Thank you for the video. I’m an anesthesiology applicant this year and completed my final interview this week. Your advice is spot on, and your insight into the Doximity rankings was intriguing. I will be reading your study very soon!
New to the channel but I've always said you Guys are our LIFE LINE and I Appreciate you all even more now. After a torn labrum, septoplasty, Tonsillectomy at the same time, Bone spur, carpal tunnel both 🙌 and Trigger thumb Surgery whew sheesh I THANK YOU. I always like the part when he/she would enter the room and ask to open wide and what I had for breakfast 🤣🤣 knowing good and well we haven't eaten anything
I'm glad you've had positive experiences with your anesthesia care! Haha yes I always appreciate when patients have been fasted for a while so I have lower concerns for any problems related to recent food/liquid intake.
As always, your videos are the best. I am truly grateful for them- they’ve guided me through successful anesthesiology rotations and now as I am preparing for my interviews. Thank you!!
Hey Dr. Max...thanks for your kind reply. Your work is extremely exact and obviously must be so. You are a dedicated, thorough, and compassionate professional. If I ever need surgery again I certainly would want a doctor like you. Thanks so much! Dr. Bobbi
Thank you for always making such in depth and informative videos! Nice to see you live/ work in NY. I also live in NY although I’m upstate. I’m actually having a procedure done at Albany Medical Center in two weeks. I hope that the physicians and staff taking care of me are as great as you seem to be ☺️
Thanks very much for the nice feedback! I hope everything goes well with your procedure. Albany Medical Center is great and I have no doubt you'll be in good hands there.
I remember reading your Doximity study when it came out. Great job! You think like an epidemiologist-and there are far too few people who have done an anesth residency who get graduate degrees in epi, and many many opportunities to combine them.
Great videos Dr. Feinstein! I would've became a Dr myself many yrs ago but I lost a lot of my sight in my teen years so that put a damper on my dream of being a Dr. But I at age 53 still love the medical field a lot! Yes I do help people with minor medical problems that I know how to handle with out asking a Dr for their help.👼1 Dr I walk with 3 days a week told me "Sunny you'd make a excellent Dr!" I said "Thanks but since I'm blind in 1 eye & can barely see out of the other who'd be my eyes for doing the paper work?" He said "The nurses would!" Every time I hear him coming up the side walk on Wednesday - Friday he always has a way of encouraging me to keep studying medicine. He gives me advice to help others & I put it in to practice. My neighbors know that if they need medical help I'm always a call away.😺Keep up the great work! Sunny in Pineville , Kentucky😺
Hey Dr. Feinstein, you should do stand up comedy! You're hilarious man, I'm a nursing student about to start working in the ICU after graduation and planning to go CRNA school, you are one of my inspirations! Thank you!
@@MaxFeinsteinMD Why do doctors get paid during residency because it looks like residency is almost like an internship? Nobody in any other field gets paid for any work that is done as part of their education.
Same applies to veterinary medicine! I matched for an anesthesia residency this year and I ultimately prioritized programs that I felt I would be happy at and feel that the work I put in was worth it 😊
Man that really means a lot! Good luck on your journey, stick with it through the tough times (there will be many), enjoy the high points (also many), and in the end, finally getting to practice medicine is an incredible privilege.
i like your videos because they are very informative and straightforward. i disagree that the more you work the better you are. it depends what you do with the experience you lived. some are very experienced in what they do but just lack to self reflect and also do the same mistakes over and over again. this is what i experienced with some foresters in logging as im a trained forester. now as a medical student im looking forward to the hands on residency time. and i will not apply to hospitals where they want me to work up to 60 hrs a week constantly. i need time in my freetime to think what i do in my work so i can reflect and learn instead would i work too much i would just sleep in my freetime. but for sure this is a subjective topic.
I think the most important questions would pertain to whether the resident is happy at the program, and learning the reasons for why or why not. That can reveal a lot of the important details.
Hey I wish when i was applying for psych PhD programs there were doc students, post-docs and licensed psychologists sharing like u are. Great job! Just my 2nd video and looking forward to watching many more. Dr. Bobbi
Thank you for this information! I am couples matching with my partner and he is applying anesthesiology and I am applying to family medicine. If you can do a video about the rank list with couples matching that would be great. Thanks again!!
My wife and I have been talking about making a video about the couples match, hope we'll have some time to do that soon! Good luck on the interview trail to both of you!
Once you realized you wanted to publish your findings in a journal, what steps did you take? Did you need to get a PI in order to do it? Did it cost you money?
To publish a manuscript, you generally just need to format the manuscript as requested by the target journal. You can just search for “instructions for authors” and the journal’s name and they should come up. Generally it does not cost money to publish an article unless either it’s an open access journal or predatory journal (or both). And yes, the PI (and all coauthors) should be in agreement about the final manuscript and where it gets submitted. I hope that helps!
