First Week of Anesthesiology Residency - How it went for me!
ฝัง
- เผยแพร่เมื่อ 19 มิ.ย. 2024
- I just finished my first week of anesthesia residency, which was both exciting and exhausting! Here I reflect on my cases, highlights, challenges, and how I’m studying.
📫 Read my anesthesiology trainee newsletter: soapnotes.substack.com/
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🩺 Essential equipment I carry in the hospital: a.co/8Zdv42l
0:00 Start
0:54 Cases
1:40 Highlights
5:20 Challenges
6:22 Study habits
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Find Max Feinstein, MD online:
Instagram: @MaxMFeinstein
Twitter: @MaxMFeinstein
Website: www.MaxFeinsteinMD.com
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Music
Subtle Swagger by Ron Gelinas Chillout Lounge | / atmospheric-music-portal
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Creative Commons Attribution 3.0 Unported License
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The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional.
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#Anesthesiology #Residency #MedicalSchool - วิทยาศาสตร์และเทคโนโลยี
Really appreciate the videos Dr. Feinstein.
please keep uploading videos about this beautiful specialty, so we can learn more about it and make things clear to those who are interested in anesthesiology as a future career in medicine.
Thanks Fouad, I appreciate the kind words and plan to keep uploading more videos about anesthesia!
I recently had an acl graft surgery. Going in I was nervous as hell. That 2 mg of versed really helped. Thankful for anesthesiologists like you guys!
Versed is really great for anxiety! Glad you ended up having a positive experience.
Love your videos man! I'm an MS2 strongly considering anesthesia and your videos are a big help. Looking forward to tracking your journey through residency and your evolving thoughts on the specialty!
Thanks Kamron! Let me know if you have any questions or anything along the way. Anesthesia the best and you have a great career ahead of you!
Max Feinstein, MD appreciate it! Will do :)
Thank you so much for including us and letting us learn through you. It is great to learn how IM had so many notes and the rounding time vs. to-do list. Thank you for your time. Would you be able to talk about what the anesthesia field is known for (lack of notes like you already said, the risk of a patient dying due to the anesthetics, if it has a reputation for being boring, how high risk the speciality is, how strong personalities in the OR can be to work with, good work/life balance, how often you're actually scared and don't know what to do, if it's a good field if you like teamwork or being a part of a team or are you just off by yourself, etc.) please? Thank you so much!!!
Hi Kate, I'm glad you enjoyed the video and I really appreciate the feedback! These are great questions you brought up and I will address them in future videos. I have recorded an interview with one of the anesthesiology attendings at my hospital in which he touches on some of the topics you brought up- should have that video posted in the next month or so! Please let me know if you have any other questions that I can address and I'll try to include them in future videos.
@@MaxFeinsteinMD Thanks so much Max for your response! Thank you for saying they are good questions! :) I am glad that some of them will be in the interview with the attending and in later videos! I appreciate it so much! Thank you!
Great video! Thanks a lot for making this!!
This is awesome thanks doctor I was looking for this for a long time on TH-cam.. All the best.
Thank you, glad you enjoyed!
I laughed out loud at the part with the IM intern! I loved how his head was bobbing like he was about to fall asleep
Barely needed to act-- it was all too real and too recent lol
@@MaxFeinsteinMD what books do you recommend for learning about the basics of anesthesiology if you want to learn about it from the perspective of doctors not nurses?
@@MaxFeinsteinMD where can I find a multicolored pen?
Hi Dr. Feinstein I'm a M2 and I'm very much interested in Anesthesiology! Thanks for your video :) I'm gonna try to do well on my Step 1 so I can hopefully match!
It's great that you've got an early interest in anesthesiology! Glad you enjoyed the video. Best of luck with Step 1 and your journey to anesthesia!
Nailed it! Anesthesia Rules!
