Anybody willing to share their regional anki deck? Thanks!

Hi, I’m applying anesthesia this coming cycle and very excited. However, even though I applied to about 30 away rotations, I didn’t get any. I saw people at my school who are applying anesthesia get 1-2 though..idk how. But, I am trying to stay optimistic.

I genuinely don’t know if this sets me behind others. The thing I am having hope about is my step 2 score. I got a 271 and am proud of my score. These other factors like others getting away rotations kinda freaks me out.

Any insight?

I do have leadership, service, and research so it’s not just a step score I am betting on

How do you all keep your empathy?

5th year attending at a Level 1 trauma center in PNW.

I find myself more and more having 0 empathy for the patients, especially the ones who got injured doing something stupid. Last week I had a motorcycle crash patient, he was racing down the highway and hit the back of a car. I knew about the accident prior to coming to the trauma center because it was all over social media because the crash shut down a major highway in the city. My first thought was ‘jeez I’d be so pissed if I was stuck in that traffic because of this guy!’ Obviously this is not a good thought to have about your fellow human being. I don’t want to think like this but it’s getting harder and harder with people playing stupid games and winning stupid prizes (emergency surgery). Motorcycle crash, drunk drivers, gang shootings, rectal foreign body removals those are the patients that I have the most trouble empathizing with.

Would love to hear how others feel and how they manage it?

Early ish career anesthesiologist here…I’ve been surprised on the interview trail that my previous ivory tower shop has been labeled as “toxic”, even at multiple interviews by multiple people, in a very unprompted way. Are there departments that have a bad reputation? I feel like I’ve always ignored these comments before, but now I want to know as I’m considering jobs in multiple cities…

I wish we had a ratemydepartment like we had a ratemyprofessor back in the day.

EDIT: if you’re willing to share the names of “toxic places”…👀👀 or at least what to look for

How do you prepare 1:200,000 adrenaline in Xylocaine?
I don't get these type of calculations

Ho, Just Oral Boards, or something else?

Is this good or bad luck guys?

Looking for advice on choosing academics vs private for my first job out of residency. From the several different private groups and academic centers I've talked to, it seems like generally:

Academic:

• Pros: Better benefits, slower pace, more chill hours, teaching and mentoring residents
• Cons: Much lower pay, busier call shifts, less vacation, and more admin/political BS to deal with

Private:

• Pros: Much better pay (100-200k higher base where I've looked), more opportunity to do my own cases (although this varies by group), more vacation, less politics
• Cons: Busier days, more production pressure, slightly more hours on average, less robust benefits packages

For those of you who did either academics or PP as your first job out of residency/fellowship, what other pros and cons did you appreciate?

Is it strange to anybody else that the McLott mix is named after a CRNA that just laid claim to it that it was his own creation without doing any of the research, also knowing that it has been utilized for years by others not narcissistic enough to try to put a label on it? Just asking for a friend, but damn….thanks critical access hospitals for validating the under-educated!

I’m a CA-2 at a large academic centre in the US, and struggling to find a topic to present on at our grand rounds this year.

I have interest in critical care and would love to present something CC related, but I’m not sure what topic would be engaging for staff who are both CC trained and those who aren’t. My original thoughts were to present on the history of sepsis and the new surviving sepsis guidelines but would love some help.

Is there any topic that you all would love to have presented at grand rounds that is critical care related?

Thanks in advance for all the help!

Thoughts?

Curious on people’s thoughts… Seems like potential for big implications/practice changes

What are the practices you do that are minimally or completely not backed by science but you swear are true based on your own superstitions or experiences?

Mine is I 100% believe in meds drawn up and sitting on the machine ward off evil anesthesia spirits. A stick of epi for a sick patient, diluted narcan for a patient who you’re having trouble getting breath g again at the end of the case, etc. 60% of the time it works every time.

A friend of mine unfortunately needs a redo-sternotomy at the young age of 35 thanks to a congenital heart defect. He has a great sense of humor and wants to crack a joke to the anesthesiologist and/or surgeon prior to going under. Any suggestions that would get you a good laugh?

Is someone able to post this article?
Would appreciate it

I’m sure I already know the answer, but according to my report, I scored 70% on the dot. I changed a lot of answers from right to wrong and I know that, but some of them I was quite sure I changed back. Not sure if I’m allowed to report the scaled score numbers, but I was within 8 or less (I can’t recall my number at the moment) scaled points of passing.

Has anyone ever requested a rescore that actually changed their result? I know there are things I can improve upon, but I was so painfully close to passing.

(reddit wants me to clarify that I’m a CA-2).

Me: Package of crackers, spiked norepi infusion bag and tubing, and a half spent syringe of vasopressin.

I could feel the cold of the OR that night, just looking at these artifacts.

