WHY DOES ANYONE DECIDE THEY WANT TO BECOME AN ANESTHESIOLOGIST?

A question anesthesiologists are commonly asked is, “Why did you decide to become an anesthesiologist?

Let’s assume a young man or woman has the discipline and intellect to attend medical school. Once that individual gains their M.D. degree, they will choose a specialty from a long line-up that includes multiple surgical specialties (general surgery, orthopedics, urology, neurosurgery, cardiac surgery, ophthalmology, plastic surgery, ear-nose-and-throat surgery), internal medicine, pediatrics, family practice, dermatology, radiology, invasive radiology, radiation oncology, allergy-immunology, emergency medicine, and anesthesiology.

Why choose anesthesiology? I offer up a list of the reasons individuals like myself chose this specialty:

  1. Anesthesiologists do acute care rather than clinic care or chronic care. Some doctors enjoy sitting in a clinic 40+ hours a week, talking to and listening to patients. Other doctors prefer acute care, where more exciting things happen moment to moment. It’s true that surgeons do acute care in the operating room, but most surgeons spend an equal amount of time in clinic, seeing patients before and after scheduled surgical procedures. Chronic care in clinics can be emotionally taxing. Ordering diagnostic studies and prescribing a variety of pills suits certain M.D.’s, but acute care in operating rooms and intensive care units is more stimulating. It’s exciting controlling a patient’s airway, breathing, and circulation. It’s exciting having a patient’s life in your hands. Time flies.
  2. Patients like and respect their anesthesiologist, and that feels good. Maybe it’s because we are about to take each patient’s life into our hands, but during those minutes prior to surgery, patients treat anesthesiologists very well. I tend to learn more about my patients’ personal lives, hobbies, and social history in those 10 minutes of conversation prior to surgery than I ever did in my internal medicine clinic.
  3. An anesthesiologist’s patients are unconscious the majority of time. Some anesthesiologists are attracted the this aspect. An unconscious patient is not complaining. In contrast, try to imagine a 50-hour-a-week clinic practice as an internal medicine doctor, in which every one of your patients has a list of medical problems they are eager to tell you about.
  4. There is tremendous variety in anesthesia practice. We take care of patients ranging in ages from newborns to 100-year-olds. We anesthetize patients for heart surgery, brain surgery, abdominal or chest surgeries, bone and joint surgeries, cosmetic surgery, eye surgery, urological surgery, trauma surgery, and organ transplantation surgery. Every mother for Cesarean section has an anesthetist, as do mothers for many vaginal deliveries for childbirth. Anesthesiologists run intensive care units and anesthesiologists are medical directors of operating rooms as well as pain clinics.
  5. Anesthesiologists work with a lot of cool gadgets and advanced technology. The modern anesthesia workstation is full of computers and computerized devices we use to monitor patients. The modern anesthesia workstation has parallels to a commercial aircraft cockpit.
  6. Lifestyle. We work hard, but if an anesthesiologist chooses to take a month off, he or she can be easily replaced during the absence. It’s very hard for an office doctor to take extended time away from their patients. Many patients will find a alternate doctor during a one month absence if the original physician is unavailable. This aspect of anesthesia is particularly attractive to some female physicians who have dual roles as mother and physician, and choose to work less than full-time as an anesthesiologist so they can attend to their children and family.
  7. Anesthesia is a procedural specialty. We work with our hands inserting IV’s, breathing tubes, central venous IV catheters, arterial catheters, spinal blocks, epidural blocks, and peripheral nerve blocks as needed. It’s fun to do these procedures. Historically, procedural specialties have been higher paid than non=procedural specialties.

What about problematic issues with a career in anesthesia? There are a few:

  1. We work hard. Surgical schedules commonly begin at 7:30 a.m., and anesthesiologists have to arrive well before that time to prepare equipment, evaluate the first patient, and get that patient asleep before any surgery can commence. After years of this, my internal alarm clock tends to wake me at 6:00 a.m. even on weekends.
  2. Crazy hours. Every emergency surgery—every automobile accident, gunshot wound, heart transplant, or urgent Cesarean section at 3 a.m. needs an anesthetist. Working around the clock can wear you out.
  3. The stakes are high if you make a serious mistake. In a clinic setting, an M.D. may commit malpractice by failing to recognize that a patient’s vague chest pain is really a heart attack, or an M.D. may fail to order or to check on an important lab test, leading to a missed diagnosis. But in an operating room, the malpractice risks to an anesthesiologist are dire. A failure in properly insert a breathing tube can lead to brain death in minutes. This level of tension isn’t for everyone. Some doctors are not emotionally suited for anesthesia practice.
  4. In the future, anesthesia doctors may gradually lose market share of their practice to nurse anesthetists. You can peruse other columns in this blog where I’ve discussed this issue.
  5. Anesthesiologists don’t bring any patients to a medical center. In medical politics, this can be problematic. Anesthesiologists have limited power in some negotiations, because we can be seen as service providers rather than as a source of new patient referrals for a hospital. Some hospital administrators see an anesthetist as easily replaced by the next anesthetist who walks through the door, or who offers to work for a lower wage.

