Anesthesia Residency

[DeeplySuperficial]

Hello everyone. I am interested in Anesthesia but am a mature student so lifestyle during residency is important to me. I was wondering if people can comment on the intensity/difficulty of an Anesthesia residency and the type of call shifts that are required. Thanks in advance.

[#YOLO]

if u value lifesstyle...dont do steez. 

[insomnias]

2 hours ago, #YOLO said:

if u value lifesstyle...dont do steez. 

Could you expand?

[hopeful_med]

2 hours ago, #YOLO said:

if u value lifesstyle...dont do steez. 

huh. whats your specialty again?

[#YOLO]

On 4/4/2020 at 11:38 PM, hopeful_med said:

huh. whats your specialty again?

whats urs chief 

[blah1234]

My friends underwent busy training during their residency. I can't say it was very lifestyle friendly to be honest. If you're very lifestyle oriented (nothing wrong with that being a mature student) I'm not sure if it will be good in that aspect.

[hopeful_med]

11 hours ago, #YOLO said:

whats urs chief 

Anesthesia

[#YOLO]

6 hours ago, hopeful_med said:

Anesthesia

gl 

[Od-in]

On 4/6/2020 at 2:50 AM, blah1234 said:

My friends underwent busy training during their residency. I can't say it was very lifestyle friendly to be honest. If you're very lifestyle oriented (nothing wrong with that being a mature student) I'm not sure if it will be good in that aspect.

Expand please. More info on this would be great. Like.. Busy calls? Long hours? Lot of stress? Etc

[blah1234]

On 4/19/2020 at 8:15 PM, Od-in said:

Expand please. More info on this would be great. Like.. Busy calls? Long hours? Lot of stress? Etc

They would complain about busy calls and the overall stress of managing high-acuity patients. I mean it could've been program dependent as well but more than one friend conveyed to me the difficulty during the training.

[Od-in]

26 minutes ago, blah1234 said:

They would complain about busy calls and the overall stress of managing high-acuity patients. I mean it could've been program dependent as well but more than one friend conveyed to me the difficulty during the training.

Thanks bro.

[Cupboardsauce]

Hi  - Anesthesia senior resident.

Call burden is dependent on the program you are in. I can only speak to my program and what I know from some buddies across the country. Large academic hospitals typically want 24 hr resident coverage - so in my program we are typically doing the max allowable call a month (6-7 shifts).  Depending on the program, shifts can be 12 hrs or 24 hrs in length. Typically a hospital that is busy overnight all night will have 12 hr call, while hospitals that tend to shut down at 11PM will have 24 hr call.  Depending on the program you may also routinely get pre-call days for 12 hr shifts (ie don't come in to work until 6PM, work until 8AM, then get a post call day). Pre-call days are the best.

In anesthesia residency you also do a number of off-service rotations such as a decent amount of ICU, CCU, PICU, which all notably have more intense call requirements. However, there are also many rotations with more relaxed to no call burden - for us that is when we do sub-speciality  rotations, in our senior years for studying purposes (the anesthesia exam is hard), and when we do rural rotations.

Overall, I would say that we have it better than our surgical and IM colleagues - we reliably get to go home at 8AM post call, are not expected to stay post call until 1PM or come in on weekends, and it has been easier for us to get requested vacation time. On the flip side, when you are on call overnight there is every chance you will be up all night working hard.

Lots of cool cases and high intensity cases in residency, mixed in with the bread and butter stuff. You will work hard, and cases can be stressful but rewarding. You can also have a life outside of residency. In the long run, if lifestyle is important to you there are lots of community and academic anesthesia jobs that will be great for balance. There are also a lot of jobs in anesthesia that are not great at balance. Luckily, you have many options and a great job market. Many people are accepting great jobs out of residency even at academic hospitals - an example might be accepting a full time position at 4 days a week with call once every two-three weeks, and 8-12 weeks of vacation time, no overhead, no clinic to cover. If spending less time / more relaxed  residency is your highest priority consider if GP+1 might be right for you. 

Lots of great options out there. I would encourage you to think about what you want your job and career to look like, rather then what you want your residency to look like. What is going to make you happy and fulfilled 15 years from now?

 

 

[insomnias]

On 12/14/2020 at 8:25 PM, Cupboardsauce said:

Hi  - Anesthesia senior resident.

Call burden is dependent on the program you are in. I can only speak to my program and what I know from some buddies across the country. Large academic hospitals typically want 24 hr resident coverage - so in my program we are typically doing the max allowable call a month (6-7 shifts).  Depending on the program, shifts can be 12 hrs or 24 hrs in length. Typically a hospital that is busy overnight all night will have 12 hr call, while hospitals that tend to shut down at 11PM will have 24 hr call.  Depending on the program you may also routinely get pre-call days for 12 hr shifts (ie don't come in to work until 6PM, work until 8AM, then get a post call day). Pre-call days are the best.

In anesthesia residency you also do a number of off-service rotations such as a decent amount of ICU, CCU, PICU, which all notably have more intense call requirements. However, there are also many rotations with more relaxed to no call burden - for us that is when we do sub-speciality  rotations, in our senior years for studying purposes (the anesthesia exam is hard), and when we do rural rotations.

Overall, I would say that we have it better than our surgical and IM colleagues - we reliably get to go home at 8AM post call, are not expected to stay post call until 1PM or come in on weekends, and it has been easier for us to get requested vacation time. On the flip side, when you are on call overnight there is every chance you will be up all night working hard.

