Leaving Anesthesia Behind

Finishing anesthesia residency and moving to critical care fellowship is an odd feeling in several ways. This will be the best I am at anesthesia for a while. After three years of 60 hours a week, I've made anesthesia rote and muscle memory. The operating room is my home and I feel exquisitely comfortable there. But during my year of critical care fellowship, I will be leaving the operating room behind and putting the practice of anesthesia on hold for a year. There is no doubt that I will become rusty, and in talking to people who have been through this, it won't be anything that affects patient care or outcomes. But I will be slower, less efficient, have to think more, and less certain as an anesthesiologist. My instincts will dull, my comfort level will disappear. Yet I am choosing to do fellowship because I think advanced training in critical care will make me a better physician overall, and when I finish and return to a mix of anesthesia and critical care practice, I will be able to refresh all that I've honed in the last few years. I will miss the operating room; there is no doubt about that. But I will continue to think about, learn about, and engage anesthesia even if I am not actively doing it this year.