Insight into anesthesiology.

We have a great group of research assistants who are taking a gap year before starting medical school. Recently they asked me some great questions about medicine, and that gave me the idea to write a series of posts to provide insight into the different medical specialties. Let’s start with mine!

What is anesthesiology?

While it’s true that a lot of what we do involves altering pain perception and consciousness, we also assist the body in maintaining homeostasis during iatrogenic alterations of anatomy and physiology (a.k.a. Surgery or medical procedure).

The name anesthesiology is actually too narrow to fully describe our actual practice. Perioperative medicine is a more accurate term because we are the interface between primary care and acute care that allows so many other specialties to exist and advance, eg. laparoscopic or thoracoscopic surgery.

Physician anesthesiologists assess patients preoperatively to ensure they can tolerate the physiologic changes that come with receiving anesthetics and the surgery itself. We carry out that plan intraoperatively, while keeping an eye out for your postoperative safety and comfort.

Is anesthesiology the right specialty for me?

People who go into anesthesiology typically sound like this:

“My favorite subjects are physiology and pharmacology. I love performing procedures and want to be an airway expert. I love the instantaneous physiologic results of my pharmacologic treatments. I like the acuity of care that is required in anesthesiology. I am calm under pressure and good at multi-tasking. I like gadgets, gizmos, and tech. I like the team aspect of working in the operating room. I’m okay with the lack of longitudinal relationships with patients.”

If any of that sounds like you, then anesthesiology might just be right for you.

How do I become an anesthesiologist?

First, you’ll need a bachelor’s degree to get into medical school. Then you’ll need to match into an anesthesiology residency program, graduate from medical school, and complete residency.

Anesthesiology residency is broken into two main parts: the PGY-1 (intern) year and then the three years of clinical anesthesiology training (PGY 2-4 = CA 1-3).

The intern year (PGY-1) can be internal medicine, general surgery, or a mixture of the two if you match into a categorical residency program. Essentially this year is when you learn how healthcare works and how to manage patients outside of the OR, eg. acute kidney injury, heart attacks, cellulitis, diabetic ketoacidosis, traumas, etc.

The CA-1 year (PGY-2) is when you learn the basics of anesthesiology. The CA-2 year (PGY-3) is a dive into the subspecialties of anesthesiology: regional, cardiothoracic, obstetrics, pediatrics, pain, neuro, critical care. Finally the CA-3 year (PGY-4) is putting it all together, learning non-operating room anesthesia (NORA), and managing OR resources.

Graduates of residency programs can go on to practice anesthesiology independently. Some people, such as myself, train for an additional year as a fellow (PGY-5) to become an expert in a subspecialty, eg. RAAPM (regional anesthesia & acute pain medicine).

Until next time.

I hope I was able to give you some additional insight into anesthesiology. I plan to interview colleagues of mine in other specialties and share their insights on their specialty with you all in the future.

Email me or comment below with any additional questions.

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