Medical Residency in Anesthesiology

As I approach the end of my medical school education, I find that my thoughts often shift away from the formal material that has been my life for over three years. I have spent countless hours learning anatomy, conceptualizing physiology, practicing physical exam skills, and developing differential diagnoses to build a solid foundation upon which to establish my professional career. Supplementing my concrete knowledge and skill base are informal insights learned through clinical experiences. One such insight which I believe is critically important is to maintain a respect for the unknown.

I realize that this concept is vague and open to individual interpretation. Having a respect for the unknown means several things to me. It means that one should always be aware that there may not be a single, straightforward answer which explains all the patient's problems and that there is no such thing as a truly "stable" patient. It means that a provider should never become stagnant with a knowledge and practical skill base that does not evolve with current standards of care. It also means that one must be attentive to detail and watch vigilantly for changes when patients are under their care. While these principles apply to all fields of medicine, I feel they are particularly applicable in my chosen field of anesthesiology because the stress of surgery on the body can seriously alter pre-existing disease states, the physician's decision-making time is often very short, and the consequences of incorrect patient management are potentially grave.

My decision to pursue a career in anesthesiology was not made upon admittance to medical school. In fact, it was made somewhat late in my third year. I entered my rotation schedule with an open mind, gave each specialty a fair chance, and then reviewed how I felt about each as a career. Although I had enjoyable and educational experiences in each field, anesthesiology has been the most stimulating and rewarding. I am drawn to the dynamics of short-term relationships, the trust which must be earned with limited contact, the intensity of patient management in a critical care setting, and the practical application of pharmacology to modulate ever-changing physiologic states. I do not believe the anesthesiologist merely plays a support-role in the operating room. The anesthesiologist is an equal member of the surgery team - an intensivist whose expertise in pain-control and short-term management of the total patient is required for the other team-members to fix a focal problem. I see the anesthesiologist as a patient advocate who realizes that a patient's experience is dependent on factors other than the efficacy of the surgery and who has the capacity to control variables to ensure patient comfort, safety, and peace of mind. When I was part of an anesthesiology team that was attentive, concerned, and prepared, the surgical experience was generally better for everyone involved. This consistently gave me a personal satisfaction which I did not feel in other fields. I am confident that this satisfaction will not diminish over time.

As far as my future goals in anesthesia, I anticipate living in the place I feel is best for my family and working in a private hospital setting. I plan to serve patients in my local community and those in need in other areas through charitable organizations. The volunteer work I have done with Operation Smile has helped me see the opportunities that anesthesiologists have to assist others around the world while gaining invaluable life experiences.

What does it mean for anesthesiologists to have respect for the unknown? It means they are prepared with an established knowledge base which enables them to understand the functions and interactions of the human body with medications and diseases. It means they are prepared with newly discovered knowledge and practices which enable them to provide the most current and effective care possible. It also means they are prepared to recognize changes in the patient's condition which enables them to respond in the most appropriate fashion. And finally, it means they are prepared to earn the patient's trust and to bear primary responsibility for the patient's well-being.

The unknown is something I respect but do not fear because my medical preparation has been solid both academically and clinically. I look forward to continuing to gain the knowledge, experience, skills, and confidence required to ensure patient safety and comfort during stressful times. The unknown is something I respect but do not fear because my medical preparation has been solid both academically and clinically. I look forward to continuing to gain the knowledge, experience, skills, and confidence required to ensure patient safety and comfort, especially during stressful times.

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