The positive aspects of anesthesiology far outweigh these negatives.

Akin to the Dos Equis commercial that describes “The Most Interesting Man in the World,” I’d describe the profession of anesthesiology as “The Most Interesting Job in the World.”

And when you love your job, you’ll never work a day in your life.

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Published in September 2017:  The second edition of THE DOCTOR AND MR. DYLAN, Dr. Novak’s debut novel, a medical-legal mystery which blends the science and practice of anesthesiology with unforgettable characters, a page-turning plot, and the legacy of Nobel Prize winner Bob Dylan.

KIRKUS REVIEW

In this debut thriller, tragedies strike an anesthesiologist as he tries to start a new life with his son.

Dr. Nico Antone, an anesthesiologist at Stanford University, is married to Alexandra, a high-powered real estate agent obsessed with money. Their son, Johnny, an 11th-grader with immense potential, struggles to get the grades he’ll need to attend an Ivy League college. After a screaming match with Alexandra, Nico moves himself and Johnny from Palo Alto, California, to his frozen childhood home of Hibbing, Minnesota. The move should help Johnny improve his grades and thus seem more attractive to universities, but Nico loves the freedom from his wife, too. Hibbing also happens to be the hometown of music icon Bob Dylan. Joining the hospital staff, Nico runs afoul of a grouchy nurse anesthetist calling himself Bobby Dylan, who plays Dylan songs twice a week in a bar called Heaven’s Door. As Nico and Johnny settle in, their lives turn around; they even start dating the gorgeous mother/daughter pair of Lena and Echo Johnson. However, when Johnny accidentally impregnates Echo, the lives of the Hibbing transplants start to implode. In true page-turner fashion, first-time novelist Novak gets started by killing soulless Alexandra, which accelerates the downfall of his underdog protagonist now accused of murder. Dialogue is pitch-perfect, and the insults hurled between Nico and his wife are as hilarious as they are hurtful: “Are you my husband, Nico? Or my dependent?” The author’s medical expertise proves central to the plot, and there are a few grisly moments, as when “dark blood percolated” from a patient’s nostrils “like coffee grounds.” Bob Dylan details add quirkiness to what might otherwise be a chilly revenge tale; we’re told, for instance, that Dylan taught “every singer with a less-than-perfect voice…how to sneer and twist off syllables.” Courtroom scenes toward the end crackle with energy, though one scene involving a snowmobile ties up a certain plot thread too neatly. By the end, Nico has rolled with a great many punches.

Nuanced characterization and crafty details help this debut soar.

Click on the image below to reach the Amazon link to The Doctor and Mr. Dylan:

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LEARN MORE ABOUT RICK NOVAK’S FICTION WRITING AT RICK NOVAK.COM BY CLICKING ON THE PICTURE BELOW:

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15 thoughts on “WHY DOES ANYONE DECIDE THEY WANT TO BECOME AN ANESTHESIOLOGIST?

  1. I am currently getting a Bachelor in Health Science for anesthesia. I am curious to know, if I decided to become a CRNA how much longer would I have to go to become a Anesthesiologists?

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  2. I just finished my Veterinary Anesthesiology Residency, and I wanted to tell you that I enjoy your blog. Although many aspects are quite different, it is very interesting to read. Thanks!

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  3. What about anesthesiologist assistants? What’s the difference between them and the real anesthesiologist (besides the obvious part that an anesthesiologist supervises AA)?
    And also, what courses should I take during undergrad for AA?

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    1. An anesthesiologist assistant (AA) is a non-physician anesthesia provider qualified by advanced education and training to work cooperatively with an anesthesiologist in developing and implementing the anesthesia care plan. An anesthesiologist assistant works under the medical direction of an anesthesiologist as a part of the Anesthesia Care Team (ACT), just as a CRNA can work with an anesthesiologist as part of the ACT.

      At this time there are sixteen states, as well as Washington D.C. and the Veteran’s Affairs Medical System, in which anesthesiologist assistants are able to work.

      There are currently ten anesthesiologist assistant training programs in the United States, all of which offer degrees at the Master’s level. Approximately 97% of currently practicing anesthesiologist assistants hold a Master’s degree (some early anesthesiologist assistant graduates held Bachelor’s degrees). All newly credentialed and future anesthesiologist assistants must complete an accredited Master’s program for anesthesiologist assistants. (all information from Wikipedia, “Anesthesiologist Assistant”).