Dr. Max, my first time seeing your video and they are so well done. Having 'gone under'' 3 times before, I have a deep fascination with anesthesiology, the tools. meds, the HUGE responsibility that you are taking on. I am a retired Advanced EMT and loved (and was actually pretty good at) doing field intubations, as well the in-hospital ones while going through my training. To this day I am still am a Mac blade guy and always had very good luck with them versus the Miller blade. I still remember vividly my first successful field 'tube' on my own, it went exactly as we were trained on it. Doing tubes in the back of an ambulance isn't always so well lit and a ton of room, but it was a highpoint in my 25+ years in EMS.
Hi Dan thanks for the nice feedback! I have only gone under once (as an adult) and agree the experience was really fascinating. Crazy to just have a period of time of my life deleted from my consciousness!
My initial interest in medicine stemmed from emergency responders, leading me to do ride-alongs in ambulances when I was in highschool. Loved the experiences and really admired the EMTs and paramedics. Can easily see how intubating in the field, especially an ambulance, would be really challenging. We get spoiled with ideal conditions in the OR!
@@MaxFeinsteinMD So, are you a Mac or Miller type of guy?
@@danmcguire7728 It's probably too early in my career to say! Right now I've done more intubations with a Mac blade and for that reason am more comfortable with it, but I'm getting my Miller numbers up and slowly getting better. I don't have a preference yet... we'll see!
@@MaxFeinsteinMD Do you have a preference now that more time has passed? I have only used mac blades so far.
Fun stuff:)
Love the aspect of less paperwork
Btw, how long does typical day of anaesthesia resident last?
your videos are so entertaining, thank you!
Thanks so much!
Hi Max! Love your videos! I'm curious though. How do you guys do open hernia repair under MAC sedation? We usually do it under neuraxial anesthesia here in Philippines :)
Thanks for the amazing content!!
I am starting an internship in Anesthesiology very soon as a medical student and was wondering how go prepare for that. Would going through all of Pharma be a good start? I only have 2 weeks left before the start of this internship and was wondering how to prioritize my prep hours..!
Hi thanks for the nice feedback! I made a video recently on how to prepare for a rotation in anesthesiology, so check that out for my recommendations!
This was fantastic, you got my Sub on the first video i watched, nice
Thanks for the feedback and subscription! Glad you enjoyed the video.
Can you do a video specific to anesthesia concerns for patients with mitochondrial disease
Hi! Thank you for the video!! I am considering to become an anesthesiologist after the medical school, so I want to ask you, What were the main reasons for you, to become an anesthesiologist? Thank you in advance, greetings from Perú :)
Good luck in your career you are so methodical
Thank you! Yes, being methodical is an important way to keep patients safe.
More update videos like this!
Same as you im on my 6 month anesthesiology residency
Hi Doctor Feinstein I always enjoy your videos,I have a question if you don't mind im a somewhat apprehensive 68 year old patient and will soon be having a colonoscopy performed and I know they have to put me under for this should I be at all concerned with this,I only wish you were here to be my anesthesiologist take care keep making these awesome videos.
Hi Steve, happy to address your question. In general, the level of concern that an anesthesiologist will have about giving a patient anesthesia for a colonoscopy (or any procedure) will be a function of the complexity of the procedure, the risks related to the procedure, and how compromised the patient's health is before the procedure begins. Since I don't know the details of your medical history or your procedure (there are many reasons to do a colonoscopy) I can't comment specifically on the risks of it, but I would highly encourage you to share your concerns with your anesthesiologist and s/he will be able to address them and help you feel comfortable. If your question is specifically about the safety of the anesthesia medications, what I tell patients is the following fact: the likelihood of having a life-threatening event from the anesthesia medications is lower than the likelihood of dying in a car crash on your way coming into the hospital.
I'll also say that I underwent anesthesia for a procedure that is pretty similar to your colonoscopy, and I was quite anxious. It's very normal to feel that way, but definitely worth bringing up with your doctor. I hope that is helpful!
Have you heard of any Anki Decks that cover the basics of Baby Miller by chapter? In intern year now and would love to find a resource like the Zanki deck thst existed for Step studying...
Hi Nate, there aren’t any zanki equivalents for anesthesia... yet. I’ve seen on Reddit and heard from med students that there are quite a few people interested in making one. I wouldn’t be surprised if we see one soon.
