Questions for/by an anesthesia resident

[AnesRes2014]

In the name of open dialogue and communication, and in the vein of MilMD's stickied post, I started this thread to answer/ask questions that I've noticed in my first 30min worth of browsing forum topics. To clarify, I am a first year resident (PGY-1), so my only anesthesia experience has been my fourth-year anesthesia rotation and a year working as a clinical research coordinator before med school, so my answers on anesthesia-specific topics will be limited. But questions about medical school, intern year, and the whole residency application process are certainly fair game.

For starters:

Q: Why do some anesthesiologists not like to be referred to as MDA?

2 reasons. 1) The degree on our diploma is MD, just as it is for a family doc, general surgeon, pathologist, etc. B) MDA (to me) implies that our training was somehow different than theirs.

Q: What is intern year like? (prompted by a post that intern year more or less = nursing school)

A: I can only speak specifically about my intern year (and generally about other types that I looked into), and I can obviously not speak to nursing school at all, but I doubt seriously that the two are even roughly equivalent. Not in a pretentious-sounding way, just in a factual "they are very different" kind of way.

Let me know if there are any other burning questions out there.

[maliggs]

I would venture to say (and I can only speak from MY experience) that a first year intern has NO WHERE CLOSE to the same experience as an RN working in a high acuity ICU.

I worked in a Level 1 SICU/Trauma unit for quite a few years, when we had an intern to call, we knew that we'd be calling the shots when it came to managing the patient. But I worked in a place where if you weren't a good enough RN, you'd get fired. Perhaps it's not that way everywhere. Nursing school isn't very hard in my opinion. There are plenty of people who made it through nursing school and I hope they never take care of me. However, once you decide to become an ICU nurse, there is an entire different game to be played. My ICU training included a 12 week ICU course (computer based and interactive), as well as 3-6 months with a preceptor. And THEN you'd get easier patients....it's not until after your first 1-1.5 years that you'd get sick patients on your own.

Also, I don't use the term MDA when I'm speaking about one, I only use it here when I type to differentiate who I'm talking about. It's more shorthand than anything else (in my opinion).

[SuccsDrugs&Rocuron]

is this true?:


Posted here, http://forums.studentdoctor.net/showthread.php?t=770846
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Attendings & Residents: Take the pledge

Time to man up and take the pledge:
1. NEVER teach a CRNA or SRNA anything. If they ask "why/how did you do x/y/z", politely say "i dunno, just cause".
2. Do NOT allow them to do any Regional blocks. Maybe a spinal, but that's very generous. No ultrasound blocks or epidurals.
3. Do NOT allow them to do any Invasive lines. Maybe an arterial line, but that's generous.
4. STEP UP and take call or stay late if needed. Don't sell out our profession by being a "lounge lizard".
5. DONATE to the ASAPAC every year. Not just the minimum. Laws and policies are influenced by the amount of political donations.
6. EDUCATE your fellow attendings/residents/medical students. The more people know, the better.
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[RAYMAN]

Intern year equivalent to nursing school? Seriously? That's almost funny. A year or two in ICU, perhaps.

[AnesRes2014]

It was a CRNA that made the comparison.

The point is, I don't think equivalencies are possible. Nursing school to medical school. Post-nursing school training to post-medical school training. Trying to frame arguments in those terms, then, is pointless.

[BuckeyeRN]

I can agree that nursing school is not equivalent to medical school.

However a bachelor's level nursing school (going from my own experience here) requires many of the same basic science courses that you would need to get into medical school. There are some exceptions such as organic chemistry, physics, etc but I know of at least two nursing schools that include some organic chemistry into their degree as well.

Then after you went to medical school you received a much more in depth study into the field of medicine. Some of that is applicable to you now as an Anesthesia resident, some is not.

Edited to add: When I graduated from nursing school I worked full time in an ICU setting for 3 years before entering CRNA school, some work more some work less and we all gain and must show a certain level of knowledge (through experience, interviews, CCRN certification, etc) before being accepted into CRNA school. I would never suggest anyone applying for CRNA school until they are comfortable and capable of taking care of the sickest patients they see and comfortable discussing the goals of the treatment and the "why" behind what we are doing with the doctors for those sickest patients that we are taking care of.

While I am in CRNA school I am getting a very in depth knowledge base of the science, medicine and knowledge necessary to provide anesthesia. We use the same textbooks that medical schools use, and have Phd's lecturing us just as you did.

Then we have our clinical training whereas you have your residency. Both are similar in how they teach us the application of all the knowledge we have accumulated. We both gain more autonomy as we go through it. Both experiences are better or worse depending on where it occurs.

We both then need to pass a standardized exam to recieve our certification.

Then we can both practice independently or part of a team depending on our choice. It has been shown in multiple studies that the end result of either a CRNA or an Anesthesiologist (or MDA for shorthand but since you said you'd prefer not to be called that I'll try to remember) independently giving the anesthetic or a CRNA and an anesthesiologist giving the anesthetic together in a ACT model have the same outcome.

So while you undoubtedly know more medicine then I will (and you can have all that extra knowledge), in the realm of anesthesia our outcomes and knowledge base are the same and we are both completely capable of doing the same job equally as well.

[AnesRes2014]

Is what true, specifically? As I'm sure everyone here is acutely aware, there is a wide variety of attitudes/opinions towards CRNAs from physicians, just as there are a wide variety of attitudes/opinions towards physicians from CRNAs. From my personal standpoint, there are 2 competing forces here. Firstly, I am all about everyone furthering their knowledge as much as possible, so in general I am all for as much teaching as possible. I also think it promotes a team atmosphere. But on the other hand, there is a subset that is going to take that knowledge and then try to turn that around and use it against the teacher. So I fully understand the sentiment that is expressed on the board.

[Anthony]

Welcome to the site. I commend you for your willingness to answer questions.

I would ask that all participants remain civil and.... especially for the opportunity of learning/sharing ....keep an open mind.

[BuckeyeRN]

Welcome!
Even though we may (or may not) disagree on some issues I look forward to seeing a different viewpoint here.

[Anthony]

Do you mind sharing your transitional intern experience (eg. type of rotations, clinical expectations, general comments) - in order for readers to appreciate your POV. Thanks.

tone