4 downsides to being an academic physician (the dark side of academic medicine)

Amanda Xi

Today’s inane image of the day:

Click on the image above (or link below) to watch the video!

https://youtu.be/llazT8TSJRc

In a previous post/YouTube video, I discuss why I stayed in academic medicine. But with anything in life, where there are benefits, there are downsides. As a medical student, I remember reading and hearing about how academic medicine jobs included a lot of promotion pressures [to apply for professorship; which is why everyone is hustling/stressed to do research] and lower pay. This sounded like a terrible deal, so I never considered staying in academic medicine beyond residency [I knew I wanted training at an academic environment, but it didn’t seem like a good long-term career fit]. Fast-forward over a decade later and here I am… in academic medicine [cue: face-palm emoji]. So even though I heard about the potential downsides of an academic medicine job, I decided it was still a good fit for me.

The 4 downsides of being an academic physician that I go over in the video are:

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6 pieces of advice for pursuing a career in medicine

Amanda Xi

Today’s inane image of the day:

Click on the image above (or link below) to watch the video!

https://youtu.be/XdhEu-aSJ1k

I went to an anesthesia resident conference recently and was approached by students who had come across my blog or watched my YouTube videos. It reminded me that maybe some of the content I put out there is useful and inspired me to record this video. Here are the 6 pieces of advice for those pursuing a career in medicine:

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Advice for applying to anesthesiology for Match 2025

Amanda Xi

Today’s inane image of the day:

Hi there from the other side of the Match process – it’s worth the hustle! Also… excited to be partnering with Blue Laundry for a scrub cap giveaway on my Instagram page 9/19/2024-9/25/2024.

If you’ve landed on this page, I assume you are an anesthesiology residency applicant or soon-to-be one. Please make sure to review my 2024 Match blog entry as my goal with this entry is to build upon my thoughts from last year and offer additional insights/tools to be prepared for Match 2025.

The elephant in the room – anesthesiology is becoming more competitive

I don’t think I would have matched at MGH if I had to apply again today with my application from 4th year. I do think that I would have matched somewhere in anesthesiology based on my overall application, but maybe not. There’s some component of randomness to this process with how competitive the specialty has become.

The NRMP 2024 Main Residency Match data shows that there were zero unfilled spots for 2000 offered positions. When I matched into the specialty in 2015, there were 28 unfilled PGY-1 (intern) year spots and 37 unfilled PGY-2 (advanced) spots out of 1600 total offered positions (4% of total spots went unfilled). Also, notably, when I applied there were 1859 applicants for the 1600 offered positions, so at least 259 applicants went unmatched; in 2024, 3034 applicants applied for the 2000 total offered positions. That left 1034 applicants that did not match into anesthesiology. That’s a 5x higher unmatched rate than almost a decade ago when I matched. Things have certainly changed in the last decade.

If you want to see the slides from my August 2024 ASA presentation, they are available here: https://bit.ly/3zb9IdH

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New YouTube video: my 4AM morning routine

Amanda Xi

Today’s inane image of the day:

[I just wanted to point out that this video went live at 4am 🤣] 

I start most of my mornings at ~4am. I find that this is the best way for me to start the day to be productive and overall for my well-being. I think for a while I was in denial about being a morning person, but once I became an anesthesiologist, it became clear that my days were just *so much better* when I started them early. 

My 4am morning routine looks like this:

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How to study for the CCEeXAM – resources and other advice

Amanda Xi

Today’s inane image of the day:

Here’s proof that I actually did this thing!

It is no secret that ultrasound is a powerful tool for the anesthesiologist and intensivist. During residency, we achieve competence in using ultrasound for vascular access, regional anesthesia, and basic cardiac examination [both transesophageal and transthoracic]. When I was a resident, there were times when it was really challenging to get an ultrasound, which translated into feeling like my own skill was mediocre. Fellowship in critical care anesthesiology certainly helped me build upon my skill and clinical application of ultrasound has continued to advance my knowledge.