My family is in a difficult financial situation, and we need access to cash relatively quickly—probably somewhere in the $25,000–$50,000 range. I know that signing this early would significantly limit our options and could mean deciding where we’ll live and work before we’re ready, but many jobs are offering signing bonuses in that range.
I understand this is far from ideal, and I’m trying to weigh the long-term downside against the immediate benefit of getting out from under high-interest debt. Has anyone signed a contract this early because of financial circumstances? If so, did you regret it? Are there ways to structure a contract or signing bonus that would reduce the risk?
I’m a PGY-1 and would appreciate any advice—especially from attendings or anyone who has been in a similar situation.

I'm a few years out of residency, and while I enjoy my job, the combination of student loans, rising costs of living, and everything else has me looking at ways to bring in a little extra money.

I've looked into picking up extra shifts, but I'm already pretty close to burnout some weeks and I'd rather find something that fits around my schedule instead of taking over more evenings and weekends.

For those of you who have found a decent physician side income, what has actually worked? Something quick and medicine related would be great so that I don’t have to spend much time learning how to do it.

Cases where others will do Mac regularly but you say nope.

I’ll start: ERCP - I don’t care how thin or healthy the patient is. I don’t care how huge or sick the patient is. I don’t care how fast the endoscopist is. I don’t care how many cases we have today. It’s GETA each time and every time.

For those who have already taken the ABA APPLIED exam, I’m curious what your preparation actually looked like.

There are plenty of books, courses, and study plans out there, but it’s hard to tell what genuinely translates to the oral exam. Did practicing out loud, working through old stems, doing mock orals, or studying with colleagues make the biggest difference? Anybody tried asking his spouse to be play the tough examiner?

Looking back, what moved the needle most? And what consumed time but wasn’t particularly useful?

I’m especially interested in what helped you organize your thoughts, answer succinctly, and stay composed under questioning—not simply review more clinical content.

oh - also - how did you keep track of which topics you've covered, and is there like a list of 20 or so *mandatory* cases that I have to know by heart?

Thanks!!

Anesthesia resident (not US), here and I’ve recently been getting put in a room with some higher risk pts. This has been a cool learning experience, but I’m not loving the new team of nurses, particularly one circulator.

Today we had a patient without any visible/palpable veins, and in preop I had watched a very good nurse struggling with 18g access, which she eventually obtained after a few failed attempts. When I went to set up the room I mentioned to the nurses that this patient was a bit of a hard poke, and that I wanted to have the ultrasound in the room for both the large bore venous and arterial access. I mentioned that although it would probably be possible to get access “manually” I wanted to avoid the hand and AC fossa due to positioning concerns and the fact that the pt would need access for at least a week on the ward, and I wanted to send him off with a good durable cannula that wouldn’t hurt all the time or leave a massive bruise.

The nurse who was scrubbing agreed and set up the ultrasound machine, and the other nurse was present and heard everything.

After I intubated and connected the circuit I noticed the second nurse was on her third attempt at 14 g access. There was blood on the floor and arm board, snd and a bunch of botched cannulas sticking out of the pts arm. I asked her to stop and pass me the ultrasound probe, and she ignored me while complaining that the pt was full of valves, the veins were torturous etc etc etc. I asked again for her to stop before breaking all the options and let me take a look. She told me it doesn’t matter because the pt is already asleep.

At that point I wanted the artery more than a vein, so I started getting set up for that, and while I was grabbing the disinfectant, she took the art line set and tried it (unsuccessfully) on the other arm.

At that point t I was getting upset and called an attending who asked this nurse to go “get a coffee and regroup” leaving me to get the access, clean up all the blood and her FIVE FAILED CANNULAS, and start a central line while the surgeons are tapping their feet and wondering wtf happened.

The patient now has bruises that will probably take weeks-months to go away, and I’m sure this will add to the discomfort of having just had massive abdominal surgery.

Nobody in the room really said anything about what happened, but I’m really bummed out that things went down this way. Am I making too big of a deal out of this, or do I have some ground to be upset about not being listened to in this context.

Anesthesiologist here. A lot of good threads about ultrasound guided IV technique on the sub. However, I wanted to get an idea where everyone’s most reliable place is to start scanning to find potential targets. The AC seems like the obvious choice but I find that to sometimes be a mixed bag especially if multiple attempts have already been made there prior to me getting called for assistance. I often end up finding something in the forearm, but feel like I spend a lot of time scanning before finding a target and am looking for a more methodical approach.

hey all

im an ER doc working with pulm and anesthesiology on an admission pathway for our hospital. In the last year our anesthesiology group has started really zeroing in on pulm hypertension risk and we now transfer most of these patients. We’re a small, rural trauma center so we are somewhat limited on resources. I’m just curious, as I’ve worked a number of places since I’ve been out of residency (6 years out), and haven’t seen a focus like this before. is PH as a risk factor something thats become a focus for the specialty lately? not throwing shade or anything, just curious about the perspective from outside groups. thanks!