What is an Anesthesiologist

The field of anesthesiology is a medical specialty that focuses on the relief of pain and total care of the surgical patient as well as the immediate postoperative period. Anesthesiologists are medical doctors who must complete 4 years of undergraduate school, four years in an accredited medical school, one year as a general surgery intern, three years at a minimum in an anesthesia residency program and one or two years in a critical care medicine fellowship. This adds up to 11-13 years after high school before you can even apply for a job as an anesthesiologist!

What do Anesthesiologists do?

Anesthesiologists utilize their extensive education to provide what is termed “total patient care”. In addition to managing the airway and ensuring proper breathing during surgery, anesthesia providers also manage pain, fluid and electrolyte balance, body temperature, prevention of cardiac arrest, patient transport to the operating room and post-operative management.

Anesthesiologists are not limited to what goes on in the operating room though. They are also responsible for what happens before surgery, during the preoperative visit with a surgeon who may or may not be an anesthesiologist themselves!

For further information about what an anesthesiologist is and what they do, please check out this fine article.

Post residency training - Fellowships

Anesthesiology is a very competitive field for medical students, and many of the most talented individuals go on to do fellowships. There are different types of fellowship programs available for people interested in specializing further in anesthesiology.

Here are a few of the most popular Anesthesiology Fellowships:

Anesthesia critical care: requires 2-3 years following residency after completing at least 3 years of anesthesiology residency. This track typically leads to board certification for both anesthesia and critical care medicine, which allows you to work in academic institutions where research applications will be strongly considered. The two separate specialties must be completed back-to-back and an anesthesiology residency is typically expected for this track.

Obstetric anesthesiology: requires board certification in anesthesia followed by an additional 2 years of training after an anesthesiology residency, is necessary for this fellowship. This program is designed to train people to become experts in pain management and anesthesia during labor or cesarean delivery. A person going into this field must already have a strong knowledge of anesthetic drugs and their pharmacokinetics, as well as an interest in the endocrine system and physiology.

Pediatric anesthesiology: this option consists of an anesthesiology residency, followed by a 3-4 year pediatric anesthesia fellowship accredited by the Accreditation Council for Graduate Medical Education (ACGME). A family medicine or pediatrics residency is required prior to applying. Once you’ve completed all that, you can then take advantage of advanced training opportunities while working towards board eligibility and certification in pediatric anesthesiology. This type of job typically includes caring for children with congenital heart disease, infants with neurologic problems within the neonatal intensive care unit (NICU), and children undergoing surgical procedures.

Neuromuscular anesthesiology: this fellowship program is designed for people who want to become an anesthesiologist who specializes in neuromuscular-blocking agents (NMBA). You must complete an anesthesiology residency and the American Board of Anesthesiologists’ exam for certification before you can apply to a neuromuscular fellowship. A neuromuscular anesthesiology fellowship requires completion of an intensive clinical requirement, research project, or prior experience with NMBA titration.

Pain medicine: this track typically takes three years after an anesthesiology residency, during which time fellows gain surgical expertise in pain management techniques under an anesthesiologist who has an interest in the field. The anesthesiologist in pain management is often an expert in regional anesthesia and procedural techniques, with an in-depth understanding of neuromodulators like local anesthetics.

Cardiothoracic anesthesiology: this fellowship requires completion of an anesthesiology residency, followed by two years of training that focus on perioperative care for patients undergoing cardiothoracic surgery or thoracic pain management. You must be board certified to apply for a cardiothoracics anesthesiology fellowship associated with a university hospital or large medical center.

Regional anesthesia: this option provides continuing education opportunities and clinical experience in anesthesiology and pain management. The program lasts one year and requires an anesthesiology residency and certification in anesthesiology to apply.

For more information about Anesthesiology fellowships please visit: https://www.asahq.org/education-and-career/asa-resident-component/residentfellows-in-training/fellowship-opportunities

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The Path To Becoming a Pediatrician

The path to becoming a pediatrician requires multiple steps. The first step is completing the appropriate coursework in high school including advanced classes in math and science. After graduating from high school, students will need to gain acceptance into an accredited undergraduate institution that has a pre-medicine program although having a pre-med degree is not required to attend medical school.  Many current medical students are excepted without pre-med, chemistry or biology majors as long as they have the required classes for acceptance.

Taking The MCAT

In addition to completing the required coursework, students must take and submit their score from the Medical College Admission Test (MCAT). Achieving high scores on this 6 1/2 hour test with scored sections in physical sciences (chemistry and physics), verbal reasoning (reading comprehension), Biological Sciences (with lab) and Writing Assessment can give an applicant an advantage when applying to schools

The First Two Years Of Medical School

After being accepted into medical school, a student must complete rigorous coursework. The first 2 years of medical school at dedicated to didactic courses such as anatomy, physiology, pharmacology, neuroanatomy and others. It is towards the end of the 2nd year of medical school that students start preparing for the 1st, and most say the most difficult, of three national board examinations. This first test being the USMLE step 1 for allopathic schools and COMLEX step 1 for osteopathic medical schools. This test MUST be passed.

The Third and Fourth Year Of Medical School

The next two years of medical school is reserved for clinical rotations.  This is where students learn and participate in supervised patient care in core medical areas such as pediatrics, OBGYN, internal medicine, pathology, emergency medicine and others. After completing the required rotations, students go on to attend elective rotations.  These are often termed “audition rotations” in that students are trying to get noticed by hospitals that they wish to apply for residency at as getting selected into a residency program is often competitive. It is during the clinical rotations that students need to take and pass Step 2 on the USMLE or COMLEX.  All schools accredited by the Liaison Committee on Medical Education (LCME) will require their graduates to pass Step 1, Step 2 Clinical Knowledge (CK). in that sequence before obtaining a medical license and obtaining a residency.

Residency and Beyond

After applying and being accepted into a Pediatric residency, the third part of the national boards must be taken and passed. It is the USMLE. Step 3 or COMLEX step 3.

Residency for pediatrics is 3 years in length and must be completed in order to gain licensure to see pediatric patients without supervision. Some pediatric residents choose to further their education by attending a Fellowship program to focus on one of many subspecialties.

Click this link for a more in depth article that explains the fourteen steps of becoming a Pediatrician.  

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