I'm glad you enjoyed! I will say that since Grey's Anatomy focuses so much on surgeons, they really minimize the anesthesiologist's role. In a lot of their surgeries, they don't even have one haha.
Hi Leila, yes in the future I would love to do a video talking about the couple's match. It was a lot to think about on top of all the other factors that go into the match!
HI Max! Thanks for another great video! I am a 4th year applying to anesthesia this year and have found your videos enjoyable and informative! I was wondering if you could provide some guidance for interviews (since you went on quite a few). What were your main takeaways? What were interviewers trying to see (aside from you being normal or not)? Did you have any behavioral questions? How do you shine?
Hi Cece, thanks for the nice feedback! My main takeaways that I *tried* to get from every interview, in no particular order: 1) Are there any red flags that would make me not want to rank this program? 2) How happy are the residents not only in terms of enjoying their time, but specifically how happy are they with the training they've received, the overall vibe of the department, and the way they get treated by the program? 3) Is there anything that's important to me at this program that I wouldn't be able to get from another program? I think you hit the nail on the head with interviewers trying to just make sure I'm normal haha. Beyond that, the sense I got is that they're trying to sense if I'd be a good fit for their department in particular. That might be fit in terms of personality, research interests, or other parts of my background that the program director or other interviewers have in mind. I did encounter a few behavioral-type questions here and there, but they were few and far between. Fortunately I didn't encounter any stress interview-type questions, so I doubt you'd have to deal with anything like that! I'm not sure if I shined haha but I did try to just be my genuine self and not put on a show. I wanted to be at a program where they wanted me there for who I actually was, so it would have been to everyone's detriment if I acted more buttoned up or different than I normally am. So as cliche as it sounds, I think being your most genuine self is the best way to shine and help make a good match!
Wow, so glad I was recommended your channel, this is excellent content. I'm a medical student considering what I want to do down the line, anesthesia checks a lot of boxes with in depth pharm/phys, minimal rounding/charting, and procedures. You probably get this all the time, but what do you think about the future of anesthesia concerning midlevels? Will anesthesiologists be forced to purely supervise, or be obligated to do solely high stress cases? Thank you!
Hi Nicholas, glad you enjoyed the videos and also glad you're thinking early about anesthesiology! Good question about CRNAs and definitely important to be thinking about. So just to zoom out a bit, midlevel practitioners are present in many (most?) specialties, so anesthesia isn't unique in that sense. That's been a trend in medicine for a long time and I'm sure will continue that way. Specifically, the trend is finding less expensive ways to deliver medical care, and mid-level providers help answer that question by doing more of the bread-and-butter work in their respective fields. Going back to anesthesia, that means doing a lot of the ASA 1-2 cases (ie. patients aren't very sick at baseline) and also mostly not doing subspecialty work (eg. cardiac anesthesia, regional, OB, liver transplant etc) or at least not the advanced cases in subspecialties. Keep in mind that CRNAs practice medicine under the direction of MDs, and commonly one MD will simultaneously oversee up to 4 cases staffed by CRNAs. So to answer your question, I don't think anesthesiologists will be relegated to high stress cases, but will increasingly find themselves overseeing CRNAs providing anesthesia in the lower stress cases. It used to be that anesthesiologists would just staff the easier ASA 1-2 cases themselves, which still happens in some places, but that is slowly becoming less common. Hope that helps!
@@MaxFeinsteinMD Thank you for the prompt and in depth response! That is a good point about midlevels overall, but aren't CRNA's a special case because they have independent practice in some states? So wouldn't that then eliminate the MD altogether for these ASA 1's and 2's, driving down the demand for Anesthesiologists? Also, could you share your thoughts on the shift in the employment market with large private equity companies conglomerating practices? It seems like physician lead practices are being replaced with MBA's that care little for patients/physicians and more about $$$!
Hey @@cptKerala , yes you're right that some states are allowing CRNAs to practice independently, including NY where the state governor granted those privileges during COVID. Physician-led patient safety groups are actively advocating for that to be rescinded in NY state, and I believe that's happening elsewhere, too. Whether or not CRNA independent practice exists, I do think that they have removed some amount of demand of physicians to perform (at least directly) cases for ASA 1s and 2s. It seems like this is already baked into the current state of the job market -- if you ask an older anesthesia attending, they will probably tell you about the days when private practice anesthesia in endoscopy clinics could make loads of money doing colonoscopies for healthy people. That still exists in some areas, but not nearly as prevalent now and hasn't been for years from what I've heard. One other thing I'll mention is that the demand for anesthetics will continue to increase as baby boomers get older and have more procedures done. I'm not sure the extent to which this balances against the increase in CRNAs, but food for thought. You're right that private anesthesia practice groups are being acquired by PE firms, probably more so than most other specialties. I honestly don't know enough about how those merger/acquisitions go in terms of physician happiness with employment. I'll be very interested to follow along, particularly the year-over-year trends of happiness surveys from Medscape which are representative of national samples.
