Category Archive: Specialties

Hunter Optics Lectures and Last Minute Optics

Categories:

Ophthalmology

May 4, 2015

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David Hunter md phd

If you are a current or future ophthalmology resident, you should become familiar with the lectures produced by Dr. David Hunter MD PhD. He is the Chief of Ophthalmology at Boston Children's Hospital and has produced four, one-hour lectures that are incredibly high yield. I heard about these lectures before I took the OKAPs in-service exam during my first year of ophthalmology residency and I haven't looked back. Optics was, by far, my best score on the OKAPs my first year and I credit Dr. Hunter's lectures for the success. 

You can find all of his lectures on video, for free, on the Boston Children's Hospital website (link).  He has specifically said that he would love for everyone to have these lectures for free. Therefore, I will link to each of his lectures below. I have found that the above link occasionally does not work (usually in early March of every year, because we are all downloading from it). If you have issues, let me know and I can send you the files from my computer.

I really like the video lectures, however he has also published a book with the same content. Most of the residents in my program actually prefer the book because they feel like they can get through it faster and things are more clear when they read the book.  Whether you use his lectures or his book, the content is the same and it is fantastic. Take a few hours before the OKAPs to really learn this stuff, it will pay off in the long run.

 

   LINKS TO LECTURE VIDEOS

 

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Top Ten Books for Surgical Interns

Categories:

General Surgery, General Surgery Rotation

May 4, 2015

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This list is part of a series of articles about the best books for medical students. Click on the Med School Books Main Page to see other lists including the best books for each year in medical school, the best books for each clinical rotation, and the best books for USMLE Steps 1, 2, and 3.

The surgical internship is unique in that you will care for the full spectrum of patients: acute surgical patients, post-operative patients, patients with chronic illness, and very sick patient in the ICU. The surgical intern is truly a "Jack-of-all-trades" physician and must be able to reconcile huge med lists, manage diabetes, identify an acute abdomen, and take care of acute electrolyte changes in the ICU.

These are tall orders for a newly minted doctor. And don't forget, after 7am you will likely be the only one on the floor while the rest of your team heads to the operating room. Having the right books is one easy way to calm some of the inevitable anxiety. After much discussion with interns and residents at my last two hospitals, I have compiled the following Top Ten Books for Surgical Interns. These books are also great resources for preliminary surgery residents, or other surgical supspecialistis completing a general surgical internship. Most of the general surgery residents I spoke to agree that this list remains the same into their entire residency. Good Luck!

  • Updated May 2015

1. The Mont Reid Surgical Handbook:

The Mont Reid Handbook is a great reference tool to keep in your pocket or on your phone. It was written by a group of surgical residents and is very high yield. It will cover the majority of issues you run into while managing the floors during a surgical internship. It is also great for reviewing for OR cases…if you get to see any during your first year.

2. Surgery On Call:

Surgery On Call is another great pocket reference. The goal of this book, however, is more in the initial evaluation and treatment of surgical patients. The quick-reference format is great for a quick consultation. Some interns also suggest Surgical Recall , which has a similar format but is geared more towards 3rd and 4th year medical students. 

3. A Textbook: Cameron, Current Surgical Therapy:

Every surgery resident, even surgical interns, will benefit from a great surgery text. Many of you will be provided a text at the start of residency, so ask your department before investing hundreds in one of these books. Cameron's Current Surgical Therapy is the highest rated by surgical residents. However, there are other great options. Greenfield's Surgery is well-regarded and cheaper than Cameron's. There are also many people who swear by the Sabiston Textbook of Surgery. 

4. Tarascon Pocket Pharmacopedia:

While we all have access to online pharmaceutical indexes during residency, I agree with most interns and residents that a pocket manual like this great Tarascon book is far faster and more reliable than most online resources.

5. The ICU Book:

You really should get an ICU book. You can get through your first month as an intern in the SICU or MICU without one of these books, but they make your life so much easier that it is just not worth it. Even if you just read through it a few weeks before starting in the ICU, the information will be fresh on your mind and will help you a lot. This is the ICU book I used, it addresses both medical and surgical intensive care issues. Many residents also like The Little ICU Book. 

