There are so many things going on during a residency like exposure to new subspecialties, learning new instruments, and new techniques. These tips for success during anesthesia residency will position you at a competitive level for acing the exams, managing patients, and teaching others.
By Dr. Rajeev Iyer, MBBS, MD, FASA, Board Certified Anesthesiologist
1. Divide your residency timeline into blocks of 6 months
Divide your total residency time into blocks of six months each in it. You could do this electronically on a notepad or on paper. I will use this to reference as I move through other tips. I am going to use a three-year residency as an example. If your residency is four years or longer like in Canada and other countries then you could still do the same, just keep on adding those blocks of six months each.
2. Pick your books that cover basics and sub specialties
You need a book that covers all the basics and sub-specialties at this stage. The goal is not just to pass your exams but to build your knowledge. You need to know as a physician what you should do, how you should be doing it, and why you do what you do?
Here are my top choices. This is based on categories like general topics, physics, pharmacology, equipment, and subspeciality books.
|Category||Book Title||Amazon.Com Affiliate Link (See Affiliate link disclaimer below)|
|General Topics||Miller's Anesthesia, 9th Edition||https://amzn.to/3OUuMHi|
|Morgan and Mikhail's Clinical Anesthesiology, 7th Ed||https://amzn.to/3OWcINa|
|Clinical Cases||Stoelting's Anesthesia and Co-Existing Disease 8th Edition||https://amzn.to/3a9m89c|
|Yao & Artusio’s Anesthesiology: Problem-Oriented Patient Management 9th Edition||https://amzn.to/3nxhbdA|
|Physiology and Pharmacology||Stoelting's Pharmacology & Physiology in Anesthetic Practice||https://amzn.to/3yDBD2N|
|Manual of Surgical procedures||Anesthesiologist's Manual of Surgical Procedures, 5e||https://amzn.to/3Ro6cAR|
|Anesthesia Equipment||Anesthesia Equipment 3rd Edition|
by Jan Ehrenwerth MD (Author), James B. Eisenkraft MD MRCP(UK) FFARCS (Author), James M Berry MD (Author)
These excellent books provide a summary of all important topics and in my opinion are a definite buy. If you want to test them out, check them out in your library, read through a few pages or chapters, and then make a decision.
3. Focus the first 6 months on physics, physiology, pharmacology
The first 6 months are very exciting. So many new things going on around you. This is the time to read about
Great time to read about all the gas laws and physics as relevant to anesthesiologists. Well, if you are thinking how is this relevant to you and your practice as an anesthesiologist? Think of a tall building and the amount of foundation it needs; the amount of earth that needs to be dug up, and the amount of concrete that’s poured in to make the building taller. You’re exactly similar to that you need a solid foundation to become an outstanding anesthesiologist or anesthetist, So the stronger the foundation, the longer you will go. This will not only help you ace your exams but this would help you manage cases in a very safe and comfortable way. This will help you know not only what to do but also know what not to do which is a very critical part of decision making.
As you’re reading physics, physiology, and pharmacology you’re getting oriented to the basics of anesthesia, working in the operating room or operation theater like induction, maintenance, emergence, fluid management, intubating skills, placing IV, and many other things. If you find time with all this I would say the history of anesthesia is another really exciting thing that I personally love to see how our specialty evolved. An excellent resource for this is the Wood Library-Musem of Anesthesiology.
I was at a Wood Library-Museum of Anesthesiology special session at the American Society of Anesthesiologists Annual meeting and learned they also offer a fellowship for people who are interested in this. They also have a YouTube channel that you can check out here.
Tip # 4: Read about basics during subspecialty rotation
I have provided a list of the major subspecialty rotations you will have during residency.
- Cardiothoracic anesthesia
- Critical care anesthesia
- Neurosurgical anesthesia
- Obstetric anesthesia
- Pediatric anesthesia
- Regional anesthesia
- USA and Canadian programs offer electives such as research time or clinical time nationally or internationally.
As you are cruising along with your residency you will be exposed to subspecialties (how exciting is this and also stressful thinking of new rotations every time you have to do this)! When you’re actually going through these sub-specialties now pick your book which could be Morgan or Miller or any other, read all the basics related to that sub-specialty.
