Second Year Of Anesthesiology Residency (CA-2) In Retrospect

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Another July, another transition to the next academic year of my training. I’m now finished with my CA-2 year and entering my final year as an anesthesiology resident physician (CA-3, otherwise known as PGY-4) serving as one of the chief residents of our program. 

One year ago, I outlined how my CA-1 year provided the basic foundation for clinical anesthesiology. My CA-2 year was very different – I dabbled in sub specialities within anesthesiology including intensive care, cardiothoracic anesthesia, acute/chronic pain management, pediatric anesthesia, neuroanesthesia, trauma, and obstetric anesthesia.

bwh-hms-logoThis past year I also accepted an out-of-match offer from Harvard Medical School and Brigham and Women’s Hospital to do my dual fellowship in Boston from July 2017 – June 2019. Despite entering my final year as a resident, that means I’ve only reached the halfway point of my graduate medical training. 😀

Besides the obvious growth in maturity and experience afforded by another year of residency, I wanted to reflect on two lessons which served me well throughout the last year.

Remember Names
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On call on our last day as CA-2s!

I interact with an incredible number of people from different departments on a daily basis – my attendings and co-residents, CRNAs, the surgery attendings and residents, anesthesia techs, perfusionists, respiratory therapists, pharmacists, scrub techs, circulating nurses, janitors, food services, PACU nurses, patient liaisons, and consultants just to name a few. Whenever I started a new rotation, I started off as “the new anesthesia resident”, but I made an honest attempt to introduce myself to everyone and got to know their names and at least one unique thing about each individual.

People genuinely appreciate when you greet them by their name each day. More than once I was pulled aside and thanked for calling someone by their name and how it made them feel all warm and fuzzy. It’s a small but important gesture of friendship and kindness which all should practice, in my opinion. 🙂

Don’t Sweat The Little Things

As trainees in healthcare, we tend to be “type A” go-getters who strive for perfection in everything we do. This isn’t a practical expectation in the imperfect science of medicine. No matter how much experience, knowledge, or skill we have, there will be days when things just don’t work out. And that’s okay.

I’ve blown peripheral IV cannulations in bulging veins, missed intubations in ASA 1 patients who you could throw an endotracheal tube in from across the room, and made countless (minor) errors in efficiency and preparation. With time, I’ve come to rely on my skills and judgment to minimize these mistakes and to always prepare for the worst. That being said, when I do blow an easy IV, I don’t sweat it anymore. I’ve come to see the proverbial “forest through the trees” and focus on the big picture now.

This will be especially important as I oversee the anesthetics of junior residents on call. The best way for them to learn is to make the clinically insignificant mistakes on their own so they can adjust their technique and attention to detail. My role will be to ensure patient safety during this process. Fortunately I’ve had incredible mentors which I hope to emulate during this process. 🙂

Finally, some pictures (more or less in chronological order) reflecting on my CA-2 year:

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