MD/DO anesthesiologist vs. CRNA vs. CAA

Amanda Xi

Today’s inane image of the day:

All three jobs provide anesthesia, so what’s the difference?

While true that an anesthesiologist, CRNA [certified registered nurse anesthetist], and CAA [certified anesthesiologist assistant – generally shortened to AA, which is the designation I will use for this entry] all provide anesthesia to patients, the pathways to get to each profession and the actual practice are different. I think all three paths can definitely provide a fulfilling career and should all be considered for anyone that might have an early interest in the practice of anesthesia.

I want to note that I did not know I’d be pursuing anesthesia when I entered medical school, so I didn’t consider the CRNA/AA route. I did briefly consider PA school as a backup plan to MD/DO if I didn’t get in, but I didn’t need to go down that path. Anyway, let’s dive in.

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$200,000 MD/DO: is becoming a doctor worth it FINANCIALLY?

Amanda Xi

Today’s inane image of the day:

Introduction

Back in May 2015, I wrote a blog entry entitled, “Don’t go into medicine for the money” where I crunch some numbers to counter the claim that doctors are all part of the 1%. Sure, there are doctors that are doing really well out there. And yes, the salary of a doctor out of residency is quite nice. But these things do not take into account the current status of crippling debt that many medical students take on. Becoming a doctor is a challenging road, especially if an individual is coming from a lower socioeconomic status which requires taking on more and more debt. Furthermore, doctors just don’t get a lot of education on managing finances, even when the average medical student graduate has OVER $200,000 IN DEBT.

Anyway, I decided to revisit this question of whether becoming a doctor is worth it financially and make a YouTube video on it. This time, I made different assumptions… specifically, I decided to look at whether I’m better off financially as a physician rather than an engineer. For those of you that are just getting to know me, I graduated with my Master’s degree in Biomedical Engineering. All of my friends went off to start their engineering jobs with real salaries and the ability to start saving money for life things – a car, a house, vacations, retirement – while I went off to medical school and residency and saved barely any money while also working ridiculous hours, exposing myself to occupational hazards [let’s not forget that I was an ICU fellow at the peak of our COVID surge and continue to care for COVID patients to this day], and letting the “best years of my life” go to waste.

Here’s the spreadsheet to check out my assumptions and conclusions: http://bit.ly/doctorfinances.

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NIGHT SHIFT | A glimpse into a night shift as an ICU doctor

Amanda Xi

Today’s inane image of the day:

Here’s a video with my thoughts on night shift and a glimpse into a night with me. Make sure you’ve already watched my day in the life video for what day shift looks like!

Introduction

Night shift is a different beast altogether. My shifts are 14 hours long – technically I’m on service from 1700 – 0700, but there is a lot of preparation that goes into this shift. I spend hours prior to going into the hospital looking over my patients and sometimes pre-writing my notes in order to get a good understanding of what happened during the course of the patient’s ICU stay. Maybe it’s because I’m a new attending, but I also feel like if I get to know my patients better, they receive better care.

Anyway, in my video, I go over some of my strong feelings surrounding how tough working night shifts can be on the body as well as take you with me on a shift for you to get a glimpse into what a night shift in the ICU looks like for an attending.

Keep reading if you want to see an hourly breakdown of what my night shift schedule looks like.

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Specialty series: anesthesiology

Amanda Xi

Today’s inane image of the day:

Back in 2015, I had grand plans to write up entries discussing different specialties and my personal thoughts on why they were not quite a good fit for me but how I could see they could be a good fit for others. I only wrote up one entry on emergency medicine. But it’s never too late to keep adding to it, right?!

A lot of premeds and medical students have asked me about my journey and path to anesthesiology and I finally took the time to record a video outlining my journey AND threw in some fun throwback photos from over a decade ago, when I was in college! I hope you’ll take the time to watch the video above, if you haven’t already.

If you’re interested in reading more about what I like and do not like about the field of anesthesiology, keep reading!

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STUDYING: 10 ways I stay motivated to study at home

Amanda Xi

Today’s inane image of the day:

Throughout my life, when I’ve needed to study for something, I would head over to a coffee shop and sit there for extended periods of time. I started this habit in high school when I used to go to the Barnes and Noble Starbucks and enjoy a frappuccino over my biology textbook. There were times when I would meet up with classmates and we would do a group studying session. When I got to college [first at Bard College at Simon’s Rock then later at the University of Michigan], I always had to be in a new setting in order to be productive. When I was at Bard College, I would study in the library [since I didn’t have a car there and it was the middle of the Berkshires]. At Michigan, I was either at Starbucks or Espresso Royale. In medical school, I spent hours upon hours at the Starbucks a mile away from my home. In residency, I explored various coffee shops around Boston, but I especially loved going to Ogawa Coffee when I wanted to be productive.