6. The Washington Manual Internship Survival Guide:

This is a lesser-known internship manual written by the same people who developed the highly rated medication reference, The Washington Manual of Medical Therapeutics. Not as well known as the Mont Reid manual, this is a book from a similar mold with a small but vocal cult-following.  

7. Zollinger Atlas of Surgical Operations:

A surgical atlas is the best way to learn the anatomy and prepare for pimping in the OR. A great surgical atlas will become one of your most important references during residency. If you are a general surgery resident, Zollinger's is the go-to atlas for most residents. 

8. Operative Dictations in General Surgery:

Dictating operative notes is a necessary evil. It has to be done, and it has to be done well for documentation purposes. As the low man on the totem pole, the job of dictation will fall on you. This is a highly recommended book to help interns and residents early in their career. I have a number of procedure note templates available on this website.

9. The ABSITE Review (FISER):

Many surgical interns will complete residencies in specialties other than general surgery. For those of you moving on the general surgery after your internship, you should start studying for your ABSITE early. I know you are incredibly busy in the hospital, but when you have a minute you should keep an ABSITE review book and/or question book handy. The Fiser review comes highly recommended. Another book that many residents recommend is ABSITE Slayer.

10. Old-School and Out-of-Print:

After discussing books for surgical internship and residency with many people, there were two books that were mentioned many times but are no longer in print: The Cleveland Clinic Guide to Surgical Patient Management and The Surgical Intern Pocket Survival Guide . These two books come as high or more highly recommended than every other book on this list. Some residents say these were the most used books in their white coats. Unfortunately, you can no longer buy either of them new, but there are many used options.  

 
 
 

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Which Residents Work the Hardest?

Categories:

Choosing a Specialty, Dermatology, General Surgery, Neurology, Neurosurgery

February 12, 2013

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No one will ever agree on which residency is the hardest, or which residents work the most. However, with some new data from the FREIDA website, we get a better idea than ever before.  (For more information about the FREIDA website, read my previous article) FREIDA reports diverse variables about each specialty including the average of numbers worked per week, the average number of days off per week, and the average vacation time of each specialty.  I have compiled these into one database so that for THE FIRST TIME EVER you can compare objectively which residencies work the hardest.  (Well, at least you can compare which work the longest).

The first figure demonstrates the average number of hours worked by each specialty. As expected, the surgical sub-specialties work the longest hours with neurosurgery leading the pack and general surgery following closely in second.  Of the medical specialties, suprisingly, neurology works the most hours, with pediatrics and internal medicine following close behind. And at the bottom of the list… you guessed it, Dermatology. I wish I loved skin!

The results of the average number of days off per week and the average vacation time during residency follows closely with the trend seen in the graph above. For your viewing pleasure I have the entire compiled dataset posted below.  

 

 

 

 

 

Hours worked per week

Days off per week

Vacation weeks per year

Dermatology

45.0

1.9

3.3

Nuclear Medicine

47.4

1.8

3.5

Medical Genetics

48.2

1.7

3.4

Radiation Oncology

50.0

1.9

3.4

Pathology

51.4

1.8

3.3

Ophthalmology

51.8

1.6

3.3

Radiology

51.8

1.7

3.5

PM&R

54.2

1.6

3.4

Psychiatry

55.7

1.5

3.3

Emergency Medicine

56.6

1.6

3.3

Transitional Year

60.5

1.3

3.1

Colon and Rectal Surgery

61.3

1.4

3.3

Anesthesiology

61.5

1.6

3.4

Family Medicine

62.8

1.3

3.1

Internal Medicine

63.7

1.2

3.4

Pediatrics

64.2

1.3

3.4

Neurology

64.6

1.3

3.4

Urology

66.0

1.3

3.4

Otolaryngology

67.7

1.2

3.1

Orthopaedic Surgery

69.6

1.3

3.1

Obstetrics and Gynecology

70.8

1.3

3.2

Plastic Surgery

71.2

1.2

3.0

Vascular Surgery

72.0

1.2

3.1

Thoracic Surgery

73.0

1.1

3.2

General Surgery

75.1

1.1

3.1

Neurological Surgery

75.6

1.2

3.1

 