During my critical care fellowship, I opted to take the CCEeXAM® Examination of Special Competence in Critical Care Echocardiography. Mostly because someone else was paying for the certification and I thought that it could be a useful certification to possess. At the time, the exam had only been administered a few times; there were limited resources to study from and very sparse information on the internet on how to structure my studying or where to focus my attention.

Luckily, if you’re looking to make this ~$1,000+ [probably more like ~$2000-$3000 after you include the study resources below] investment in your clinical practice, I have some advice from my own experience and a recent test-taker’s experience to help guide your study plan.

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You were insufferable

Amanda Xi

Today’s inane image of the day:

Another gem from my London trip. Since this post is a reflection of my evolution over the years, I thought it appropriate to distill my essence through this image. These delightful treats brought me so much joy [as did the company I was with]; ultimately, this is the energy I hope I can consistently give.

I was recently reflecting on who I was during internship, residency, and fellowship. You might be wondering, “What does that even mean?”

There was a period in my life where I staunchly believed that people do not change. You are fundamentally who you are. There then came an era where I was less sure of this assertion. I started to waver in my belief as I watched my parents evolve. I noticed that my friends showed up in different ways over the years and during life events. I reflected on my own journey and who I was. I wondered if, maybe, people could change.

I’ve now come back full circle in my belief that people have a fundamental foundation… but the way that it is presented and shows up changes with the situation.

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Every moment of the day need *not* be productive

Amanda Xi

Today’s inane image of the day:

Another gem from my one-day adventure out to Western MA – I finally got to explore The Clark. The impressionist room is breathtaking and if it weren’t for rain, I would have probably spent hours exploring the grounds.

I spent the majority of my life feeling the pressure to “hustle.” That productivity was equated with my worth. If I wasn’t productive, then what purpose do I serve?

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Setting 2024 intentions: listening, curiosity, being healthy-ish, creativity, and anxiety spirals

Amanda Xi

Today’s inane image of the day:

Posing in a thoughtful manner during my fall trip to London.

Last week, I reflected on 2023. As sort-of-promised, I decided to set some 2024 intentions. I think that every single day is a new opportunity to set and achieve goals; I don’t think we need a designated time of the year to do these things. I have short-term, intermediate-term, and long-term goals that I set and review on a semi-regular basis. But the idea of intentions feels like the right approach for 2024; they are touchy-feely types of ideas that I’d like to work toward in the new year. There is no checkbox for these items… they are lofty ideals that I hope I can remind myself to embody throughout the year. Maybe my 2024 reflections post will be assessing how these intentions came into play [or didn’t!]. Who knows. Maybe there will be silence on the blog for almost a year again [let’s hope not].

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Reflections from 2023: my greatest achievement, travel, work boundaries and modern dating

Amanda Xi

Today’s inane image of the day:

When a beautiful fall weekend presented itself, I went on a roadtrip to Western Massachusetts. All the leaves had already fallen, but it was a beautiful hike nonetheless.

I keep telling myself I will get back into blogging regularly but the words don’t flow the way they used to. The further along in my career I get [and the older I get], the more it seems “risky” to pour my heart and soul out to the internet. Yet, it feels like there is a part of me I am not honoring by being silent. There is also something to be said about the loss of connection to those of you still reading my updates with anticipation and excitement [I appreciate you – I know you’re out there and support my writing endeavors].

This is by no means a declaration of more consistent writing in 2024, but a reflection that this space is an important one that I want to integrate into my life in a more consistent manner again.

A couple years ago in an effort to reflect upon a relationship ending, I started journaling on a regular basis. I’ve actually kept a journal/blog for most of my life, but consistency was never my strong suit. Or perhaps I should say frequency was never my strong suit since I consistently went back to it. Either way, a couple years ago, I picked up journaling and it stuck. As a result, I have my own written words/emotions/thoughts/feelings to reflect upon on an annual basis. As we near the end of 2023, I figured I’d share some the reflections I had from 2023.

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