Very informative, keep up the great work! Also any advice for someone trying to decide between a PhD (Chemistry) and a MD program? I like both very much but I'm not sure what the best step to make will be (I'm a senior in University)... I like the idea of being a physician a bit more but I'm worried about not having enough time to spend with my fiancé/future family. I know PhD programs demand a lot of work, but not on the same level as MD programs and residency. Is your schedule manageable? Side note: I appreciate you replying to my last comment! Dr. Cellini won't know me I just really like his content. You and him are both hard workers, which is why I look up to y'all.
Hey Justin, I had actually debated between going to grad school for a PhD (in the humanities) vs. going to med school, and I’ll pass along the summary of differences that stuck out besides the obvious day-to-day stuff: - PhDs require you to be self-motivated thru grad school, and so your rate of progress will largely be up to how much effort you put in. The barrier to entering a PhD program is relatively lower than going to med school (depending on the program of course) but the real struggle is getting a job afterward. You will almost definitely not be able to pick which city you live in- you’ll have to go to where the job is if you can find one. There is a huge supply of PhDs so demand for jobs is relatively low. - Med school has a higher barrier to entry, but once you’re in, you’re essentially guaranteed a job barring any issues getting thru training. That said, med school is hard, and residency is harder. The shortest time period you can expect to complete training is 7 years (longer depending on the field) and your free time will play second fiddle to your career. Some specialties allow for a nicer work-life balance, but those tend to be either relatively low-paying or extremely difficult to get into. You’ll always have a job and you’ll pretty much always be able to pick which city you’d like to work in. Hope that helps!
@@MaxFeinsteinMD Thanks for the quick reply, I'm greatful for the advice. The main hurdle I need to overcome to get into med school is getting shadowing hours. How do you recommend I get in contact with an attending about an undergraduate student wanting to shadow?
There are a couple approaches you can consider: - Find an attending’s email address online (preferably one working at a hospital affiliated with your university) and just do a cold ask- say you’re interested and want to see about shadowing. - Reach out to your university’s premed advisor and ask for help connecting with an attending who’ll let you shadow. Just keep in mind that opportunities may be limited right now due to COVID (at least at my hospital in NYC, no observers are currently allowed) and even under ordinary circumstances, you’ll have to go thru a process of getting a hospital ID as a volunteer, most likely.
can you tell me what you think about how crna can impact future of anesthesiologist please? I heard number of crna is increasing and I'm worried about demand for anesthesiologist will go down in near future.
Hi D L, this is an important topic and I'm glad you're bringing it up. So just to zoom out a bit, midlevel practitioners are present in many (most?) specialties, so anesthesia isn't unique in that sense. That's been a trend in medicine for a long time and I'm sure will continue that way. Specifically, the trend is finding less expensive ways to deliver medical care, and mid-level providers help answer that question by doing more of the bread-and-butter work in their respective fields. Going back to anesthesia, that means doing a lot of the ASA 1-2 cases (ie. patients aren't very sick at baselines) and also mostly not doing subspecialty work (eg. cardiac anesthesia, regional, OB, liver transplant etc). What that practically means for anesthesiologists is that it's important to figure out a way to distinguish yourself from a CRNA, which for a lot of people means subspecializing. For other people, the answer to that might be getting involved with hospital committees, clinical research etc. Overall, I don't think this is an existential crisis for anesthesiologists, but it is important to make sure your career path builds in reasons for hospitals to hire you as an MD and not replace you with a CRNA.
Can I ask about how hard you studied for step 1 and your score if it's not too personal? I will take step 1 next year as a US IMG. I was stupid and wanted to study at the medical school my grandfather went to, so I moved to Europe. Now I'll be applying as a US IMG, which is a huge red flag, or so I heard. Now step 1 will be pass or fail which makes it even harder for me. I just hope that I'm not completely screwed, I just want to get anesthesiology residency interviews.
Hi there, I studied extremely hard for Step 1 and am happy to talk specifics if you message me on Instagram. I don't think that you're categorically screwed as a US IMG. For what it's worth, I think personal connections are extremely important in anesthesia (and medicine in general) so anything you can do to build relationships with residency programs in the US would be helpful.
Sure, I filmed this using a Canon SL2 with a Rhode Videomicro external microphone, a Neewer 18" light, and then edited everything with Wondershare Filmora 9. Hope that helps!
Hey MS3 here thinking of anesthesia. Love your channel and videos they are always inspiring me to keep studying. How did you pick which programs you wanted to do a sub i at?
Hey Erik, I was also an MS3 when I started considering anesthesia! Glad you’re getting inspiration from these videos. As far as sub internships, I picked programs based on cities that had the most dermatology residencies since my wife was applying for derm and I wanted to maximize my odds of getting into anesthesia programs in cities where my wife theoretically had the most possibilities of matching.
Thanks a lot for the videos! I'm curious about the hours worked part, you say 45 hours a week will not be enough to make you prepared, but how much of those extra 20 hours a week in your other example are actually "learning" and making you a better doctor?