 

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FREIDA: Also a Great Resource to Compare Specialties

Categories:

Choosing a Specialty, Specialties, The Match

December 31, 2012

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FREIDA Online is a fantastic resource for any medical student. I recently wrote about how students can compare individual residency programs using FREIDA's various different variables.  The database is not limited to comparing individual training programs; it also allows students to compare different specialties.  

The "Specialty Training Statistics" section provides basic statistics about training in each specialty. Variables presented for each specialty include:

  1. Number of residency programs in the US
  2. Length of training programs
  3. Average number of interviews performed by each residency program
  4. Total number of residents
  5. Gender Gap for each specialty
  6. Average number of faculty per resident
  7. Average number of work hours per week for each specialty
  8. Average number of days off per week  (THESE LAST TWO ARE VERY IMPORTANT!  COMPARE SPECIALTIES!)

LINK HERE

 

The "Graduate Career Plans" section of FREIDA provides information about the careers plans of each of the medical specialties.  Variables presented for each specialty include:

  1. Percentage of residency graduates pursuing further training
  2. Percentage of last year's graduates who are in private practice
  3. Percentage of last year's graduates who are employed in academic settings
  4. Percentage in the military
  5. Percentage employed as basic scientists
  6. Percentage who are unemployed

In each case, the statistics are taken from the most recent graduating class and the database is updated each year. 

LINK HERE

 

Read these data carefully.  I found that the "Hours Per Week" section was very useful and very realistic!

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Spotlight Interviews: What is a Transitional Year Residency?

Categories:

Residency, Anesthesia, Choosing a Specialty, Dermatology, How to match in....?, Neurology, Ophthalmology, Radiology, The Match, Why did you choose....?

September 11, 2012

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A Transitional Year Resident's Perspective: An interview with a transitional year resident from the Ann Arbor, Michigan.

Part of an interview series entitled, "Specialty Spotlights", which asks medical students' most burning questions to physicians of every specialty. See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • What is a transitional year residency?

Transitional Year (TY) residencies might be the least well known residency option after medical school. The TY is a one year residency with a general focus which prepares recent graduates for advanced residencies. To understand where a TY fits in, you must understand that there are a number of residency programs that do not start specialty training until the 2nd year after medical school graduation (i.e. PGY2). These specialties include anesthesia, dermatology, neurology, physical medicine and rehabilitation, radiology, radiation oncology, and ophthalmology.

Each of these residencies begin their specialty training after a resident's intern year. Many of these residency programs will combine the intern year (PGY1) with the advanced specialty training. In these cases, the resident will remain in the same residency throughout their training and there is no need to complete a transition year residency. However, there are programs in each of these specialties that do not start training their residents until the second year after medical school (PGY2). These programs require their residents to complete an approved intern year prior to beginning specialty training. Approved intern years include a year of preliminary medicine, preliminary surgery, preliminary pediatrics, or a transitional year residency.

 

  • How is a transitional year residency different from other intern years?

The goals of training are basically the same among all intern years; we all learn hospital based patient care. Surgical interns take care of patients before and after surgery in the hospital, medicine interns take care of medical patients in the hospital, pediatric interns take care of kids in the hospital. A transitional year resident will take care of all of the above. The transitional year aims to be a broad hospital-based training. TY residents will spend various months working on medicine, surgical, OB, pediatric, outpatient, ED, ICU, and elective rotations. The great asset of a TY is that it provides more flexibility, allowing residents to focus on their interests. I am interested in research and was able to complete two months of intense research during my intern year: something no one from an internal medicine, surgery, or any other residency could say.

