A Resident's Perspective

Wake Forest University Medical Center, PGY-4

 

I was originally drawn to medicine by the unique fusion of creativity, innovation, and logical reasoning that flourishes to produce sound evidence-based advancements in knowledge and practice, thus a career in academic medicine has always appealed to me. I aspire to be a consultant physician with a deep (expert) understanding of a specialized content area whose practice is consequently more limited in breadth in exchange for a focus on depth.

 

I am pursuing fellowship training as I intend to further refine and improve upon my clinical skills, increase the depth and substance of my knowledge base, work towards mastery of echocardiographic assessment, learn how to effectively teach and motivate residents and medical students, and develop both the practical and more esoteric research skills needed to thrive in the academic setting. I want to be surrounded and mentored in the academic environment by physicians engaged in the advancement of our specialty through investigation, education, and pushing the boundaries of clinical care. Our field is advanced and defined by those who master the nuances and intricacies central to the art and science of anesthesiology and I find the academic environment invigorating and inspiring (despite the imperfections and frustrating components of modern academic medicine).

 

Practicing in a setting where my specific skillset is called upon to manage cases of a greater acuity and complexity is professionally appealing to me both in clinical practice and from a research standpoint where I believe anesthesiologists ought to serve on the front lines in establishing a further push towards optimizing patient care and advancing medical science. My specific area of interest is the high-risk obstetric patient affected by significant cardiovascular disease (peripartum cardiomyopathy, idiopathic pulmonary hypertension, and valvular disease as examples) and I intend to focus my research efforts on this complex subset of patients and their underlying pathophysiology as it applies to peripartum/perioperative management.

 

The further I progress into my residency, the more valuable I believe obtaining advanced subspecialty training will be to help continue to build and establish a true foundational framework for non-satisficing clinical judgment, thoughtful and engaging teaching skills, and innovative research.

 

When applying for cardiothoracic anesthesiology positions I think it is important for applicants to understand that there is a vast spectrum of different and valid experiences available. Programs are often wildly divergent from one another in many aspects including case mix and volume (eg. heart/lung transplantation, ECMO, VAD implantation, percutaneous procedures, congenital cardiac exposure, etc.), role as a fellow (eg. primarily supervisory, primarily “sitting” one’s own cases), opportunities for teaching, opportunities for networking, and opportunities for research (eg. potential integration with T32 grant positions, research fellowships, or other mechanisms for protected pre- or post-fellowship non-clinical time). This variety is daunting while on the interview trail, but I believe the numerous unique fellowship designs afford the applicant a chance to specifically tailor their experience to best fit their interests and needs. In my opinion the most important part of the application process is for the applicant to determine, as precisely as they are able, their ultimate goals and what the ideal fellowship year would look like to help them achieve those objectives.