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Residency in Anesthesiology, UK, CABG

 While a senior at the University of XXXX, I was shocked to see poverty and disease up close, to learn its reality. As a rural health care volunteer in northern India, without portable machines or diagnostic equipment, I experienced medicine and surgery at its roots: my hands and ears were my most valuable tools. I gave children vaccinations, assisted with births, administered epidurals and helped end stage cancer sufferers with pain management. This experience taught me how to remain calm during emergencies and to endure the pressures of handling crisis. The enthusiasm of combining the mental rigors of medicine with the challenging depths of surgery brought out a certain energy and passion within me. I believe a career as an anesthesiologist will allow me to pursue that energy and apply it to patient care.

My love of traveling and learning about new cultures cultivated my decision to attend medical school in England. Living in a foreign country, I learned to be resourceful and flexible while taking on new challenges. Along with tremendous mental and physical stamina, I developed strong interpersonal and communication skills. The experience taught me how to multitask efficiently and acclimate quickly into unfamilier places. As a resident, I will use these skills to handle a fast-paced and demanding workload without becoming stressed.

My clinical rotation in anesthesiology and pain management at a County Hospital cemented my decision. The rotation ended up being one of the most enriching experiences in my medical education. I loved the dynamics of epidurals and emergency c-sections. I learned to rapidly incorporate sound judgment, pathophysiology and pharmacology into caring for two lives. In the end, it was truly a humbling experience to witness the relief of a woman’s pain during childbirth. Being exposed to the challenges of perioperative risks, I became familiar with the skills of quick assessment, hemodynamic management and of manipulating a patient’s physiology and anatomy.

At County, I was exposed to patients from various multi-cultural and socio-economic backgrounds. I never shied away from the many complex social issues that confront an anesthesiologist with such populations. To fulfill these social convictions, I attended workshops in recognizing and addressing domestic violence, high risk obstetrics, alcoholism, the ethics of pain management and substance dependency. I often performed the duties of a first-year resident, including blood draws, placing IV lines, history-taking and post operative care. I developed confidence in handling a multitude of presenting complaints and procedures.

Anesthesiology is a field where my perseverance, dedication, respect, and compassion will flourish. I have genuine enthusiasm for working hard and making a positive difference. I am seeking a residency program that will allow me to develop independently and as part of a team. I value excellent faculty and the opportunity to approach cases with a blend of compassion, wisdom and academics in order to optimally care for each patient. There are days I think about my experiences of working in India and how not all people were able to have the comforts of epidurals, analgesia or cancer pain management. I plan to use my training to work in areas where a good anesthesiologist is needed. I understand what a privilege it is to receive the type of medical training your program provides, and I will take advantage of every opportunity to learn and develop during my residency and exceed expectations.

Anesthesiology provides opportunities to display specialized skills by performing a wide range of procedures while having cognitive challenges as well. After medical school I was selected for a two year anesthesiology residency program at Large Medical College, India. During my training, I learned to administer anesthesia for a wide array of cases: pediatric, neurosurgery, obstetrics and gynecology, urology, orthopedics and general surgeries.

In residency, I became more responsible and confident in handling various cases independently. I enjoyed my work of putting patients to sleep and maintaining their vitals during the critical points of surgery.

My critical care rotation allowed me to learn about ventilators and manage patients that required long term intensive care. There I was awed by the mix of internal medicine and anesthesia skills required in managing critically ill patients. I found most aspects of modern intensive therapy – invasive cardiovascular monitoring, manipulation of the circulation, renal support, postoperative analgesia, and the management of shock fascinating and challenging.

Performing well in my residency, I joined as an attending anesthesiologist at India Hospitals. This experience of seven months allowed me to sharpen my technical skills including catheterization of central veins, placement of arterial lines and epidural catheters, and various regional blocks. Being part of the cardiac anesthesia team gave me an amazing experience of handling CABG surgeries and many pediatric congenital heart cases. Working as an attending anesthesiologist required to manage the administrative aspects of anesthesiology – efficiently managing operating room time; building and maintaining team spirit; establishing rapport with colleagues, surgeons and OR personnel. In order to continue teaching, I instructed classes for nurses and OR technicians. My position often had me administering anesthesia outside of the operating rooms in radiology and cardiac catheterization labs. This experience provided me the ability to anticipate problems ahead and take necessary precautions to handle difficult situations.