More time in the OR = more clinical experience. That would include more repetitions with procedures, more experience extubating patients, and more experience managing complications that come up during surgery. So I’d say a lot of learning through experience!
The pathway to becoming a resident with prepare you-- taking pre-med classes helped me build stamina for med school, which helped me build stamina for residency. So just focus on the tasks in front of you, and the stamina will come with time!
In the US, it’s actually the federal government that pays all residents. The hospitals have to provide academic support for residents, but the hospitals themselves aren’t paying the residents. Also for what it’s worth, Colombia (the country) is a notable exception where residents actually have to pay to do residency, they don’t get paid.
Heyy, I have a question! What did you major in College? I’m planning to become an anesthesiologist but I’m not sure what to major in. And also do you need to be extremely good at math to become an anesthesiologist?
Hi Shreya, I double-majored in philosophy and neuroscience in college. I didn't actually take all the pre-med requirements in college, so I did a post-bacc program for a couple years afterward. My personal opinion is that you don't need to major in biology or even anything science-related in college just for the sake of applying to medical school. If you *want* to do something science-related, that's great. Otherwise, do whatever degree makes you happy, and take the pre-med classes (either in college or afterwards) and you'll be able to apply to med school. If anything, medical school admissions committees may get intrigued seeing a unique, humanities-oriented degree. Just my 2c. I am not great at math, but I am very detail-oriented so I double- and triple-check calculations. I don't think being good at math is a requirement, but it would be helpful!
Hi there, I went to the University of Southern California where I got a degree in Philosophy and Neuroscience. I actually only took a couple of my premed classes there. I took the majority of my premed classes after I graduated.
Subscribed on the first video, love the content! If I may recommend a topic I would recommend something on the subject of stress managment as a doctor. This due to the fact that mental illness and the suicid rate is over-represent amongst doctors compered to the general population. I find this a fascinating and important topic. Have a great day Mr Feinstein!
Thanks for the nice feedback! I think that's a great suggestion, and it's especially appropriate for anesthesiology where the rate of suicide is higher than any other medical specialty last time I checked (unclear the extent to which that's intentional suicide vs. accidental drug overdose -- either way still a very important topic).
@@MaxFeinsteinMD Dr. Feinstein, I think psychiatry is first and oncology is second in suicide rates. Agree mental hygiene for doctors (and nurses) would be an excellent topic!
You need to talk about CRNA’s and the very possibility that you might have just wasted 4 years of med school and 4 years of anesthesia plus or minus a fellowship to supervise someone else doing your job.
It sounds like I need to talk about how both fellowship and non-fellowship trained anesthesiologists have excellent career options in spite of 20+ years of people speculating that nurses will supplant physicians. But thanks for the suggestion!
@@MaxFeinsteinMD I’m an attending physician trained in ICU. I am a full time intensivist not only because I love it but because Of the facts I stated in my earlier comment. I provide anesthesia on a prn basis and have yet to step foot in the OR to do an actual case on my own. This is the trajectory of the anesthesia filed in my opinion. And because of this, I also find that it is not a respectable field to be in anymore. I guess you’ll find out once you become an attending.
Well, that is not encouraging to hear from an anesthesia trained intensivist. The attendings I’ve worked with haven’t expressed this concern, if anything the opposite based on the current job market in the NYC area. I also keep an eye on job listings through Anesthesia Ready which is similarly encouraging. So, I guess I’ll find out one way or another after I graduate.
@@MaxFeinsteinMD I practice in Florida. The model in this state is very heavy on CRNA’s. This obviously differs per state. Anyway, I’m not trying to be a Debby downer here but these are issues that I feel need to be addressed, especially when medical students are deciding what specialty they would like to pursue. Good luck with everything.
I appreciate your perspective and will spend more time asking attendings about their experience and take on the future of anesthesia, especially as I start thinking more about fellowship or not. I had gotten a lot of attending input as a medical student (in Ohio) several years ago and felt very reassured. At any rate, best wishes to you as well.
Hey I love ur UA-cam channel information is very helpful thank uh so much I’m medical student from India studying bsc in anesthesia technician your videos are very helpful can u please suggest a good forgein country to apply for job 😍found ur videos so helpful hope u ll reply
Hi Sana, thanks for the nice feedback and for following along with my channel! I wish I had more experience to be able to recommend where is a good place to apply for a job. I don't even know much about applying for anesthesiology jobs in the US because I'm still several years out from completing my training. Maybe in a couple years I'll have more information I can share!
Wow your wife is beautiful. What made u decide on the scarest job in medicine? I've always had full respect for all the anesthesiologists who put me under. Have to admit though its sky high anxiety when I get a rude nasty one. But I bet you will be awesome!
