CEO: Medical Knowledge and Skills

Objective: Understand the indications, contraindications, and potential complications of common clinical procedures and perform the basic clinical procedures expected of a new PGY-1.

In my future career as an anesthesiologist, I will be expected to perform many different procedures. From central lines to neuraxial anesthesia, my skill set will need to be robust in order to do what is best for my patients in preparation for their procedure. Most basic and perhaps vital is insertion of an intravenous line (IV). I have had some opportunities to practice with placing IVs during my medical school career and have been able to get a lot of feedback from residents and attendings regarding proper technique and recommended strategies for particularly difficult veins. But I have yet to practice with using ultrasound guided technique, something that I know will become more widely used in the future. Thankfully, I had the opportunity to use the ultrasound during a simulation session during the Part 2 curriculum. This was an important experience, as I was able to hone the basic skills of how to hold the probe, how to obtain the best image, and the best way to advance my needle.

Although placing an IV may seem mundane to some, I truly enjoy the procedure. It is very satisfying once you get that flash of venous blood and advance the catheter into the vein. And having that ultrasound probe in my hand during the simulation felt comfortable, like I was meant to use it during my career. I imagine that feeling is similar to my colleagues pursuing surgery with a scalpel in their hand.

Part of why I chose to pursue anesthesiology is because of the opportunity to do procedures every day. And that is also why I hope to complete a fellowship in cardiothoracic anesthesiology. In this field, I will expand my skillset to be able to perform and interpret transesophageal echocardiograms to provide real-time feedback on the cardiac function of my patient. Central venous lines and arterial lines will become second nature as each patient will require them prior to their procedure.

I will be rotating through many different services during my intern year prior to starting my anesthesia training, but I am going to try my best to get opportunities to do any procedures that are available. My goal for that important year is to hone my medical knowledge and start preparing for my anesthesia training.

As I reflect on my journey to becoming an anesthesiologist, this moment was crucial. It signified an opportunity to practice an important skill that I will no doubt use extensively during my future practice. And most importantly, the smile on my face is real as I genuinely enjoyed having the probe in my hand and a needle in the other. I know that there will be times where that smile might be replaced with a grimace or a somber frown as things might not always go as planned. There will be occasions where I question my choices and doubt myself. But I hope that in those times, I can remember this innocent moment as a third year medical student and the excitement I felt about such a basic procedure. The joy in the little things is what will carry me forward both in my career and in life.