Yep u can tell your 100%into your specialty. U all ready have good habits. Your so interesting.
Thanks Sherry! I do love anesthesiology.
I am 1st year Anesthesiology residency nice video
How many cases do you have in the main OR in a day? :) Thanks for making this video.
In the ORs I've been doing 3-4 cases each day, but I also spent a day in the endoscopy suite where we did 7 or so cases!
@@MaxFeinsteinMD Nice, thanks for the reply!
Your first week of residency video is informative, interesting and FUNNY, bro.
Thanks man glad you enjoyed the video!
I want to become an anesthesiologist I just finished one year of college. And I don't have an advisor to tell me what classes I should be taking in order to complete the course of becoming an anesthesiologist. Besides 4 years of medical school what classes should I be taken in college.
Hi Dr Max, I'm sure you get asked this a lot, but I am in med school right now, and really leaning toward anaesthesia, but there is the issue of CRNA encroachment that looms large over the specialty. Do you see this as a big issue, or is it just much ado about nothing?
Hi ActuarialNinja, this is an important topic and I'm glad you're thinking about it at this early stage in med school. So just to zoom out a bit, midlevel practitioners are present in many (most?) specialties, so anesthesia isn't unique in that sense. That's been a trend in medicine for a long time and I'm sure will continue that way. Specifically, the trend is finding less expensive ways to deliver medical care, and mid-level providers help answer that question by doing more of the bread-and-butter work in their respective fields. Going back to anesthesia, that means doing a lot of the ASA 1-2 cases (ie. patients aren't very sick at baselines) and also mostly not doing subspecialty work (eg. cardiac anesthesia, regional, OB, liver transplant etc). What that practically means for anesthesiologists is that it's important to figure out a way to distinguish yourself from a CRNA, which for a lot of people means subspecializing. For other people, the answer to that might be getting involved with hospital committees, clinical research etc.
Overall, I don't think this is an existential crisis for anesthesiologists, but it is important to make sure your career path builds in reasons for hospitals to hire you as an MD and not replace you with a CRNA.
@@MaxFeinsteinMD that's a really thoughtful response. Thanks!
Great video! Did you learn to directly intubate with larnyngoscopi during internship? Did you also learn how to handle the ventilatorn and all it's functions during internship, or did you teach yourself that during the first day?
Thanks for the nice feedback! I first began learning how to intubate when I was a 4th year medical student, under very close attending supervision. My month-long anesthesia rotation during intern year was actually canceled due to COVID, so then I really got to start honing my intubation skills in the beginning weeks/months of CA1 year. I still do periodically struggle with an intubation and need to ask for help, so I still have more skill to develop.
As far as ventilator management, I had read quite a bit about it before I started CA-1 year. We've also received a lot of lectures and done simulations on management. But then being in the OR every day, I very quickly got comfortable with the basics, say within 1-2 weeks.
@@MaxFeinsteinMD Interesting! Thank you for the lenghty answer!
@@MaxFeinsteinMD Do you have a recommendation for a high yield resource on ventilator settings?
Thanks!
Thanks for watching!
What would you say is the general knowledge level of most first week residents in terms of anesthesiology? I'm sure most students, at most, had an elective in it, but that's about it. Do programs such as yours require you to know a general amount? Or is it safe to say the step 2 level of medicine is ok and you won't know much until you start residency.
I’d say that interns going into anesthesia are generally pretty motivated to study anesthesia during intern year so that once they hit the OR, they have a good foundation regarding the basics. That said, a lot of the procedural skills and workflow aren’t really amenable to being learned anywhere other than in the OR, so there’s a lot of knowledge that people start to accumulate during the first couple months of anesthesia.
Can someone be like my guide lol. Wanted to be an anesthesiologist for about 7 years now and I’m a junior in highschool. Just need someone to chat with so I can get some ideas of what to do and how to become an anesthesiologist.
Feel free to message me on Instagram if you'd like!
Subbed liked your style my guy
Thank you, I appreciate that!
Just getting into high school and have been thinking about doing this for a while now any tips or things I should know?
