Navigating Different Hospitals

One of the things I looked for in a residency program was the opportunity to go to different hospitals. Some programs are based solely at one hospital, which allows one to become intimately familiar with the institution, people, and culture. But I wanted to diversify my training, and coming back to the VA reminded me that this is an important aspect of residency. Although some inconveniences such as the administrative paperwork are frustrating, other inconveniences such as different equipment become opportunities for learning. The anesthesia machines at the VA are from a different vendor than those at Stanford, which encourages me to play around with them, explore the differences in capabilities and functions, and learn more about how they work. Different institutions have different drug shortages, which affects the anesthetic I provide. A temporary shortage of paralytic reversal changes my choice of muscle relaxant. Because the VA acquires dexmedetomidine at a lower price, we use it more often. Even small things like the types of IVs, the amount of space in the operating rooms, and the electronic medical record differ, forcing me to adapt and allowing me to determine what things I like best, which may become useful when I start thinking about practice later on.