Yes she is! I'm a lucky guy. I don't know that anesthesiology is the scariest job in medicine - I think a lot of the surgical subspecialties would give me anxiety to do - but I take comfort in the training I'm getting. As long as I'm diligent with studying and detail-oriented at work, I believe my training should help me navigate even the most concerning situations in the OR. Thanks for the vote of confidence!
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Thank you for the video. I’m an anesthesiology applicant this year and completed my final interview this week. Your advice is spot on, and your insight into the Doximity rankings was intriguing. I will be reading your study very soon!
Congrats on finishing your interviews! Very exciting times. Best of luck on your match!
How did it go
New to the channel but I've always said you Guys are our LIFE LINE and I Appreciate you all even more now. After a torn labrum, septoplasty, Tonsillectomy at the same time, Bone spur, carpal tunnel both 🙌 and Trigger thumb Surgery whew sheesh I THANK YOU. I always like the part when he/she would enter the room and ask to open wide and what I had for breakfast 🤣🤣 knowing good and well we haven't eaten anything
I'm glad you've had positive experiences with your anesthesia care! Haha yes I always appreciate when patients have been fasted for a while so I have lower concerns for any problems related to recent food/liquid intake.
I know, I know, I'm ridiculously biased, but you're amazing.
Thanks Mom!!
As always, your videos are the best. I am truly grateful for them- they’ve guided me through successful anesthesiology rotations and now as I am preparing for my interviews. Thank you!!
Hey Dr. Max...thanks for your kind reply. Your work is extremely exact and obviously must be so. You are a dedicated, thorough, and compassionate professional. If I ever need surgery again I certainly would want a doctor like you. Thanks so much!
Dr. Bobbi
Thanks again for the kind words, Dr. Bobbi!
Thank you for always making such in depth and informative videos! Nice to see you live/ work in NY. I also live in NY although I’m upstate. I’m actually having a procedure done at Albany Medical Center in two weeks. I hope that the physicians and staff taking care of me are as great as you seem to be ☺️
Thanks very much for the nice feedback! I hope everything goes well with your procedure. Albany Medical Center is great and I have no doubt you'll be in good hands there.
I remember reading your Doximity study when it came out. Great job! You think like an epidemiologist-and there are far too few people who have done an anesth residency who get graduate degrees in epi, and many many opportunities to combine them.
That's awesome you had seen that Doximity study! I was more proud of that study than any other research I did, although nobody has cited it lol.
Great videos Dr. Feinstein! I would've became a Dr myself many yrs ago but I lost a lot of my sight in my teen years so that put a damper on my dream of being a Dr. But I at age 53 still love the medical field a lot! Yes I do help people with minor medical problems that I know how to handle with out asking a Dr for their help.👼1 Dr I walk with 3 days a week told me "Sunny you'd make a excellent Dr!" I said "Thanks but since I'm blind in 1 eye & can barely see out of the other who'd be my eyes for doing the paper work?" He said "The nurses would!" Every time I hear him coming up the side walk on Wednesday - Friday he always has a way of encouraging me to keep studying medicine. He gives me advice to help others & I put it in to practice. My neighbors know that if they need medical help I'm always a call away.😺Keep up the great work! Sunny in Pineville , Kentucky😺
You can still do it!!!
Hey Dr. Feinstein, you should do stand up comedy! You're hilarious man, I'm a nursing student about to start working in the ICU after graduation and planning to go CRNA school, you are one of my inspirations! Thank you!
wow I applied to three places Baylor, UT Southwestern , and SA.. that was in 1999
haha! skits getting better by the video! hilarious as usual.
Thanks man I appreciate you following along since pretty much the beginning!
@@MaxFeinsteinMD Why do doctors get paid during residency because it looks like residency is almost like an internship? Nobody in any other field gets paid for any work that is done as part of their education.
Same applies to veterinary medicine! I matched for an anesthesia residency this year and I ultimately prioritized programs that I felt I would be happy at and feel that the work I put in was worth it 😊
I'm only a freshman and it's my dream to be an anesthesiologist because of people like you who inspire me. Thanks a lot man
Man that really means a lot! Good luck on your journey, stick with it through the tough times (there will be many), enjoy the high points (also many), and in the end, finally getting to practice medicine is an incredible privilege.
i like your videos because they are very informative and straightforward.
i disagree that the more you work the better you are. it depends what you do with the experience you lived. some are very experienced in what they do but just lack to self reflect and also do the same mistakes over and over again.
this is what i experienced with some foresters in logging as im a trained forester. now as a medical student im looking forward to the hands on residency time. and i will not apply to hospitals where they want me to work up to 60 hrs a week constantly.
i need time in my freetime to think what i do in my work so i can reflect and learn instead would i work too much i would just sleep in my freetime. but for sure this is a subjective topic.
You’ve come a long way from the intern in the research room! Love the channel bro!
Thanks man! Hope your year is going well!
If you had the opportunity to sit down with a current resident, what are the most important questions to ask?
I think the most important questions would pertain to whether the resident is happy at the program, and learning the reasons for why or why not. That can reveal a lot of the important details.