      An MD anesthesiologist has an MD and at least 4 post-graduate years of residency, significant extra training that exceeds that required to become an anesthesiologist assistant.

      I would suggest you identify the anesthesiologist training program(s) you might be interested in, and contact them to ask them what undergraduate curriculum is required for admission.

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  4. Hello sir, I am a final year undergraduate student of medicine from India who is very much interested in anesthesiology. Soon I will complete my course and start the compulsory rotatory internship after which I will have to appear for post graduate medical entrance exams to secure my junior residency. Anesthesiology is not a much sought after field for post graduation in my country, at least that’s what I feel. So my question to you is- did you choose anesthesia by choice or chance? And if, by choice, how would you rate your professional satisfaction?
    -An anxious undergraduate.

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    1. I am no expert on the medical student career choices in India, nor do I know details on the state of anesthesiology practice throughout India.
      My professional satisfaction is high, and I would strongly recommend the field of anesthesia if it interests you. Good luck!

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  5. Does it matter what my major is to become an anesthesiologist? Or do I have to go pre-med for all four of my undergraduate years?

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    1. Your college major can be in any subject. The first project is to be admitted into medical school following college. Your major in college doesn’t matter, but you must take the required pre-med classes during those college years, no matter what your major is. After four years of college and four years of medical school, then you attend four years of anesthesia residency (counting your internship year).

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  6. Hello,
    What do you recommend a junior in high school to do until I graduate? I’m currently in the process of getting my AA also so when I graduate form high school I will start my undergrad years as a junior. So far I have shadowed a doctor in the emergency department. What would you recommend I do that colleges would like? Also I was wondering, how hard is medical school? How hard is the road to become an anesthesiologist ? Every time someone asks me what I want to do and I say I want to study medicine, they ALWAYS go on to say, “it’s going to be so hard.” I’m really starting to get nervous about my decision but I also really want to study medicine. Also I’ve heard a lot about how I don’t need to have a major. Is that true? And if not, what do you recommend I major in? And lastly, can you describe a little what premed was like?

    Thank you

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    1. What do you recommend a junior in high school to do until I graduate? TAKE THE CLASSES YOU LIKE. YOU’LL NEED TO ENJOY AND SUCCEED IN SCIENCE AND MATH CLASSES IF YOU PLAN A CAREER IN MEDICINE.
      I’m currently in the process of getting my AA also so when I graduate form high school I will start my undergrad years as a junior. So far I have shadowed a doctor in the emergency department. What would you recommend I do that colleges would like? BESIDES GOOD GRADES AND STANDARDIZED TEST SCORES, FOLLOW YOUR HEART AND TAKE PART IN THINGS YOU HAVE A PASSION FOR. SHOW COLLEGES THAT YOU HAVE DISCIPLINE AND ARDOR FOR SOMETHING NON-ACADEMIC THAT ALSO SINGLES YOU OUT AS A UNIQUE INDIVIDUAL.
      Also I was wondering, how hard is medical school? YOU’LL GO TO CLASS, LAB, OR STUDY MOST OF EVERY DAY THE FIRST TWO YEARS. THE SECOND TWO YEARS ARE HOSPITAL AND CLINIC ROTATIONS, AND YOU MAY WORK 60 – 80 HOURS A WEEK, BUT YOU’LL BE EXCITED TO LEARN MEDICINE AT LAST.
      How hard is the road to become an anesthesiologist ? FOUR MORE YEARS AFTER MEDICAL SCHOOL, AGAIN AT 60 – 80 HOURS PER WEEK, WITH MULTIPLE NIGHTS WORKING ALL NIGHT IN BUSY HOSPITALS ANESTHETIZING EMERGENCY SURGERIES.
      Every time someone asks me what I want to do and I say I want to study medicine, they ALWAYS go on to say, “it’s going to be so hard.” I’m really starting to get nervous about my decision but I also really want to study medicine. Also I’ve heard a lot about how I don’t need to have a major. Is that true? And if not, what do you recommend I major in? YOU DON’T HAVE TO PICK A MAJOR UNTIL COLLEGE. MOST MD’S MAJORED IN A SCIENCE, BUT SOME MAJORED IN PHILOSOPHY OR RELIGION, ETC, AS LONG AS THEY ALSO TOOK ALL THE PREREQUISITE SCIENCE AND MATH CLASSES.
      And lastly, can you describe a little what premed was like? SEE ABOVE. YOU’LL WORK HARD TO GET FINE GRADES, APPLY TO MULTIPLE MEDICAL SCHOOLS, AND HOPEFULLY BE ACCEPTED. GOOD LUCK!

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