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Anaesthesia
Why did you choose your area of specialty?
It is a real balance between theoretical medicine (pharmacology and physiology), with procedural medicine (airway, vascular access, pain control) and acute patient care (both with very critical and healthy patients). It provides a very interesting communication dynamic between health care providers (nurses, surgeons, anaesthesiologists) and patients/families.
What is the best part of the job?
I really enjoy the procedural nature of the job. Additionally I like the challenge of always being on your toes. You never know when a smooth procedure can turn rocky.
What is the worst part of the job?
In many centers you will be doing in-house call for the rest of your life. In most professions, as you increase in seniority you will do call from home. This is not the case for anaesthesia in either trauma centers or any center with obstetric coverage (as you never know when there will be a need for your service).
What patient population do you work with?
That is the great part of anaesthesia. In a general hospital you would work with everyone from neonates to geriatrics, including obstetrics. It can be a spring board for doing critical care, or fellowships to specialize in paediatrics, pain management, etc.. You are really work with every patient population possible.
What type of technical things do you do during the day?
A normal day in the OR includes checks of the anaesthetic machines, preparation of medications (both routine and emergency medications) and then your interactions in the OR. These can vary substantially depending on the room you are assigned. It can include airway management (intubation or mask airways), acute pain control (epidural, spinal or nerve block techniques), and then maintaining homodynamic patient stability both during and following the surgical procedure. So you may have tons of procedures in the day for someone undergoing a major thoracic procedure (epidural, central venous access, arterial access, intubation etc, etc). Or you could be doing conscious sedation and with an awake patient.
What type of patient interactions do you have during the day?
Prior to the procedure you would meet the patient and family, do a history and physical prior to planning the anaesthetic of choice, and then inform the patient (or provide options) for the procedure. You would then interact in the OR prior to induction and during awakening. Depending on the set up of your hospital, you would also cover the post operative pain service (seeing patients on the ward and adjusting pain medications). Another aspect is doing epidurals for labouring women. And yet another aspect is the preoperative clinic, where you meet patients prior to the day of their procedure to help optimize their health and plan the anaesthetic. Lastly, some physicians also work on chronic pain teams, working in chronic pain clinics. This area is probably has the most contact with regards to continuity of patient care.
How is your day divided? Eg. time in clinic, rounding, in OR, house calls, consults
The majority of the time is spent in the OR, and in between cases you would see the next patient. The day starts quite early as most ORs start by 7:30 in the morning and you have to be there to meet the first patient and set up the room.
What type of person is well suited for your area of specialty?
You have to have excellent communication skills as you will be working with a wide variety of personalities and need to interact with them well. You also need to enjoy areas of punctuated excitement. The day can feel quite long when they are sailing smoothly along...however can turn rapidly into an emergency situation (with very little notice). You need to be someone who likes attention to detail and try to pre-empt emergency situations before they occur. You also need to be organized as you are dealing with many medications.
What advice would you give to someone interested in your job?
Do electives in this area of medicine and also in related fields (ie cardiology, respirology, ICU medicine). Really know why you like anaesthesia, but also realise that it is not a perfect speciality and that it has limitation. Do electives to see if you can live with the down sides of the profession. Meet and talk to residents and physicians in the field. Get a mentor if at all possible in the area. Good luck. It is a great career filled with professional challenges and constant learning.