For example, if you’re doing pediatric anesthesia rotation make sure you read about physiology, pharmacology, anatomical differences, differences in the airway, how to intubate, and many more during this rotation.
5. Read and prepare for the next day’s cases
You’ll be assigned to an operating room or theater and you would typically know your cases the previous day. Read about these cases – do not miss this important step.
I will give you two examples here.
- If you’re doing a pediatric anesthesia rotation and your case is an inguinal hernia, now read about how anesthesia is done in a child for an inguinal hernia. Read about ilioinguinal, iliohypogastric nerve block in a child.
- Let’s say you’re doing a thoracotomy, read about how to do one-lung ventilation and lung mechanics during one-lung ventilation. This is the time when you realize most thoracotomies receive a thoracic epidural block. Great opportunity to read about epidural block for a thoracotomy.
Now, this reading should come from the following resources. I will say the more places you read this from the better it is. Each and every source may give you a unique tip that can be very valuable.
- Miller’s Anesthesia
- Morgan’s Clinical Anesthesiology
- Subspecialty books
A journal that I highly recommend for educational reviews on topics is the Indian journal of anesthesia. They provide reviews related to clinical topics that are well written and well researched. Check out the Indian Journal of anesthesia.
6. Mask a list of questions you may have
As you go through the above tips, many questions will pop up in your mind. If you don’t have any questions, then I would caution that you should pay more attention to the above steps. Having questions is a normal expected thing. Make a list of all the questions as you’re reading your basics, reading about your cases, and put it on a notepad or wherever you want it to discuss with your supervisor/attending/faculty or whatever you call them in your country. Get everything clarified. This will help to solidify your knowledge and retain everything in your long-term memory box (maybe I just made this term up!) More importantly, when you actually do a case five or ten years down the lane you will still remember it like it was yesterday.
7. Focus on exams two months before the exam date
You may have exams every six months or you may have them once every two years. Now, this is when you dedicate your last few months to your anesthesia boards or anesthesia exams. If you have an MCQ-based exam you can read about MCQs from any dedicated resource and if you have a theory-based exam from a related resource. Either way, by now you would have read all the theories and the cases. So your knowledge is so solidified that you’re going to ace the exam and also remember how to manage cases for life.
8. Plan your week on a Sunday
That’s right, plan your week on a Sunday as to what you need to read through during the week. Make sure you bring some materials to the operating room or operation theater. You never know there may be some downtime, there may be some case cancellations. You don’t want to scramble last minute as to what to do. Be well prepared for all those unexpected situations and if you have a stable case you may also have some time to skim through a few of those reading materials.
9. Read every day
Read every day. Alright, at least read most days of the week. Now I am not saying every day because practically this may not be possible. You may be on call or you may have other commitments but make sure you read at least most days of the week, daytime, evenings, and nights, whenever it works for you. Make use of the time.
10. Form a study group with other residents
Form a study group. You‘re not competing with your other residents but you’re actually learning mutually so form a group, and discuss things amongst each other. If you have any tough questions bring them to your supervisor, faculty anesthesiologist, anesthetist, or your mentor, or whoever it is who can help you answer those. You can post questions below as well. This discussion helps retain everything in your long-term memory (I will call this a box!) and clarifies the concept which is so crucial.
11. Actively seek feedback about your performance
When you’re working in the operating room or the operation theater make sure you actively seek feedback to improvise upon yourself. You may get tips on how to manage the patient’s blood pressure? how to intubate? how to place the iv better? So actively seek out feedback. You can really improvise upon your skills, and your knowledge and build a solid foundation.
12. Take care of yourself
Here is the last one. It is easy to ignore but take care of yourself. Get some good rest, and get good sleep. Some days you have to do less sleep that’s just the nature of training. Make sure you have adequate hydration. Make sure you take care of your health, and your well-being. Your mind and body will thank you.
If you know of any other book just leave it in the comments below.
Interested to check your anesthesia knowledge? Click here for anesthesia-related multiple-choice questions:
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