Hey I wish when i was applying for psych PhD programs there were doc students, post-docs and licensed psychologists sharing like u are. Great job! Just my 2nd video and looking forward to watching many more.
Dr. Bobbi
Thanks Dr. Bobbi! In making these videos, I’ve also seen people making videos for tons of other specialties and careers. Pretty amazing.
Great video Max, perfect timing for us M4s applying this week!
Also dog cameo stealing the show 🐶
Thank you! Haha yeah I only noticed as I was finishing up editing 😂😂 that little guy is mischief
Thank you for this information! I am couples matching with my partner and he is applying anesthesiology and I am applying to family medicine. If you can do a video about the rank list with couples matching that would be great. Thanks again!!
My wife and I have been talking about making a video about the couples match, hope we'll have some time to do that soon! Good luck on the interview trail to both of you!
Once you realized you wanted to publish your findings in a journal, what steps did you take? Did you need to get a PI in order to do it? Did it cost you money?
To publish a manuscript, you generally just need to format the manuscript as requested by the target journal. You can just search for “instructions for authors” and the journal’s name and they should come up. Generally it does not cost money to publish an article unless either it’s an open access journal or predatory journal (or both). And yes, the PI (and all coauthors) should be in agreement about the final manuscript and where it gets submitted. I hope that helps!
@@MaxFeinsteinMD Thank you! That was helpful :)
This is so informative, thank you Dr. Feinstein!
You're welcome!
I'm a software engineer whose only exposure to medicine is Grey's Anatomy and you entertained me for all 17 minutes haha
I'm glad you enjoyed! I will say that since Grey's Anatomy focuses so much on surgeons, they really minimize the anesthesiologist's role. In a lot of their surgeries, they don't even have one haha.
Thanks for this informative video! Can you make a video on your experience with couple's matching please?
Hi Leila, yes in the future I would love to do a video talking about the couple's match. It was a lot to think about on top of all the other factors that go into the match!
HI Max! Thanks for another great video! I am a 4th year applying to anesthesia this year and have found your videos enjoyable and informative! I was wondering if you could provide some guidance for interviews (since you went on quite a few). What were your main takeaways? What were interviewers trying to see (aside from you being normal or not)? Did you have any behavioral questions? How do you shine?
Hi Cece, thanks for the nice feedback! My main takeaways that I *tried* to get from every interview, in no particular order: 1) Are there any red flags that would make me not want to rank this program? 2) How happy are the residents not only in terms of enjoying their time, but specifically how happy are they with the training they've received, the overall vibe of the department, and the way they get treated by the program? 3) Is there anything that's important to me at this program that I wouldn't be able to get from another program?
I think you hit the nail on the head with interviewers trying to just make sure I'm normal haha. Beyond that, the sense I got is that they're trying to sense if I'd be a good fit for their department in particular. That might be fit in terms of personality, research interests, or other parts of my background that the program director or other interviewers have in mind. I did encounter a few behavioral-type questions here and there, but they were few and far between. Fortunately I didn't encounter any stress interview-type questions, so I doubt you'd have to deal with anything like that!
I'm not sure if I shined haha but I did try to just be my genuine self and not put on a show. I wanted to be at a program where they wanted me there for who I actually was, so it would have been to everyone's detriment if I acted more buttoned up or different than I normally am. So as cliche as it sounds, I think being your most genuine self is the best way to shine and help make a good match!
Think medicine is a calling, and you have to be sure you have this calling and desire to be a doctor for the right reasons.
Wow, so glad I was recommended your channel, this is excellent content.
I'm a medical student considering what I want to do down the line, anesthesia checks a lot of boxes with in depth pharm/phys, minimal rounding/charting, and procedures. You probably get this all the time, but what do you think about the future of anesthesia concerning midlevels? Will anesthesiologists be forced to purely supervise, or be obligated to do solely high stress cases?
Thank you!
Hi Nicholas, glad you enjoyed the videos and also glad you're thinking early about anesthesiology! Good question about CRNAs and definitely important to be thinking about. So just to zoom out a bit, midlevel practitioners are present in many (most?) specialties, so anesthesia isn't unique in that sense. That's been a trend in medicine for a long time and I'm sure will continue that way. Specifically, the trend is finding less expensive ways to deliver medical care, and mid-level providers help answer that question by doing more of the bread-and-butter work in their respective fields.
Going back to anesthesia, that means doing a lot of the ASA 1-2 cases (ie. patients aren't very sick at baseline) and also mostly not doing subspecialty work (eg. cardiac anesthesia, regional, OB, liver transplant etc) or at least not the advanced cases in subspecialties. Keep in mind that CRNAs practice medicine under the direction of MDs, and commonly one MD will simultaneously oversee up to 4 cases staffed by CRNAs.
