Why Do People Say Anaesthesiology Is Boring?

[mononoke]

I've heard from some upper years that they eliminated anesthesiology because it's boring - it's a lot of "watching vital signs" and "waiting". Is it really that boring?

[KellyClarkson]

I did a day elective in it and can share my experience. There is some opportunity in the pre-op to work with your hands when you inject the anesthetics as well as have some patient contact, but once the patient is in the OR and they are under & stabilized you are basically watching their vitals and fine-tuning them as the surgery progresses. I can see the mental appeal in it though, as the bread and butter of of the specialty is cardio/resp, and you are thinking through every abnormal cardio/resp vital while solving the abnormality in real-time. I can't see myself doing it, though.

[rmorelan]

 

(posted jokingly).

 

more seriously some of my friends do describe it as 99% peacefully boring, and 1% terrifying. Takes an interesting sort of person to deal with that mix

[ploughboy]

Since rmorelan beat me to saying "99% boring, 1% stark terror", I'll have to think up something original...

 

It's a tonne of physiology and pharmacology, all in real time.  You develop a good skill set, and can handle almost anything.  Probably 90% of the time when there is a stat, hospital-wide page overhead, it's for anaesthesia to show up and stabilize a pear-shaped situation (though last week at my hospital there was a stat overhead page for endocrinology, which I've never heard before and likely never will again).

 

Cool specialty overall, hard to et a good appreciation of it as a medical student.

[A-Stark]

I think people who say this don't really know much about the specialty. I know that because I once said it myself! 

 

I suppose things can seem boring to med students or off-service people without much experience, but the more you know about physiology and pharmacology the more interesting it becomes. 

 

And at least you can scratch your nose and sit in a chair under a blanket from the warmer watching the monitor while the surgeons pick away. 

[sultanator]

Anestehsiology = THE most underestimates specialty in medicine !!

 

 

 

...not that I'd be biased in any way

[ploughboy]

Actually, I'll put in one caveat here...about 20 years ago anaesthesiology was a very non-competitive specialty.  So much so that there are gas-passers of a certain vintage who are down-right *weird* . 

 

Don't let them shape your perception of the specialty.  Spend some time in a cardiac OR with somebody who's just finished a fellowship to see how cool the specialty can actually be.

 

 

**paging TMax to the thread...Dr. TMax, if you are in the building please report to this thread...***

[chromeboker]

Anesthesiologists should be called medical physiologists. They have to know practically everything that can go wrong with CV, resp, neuro to a degree. Brilliant people.

 

But it's true, a large part of their job is just sitting and waiting. Which I'm sure if better than the emotional / mental strain of constantly having to save people.

 

It's partially an academic pursuit, most I come across are up to date on literature

 

The hours and lifestyle are awesome though! It's very competitive and sought after specialty

[GrouchoMarx]

Actually, I'll put in one caveat here...about 20 years ago anaesthesiology was a very non-competitive specialty.  So much so that there are gas-passers of a certain vintage who are down-right *weird* . 

 

Don't let them shape your perception of the specialty.  Spend some time in a cardiac OR with somebody who's just finished a fellowship to see how cool the specialty can actually be.

 

 

**paging TMax to the thread...Dr. TMax, if you are in the building please report to this thread...***

 

 

Pathology weird? 

 

If so, that's really weird.

[mononoke]

Thanks for the replies! I've also heard that it's very technical and you have to be good with  your hands. Do you have to have a lot of fine motor skills like that of optho or vascular surg?

 

Also is it still very competitive? People are saying that there are no jobs b/c it's dependent on OR time and those who work in ICU say that it's hard to find jobs there too.

[Totenmesse]

Depends on what your interests are, and what you find stimulating. Typical day may involve speaking with a couple of patients pre-operatively, doing a very quick h&p, then setting up the room (drawing up meds, preparing monitors). You'll fire monitors on a cold patient who naturally is a bit apprehensive. The interaction with patients is very quick, most don't remember who you are.

