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. 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. Additionally, on the floors of major medical centers there is an anesthesiologist expected to be at (and often run) every code. What do you like about it? 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. So anesthesiology quickly dropped out of consideration, more out of default than anything else. Beyond the OR - Subspecialty-trained colleagues may take care of patients in the surgical intensive care unit post-operatively. An Anesthesia Resident’s Perspective: From an interview with an anesthesia resident from the Emory University in Atlanta, Georgia. 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. So you take that as your primary job. Income, practice pattern, employment opportunities and … 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. The end is near!" It's really not a rhetorical question. The folks on the other side of the drapes looked a whole lot happier than the surgeons. When these nurses tend to hand less complex cases (ASA1/2) of course it's going to seem simple. I would suggest that your experience has been limited. Other than make a diagnosis of course (which they will tell you they can actually do, it just doesn't count). I'm also a M4 in the match for anesthesia. It's when you probe a little more and you get someone that explains all the pathophys their thinking of and preventing problems specific to that patient before something bad happens it starts to make sense. 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. By Carolyn Schierhorn Email Thursday, March 1, 2012 Wednesday, Feb. 27, 2019 Being a physician anesthesiologist is the honor of a lifetime, and it comes with a tremendous amount of responsibility. The patient comes in for surgery, and the anesthesiologist ensures that he/she is safe and doesn't experience pain. To add to this, for bigger, more complex cases the anesthesiologist is more intimately involved. Lastly, if you could do it all over and you were to stick with medicine, would you do gas again? First off, I am not trying to start a flame war here. I was the first in my class to rotate in obstetric anesthesiology, and it made me fall in love with my career once again. Intraoperatively - Anesthesiologists may personally perform all or parts of an anesthetic plan. As I explain to med students, anesthesiology is not a field that is easy to love. Same goes for simple inguinal hernias. I guess they all believe they are in demand, there job still exists, etc... Stacular, I agree with most of your post. I am doing a rotation with anesthesiology this month and it has really changed my perspective on the whole field. Press J to jump to the feed. 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. 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. It's shifting to more of a supervision role, rather than a direct 1 vs 1 encounter. One of the top-paying medical specialties, anesthesiology attracts far more applicants than available residency slots can accommodate. The hospital has 1 anesthesiologist and like 20 CRNAs. Post-operatively - Anesthesiologists manage the post-anesthesia care unit or recovery room. It is at the same time incredibly cerebral and extremely physical. What was it about the rotations you were on that sold you? This is how it should be, I believe, in most practices. That's really where the medical knowledge and training come to use. Anesthesiologists are medical doctors who specialize in the care of patients before, during and after surgery. I agree though it does seem like a very natural fit, and I think many european countries have it similar to you. I understand that it is a very responsible, autonomous position, but there are lots of jobs that have those characteristics as well. Watch what the crna does. Why is administering Anesthesia appealing to you? Feel free to ignore me, I'm just a dude with an opinion :-). This is one of the main reasons I chose anesthesia on … Welcome to /r/MedicalSchool: An international community for medical students. Press J to jump to the feed. If … What is the most challenging/frustrating part of the work you do? Sasha K. Shillcutt is an anesthesiologist who blogs at Brave Enough. Making a critical decision based on this information is not magic, as some people would think. They often compare pilots to anaesthetists. 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. Similarly, I'm 100% positive that abbreviated, focused training on screening colonoscopies could be easily carried out by a mid-level provider. I rearranged my schedule to do an anesthesia rotation, fell in love with the specialty, and never looked back. One commenter relayed how a patient stroked his arm and said, "You'd make such a … 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. Good luck to everyone starting this rewarding journey in anesthesia training! There will always be a need for anesthesiologists, no doubt about it. Tell me how I am wrong and just happen to be witnessing one facet of the field. I feel like anesthesia folk gets treated like crap not only by surgeons, but also even by people in primary care. Why Doctors Choose Anesthesiology As a Career. each resident amounts to another room or another billable encounter. The folks on the other side of the drapes looked a whole lot happier than the surgeons. Most of us have great relationships with nurse anesthetists. CRNAs have a long history in providing anesthesia care - generally for routine cases. 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. Plus most pre/post-op are done by an attending. P.S. tracheostomy can be entirely up to the anaesthesiologists to perform. So someone, please, broaden my horizons. Also, when shit hits the fan in a normal case the crna calls the MD. I do believe that most CRNAs do not do major cases. Childbirth is an immensely stressful experience for the body, and having the skills to alleviate that trauma gives me a great sense of fulfillment. Meaning that we can provide medical treatment for patients and provide unique value throughout all phases of surgical and procedural care. For context, I'm an Anesthesiology resident. And then he comes back when the operation is finished, and extubates/makes sure everything goes smoothly with the waking up etc. In any case, when we supervise nurse anesthetists, we are always immediately available to render personal assistance. 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. Not from a legal standpoint anyhow. They push some drugs, turn on some gas and then sit down and read an ipad etc and usually have the student leave. Or if the operationg is really risky and shit can hit the fan at any moment. Hospitals and surgical centers don't want to run operating or procedure suites without physicians to direct the perioperative care of patients. 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 am a cardiac anesthesiologist. Anyone I ask will say "there will always be a need for Anesthesiologists" but it seems like the only point for an anesthesiologist to exist will be for liability purposes because that is the one area of responsibility a nurse does not want. I thought I wanted to do surgery and be in the OR. That's not to say they can't handle complex cases (cardiac, neuro, etc) but many are ill-equipped for routinely managing these cases. Image credit: Shutterstock.com (The nurse asked what kind of music he wanted … We got you. They can do the same thing an attending can do (in the large majority of the case) for much less of a cost. 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. 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, and hundreds of others, do this everyday. 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 don't mean to be too cynical about this, but this issue is not isolated to Anesthesiology. Even though women comprised 47% of the US medical school graduates in 2014, only about 33% of the applicants for anesthesiology residency were women. It is a decision based on years of study and practice; both of which are not held exclusively by anesthesiologists. 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. 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. The reason I'm going into the field is the sheer breadth of possibilities that it offers. 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. In the middle of a case, even a MS3 at the end of a rotation can handle a straightforward one. We work in collaboration and in no way does he interfere with my anesthetic. 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