So to answer your question, I don't think anesthesiologists will be relegated to high stress cases, but will increasingly find themselves overseeing CRNAs providing anesthesia in the lower stress cases. It used to be that anesthesiologists would just staff the easier ASA 1-2 cases themselves, which still happens in some places, but that is slowly becoming less common. Hope that helps!
@@MaxFeinsteinMD Thank you for the prompt and in depth response! That is a good point about midlevels overall, but aren't CRNA's a special case because they have independent practice in some states? So wouldn't that then eliminate the MD altogether for these ASA 1's and 2's, driving down the demand for Anesthesiologists?
Also, could you share your thoughts on the shift in the employment market with large private equity companies conglomerating practices? It seems like physician lead practices are being replaced with MBA's that care little for patients/physicians and more about $$$!
Hey @@cptKerala , yes you're right that some states are allowing CRNAs to practice independently, including NY where the state governor granted those privileges during COVID. Physician-led patient safety groups are actively advocating for that to be rescinded in NY state, and I believe that's happening elsewhere, too. Whether or not CRNA independent practice exists, I do think that they have removed some amount of demand of physicians to perform (at least directly) cases for ASA 1s and 2s. It seems like this is already baked into the current state of the job market -- if you ask an older anesthesia attending, they will probably tell you about the days when private practice anesthesia in endoscopy clinics could make loads of money doing colonoscopies for healthy people. That still exists in some areas, but not nearly as prevalent now and hasn't been for years from what I've heard.
One other thing I'll mention is that the demand for anesthetics will continue to increase as baby boomers get older and have more procedures done. I'm not sure the extent to which this balances against the increase in CRNAs, but food for thought.
You're right that private anesthesia practice groups are being acquired by PE firms, probably more so than most other specialties. I honestly don't know enough about how those merger/acquisitions go in terms of physician happiness with employment. I'll be very interested to follow along, particularly the year-over-year trends of happiness surveys from Medscape which are representative of national samples.
Skits are the best part 🤣
Thanks! They're the most fun parts to make, too
Has anesthesiology become more competitive in recent years? As a DO student, how many programs do you recommend applying to?
I just found your channel and subscribed. Hello from a fellow MD. Excited to see more of your videos. :)
Awesome thanks for following along Dr. Marie!
Very informative, keep up the great work! Also any advice for someone trying to decide between a PhD (Chemistry) and a MD program? I like both very much but I'm not sure what the best step to make will be (I'm a senior in University)... I like the idea of being a physician a bit more but I'm worried about not having enough time to spend with my fiancé/future family. I know PhD programs demand a lot of work, but not on the same level as MD programs and residency. Is your schedule manageable? Side note: I appreciate you replying to my last comment! Dr. Cellini won't know me I just really like his content. You and him are both hard workers, which is why I look up to y'all.
Hey Justin, I had actually debated between going to grad school for a PhD (in the humanities) vs. going to med school, and I’ll pass along the summary of differences that stuck out besides the obvious day-to-day stuff:
- PhDs require you to be self-motivated thru grad school, and so your rate of progress will largely be up to how much effort you put in. The barrier to entering a PhD program is relatively lower than going to med school (depending on the program of course) but the real struggle is getting a job afterward. You will almost definitely not be able to pick which city you live in- you’ll have to go to where the job is if you can find one. There is a huge supply of PhDs so demand for jobs is relatively low.
- Med school has a higher barrier to entry, but once you’re in, you’re essentially guaranteed a job barring any issues getting thru training. That said, med school is hard, and residency is harder. The shortest time period you can expect to complete training is 7 years (longer depending on the field) and your free time will play second fiddle to your career. Some specialties allow for a nicer work-life balance, but those tend to be either relatively low-paying or extremely difficult to get into. You’ll always have a job and you’ll pretty much always be able to pick which city you’d like to work in.
Hope that helps!
@@MaxFeinsteinMD Thanks for the quick reply, I'm greatful for the advice. The main hurdle I need to overcome to get into med school is getting shadowing hours. How do you recommend I get in contact with an attending about an undergraduate student wanting to shadow?
There are a couple approaches you can consider:
- Find an attending’s email address online (preferably one working at a hospital affiliated with your university) and just do a cold ask- say you’re interested and want to see about shadowing.
- Reach out to your university’s premed advisor and ask for help connecting with an attending who’ll let you shadow.
Just keep in mind that opportunities may be limited right now due to COVID (at least at my hospital in NYC, no observers are currently allowed) and even under ordinary circumstances, you’ll have to go thru a process of getting a hospital ID as a volunteer, most likely.
Thank you for the great advice!
Thanks as always for watching Ryan!
can you tell me what you think about how crna can impact future of anesthesiologist please? I heard number of crna is increasing and I'm worried about demand for anesthesiologist will go down in near future.
