Half-Way Point

It's pretty close to the half-way point of my anesthesia training. I'm through with a year and a half of the three years of dedicated anesthesia learning. What is it like? I feel pretty confident with most anesthetic cases. I can be given nearly any kind of surgery and look at a patient's other medical conditions and identify a reasonable anesthetic plan. Although I continue to read about different surgeries and anesthetic techniques, I have a pretty good understanding of the key points in most surgeries. Even rare procedures I haven't done before, I can make pretty educated inferences about. The same applies to various patient conditions and medical problems. While I would find the management of multiorgan system failure tricky, I at least know where to begin, what to avoid, and what goals I have.

After a year and a half of putting in IVs, breathing tubes, arterial lines, central lines, spinals, and epidurals, I feel like I could troubleshoot most procedures. I don't think I can get everything in perfectly, but I know where to begin, where I get hung up on, and how to fix problems that crop up. Even recently, I had a patient I couldn't intubate with a direct laryngoscope. Neither could my attending. We did not panic and simply asked for another tool and intubated the patient smoothly and safely. I think over time I have become much better in responding to changing circumstances, emergencies, problems, deteriorating patients, and complex situations. I may not always know what to do, but I don't panic and I start with the basics and do things step by step.

All of this is quite reassuring. I don't have to be an independent anesthesiologist for another year and a half, but I feel like I could handle the majority of things independently. The rest of residency, then, is to find and work on my weaknesses, refine my technique, and study the material in greater depth so that I feel comfortable with any operation, procedure, or ICU patient.