 

  • Are Transitional Year Residencies easy?

Not all TYs are made equally. It is a well known fact that there are some pretty cush TY residencies out there. However, there are also some very difficult TYs. To illustrate this fact, last year I interviewed at a number of TY residencies of varying difficulties. The easiest one had 4 required inpatient months, one outpatient month, one ED month, and 6 electives. Sign out during inpatient months was 3pm. When you were in the ICU you covered 2-3 patients, and you were NEVER on call the entire year. In contrast, I interviewed at a big hospital TY where there were two MICU months where you covered 15 patients, 6 required inpatient medicine months, 2 surgery months, a busy ED month, terrible call, and three 'electives' which were all time consuming. In general, however, the answer to this question is yes. Transitional years are FAR easier than prelim surg residencies and quite a bit easier than prelim medicine residencies as well.

 

  • Is the training as good at a Transitional Year Residency?

Absolutely, if you choose the right place. Many months this year I have more free time than I did in medical school. I have found that with the free time I am actually reading and studying a ton. I think that you MUST take call to learn how to be a doctor during your intern year. I am not sure how you can become a 'well trained' doctor if you never take call during your intern year. Being on call at night is when you really have to make decisions and you really learn a ton. You don't need 11 months of inpatient work to become a great radiologist or a great ophthalmologist. However, 6 solid months of medicine/surgery will certainly prepare you for your next level of training. Then you can spend the other half of the year becoming great at something else: research, pediatrics, surgery, golf, sleeping, etc etc

 

  • Describe a typical transitional year schedule?

Everyone must do: 1 month in the ICU, 1 month ED, 1 month outpatient, 2 months general medicine. I believe the rest is up to the residency program. Most programs end up giving 3-5 months of electives.

 

  • What are the potential downsides of a Transitional Year?

Not many! More free time, less stress, more fun…what's not to like. I guess one downside is that it closes some doors if you choose to switch specialties. For example, if you were doing a preliminary medicine year at an academic center and decided you wanted to do medicine instead of anesthesia, the switch would be easier. After completing a TY year you can only go into the specialties I listed above.

 

  • How competitive is the Transitional Year match?

It is actually very competitive. There are not many spots, and they are all coveted because they represent less work, more free time, more electives, and a much easier year. Also, imagine all the applicants trying to get spots: future radiologists, ophthalmologists, radiation oncologists, dermatologists. This is not a list of ordinary applicants. Matching into a TY is about as hard as matching into radiology or ophthalmology.

 

  • What are residencies looking for in a Transitional Year applicant?

I asked my TY program director this exact question and this was his response: "We know we will only have you for one year. However, during that year the TY class will take care of about 50% of all the patients in this hospital. So, it is in the hospitals best interest to have someone who 1- will work hard without being asked, and 2- will maintain the great patient care that we have at the hospital." I think those two things are exactly what all programs want. I think item #2 may touch on competency a little bit, but is mostly referring to your interpersonal skills.

 

  • What should students look for in a Transitional Year residency?

Whatever you want to look for in a TY year. That sounds cliche, but as I said above, not all TYs are made equally. Do you want a chill year at the risk of missing out on training? You can find that. Do you want to do pediatrics as well as medicine and surgery? You can find that.

 

  • Is there anything you wish you knew before application season?

I interviewed at a few places that had both TY years as well as preliminary medicine years but the curriculum was exactly the same. In other words, if you match into the preliminary medicine year, you still have the flexibility that the TY residents at the same program have. All of these programs will let you apply to both the TY and the prelim med year after your single interview. These are great programs to find because even though there is no difference at all in the curriculum, the preliminary medicine years are a bit easier to get into.

 

  • What other advice to you have for students applying to a Transitional Year?

Good luck, intern year is exhilarating, fantastically rewarding, difficult, and very very short. Enjoy it. Read The House of God (amazon link), there is no better time than intern year. Also, watch the first season of Scrubs where the characters are interns…it is incredibly realistic!

