It is a worthwhile exercise to take a moment from time to time and look back at how far we’ve come from our first day in medical school to where we are currently. There is still so much more information that needs to be learned, much more time required to fully master what it means to be a physician on all levels. At times, it can feel like a mountain without a summit. That is, until you look away from the future for a moment and turn your attention to the past. Even something as second-nature to a seasoned physician as successfully intubating a patient is truly an accomplishment for someone at my level of training. Like all learned skills, taking the time to practice and improve is a fundamental part of transitioning someone from a novice to an expert.
In my fourth year, following the Anesthesiology Clinical Track, I was able to spend a month on an Advanced Anesthesia Elective. I thoroughly enjoyed my time on this rotation and, as a quick aside, it truly helped to solidify my choice to pursue anesthesiology. During this month, I was not only exposed to multiple areas within anesthesiology but was also given the opportunity to practice my procedure skills. I practiced my ability to place IVs and A-lines, mask ventilate patients with both a two-handed and one-handed technique and intubate patients. We as medical students have had practice in these areas during workshops earlier in our education, but without repeat and consistent practice I did not feel confident in my abilities at the start of my rotation. I remember the first intubation I performed, feeling nervous and hesitant. But I listened to feedback throughout the procedure and asked for pointers at an appropriate time afterwards. The second intubation went a little smoother. The third, smoother still. Further along in my rotation, I rotated through cardiac anesthesia and was able to intubate a difficult patient who had a propensity for desaturating. I was able to stay calm and listened to my attending and successfully completed intubation. The confidence in my abilities dramatically improved over the month but I remained aware that there was much more practice that needed to be done. At the end of the month, I felt quite competent in the procedures I performed and it was a pleasure to think back on how much I had improved in approximately 30 days. It gave me the first glimpse at what I could potentially be capable of with enough hard work.
It’s important to keep one’s focus and energy on what has yet to be accomplished and not rest on our laurels. However, every once in a while it’s both educationally and personally rewarding to acknowledge what strides forward we’ve made to date. Small improvements really do lead to large improvements with enough time and dedication. Moving forward, I hope to continue along this trajectory and practice, practice, practice. I saw a large improvement over one month, but after having spent the last several months on different rotations and going on interviews I know that there will be a learning curve when I get back to performing procedures. I would say that procedures are less like riding a bike and more like shooting a 3-pointer in basketball. You can see improvements and even feel proficient at a certain point, but it’s the continued practice that allows you to hold on to your refined technique. So, I plan on getting as much hands on experience in residency so as to feel proficient with time and hold onto that proficiency.