emailrjnov@yahoo.com
- BRAIN TRANSPLANTATION? - 28 Mar 2024
- THE ANESTHESIA CONSULTANT NAMED THE #1 ANESTHESIOLOGY BLOG IN THE WORLD FOR 2024 BY FEEDSPOT - 7 Mar 2024
- AN ANESTHESIA STORY LIKE NO OTHER - 2 Mar 2024
New anesthesiology graduates know a great deal, and yet still have a lot to learn. What do you need to know before you start your first job following anesthesia residency? You already know the basic science facts, and you’ve done three years of cases with a faculty member next to your right elbow at every crucial moment.
But are you ready to work alone?
When an anesthesiologist finishes their formal training, he or she has a brain full of academic teachings, and has performed hundreds of anesthetics in a university setting while being supervised by faculty members.
Turn the page to the first weeks of an anesthesia career in a private or community practice, and the setting is different: The new graduate must work by themselves, without supervision, in a new and unfamiliar hospital, alongside surgeons and nurses they don’t know.
It’s the most difficult transition in an anesthesiologist’s career.
I learned a lot in my first year(s) in private practice. What follows are links to the columns I wrote to bolster the knowledge base of the new graduate. In essence, these are the points of wisdom I wish I’d known when I finished residency. These are the pearls not available in the standard textbooks:
10 WAYS PRIVATE PRACTICE ANESTHESIA DIFFERS FROM ACADEMIC ANESTHESIA
A discussion of the key differences between private practice and university anesthesia practice.
12 THINGS TO KNOW AS YOU NEAR THE END OF YOUR ANESTHESIA TRAINING
A summary of resources to prepare yourself to practice anesthesia outside of the academic setting.
AVOIDING AIRWAY DISASTERS IN ANESTHESIA
An airway disaster can cost your patient’s life, and radically alter the career of a young anesthesiologist. This column offers advice on how to stay out of an airway disaster.
12 TIPS ON BECOMING AN OUTSTANDING ANESTHESIOLOGIST
This column summarizes the qualities you’ll need to succeed as an anesthesiologist.
FIVE MINUTES . . . TO AVOID ANOXIC BRAIN INJURY
As an expert witness, I’ve seen dozens of cases of anoxic brain death cases. It only takes five minutes of botched anesthesia practice to cause anoxic brain injury, and this column offers advice on how to avoid becoming a defendant in a malpractice suit.
HOW TO WAKE UP PATIENTS PROMPTLY FOLLOWING GENERAL ANESTHETICS
You’ll become a better anesthesiologist over the decades. Based on my 30+ years of experience, this column give advice on how to wake patients quickly and with excellent airway maintenance.
10 TRENDS FOR THE FUTURE OF ANESTHESIOLOGY
What are next 30 years of your career going to look like? No one knows for sure, but this column discusses the current trends, and where they are heading.
ADVICE FOR PASSING THE ORAL BOARD EXAMS IN ANESTHESIOLOGY
You’ll have to pass the oral exam to become board-certified. Here I offer advice, based on decades of giving mock oral examinations to residents at Stanford.
SMOOTH EMERGENCE FROM GENERAL ANESTHESIA
Smooth emergence from anesthesia is important in every case, from a craniotomy to a tonsillectomy to a facelift. I offer advice from 30+ years of experience.
WOULD YOU GIVE AN NFL QUARTERBACK A PERIPHERAL NERVE BLOCK?
Regional anesthesia is touted by university regional anesthetic specialists. In the community, you will have to decide how to give informed consent regarding nerve damage, and who is at prohibitive risk for any incidence of nerve damage.
HOW DO YOU START A PEDIATRIC ANESTHETIC WITHOUT A SECOND ANESTHESIOLOGIST?
In residency, you have four hands available, because your faculty member is at your assistance. In private practice, you’ll have to learn to anesthetize children by yourself. This column gives advice on solo practice of pediatric anesthesia.
HOW TO PREPARE TO SAFELY INDUCE GENERAL ANESTHESIA IN TWO MINUTES
You’re young, you’re green, and the surgeon is in a hurry. This column gives pearls on how to start an anesthetic as quickly and safely as possible.
WHAT ONE QUESTION SHOULD YOU ASK TO DETERMINE IF A PATIENT IS ACUTELY ILL?
A nurse telephones you regarding one of your patients in the Post Operative Care Unit. What one question do you ask to determine if the patient is acutely ill or not?
KEEPING ANESTHESIA SIMPLE: THE KISS PRINCIPLE
In university training, professors often attempt to make anesthetics interesting and unique. In private practice, a key objective is to keep anesthetics simple, i.e. following the KISS principle, or Keep It Simple Stupid.
LANDING THE ANESTHESIA PLANE: WHEN SHOULD YOU EXTUBATE THE TRACHEA?
Your work is not finished until you’ve extubated the trachea safely. What does the medical literature advise regarding the proper time and techniques regarding extubation, particularly in difficult airway patients?
Good luck with your first job! Keep reading, and don’t be afraid to ask your senior colleagues for advice and guidance.