 

 

Editor's Note: Applying for residency or preparing for your interviews? I highly recommend First Aid for the Match, The Successful Match: 200 Rules to Succeed in the Residency Match, and The Residency Interview: How To Make the Best Possible Impression .


 

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Spotlight Interview: An Orthopaedic Surgeon’s Job Description

Categories:

Residency, Choosing a Specialty, How to match in....?, Orthopedic Surgery, The Match, Why did you choose....?

August 18, 2012

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An Orthopedic Surgery Resident's Perspective: An interview with an orthopedics resident from the West Coast

Part of an interview series entitled, "Specialty Spotlights", which asks medical students' most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • What attracted you to Orthopedic Surgery?

I feel like you can learn a lot about a specialty based on what you see in the attending physicians of that specialty. The orthopedic attendings, for the most part, seemed happy. There are many sub-specialties in Ortho and was interested in nearly all of them. The patients' prognoses in many cases were very good. Patient’s lives were improved dramatically by Orthopedic intervention.

 

 

  • Describe an Orthopedic Surgeon's typical work day?

Long. Orthopedic Surgery is no place for individuals looking for a structured 8 to 5 job. Attendings often work harder than residents. First and foremost, the patient comes first and your day ends when the work is done.

 

  • What type of lifestyle can a an Orthopedic Surgeon expect?  

It's not dermatology. Call and nights vary between sub-specialties, but generally if you are asking this question, Orthopedic Surgery may not be the right choice for you.

 

  • What is the average salary of an Orthopedic Surgeon?

Also varies from specialty to specialty. Generally speaking Orthopedic Surgeons are some of the best compensated surgical specialists, but that should only be a perk. Don’t go into Orthopedic Surgery for the money, times are changing.

 

  • What is the job market like for Orthopedic Surgery?

The market varies amongst subspecialties. Hand Surgery and Sports Medicine are amongst the most competitive now, but are also rather saturated. Generally speaking, our aging population bodes well for our job security for the next couple of decades at least.

 

  • What can you tell us about Orthopedic Surgery sub-specialties?

Residencies currently range from 5-6 years with 1 year fellowships available in: Shoulder, Hand, Spine, Tumor, Joints, Sports Medicine, Pediatrics, Trauma… About 85% of current residency graduates are going onto Fellowship training.

 

  • What are the potential downsides of Orthopedic Surgery?

Be prepared to work hard and not complain.

 

  • What else would you tell medical students who are considering Orthopedic Surgery?

With a good work ethic and the right motives, Orthopedic Surgery will offer a rewarding lifetime of challenge and service.

 

  • How competitive is the Orthopedic Surgery match?

Very, with the caveat that interpersonal and personality traits cannot emphasized enough.

 

  • What are residencies looking for in an Orthopedic Surgery applicant?

You will need to reach a certain threshold of competency/test scores (different programs weight each of these differently). The rest is studying and hard work. Away rotations are usually weighted pretty heavily and should be considered a month long job interview. Dress appropriately, prepare for cases/clinic, show up early, etc.

 

 

  • What should students look for in an Orthopedic Surgery residency?

I would want to feel fairly comfortable with the people you interact with. You will be spending a good chunk of your life with them. Also, ask them the appropriate, but difficult questions. I always appreciated programs that seemed to be up front and honest.

 

 

  • Do you have any advice about the residency application?

Spend plenty of time on your personal statement and have it proofread by several different people. Another thing that I found useful was to offer to draft letters for those you ask…chances are good they are probably busier than you are.

 

  • Is there anything you wish you knew before application season?

Give every day your best shot. Otherwise stop worrying. The rest takes care of itself. No amount of worry will do anything but shorten your life span.

 

  • What other advice to you have for students applying to Orthopedics?

Good luck! It is a stressful, but dynamic time in life.

 

Editor's Note: For more help choosing a specialty in medicine, I highly recommend one or both of these two great books. I found both very useful.

 

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Spotlight Interview: Why Did You Choose Anesthesia? (Pittsburgh Resident)

Categories:

Residency, Anesthesia, Choosing a Specialty, Why did you choose....?

