An Anesthesiology Resident’s First Day Of Anesthesia

Yesterday was more or less an orientation day spent in the simulation lab and doing pre-op evaluations on a few patients, but today was my first real day being an anesthesiologist-in-training. The first three weeks of this month are in “mentor mode” – I’m paired with an upper-level resident and shown the ropes of clinical anesthesia. But it’s the last week which is terrifying… our training wheels are taken off, and we’re left to run the operating room (with an attending physician down the hall, of course). 😉

My first day of mentor mode was spent realizing how much of a learning curve there really is to clinical anesthesia. Just a brief run-through of today’s blur:

First day of anesthesia (CA-1)!

Place the IV. Make sure it works. Premedicate. Wheel the patient back to the operating room. Place the blood pressure cuff, pulse oximeter, and EKG leads. Position the patient. Pre-oxygenate. Get ready for the attending to push your meds. Perform direct laryngoscopy and intubate. Make sure the volatile agent is on, and the circuit is flowing. Oh, and in the interim, make sure the Foley ended up near you, the drapes are up, the surgeon’s table is adjusted, the chart is updated, the vitals are stable, antibiotics have been given, fluids are running, and the train-of-four is hooked up. And this is before the surgeon has made a single incision. 😯

I guess it was the “first-day jitters,” but I can’t remember ever sitting down and only took a 10-minute lunch break to scarf down a wrap from McDonald’s. I needed to immerse myself in the environment and learn from the various nurse anesthetists, attendings, and residents I encountered. There are countless recipes for anesthesia (and everyone thinks their method is correct), so it’ll be nice to gather techniques from multiple experts in the coming weeks to create my own style. As I’m writing this, I’m happy but exhausted. And USMLE Step 3 this coming weekend doesn’t make my mindset any more relaxed.

Tomorrow morning is Grand Rounds, followed by day 2 of mentor mode and then evening lectures. The cases are drastically different compared to what I participated in today, so I’m hoping to learn even more and improve my confidence, efficiency, and judgment as a rookie—one day at a time.

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  1. Hey Rishi, glad to see you are doing so well! Quick question for a friend, how many spots are there for the anesthesiology residency program at BCM currently or are there any vacant spots for a PGY1 resident looking to switch from a current program at BCM?


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