The trend these days is for graduates of anesthesia residency to pursue additional specialized training in the form of a fellowship. This is a new tendency; even five years ago, most residents went out and found a practice to work in. But recently the job market has tightened, especially in the bay area, and it behooves us to have a specific expertise in pediatric anesthesia, regional nerve blocks, cardiovascular anesthesia, pain management, etc.
I probably would have done a fellowship anyway; I've always been the type to stay in training forever. After considering the various subspecialties and the rotations I enjoyed, I ended up choosing the field I always thought I'd end up in: critical care. As an anesthesiologist, I've become proficient in certain aspects of intensive care medicine: the cardiopulmonary system, medications, procedures. But I've missed those things that fascinated me so from medical school and internship: infectious disease, end-of-life care, continuity with a patient. Although the ICU rotations can be grueling, they are also intensely rewarding as we struggle and grapple with the sickest patients, most difficult ethical dilemmas, and hardest situations for a family to cope with. I think as I become a fellow and eventually an attending, I will enjoy engaging the big picture and be a little shielded against the day-to-day exhaustion.
In any case, after I finish my last year of residency in anesthesia, I will stay at Stanford to do my fellowship. I may not be a Bay Area native, but I've definitely made this place my home.
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6 comments:
I just wanted to say a huge congrats to you, Dr. Chen! That's very cool. :)
How many years do you typically spend on a fellowship?
Thanks! In anesthesiology, all fellowships are one year long. This is in contrast to critical care for medicine and emergency medicine residents which is usually 2 years long.
Do you plan on doing all CC in the future or trying to split between the OR and ICU?
Most critical care physicians (especially in academics) do a split between ICU and OR/clinic (for pulmonary). ICU can be really emotionally and physically draining, so balancing it out with some time doing hernia repairs and cataracts can sometimes be good (though some faculty go straight to the tough stuff - liver resections and neuro cases). Not sure about the community ICU doc. Not sure what kind of ratio I want.
Congratulations!!! I'm so looking forward to your upcoming blogs throughout your fellowship. I am also a graduating anesthesia resident about to start a CCM fellowship this July. Keep us posted.
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