July 9, 2012

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An Anesthesia Resident's Perspective: From an interview with an anesthesia resident from the University of Pittsburgh Medical Center in Pittsburgh, Pennsylvania.

Part of an interview series entitled, "Specialty Spotlights", which asks medical students' most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • What attracted you to Anesthesia?

I was attracted to the intimate patient care, to a specialty that is procedurally oriented, and to a specialty that requires a working knowledge of physiology and pharmacology.  I saw a lot of energy in the fact that anesthesiologists need to have the ability to control all aspects of a patient's response to surgery in real time.

 

  • Describe an Anesthesiologist's typical work day?

This depends on the type of practice you will ultimately choose. Generally, anesthesiologists arrive early-ish (like 6:30-7am) and are usually done when all surgeries are finished for the day (this can range from 3pm- 6pm depending on working environment).  Weekends and nights are infrequent, but some call is generally taken at least early in your career.

 

  • What type of lifestyle can a Anesthesiologist expect?

The lifestyle is very good. Like I said, weekends and nights are usually free unless you need to take hospital call, which is infrequent at worst.  If you end up at a private practice at an outpatient surgery center you can expect to work from 7am until 5pm Monday thru Friday!

 

  • What is the average salary of a Anesthesiologist?

250k-450k per year.  Some jobs will start you as high as 400k if you will move to a 'less desirable' location.  Salaries are lower for big cities, just like all other specialties. More details at http://www.gaswork.com

 

  • What is the job market like for Anesthesiology?

Excellent.

 

  • What can you tell us about Anesthesiology Sub-specialties?

Most fellowships are another 1-2 years after residency. The most common fellowships are pain management, pediatrics, critical care medicine, and cardiovascular anesthesia.

 

  • What are the potential downsides of Anesthesiology that students should be aware of?

There is some concern over liability, but this is no different than Ortho, neurosurgery, ob/gyn, and many other specialties involved in surgery..  The concern that CRNA's will take all the work away is commonly overstated.

 

  • What else would you tell medical students who are considering Anesthesiology?

Work hard in all rotations, and especially on your anesthesia rotation.  Commonly an anesthesia rotation is one where you can go home at lunch and no one notices, but it pays huge dividends if you get noticed working "late" (like til 4pm).  Actively seek out procedural opportunities on all rotations.  Try to do related rotations like pulmonary consults and pain management. You definitely should complete an ICU rotation and you should do you best to excel at it.

 

Editor's Note: For more help choosing a specialty in medicine, I highly recommend one or both of these two great books. I found both very useful.

 

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Spotlight Interview: How to Match in Anesthesiology (Pittsburgh Resident)

Categories:

Residency, Anesthesia, How to match in....?, The Match

July 8, 2012

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An Anesthesia Resident’s Perspective:  From an interview with an anesthesia resident from the University of Pittsburgh School of Medicine in Pennsylvania.

Part of an interview series entitled, "Specialty Spotlights", which asks medical students' most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • How competitive is the Anesthesiology match?

The anesthesia match is moderately difficult.  However, the answer to this question really depends on how you look on paper and in person. Our match is not as difficult as plastic surgery, but there are always a few people in the country who do not match. You should speak with one of the deans of your medical school if you have concerns.

 

  • What are residencies looking for in an Anesthesiology applicant?

The most important factors initially are a student's performance in anesthesia rotations and letters of recommendation.  Board scores do matter, but need not be sky high.  Mostly, anesthesiologists are laid back and are looking for someone they can work easily with.  You also need to show initiative and be able to make decisions quickly and respond to crises effectively. I am not sure exactly how one portrays these qualities, but the interview certainly can help.  Have answers in your mind to questions that you will almost certainly get asked (examples: Why have you chosen anesthesia?,Can you tell me an example in your life of problem solving?, Where do you think the specialty is going in next 10-25 years?, etc.).

 

  • What do you wish you knew before application/interview season?  

