February 2000
Volume 64 |
Number 2
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| The Best-Kept
Secret in All of Medicine |
Jeffrey B. Glaser, M.D.
Sure, I'm referring to the field of anesthesiology! During my
first two years of medical school, I can recall working seemingly
endless days and nights just to keep up with the vast amount of
information physicians were expected to learn and comprehend.
Rarely did I consider what field I would ultimately pursue; who
had time for such luxurious thoughts? Soon, however, my clinical
years would begin.
Wow! I remember that first day of my third year of medical school
like it was yesterday. A beautiful fall day in Philadelphia, the
air was warm and breezy, skies were blue and I walked five blocks
through center-city Philadelphia to report for my medicine rotation.
I was a young pup, a "doctor-wanna-be" in my crisp white coat,
nicely pressed shirt and pants, colorful tie, and, oh yes, a stethoscope!
I certainly looked like I knew something, but the short white
coat told the medically savvy to beware. I was a neophyte, an
impressionable "blank slate."
As I worked through my clinical rotations, the buzzwords "primary
care" were embedded in my brain like an incurable and quickly
replicating virus. However, there were so many fields from which
to choose: internal medicine, radiology, dermatology, surgery,
urology, pediatrics, etc. But who ever gave serious consideration
to anesthesiology?
Well, the match came and went, and I was going to be an internist.
I matched as a categorical internal medicine resident. My pediatrics
advisor was quite proud. I was just what the medical school had
ordered: another primary care doctor.
In the middle of my internship year, a light bulb went on in
my "noodle." I loved critical care and the instant gratification
aspects of medicine, but I could not stand the smell of "code
browns." Furthermore, I hated managing high blood pressure, diabetes
and other chronic diseases where results were often difficult
to see.
Serendipitously, I was introduced to the field of anesthesiology:
the best-kept secret in all of medicine. To the chagrin and disappointment
of my internal medicine residency director, I left the program
after my internship to become an anesthesiology resident.
As it turned out for me, no time was lost, and I matriculated
directly out of internship into an anesthesiology residency. However,
many decided to pursue anesthesiology after several years of training
in another specialty, or perhaps even after practicing in the
community for many years. I believe this phenomenon is a result
of minimal exposure to anesthesiology as medical students.
Why is it so difficult to introduce medical students to anesthesiology
during their clinical years? Unfortunately, core curriculums at
most medical schools do not include clinical course work in anesthesiology.
But moreover, this trend is not getting any better -- in fact,
it is getting worse.
At the University of California-Los Angeles (UCLA), I am dedicated
to exposing medical students (those "blank slates" mentioned earlier)
to anesthesiology. With tremendous support from my program, I
have developed an anesthesiology society geared toward the medical
student. My goal is to make a positive impression early on in
one's medical education that will entice medical students to consider
anesthesiology as their potential specialty choice.
In creating this society, I was cautious not to promote a blatant
recruitment project for the field; I felt that this would lessen
the value of a residency in our specialty. Instead, I have developed
seminars for first- through fourth-year medical students, given
by anesthesiologists, that will stimulate them and arouse their
curiosity.
On September 25, 1999, the first anesthesiology society meeting
was held at UCLA. More than 70 medical students attended a seminar
on basic monitoring and enjoyed a lunch, compliments of our department.
The topic was "A 24-Year-Old Male with Stab Wounds to the Chest
and Abdomen . . . How Would You Monitor This Patient? A Hands-on
Approach." The session lasted one hour. The first quarter hour
consisted of an orientation given by our excellent faculty advisor,
Randolph H. Steadman, M.D. The next part of the hour was broken
into three 15-minute blocks where medical students rotated through
a pulse oximetry station, blood pressure station and EKG station.
Based on feedback, the students loved this program. I was most
impressed by the unsolicited questions that were entertained regarding
the specialty of anesthesiology. Furthermore, many myths about
our specialty were dispelled.
Certainly, it is too early to tell if this program will have
any impact on the future anesthesiology applicant pool at UCLA.
However, my plan is to have approximately six "hands-on" lunchtime
meetings per year. Topics may include intravenous and central
line placement, direct laryngoscopy and arterial line insertion
and other topics that are germane to medical students regardless
of what internship they ultimately pursue.
As Resident District Director of the California Society of Anesthesiologists,
I am encouraging all anesthesiology residency programs in California
to develop medical student societies at their respective institutions.
With the support of delegates from across the state, I am confident
that this will be possible in the upcoming months.
The program I have developed is simple and elegant in theory,
but it took the dedication and commitment of many to make it work.
Such a program needs a supportive department chair, a faculty
advisor, a resident coordinator and a medical student liaison.
In conclusion, I would encourage anesthesiology residency programs
across the country to develop medical student societies similar
to the one I have created at UCLA. Impressions are formed early
on in one's medical career. If we can leave indelible impressions
on the "blank slates" in their early years, I am certain that
we will convince them that anesthesiology is "the best kept secret
in all of medicine."
My yard stick for success will be when the intrigue of anesthesiology
is no longer just a secret, but a well-known fact.
Jeffrey B. Glaser, M.D., is a CA-3 resident
at the University of California-Los Angeles.
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