My interest and previous experience in India has led me to pursue anesthesiology in the United States. To prepare for residency, I joined an observership at the XXXX Clinic of Florida, where I observed the use of the latest equipment in the operating room and familiarized myself with the US medical trends. I also attended the pain management clinic that gave me an opportunity to learn the nerve blocks used to relieve chronic pain. The significance of easing of pain impressed me such that I am considering a pain management fellowship.

I am currently working for Dr. XXXX, Program Director for the Department of Anesthesiology at University of XXXX in research of geriatric anesthesia. While involved in this project, I realized that as our elderly population is increasing and as an anesthesiologist it is critical to consider physiologic changes that occur in older patients and have a thorough knowledge about pharmacodynamics and pharmacokinetics . I also observed operating rooms at XXXX Hospital to further acquaint myself with the latest techniques. This experience as a research associate grounded my interest for pursuing clinical research in my future endeavors.

I am a confident individual, yet I know my limitations and when to ask for help. I pride myself on good communication skills, an key skill required in the operating room when working with surgical teams. My previous experience as an anesthesiologist shows my ability to handle high level of stress that this field demands. I am looking forward for a program that would cultivate learning and independent thinking. I would like to be in a hospital where residents are given extensive responsibilities under the supervision of faculty. I look forward to being challenged every day during my anesthesia residency. 

I was born, raised and spent more than 16 years of my life in India, immigrating to the U.S. in 1999. As a teenager, the transition from my native culture to a completely unknown place and culture was very dramatic. The change was frustrating in the beginning, but I knew that ultimately it was up to me to adapt to my new environment and build my identity. My accent slowly devolved, my new wardrobe collection evolved, as my name Rajiv, a traditional Hindu name simultaneously simplified into the single letter “R”. Adapting has been difficult, requiring maturity, resilience, and persistence.

Analogous to my adaptation to American culture, anesthesiologists encompass the same adaptation at work everyday, whether it is alleviating the concerns of a parent or taking care of a child who gets hypotensive on the operating table. Furthermore, anesthesiologists serve as primary consultants for several departments in a hospital setting. From starting an epidural in L&D to placing a popliteal block for orthopaedic surgery, or from performing an endotracheal intubation on premature infant in the NICU, being able to adapt and compliment that situation with confidence is a crucial attribute to have in an anesthesiologist. The ability to adapt in a variety of situations while applying my knowledge and training skills is an attribute that I possess and my past experiences have prepared me well to take on the challenges in displaying and executing these versatile qualities.

I believe that the transition from an individual with a medical degree to a physician occurs when that person develops sincerity, honesty, maturity, and above all, the desire to take care of patients. Anesthesiology is a field that allows for the nurturing of my innate passion in taking care of a patient as a whole rather than a specific procedure or an organ system. The desire to serve holistic care to a patient has stimulated my interest in pursuing a further training in the form of critical care fellowship upon completion of resident training in anesthesia. A critical care specialist has the responsibility to simultaneously manage a challenging patient with numerous complex medical and surgical issues, and the anxious family in the waiting room. Throughout my clinical rotations as a medical student, besides providing utmost care to a patient, I constantly made an effort to insure that family members were appropriately involved and informed in the care of their loved ones.

Besides applying broad based clinical knowledge, the “hands on” approach and ability to perform procedures in a variety of situations has been a major attraction for me. It is fascinating and inspiring to know that from starting the IV in the pre-operative unit to their stable transfer en route for post-anesthesia care unit, I am going to be present by the patient. This aspect makes anesthesia unique because it is the only specialty that devotes 100% effort to ‘active’ patient care, especially in critical points in a patient’s care, albeit for a short period of time. I believe that my strong base in medical knowledge and the desire for the continuous improvement in refining my procedural skills as a medical student have allowed for an ideal platform to build upon my training as an efficient and caring anesthesiologist. I am thrilled to have this opportunity to embark on this excitable journey of training in anesthesia and become part of a very special fraternity of physicians. 

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