I did not have much exposure to FREIDA. I would recommend researching program statistics on FREIDA prior to applying, you will learn some interesting things about programs and may even choose not to apply to one and to apply to a different program.  Also, the ASA (American Society of Anesthesiologists) annual meeting is in October (right before interview season) and there are a number of medical student specific programs that include an opportunity to meet and talk with many program directors (this event occurs on the weekend portion of the meeting).  I would try to attend if it is at all financially possible to do so.

 

  • What should students be looking for in an Anesthesia residency program?

Use FREIDA and your other tools to determine what size program you want to be part of. Large and small programs each have their positives and negatives. Look for residencies that fit into the program size and 'level of prestige' that fits what you're looking for in the work/life balance and where you want to go with your future career.  You will also find that more prestigious schools at big research universities also have positives and negatives.

 

  • What other advice do you have for students applying to Anesthesiology residency?

Start early and get everything submitted ASAP, most programs filter through the applicant pool once and then fill all interview spots. Furthermore, spots fill quickly, so have your email forwarded to your phone/pager and don't be afraid to excuse yourself from your rotation to set up an interview; 4 hours later may be too late.  It is not uncommon for programs to send out more invites than they have interview spots.

 

Editor's Note: Applying for residency or preparing for your interviews? I highly recommend First Aid for the Match, The Successful Match: 200 Rules to Succeed in the Residency Match, and The Residency Interview: How To Make the Best Possible Impression .


 

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Spotlight Interview: How to Match in Anesthesiology (Emory Resident)

Categories:

Residency, Anesthesia, Choosing a Specialty, How to match in....?, The Match

June 4, 2012

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An Anesthesia Resident’s Perspective:  From an interview with an anesthesia resident from Emory University in Atlanta, Georgia.

Part of an interview series entitled, “Specialty Spotlights“, which asks medical students’ most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • How competitive is the Anesthesiology match?

Comfortably in between family practice and plastic surgery.  Overall, it would probably be considered medium competitiveness.  Interestingly, the competitiveness of anesthesia has varied quite a bit over the years (higher board scores, lower match rate, etc). The numbers seem to be about average right now though.

 

  •  What must a student do to match well in Anesthesia?

You need to find great references from anesthesiologists.  This can be accomplished in the standard ways but most importantly is to demonstrate interest by performing well in an anesthesiology rotation.

 

  • What are residencies looking for in an Anesthesiology applicant?

Residencies are most interested in a well-rounded medical student that can think well on his/her feet.  The same positives from other professional arenas apply to anesthesia – personality, humility, empathy, etcs.

 

  • What should students look for in an Anesthesia residency?

There are a few things you need to be aware of. First, you need to know the number of cases completed by residents at each of your interviews. You need to be ready to hit the ground running, so # of cases and variety is important. You will be able to learn about the satisfaction of current residents while on your interviews. You should also consider georgraphic fit with family, and your career goals in general (academics vs. private among other questions). Ask where past residents have ended up – fellowships?  Jobs?  What are the employment statistics?

 

  • Do you have any advice on the application, letters of recommendation, personal statements, or how to rank programs?

The best 20-30 programs essentially all offer the same things.  Everyone gets jobs, or has fellowship options.  Go where you have the best fit, where the geography/hospital best suits the interest of your family (or yourself).

 

  • What do you wish you knew before application/interview season?  

Calling programs once or twice is not seen as “nagging” – a friendly, professional follow-up to applications will oftentimes turn into an interview offer so long as you do it early in the process.

 

  • What other advice do you have for students applying to Anesthesiology residency?

Whether you apply to anesthesia, emergency medicine or ophthalmology – you need to be honest with yourself about your career aspirations.  Try and get past the notion that you “need to be a neurosurgeon or your life was for naught.”  Accept that there are many specialties and many places where you can be a very successful, happy professional.  Remember to mind your spouse/significant other and ask for their input – your decision will affect more lives than your own.