Study hard, do your best in school, and also pursue hobbies outside of school so that your life isn’t just about your career!
What do think is important to build your resume for applying to anesthesiology residency? What kind of research? Thank you!
Hi Kali, in my opinion the two most important things you can do to build a strong resume for anesthesiology are: 1) Demonstrate an interest in anesthesiology, even if it's just a couple of rotations later on in medical school 2) Do the best you can in your core rotations, as general principles in medicine, surgery, and pediatrics are essential to understand in order to do anesthesiology well.
As far as research goes, I don't believe it's a prerequisite for getting into any particular residency program. That said, if you enjoy research, I'd say do your research in anything that interests you! That's the most important way to make sure you actually stay interested in the research and follow through on it (projects can often drag on for months or years, so sustained interest is important). It's a bonus if the research is in anesthesia, but honestly a lot of people discover anesthesia late during medical school which program directors understand. I did some anesthesia research, but also infectious diseases and bioethics just because they interested me.
Hi Max had you ever had blind patient? When I had my spine done yeah I know what you were talking about the tube. And the next day they took it out of me. After I woke up from surgery mine was an 12 hour,and long one. ThoughtI ask. Like it all.
Hi Rebecca, I've actually never taken care of a patient who is blind (or deaf for that matter). I'm sure I will eventually!
@@MaxFeinsteinMD ok good if you do tell me or us how it went. Like your videos. Thanks. I’m sure you will. And since your a kind person they will be ok. As long they are in good hands like Iwas with my last surgery.
Do you use any pre made decks?
No, I don't know of any that are generally well-regarded. I'd share my own but I know for sure that it's filled with irrelevant stuff that I'll only figure out is relevant months down the road as I learn more.
What is direct line? I recently had kidney stone surgery and they didn’t give me a cannula. Later I asked my wife about it and she said they intabated me. So when I went back to get the stint out I asked the doctor. He said he didn’t fully intabate me so I was wondering what did he do? Would it be a breathing tube or what? I am just curious. Anesthesiology is interesting to me. Thanks
Hi David, *direct laryngoscopy is when we use a special piece of equipment to look into someone's mouth and see their vocal cords (or other structures very close by). Once we do that, we're able to place a breathing tube.
It's possible that you had a breathing device called a "laryngeal mask airway" (LMA for short) placed into your mouth when you had the stent removed. That goes in your mouth and helps you breathe, but doesn't go as far as an endotracheal tube (intubation). There are pros and cons to LMA vs. endotracheal tube, it really just depends on the specifics of the surgery and the patient.
Hope that helps!
What classes would you suggest for a premed student who wants to do anesthesiology?
Hi Ashley, I actually just uploaded a video with suggestions for premed students! The short answer is to do the required prerequisites for medical school, and then major it whatever subject seems interesting to you!
How many hours did you work at the hospital and then how many would you say you spend studying nightly ?
I had relatively light weeks in terms of hours worked during my first month (I'm currently on my 5th week as of replying to you). On average, I worked about 50 hours/week. This will get into the 60-70hr/week range as I gain more knowledge/skill/independence and get more call responsibility. However, night studying is at a maximum-- I have been studying essentially from the time I get home to when I go to sleep, minus a little bit of time to have dinner and exercise. There is a *ton* to learn for anesthesia!
@@MaxFeinsteinMD Wow 60-70 hrs/week + studying all night is a lot. Is that regular for most anesthesia residencies? Those are almost surgeon hours sounds no?
Thank you for giving us a 👁👁
into what you and others do. Simply enlightening and informative.
👏😁
Thanks again!
Lord bless you and your days work keep warm
Thank you!
Hi Dr Max
My name's Eric from Oregon I live on the North Oregon Coast in Seaside
We have a rural 30 bed Hospital were we get awesome care from CRNA I have a chronic condition from Birth call CP or Cerebral Palsy
I think I have a mild case as cases go. I loved the video on the rating scale that you use I most likely would guess to be a 3 to 4 out of the. Gate LOL
I wanted to share some future video IDEAS.
