I've rotated at a community hospital and at two university hospitals in anesthesia. It seems so natural. USMLE Step 1 is the first national board exam all United States medical students must take before graduating medical school. They carry the trauma pager and the code pager and manage the codes, with the exception of those in the emergency room (sometimes). ⁣ ⁣ 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! The anesthesiologists are a large presence and manage patients in the MICU, SICU, PICU, and any other ICU you can think of. As I explain to med students, anesthesiology is not a field that is easy to love. Anesthesiologists are physicians. Being a physician anesthesiologist is the honor of a lifetime, and it comes with a tremendous amount of responsibility. Yet due to competitive nature of the program and not wanting to face my prog. By using our Services or clicking I agree, you agree to our use of cookies. tracheostomy can be entirely up to the anaesthesiologists to perform. Why Doctors Choose Anesthesiology As a Career. We got you. 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). A simple answer, from my perspective: wait until you see one of the cases headed very south. It will likely be a growing trend in all of medicine. 1. Good luck to everyone starting this rewarding journey in anesthesia training! I'd do anesthesia again. If you enjoy critical care and like the OR environment, you should give anesthesiology more thought. 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. When you need us, we are there. I do believe that most CRNAs do not do major cases. By Carolyn Schierhorn Email Thursday, March 1, 2012 Wednesday, Feb. 27, 2019 We are skilled in taking care of critically ill patients and responding to intraoperative emergencies. 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. Plus most pre/post-op are done by an attending. 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. The nurse anesthetists go around and take care of the cases while the MD does some pain injections and the occasional induction. Anesthesiologists are the guardians of the operating room. In the middle of a case, even a MS3 at the end of a rotation can handle a straightforward one. 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. First off, I am not trying to start a flame war here. Not all CRNA schools produce the top of the line 'critical thinkers'. 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. I first thought about anesthesia during my surgery rotation as an MS3. That is not to say we do not do them though. Tell me how I am wrong and just happen to be witnessing one facet of the field. The value of an anesthesiologist (US medical system) is that we are perioperative physicians. What was it about the rotations you were on that sold you? 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. Most likely to be born out of necessity from exploding costs, you'll probably start to see a large rise of mid-level providers "taking away" cases, procedures, etc. The problem only comes with diagnosing and managing complex patients or patients with rare disease. The positive side is you have no patients, but the negative side is … To all the anesthesiologists on Reddit, why did you decide to pursue gas? But if they really had to do all of what an actual anaesthetist has to do they'd shit a brick. I rearranged my schedule to do an anesthesia rotation, fell in love with the specialty, and never looked back. But yeah...Lifestyle in the field will always be great, but the pay will drop in the future no doubt about it. On Reddit, a user asked anesthesiologists to post the funniest things people have said while under gas. Hospitals and surgical centers don't want to run operating or procedure suites without physicians to direct the perioperative care of patients. Colleagues may take care of patients, starting arterial lines, femoral blocs etc. Anesthesia training vs 1 encounter do them though and you were on that person when complication. Common this joint field is elsewhere in the or environment, you should give anesthesiology thought... Most CRNAs do not do major cases experience to know be a growing trend in of. Procedural care and, why i love anesthesiology reddit possible, attending anesthesiologist little respect work in collaboration with anesthesiologists for. 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