Medical Residency Anesthesiology, ICU

My first thoughts of pursuing a career in anesthesia occurred while I worked as an ICU nurse.  After working in various medical settings I found the intensive care unit to be the most fascinating and immensely challenging.  As an ICU nurse, the most rewarding part of my job was the recovery of patients whom had just undergone cardiothoracic surgery.  It was not unusual for our cardiothoracic patients to come back with balloon pumps or open chests. The immediate hemodynamic management in the first hours after surgery strongly affected patient outcomes. Critical thinking and teamwork were necessary for successful recoveries.  In this setting, I was impressed by the anesthetists’ medical knowledge and clinical skills, as well as their cooperation with the surgeons and management of the recovery team. I briefly looked into nurse anesthetist training but realized I wanted a more in-depth, broad, and comprehensive medical education.  Also, I did not want to be limited in practice setting or the cases I could perform.

As I left my job in the ICU, I dreaded what I expected to be the tedious preclinical years. Instead I found the basic sciences fascinating. I especially enjoyed biochemistry, physiology, and pharmacology. I still remember the light bulb going off when I learned the physiology behind why nurses are instructed to immediately administer calcium to severely hyperkalemic patients. These types of discoveries where I could apply basic sciences to my clinical knowledge from the ICU reinforced the fact that I had made the right decision to become a physician.

I was again drawn to anesthesia during my clerkship but for different reasons than I had recognized as a nurse. The integration of the basic sciences with each operating room case presented a lesson in physiology and pharmacology, with quick assessment, diagnosis, and intervention by the anesthesiologist. During my anesthesia rotation, I found that much of anesthesia is learning to anticipate. Anticipation of patients’ physiology, medication pharmacology, and surgical changes to actively circumvent problems is a delicate balance. Although I enjoyed several other specialties during my clerkships, I know many of these I will still be involved with, as anesthesiologists are valued consultants in the emergency departments, labor wards, ICU’s, and pain clinics.

My strong basic science interest, attention to detail, and strong work ethic make me well suited for anesthesia.  In addition, my nursing background gives me experience in procedural skills and a perspective on how to work as a medical team as well as how to effectively communicate with staff, patients and their families. I hope to attend an anesthesiology program where I can be exposed to a wide variety of cases as well as complex cardiothoracic cases, and continue my exposure to research.  Eventually I would like to pursue a fellowship in critical care medicine, so I can work both in the operating room as well as the surgical intensive care unit.

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