Resident Life

A day in the life of a Kaweah Health Anesthesiology resident

Intern Year:

Intern year is great! We typically rotate through Medicine, ICU, General/Trauma Surgery, Vascular Surgery, Neurosurgery, Emergency medicine, Neurology, and Ultrasound. Days usually start between 6-7am, and the hourly schedule varies greatly between rotations. Mornings may be spent rounding, admitting patients, seeing consults, and any other activity of interest. Attendings for our off-service rotations are welcoming and truly tailor our rotations to Anesthesiology. Additionally, we feel supported and protected by our Anesthesia residency leadership. For example, clinic time was removed from off-service rotations for Anesthesiology residents. Residents from all programs work well together in a collegial manner, eat lunch together, and socialize after work. Senior Surgery, EM, and Family Medicine residents are supportive in our goals for each rotation. Our work environment gives a feeling of togetherness rather than hierarchy. Our days usually finish by 5pm, and we do not take call internship year. There is plenty of time for learning, procedures, studying, and wellness outside of work. We finish off intern year with an "Anesthesiology Bootcamp" that includes working one-on-one with attendings and a robust lecture schedule to prepare us for joining our Anesthesiology family as a CA-1 (PGY-2).

CA-1 Year:

A day in the life of a CA-1 varies considerably, depending on the rotation, and on the day. One month it will be caring for a handful of very sick patients in the ICU, another managing all of the patients in the PACU. We also complete rotations in the pre-op clinic, obstetric and vascular anesthesia, and ultrasound with emphasis on TEE. Most of our time, however, is spent in the main OR, where we may be seeing cases from general surgery, orthopedic surgery, hand surgery, ophthalmology, urology, gynecology, neurosurgery, podiatry, trauma, or any combination of the above.

Most of the time, I try to arrive at the hospital by 5:30AM, change into OR scrubs, and stuff the pockets of my jacket with essentials like clear tape and alcohol swabs. I then go to my room, run diagnostics on my anesthesia machine, gather my checklist of equipment, and prepare drugs for the first case. Next, I introduce myself to my first patient, perform a focused history and physical exam, and write a pre-op note. By now, it will be almost 6:30AM, time for the morning conference. One of my colleagues or I will present for half an hour on a drug or keyword with one or more attendings present to add further insight to the discussion. We then go to the morning huddle for brief departmental updates before starting the day’s cases at 7:30AM.

Depending on the types of cases we are doing, we generally see three to eight patients per day, with the last case wrapping up by 6:00PM. If we are on call, once we finish our last scheduled case, we will start relieving our colleagues to get them home, prioritizing the person who is on call the following day. Once finished with these cases, we will eat, sleep, and study whenever we can until morning, while responding to any critical traumas that arrive in the ED and running any emergency cases that need to go to the OR before morning.

If we are not on call, once we finish our day’s cases, we look up our cases for the following day, discussing plans and learning from our attending. After this, dinner, studying, exercise, and/or “me/family time.” And then... bedtime and reset!

CA-2 Year:

The days of PGY-3 (CA-2) anesthesia residents are extremely diverse and are rotation-dependent. Living beyond your comfort zone is a large requisite of this year, as you will be asked to competently perform in many different arenas. Adaptability and flexibility are characteristics that will be highlighted and will also will cushion you from the natural whiplash that accompanies transitioning between OB, acute pain, Difficult airway, cardiac, chronic pain, CVICU, neuro, peds and the main OR.

Generally speaking, I set my alarm for 5:00 knowing that I will likely snooze 2-3 times. Luckily, the hospital is only ten minutes from where I live, as is generally the case all over this fine town, but we try to arrive about ten minutes to 6:00. If you do this, you can start setting up your rooms at 6:00AM and have time to interview your patients before daily conference at 6:30. After learning about an anesthesia key word topic, I am off to start my cases for the day! After a full day of learning and functioning as an integral component of our anesthesia team, I go home to spend one-on-one time with my family.

From an academic standpoint, we have ample time to study either after cases each day or during resident conference. We also have oral board prep and problem based learning with SIM lab in the mix.

CA-3 Year:

The days of PGY-4 (CA-3) anesthesia residents, apart from the stark recognition of becoming a CA-3, this year is spent honing in on skills and refining anesthetic techniques. The trusted independence mirrors what soon will come as I venture to independent practice.

Depending on the rotation, my days start anywhere from 0530 to 0600 each day. If lucky, I am able to get a cup of coffee/bite to eat before work, however, snuggling my baby often takes priority to a leisurely morning breakfast. When I get to the hospital, I set up my OR with the airway and medication supplies then assess and consent the first patient. At 0630, I attend our daily keyword didactics where we discuss high yield topics with junior residents. The engaging and stimulating conversations help with ITE and Basic prep. After the morning conference, I scurry off to the OR and get ready for the patient to roll in. The diverse case exposure continues with cervical laminectomies one day to robotic nephrectomies the next. At this point in my training, the attendings are there to any questions/concerns but encourage self sufficiency and practice.

When working off service rotations such as CVICU, you are responsible for the unit, managing acute post operative bypass/valve patients to heart failure and occasional ECMO. There is also an “Attending of Day” rotation where we facilitate the OR efficiency and take anesthesia consults for complex surgical patients.

The wide variety of rotations as a CA-3 ensures procedural, pharmacological, and anesthetic aptitude as well as a chance to develop your own “style” of anesthesia.

In addition to the clinical exposure, CA-3 year is an exciting time to determine your future, whether it be for fellowship application or starting in private practice. Either way, graduation is just around the corner as you near the long career path of becoming an Anesthesiologist!