 

Editor's Note: Applying for residency or preparing for your interviews? I highly recommend First Aid for the Match, The Successful Match: 200 Rules to Succeed in the Residency Match, and The Residency Interview: How To Make the Best Possible Impression .


 

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Spotlight Interview: Why Did You Choose Anesthesia? (Emory Resident)

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Anesthesia, Choosing a Specialty, Why did you choose....?

June 4, 2012

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An Anesthesia Resident’s Perspective: From an interview with an anesthesia resident from the Emory University in Atlanta, Georgia.

Part of an interview series entitled, “Specialty Spotlights“, which asks medical students’ most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • What attracted you to Anesthesia?

A couple of things stand out to me.  First and foremost, I was attracted to its pace & acuity.  I learned pretty quickly in medical school that I was not destined to manage a wide variety of chronic problems.  I have always been the type of person that prefers high-pressure situations and quick decision-making.  Secondly, I felt I had a lot in common with the other anesthesiologists I met.  There is most certainly a “personality type” that seems to gravitate toward the field – usually personable, outgoing but quietly knowledgable physicians.  Most importantly, they are the type of doctors that underscore doing a great job by staying out of the limelight.

 

  • Describe an Anesthesiologist’s typical work day?

A typical day for a general OR anesthesiologist involves the following – Arriving at the hospital around 615 am to prepare your rooms, see your patients, start any necessary IVs, lines etc.  Cases are ready to go around 7:15 at most hospitals.  As a resident you will typically stay with your patients for the duration of their case.  On a typical OR day with bread and butter abdominal surgery you oversee 4-5 cases a day.  At the end of the day you are relieved to go pre-op the next day’s patients (physical exam, brief H&P).  As an attending, the field is shifting to more of a perioperative & Anesthesia Care Team model.  This usually involves a physician overseeing the anesthesia to 3-4 cases simultaneously.  Nurses or residents work directly beneath the attending at the patient’s bedside.

 

  • What type of lifestyle can a Anesthesiologist expect?

Anesthesiology is far from a “lifestyle” specialty – busy practices will necessitate call (usually a weekend a month, or one night in seven as “first call”).  That being said, anesthesia has the perk of more defined hours than many other specialties.  When cases are done in your operating room, you are free to go home.  There are no follow up visits in clinics, floor management or chronic care with which to be concerned.

 

  • What is the average salary of a Anesthesiologist?

Typically new graduates will make around $250,000 average, depending on geographic location.  After a few years of practice (or with partnership) salary typically rises closer to $330-$350k per year.

 

  • What is the job market like for Anesthesiology?

There are always jobs for anesthesiologists.  Availability is geographically dependent, however.   If you are dead-set on working in midtown Manhattan you will have to take a pay cut, and your  job search will be a bit more labored.

 

  • What can you tell us about Anesthesiology Sub-specialties?

Typically the sub specialists will spend one extra year as a fellow (PGY5, five years total).   There are only a handful of ABA-recognized fellowships at this time.  Pain medicine, critical care medicine, cardiovascular anesthesia and pediatric anesthesia.  Experts predict there will soon be board-certification in obstetrics, neuro, and local anesthesia.

 

  • What are the potential downsides of Anesthesiology that students should be aware of?

I am always asked about the political climate of anesthesia, and the supposed “take over” by nurses.  This is something to consider before entering the field – the role of the anesthesiologist is always evolving, we are seeing a shift towards perioperative management and an “anesthesia care team” model being emphasized so physicians can manage multiple cases at the same time.  No one can predict what legislation will mandate in the future.  It goes without question that a physician-trained anesthesiologist will always be a necessity at major medical centers – and the need for good physicians will always be greater than the supply.

 

  • What else would you tell medical students who are considering Anesthesiology?

Spend time following anesthesiologists in the hospital setting.  If you know any anesthesiologists privately, try and assess how happy they are with their career choice.

 

Editor's Note: For more help choosing a specialty in medicine, I highly recommend one or both of these two great books. I found both very useful.

 

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