I wanted to know the difference between MD and CRNA I know the basic difference but not in terms of ansisthia it self both excellent fields
Also
I had several great examples to look into medicine Iam curious who has influenced you on your journey into medicine?
Listening to you I can see and feel your giving spirit I can see the compassion in your eyes into your heart and that is such an awesome quality to have never loose that.
This is so important in medicine and. In your field
I noticed that the last time I was in the OR they used propofal to put me under and I felt so good when I woke. Up is this a common reaction for someone in my case with a chronic condition?
I love the fact you are into knowledge
Maybe this is something you could look into I know pain management is a specialty are you can study
I take oral pain meds as needed by I work FT as a transportation dispatcher and have to be awake and alert and Iam not to excited when I have to take it
I was hoping people can be treated with anesthesia meds for pain that have longer good outcomes I. Know you can't give medical advice but the positive outcome got my attention.
In the past I have been a case study volunteer for our local medical school Oregon Health and Sciences University when I was a pediatric orthopedic patient I got to evaluate each ones bed side manner and it was great and this is so so important.
I have fast become a fan of your channel and look forward to following your life and medical journey.
Thanks for your time
All the best
Eric Barton
New Fan
Seaside Oregon
Uh dude,If you were giving the guy 1 or 2 mg. Of Versed. Was that after you gave him the midazolam in that midazolam syringe?? Just wondering.lol.
Versed is a brand name. It is midazolam
hey doctor feinstein, can I ask how old you are?
All days learning days
Checking your mental physical break point
Yes there is a lot of learning! I do have to say that medical school was good preparation for understanding my mental/physical limits for absorbing new information day after day for weeks/months/years.
@@MaxFeinsteinMD 👍🏿👍🏿👍🏿
Awesome. Gotta love dropping the mic with that annoying pen. Greatness.
So glad to have that pen out of my life LOL
are you the best cas crispR student in the universe?
Can you please do an addendum life say a damn life with you a day in the life
Haha interesting idea, will consider it!
Yeah closed Caption ..👍
I always use it when I watch other videos, so I make sure to have it on mine!
Hhhhhhh ill pick anesthesiology just to avoid the paper work
hilarious and inspiring
Check out "
Have u ever seen a malignant hyperthermia happen in your IR
No I have not, however we did have malignant hyperthermia training early on in residency and we have carts with treatment supplies readily available in the OR clusters.
@@MaxFeinsteinMD Dantrolene, right?
@@user-jb2lk8jn4t Yes, that's right!
At dental hey story. Ask. Chair
Max do you guys the butcher to take the job? Do you guys do blood draws at the hospital I like the finger prick you should just say that it's like a bun and then you have a red thing a purple thing collect surviving he put a machine
I’m not sure what this means
24 hour Kostis I want to make a video of that please 24 hour call shift
how much anatomy knowledge should an anesthesiologist know?
Hi Shahad, it's important for anesthesiologists to be familiar with anatomy generally speaking so we understand what is happening (and what can go wrong) with the surgeries we provide anesthesia for. Even more important is being familiar with anatomy as it pertains to procedures we do, such as intubations (must be familiar with head/neck anatomy), nerve blocks (must be familiar with the muscles, bones, nerves, and blood vessels around where we want to place our nerve blocks), and vascular access (must be familiar with arteries and veins where we place IVs). So overall, anesthesiologists should have quite a bit of anatomy knowledge!
I went to the elephants fair the bees and birds were there by the leg of the moon the big boboon he comb in the fair the monkey he got drunk climbed the elephants trunk and that's the end of the monk monk monk ey
Sometimes it do be like that.
Mr patient 🤣🤣🤣
Was he Mr. Patient Dude once he was chill?
Hehe are you left handedly? 🤭
No, I'm right-handed. I think it would be difficult to learn how to do anesthesia being left-handed since the majority of procedures are designed for righties.
Eyes of Jesus look on me lips of Jesus smile on me ears of Jesus hear me hands of Jesus bless me arms of Jesus inform me feet of Jesus guide me now and forever more amen o sacred heart of Jesus I place all my trust in thee.