Today’s inane image of the day:
Internship/residency were HARD. There were some REALLY low moments and some really tough scenarios that you face for the first time as a doctor-in-training. The hours are long and the work is tough. So… when I got an email that asked me to record a video about how I survived residency, it took me a little bit to reflect upon the experience and come up with 4 concrete things:
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There’s a stereotype that anesthesiologists are hiding behind the drapes trading stocks or doing sudoku puzzles, but that’s certainly not the reality of my job! I think it’s so important to share what the reality of the job is like and one reality of being an anesthesiologist is that it can be physically and mentally exhausting. Here are some of the reasons that contribute to this:
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If you’ve come to this page, it’s probably because you’re a 4th year medical student searching how to figure out how to excel at your residency interviews. I have had the experience of interviewing for anesthesia, preliminary medicine, and transitional year programs when I was a medical student [back then, it was in person] and also the experience of being an interviewer [in a virtual setting]. I tend to like to give a lot of unsolicited advice, so here I am again sharing 7 residency interview tips that I think will help you get to a successful 2025 Match season.
Here are the 7 tips:
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We receive feedback in numerous areas of our life. When training to become a physician, there are a lot of different timepoints where structured feedback is given. Sometimes that feedback is negative or critical. It never feels good to be the recipient of this type of feedback, but it is inevitable… none of us are perfect.
I recently received written feedback from my residents and while there were certainly positive comments, all I could do was focus on the negatives. I’d almost say I perseverated on the negatives. So I thought I’d do something productive with it… figure out the best ways to deal with this type of feedback when it comes and share it with all of you. Here’s what I came up with:
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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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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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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.
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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[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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When I started residency, I fully intended on joining a private practice group. But my residency and fellowship @mghanesthesia ended up changing my trajectory. Here are some reasons I stayed in academia:
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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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