Thursday, March 3, 2016

The Perilous Journey From Anesthesia Resident To Attending.

It's almost that time of year again, when CA3's are ready to take wing and depart the comfortable confines of residency and start their professional careers. It is a period of great excitement and anxiety. This is when cocky senior residents suddenly realize they are finally on their own and have no attending backup for the inevitable screwup that will occur.

In the annual report of the California Society of Anesthesiologists, Dr. Adam Djurdjulov has a nice essay titled "Easing the Transition from Residency to Private Practice". He gives a few pearls about the action plan all CA3's should follow before they finish their residencies. Use all the resources that are still at your disposal before going out on your own. Even though oral boards still seem so far away, now is probably the best time to start practicing for the exam. And don't be the locker slammer of the anesthesiology department. It shows you have little respect for your departmental colleagues or your profession.

As I see the CA3's make their anesthetic plans for each patient and competently carry them out, I always admire their confidence and enthusiasm. But there is so much more to practicing anesthesiology than being able to regurgitate a book chapter in Miller. I hope they all use their remaining time in training to ask lots of questions and really explore the profession with their attendings.


  1. Thanks for posting this. I'm a few short months away from entering private practice without a fellowship and I'm definitely getting the jitters. I know that I"m adequately trained but part of me wishes I had more time....graduation came faster than I thought it would.

    I'm curious as to what piece of advice YOU'D give to other senior residents like myself?

  2. I've been telling our graduating residents to ask as many questions as possible. Anesthesiology is truly an art. Unlike a hernia operation where there is a very strict series of steps to perform, giving anesthesia is truly physician dependent. There can be ten different ways to sedate a patient for a simple colonoscopy and each one of them can be correct. So ask your attendings why they do a case a certain way. You'd be surprised that sometimes the only answer is because that was the way they were taught and that's how they've always done it. Incorporate as many of these answers as you can into your repertoire so that once you are on your own you can decide which one is the best for you.