 

Induction is one of the more exciting times in anesthesia, although they do everything to make it non-exciting so you'll quickly get used to the fent prop roc tube. For me, the remainder can unfortunately be quite boring. A healthy patient typically does not an interesting case make. You may go for a coffee break, peak over the drapes, replace fluid, prepare antiemetics/nsaids/reversal agents and then literally repeat this process, depending on the case load 3-5 times per day. There are intraop emergencies, and I've experienced a few. Even then, there isn't so much diagnosing (there's very little to none in anesthesia) but rather algorithm based problem solving. Increased airway pressures? X Y Z. Bradycardia? X Y Z.

 

I find sitting in the same place in the same room for hours on end mentally fatiguing. I like popping between floors, saying hello to patients/coworkers, etc. It's a fairly thankless profession and you need to be comfortable with what that means. With that said, they are incredibly knowledgeable regarding physiology/pharmacology and it's interesting no one knows the MOA of the volatiles. The only way to answer this for you is to do an elective or two. This time will not be wasted regardless, IVs and intubations are great skills.

[ploughboy]

Sudoku.  You forgot to mention sudoku. 

[kinemed]

Thanks for the replies! I've also heard that it's very technical and you have to be good with  your hands. Do you have to have a lot of fine motor skills like that of optho or vascular surg?

 

Also is it still very competitive? People are saying that there are no jobs b/c it's dependent on OR time and those who work in ICU say that it's hard to find jobs there too.

 

Re: technical skills. You don't need very small/fine motor skills, but you need to be dextrous and good with your hands. I'm going to go ahead and toot my own horn here - the technical skills in anesthesia have always come easily to me and I've repeatedly been told so as an MS and an R1. I worked with a young staff who said that she had been told the same thing during training, but didn't realize how significant it was until she became a staff and started working with MS/residents to whom it doesn't come naturally. You can learn, but it does makes things much easier if it comes naturally. Common stuff like difficult IVs, spinals, epidurals, central lines, regional procedures, and intubation (especially nasal) can be particular and require skill.

 

Anesthesia is increasingly competitive. In the past, they had to active recruit people. You can look at the data in lots of ways (and drive yourself mad in the process), but spots per 1st choice applicant is helpful. Last year (2014), there were 1.29 people who ranked anesthesia as first choice specialty for every available spot. 2013 - 1.27, 2012 - 1.27, 2011 - 1.22. Consistently less competitive than plastics, derm, ophtho, emerg. More competitive than usually all the other ones. ENT, urology, vascular are sometimes more competitive. I think people are increasingly seeing it as a lifestyle specialty. There are jobs, but you may need to be flexible in where you live. As far as big markets go, Vancouver apparently has lots of jobs. 

[rmorelan]

Sudoku.  You forgot to mention sudoku. 

that's right in the video!

 

ha, I love amateur transplants.

[KennethToronto]

Just to chime in - I used to think anesthesia was boring. I did several days of shadowing as a 1st and 2nd year medical student. Had no idea what the f*ck was going on, other than it seemed like that anesthesiologists sat around and fiddled with some dials. It's especially tough because it seems like all the action is going on down on the other side of the drapes. A lot of them were also kind of weird.  

 

Fortunately, I didn't let that deter me from going back to it later on after a brief flirtation with surgery. I think some others have mentioned are spot on - doing a day of shadowing as a med student, if you don't know the underlying physiology and the implications of the underlying diseases/positioning/surgical interventions have on anesthetic management, it's kinda boring and seems like you're staring at a monitor waiting for nothing to happen. That and a lot of PPF/ROC pushing. A lot of things are subtle and hard to appreciate. Knowing what I do now, the only reason I found it boring back then was because I was ignorant and didn't know sh!t.    

 

Bottom line: if you like physiology, like a broad knowledge base, like using your hands once in a while, like the idea of actually having skills that other people will call upon when someone is really going down the drain, then I'd give this specialty a chance!