All this being said, the pandemic has shut down this habit of coffeehouse productivity sessions and studying. Now, I’m stuck at home. And I have TWO big exams looming!

In this blog entry [and my YouTube video], I wanted to cover some of the ways I’ve stayed motivated to study while at home. Some of these tips are still relevant for when you’re studying at a coffeeshop or library, but I definitely focus on areas that optimized my at-home studying motivation.

Let’s dive right in:

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Love letters [vs. letters of intent], rank order lists and the match

Amanda Xi

Today’s inane image of the day:

Detroit view at night from Ford
New Year’s Eve at Henry Ford. [I started writing this post back in 2016 but never finished; it felt fitting to leave the image].

Introduction

It’s getting to the time of year where medical students across the country have interviewed [though, this is a weird interview season with the pandemic and the virtual format and all…] and are starting to ask themselves: Where do I see myself living/being/working for the next 3-7 years?

I still remember the feeling of utter exhaustion from interviewing, but also this sense of impending doom about how I was going to navigate the waters surrounding sending a love letter to my top program, how I would rank programs, and whether ranking SEVENTEEN programs would be enough to match [remember, I was in the INAUGURAL CLASS of a BRAND NEW MEDICAL SCHOOL that everyone assumed was in California]. Now that I’m a few years out, have sat on recruitment committee meetings, and have heard the advice from other program directors surrounding these exact questions, I feel that I’m in a place to provide some insight and advice to all of you.

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How I’m studying for the anesthesia oral boards [ABA APPLIED exam]

Amanda Xi

Today’s inane image of the day:

Introduction

I was supposed to take the oral boards in June of 2020, but the Covid-19 pandemic totally derailed those plans. After being canceled and anxiously awaiting news from the ABA about how I would take my exam, I was finally notified a couple weeks ago of my date. The ABA APPLIED exam will be VIRTUAL for 2021; I have been assigned an April 2021 date.

Usually I would wait until I’ve passed an exam to provide information about how I’m studying, but I wanted to share my process earlier this time since this exam is so different from any other board exam we’ve taken. I disagree with comparing it to the USMLE Step 2 CS [clinical skills] – sure, parts of the OSCE are similar, but the actual Standardized Oral Examination [SOE] portion is in a format we haven’t encountered during prior board exams.

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VLOG: COVID vaccine & a diary of my vaccination

Amanda Xi

Today’s inane image/video of the day:

References

On Stanford’s roll out [MIT Technology review]

On MGB’s roll out: article 1 [Boston Globe] and article 2 [GBH news]

If you’re curious about why I’ll be feeling better about my immunity to the virus after my second shot [I got the Pfizer vaccine, also known in the literature as the “BNT162b2 mRNA Covid-19 Vaccine”] here is the New England Journal of Medicine [NEJM] paper outlining the results of the phase 2/3 trials including 43,000+ individuals: “Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine.”

What’s in my backpack!? [you’ll NEVER guess the last item I reveal 🤔]

Amanda Xi

Today’s inane image/video of the day:

Image/video… all the same, right?!

Introduction

Inspired by all of the videos that delve into what’s in people’s purses or bags or backpacks, I thought I’d share with you what is in my daily backpack! I have a problem with wanting to have everything with me at all times [and yet, still find that I’m always missing something useful, e.g. I just figured out I don’t have acetaminophen readily available in my little medication bag], so I end up carrying a massive north face backpack [reminder to fellow healthcare workers – the 50% North Face coupon expires at the end of the calendar year; I’ve already used mine once and am considering buying this new backpack with the discount…] with me to work every day.

I had to do some digging to find the blog post, but I confirmed that I’ve had this backpack since 2012! Wow, it’s crazy to read an entry from so long ago…

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A day in the life of an intensivist (ICU doctor)

Amanda Xi

Today’s inane image/video of the day:

Introduction

As a premedical and medical student, I always wondered what an attending’s schedule the really looked like. Individuals that embark on this journey to becoming a physician are often reminded at each stage that “it gets better.” When I was a medical student starting on rotations, I frequently wondered when I would have an opportunity to really influence patient care. As an intern, I felt like I was making a difference in patient care, but lacked the experience and knowledge base to feel confident in my decisions. There were numerous moments of self-doubt when I started the anesthesiology part of my residency; after all, most medical students do not get real exposure to the complexities surrounding anesthetic care of a surgical patient.

Anyway, I digress. Long story short, at every stage of training, I wondered what the next one would look like and feel like. Now that I’m finally an attending, I can share my schedule and overall experience as an intensivist with all of you! Look out for a separate video/blog post on the anesthesiologist part of my job.

Super-detailed schedule breakdown

If you’re curious about an hourly look at my schedule, here’s an overview [in military time]:

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