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I am frequently asked by medical students whether the specialty of anesthesiology will have a future. I am asked if CRNAs/AAs will take all of our jobs. I am asked if robots or artificial intelligence will replace us. I am asked if the job market is saturated [thus pushing salaries down]. While I do not have a crystal ball, I *do* have a lot of opinions on this topic.
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Did you know that anesthesiologists can also get extra fellowship training to work as ICU doctors [also known as “intensivists”]? In this video, I share with you why the marriage of anesthesia and critical care makes sense.
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Back in January 2021, I posted about my plans for studying for the ABA Applied Exam [a.k.a. anesthesia oral boards, the-scariest-board-exam-ever, etc]. They were really involved and intense and lofty plans. Like any human, I did not actually follow through on all of them, but hey, all that matters is that I passed [cue applause, firework emojis]. Now, I figured it was a good time to impart all of my wisdom on you as you embark on your journey of tackling this beast of an exam.
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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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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 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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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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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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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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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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