Lots of cool cases and high intensity cases in residency, mixed in with the bread and butter stuff. You will work hard, and cases can be stressful but rewarding. You can also have a life outside of residency if you are effective with your time. In the long run, if lifestyle is important to you there are lots of community and academic anesthesia jobs that will be great for balance. There are also a lot of = jobs in anesthesia that are not great at balance. Luckily, you have many options and a great job market. Many people are accepting great jobs out of residency even at academic hospitals - an example might be accepting a full time position at 4 days a week with call once every two weeks, and 8 weeks of vacation time, no overhead, no clinic to cover. If spending less time / more relaxed  residency is your highest priority consider if GP+1 might be right for you. 

Lots of great options out there. I would encourage you to think about what you want your job and career to look like, rather then what you want your residency to look like. What is going to make you happy and fulfilled 15 years from now?

 

 

Realistically speaking, what does the lifestyle of CCFP-FPA vs FRCPC look like? The CCFP can only do ASA1/2, often in more rural areas, but the flip side is that they can also cover clinic and ER (since they tend to be in rural places without FRCPC/CCFP-EM)? I guess my underlying question is, what leads one to pick GPA over FRCPC?

[popfossa]

How competitive is anesthesia to match into? Should one be doing research starting in first year? 

[Cupboardsauce]

On 12/26/2020 at 12:24 PM, insomnias said:

Realistically speaking, what does the lifestyle of CCFP-FPA vs FRCPC look like? The CCFP can only do ASA1/2, often in more rural areas, but the flip side is that they can also cover clinic and ER (since they tend to be in rural places without FRCPC/CCFP-EM)? I guess my underlying question is, what leads one to pick GPA over FRCPC?

I'm with the 5 year FRCPC program, so I am not the best person to chat about GPA lifestyle or job market. Couple things I thought about though:

 As far as I know in Western Canada, FRCPC trained anesthesiologists are close to the only trainees being hired on these days in major cities. There are lots of jobs for GPAs in great rural areas all over the country, and some medium sized locations. Doing a couple locums post residency to find the right fit has been a common pathway from some of my GPA pals, while others have already been an established GP in a certain town and have been asked to do the GPA training with a job on return. So all that to say, I would think you'd need to be comfortable living in a rural location as a GPA and should consider if that will work for your lifestyle/family/interests. This is a big consideration for lots of people. 

From an anesthesia perspective, the GPA vs FRCPC cases are quite different if you consider subspecialties of anesthesia (ie cardiac, thoracics, neuro/spine, transplant, major trauma, vascular) to the average rural anesthesia case,  but it's really not so different if you consider that a lot of your time as a non-subspecialist staff anesthesiologist will be doing bread and butter sedations and GAs no matter where you work. My advice would be to think hard about what will keep you fulfilled in your career in the long run. Like you mentioned, smaller centres will refer out their complex patients, so if you're someone who enjoys the more complex periop management of anesthesia then FRCPC affords more opportunities to explore that. For some of my colleagues, the challenge of approaching a complex case or acute resuscitation is what keeps them interested and fulfilled. However, some may find that as a FRCPC practitioner the novelty of looking after complex patients and doing complex cases will wear off with time and experience. The more cases you do the more routine it becomes, especially after you've been well trained for 5 years and given that you'll be working in larger hospitals with the support to manage complex periop surgical care. As either a FRCPC anesthesiologist or a GPA there will be cases that are challenging for you. Anesthesia in a rural setting is incredibly complex when faced with an acute presentation in a setting with limited hospital and staffing resources and considerations for transport/referral.

In terms of working in ED/clinic as a GPA - I can't speak to this in detail. Some of my GP colleagues have gone on to just do GP anesthesia, and others have accepted jobs with time spent in ED or clinic or both. The variety and balance is certainly what many of my GPA colleagues have loved about their job. To me this seems like a wonderful option. Doing just anesthesiology means that you have less of other aspects of medical practice - things like patient continuity, history taking/diagnostics, and admitting/being MRP. Many of my colleagues don't find they miss these aspects of care as anesthesia alone affords a greater degree of flexibility with call/time-off/overhead, but for some people balancing out an anesthesia practice with time in clinic/other areas is a real value-add to their career. 

I'm sure there are other factors that other people have considered important. My decision was based on not being interested in the FM training program, wanting the option of living in a major city and/or doing a subspecialty, and loving resuscitation/trauma medicine. However, as a medical student I didn't appreciate that things I thought were really exciting as a medical student are not as exciting after a couple years, and rather that it's the other aspects of my career - like patient-physician relationships and a sense of community in my workplace that keep me happy and excited to come to work.

 

[Cupboardsauce]

On 12/26/2020 at 3:17 PM, popfossa said:

How competitive is anesthesia to match into? Should one be doing research starting in first year? 

I encourage you to take a look at the Canadian CARMS website to get an idea of the relative competitiveness of various specialties -  they post match statistics every year.

All programs have their own method of ranking applicants. Certainly involvement in academia is considered, and while this is most often research in anesthesiology or another field there are many students who demonstrate this quality with other pursuits. My advice is to be active about looking for leadership, academic, and skill development opportunities in medical school, but choose those that are genuinely interesting to you and are doable in terms of balance. People who are passionate or enjoy what they are doing may tend to more reliably complete projects, continue developing a project or skill in residency, and stay balanced during training. In general programs are not looking for medical students to all follow the same path, but rather to present themselves as a teachable applicant who people want to work with in the middle of the night, and whose resume reflects a strong performance in all specialties of medicine with involvement in projects that interest them.