Hi D L, this is an important topic and I'm glad you're bringing it up. So just to zoom out a bit, midlevel practitioners are present in many (most?) specialties, so anesthesia isn't unique in that sense. That's been a trend in medicine for a long time and I'm sure will continue that way. Specifically, the trend is finding less expensive ways to deliver medical care, and mid-level providers help answer that question by doing more of the bread-and-butter work in their respective fields. Going back to anesthesia, that means doing a lot of the ASA 1-2 cases (ie. patients aren't very sick at baselines) and also mostly not doing subspecialty work (eg. cardiac anesthesia, regional, OB, liver transplant etc). What that practically means for anesthesiologists is that it's important to figure out a way to distinguish yourself from a CRNA, which for a lot of people means subspecializing. For other people, the answer to that might be getting involved with hospital committees, clinical research etc.
Overall, I don't think this is an existential crisis for anesthesiologists, but it is important to make sure your career path builds in reasons for hospitals to hire you as an MD and not replace you with a CRNA.
hi doc...hope your doing great
Thanks, you too!
Can I ask about how hard you studied for step 1 and your score if it's not too personal? I will take step 1 next year as a US IMG. I was stupid and wanted to study at the medical school my grandfather went to, so I moved to Europe. Now I'll be applying as a US IMG, which is a huge red flag, or so I heard. Now step 1 will be pass or fail which makes it even harder for me. I just hope that I'm not completely screwed, I just want to get anesthesiology residency interviews.
Hi there, I studied extremely hard for Step 1 and am happy to talk specifics if you message me on Instagram. I don't think that you're categorically screwed as a US IMG. For what it's worth, I think personal connections are extremely important in anesthesia (and medicine in general) so anything you can do to build relationships with residency programs in the US would be helpful.
This is was really helpful! Thanks
Glad it was helpful!
Hey Dr...how to know whether the residency program that we about to apply has a malignant/toxic environment?
Thanks, super helpful!
Glad you found it helpful!
Hi Dr. Feinstein, great video. May I know what equipments & editing apps you are using to make videos? Thank you.
Sure, I filmed this using a Canon SL2 with a Rhode Videomicro external microphone, a Neewer 18" light, and then edited everything with Wondershare Filmora 9. Hope that helps!
Hey MS3 here thinking of anesthesia. Love your channel and videos they are always inspiring me to keep studying. How did you pick which programs you wanted to do a sub i at?
Hey Erik, I was also an MS3 when I started considering anesthesia! Glad you’re getting inspiration from these videos. As far as sub internships, I picked programs based on cities that had the most dermatology residencies since my wife was applying for derm and I wanted to maximize my odds of getting into anesthesia programs in cities where my wife theoretically had the most possibilities of matching.
I didn't know Shane from The Walking Dead went to medical school
Thanks a lot for the videos! I'm curious about the hours worked part, you say 45 hours a week will not be enough to make you prepared, but how much of those extra 20 hours a week in your other example are actually "learning" and making you a better doctor?
More time in the OR = more clinical experience. That would include more repetitions with procedures, more experience extubating patients, and more experience managing complications that come up during surgery. So I’d say a lot of learning through experience!
@@MaxFeinsteinMD Thanks a lot for the reply, I really appreciate it. What would you suggest to build stamina so I can survive residency?
The pathway to becoming a resident with prepare you-- taking pre-med classes helped me build stamina for med school, which helped me build stamina for residency. So just focus on the tasks in front of you, and the stamina will come with time!
Do all hospital pay their residents?
In the US, it’s actually the federal government that pays all residents. The hospitals have to provide academic support for residents, but the hospitals themselves aren’t paying the residents. Also for what it’s worth, Colombia (the country) is a notable exception where residents actually have to pay to do residency, they don’t get paid.
*match day happens in march not may
AH yes my mistake. I don't see a way for me to add a text overlay with a correction unless I reupload the video. Hm.
@@MaxFeinsteinMD No worries, keep up the great content!
Heyy, I have a question! What did you major in College? I’m planning to become an anesthesiologist but I’m not sure what to major in. And also do you need to be extremely good at math to become an anesthesiologist?
Hi Shreya, I double-majored in philosophy and neuroscience in college. I didn't actually take all the pre-med requirements in college, so I did a post-bacc program for a couple years afterward. My personal opinion is that you don't need to major in biology or even anything science-related in college just for the sake of applying to medical school. If you *want* to do something science-related, that's great. Otherwise, do whatever degree makes you happy, and take the pre-med classes (either in college or afterwards) and you'll be able to apply to med school. If anything, medical school admissions committees may get intrigued seeing a unique, humanities-oriented degree. Just my 2c.
I am not great at math, but I am very detail-oriented so I double- and triple-check calculations. I don't think being good at math is a requirement, but it would be helpful!
@@MaxFeinsteinMD Omg!! Thank you so much for the reply!! This helps a lot!!!
What college did you go to and did you take any type of premed?
Hi there, I went to the University of Southern California where I got a degree in Philosophy and Neuroscience. I actually only took a couple of my premed classes there. I took the majority of my premed classes after I graduated.
Max Feinstein, MD thanks!
Hi Max! M2 here looking into anesthesia. any advice? mostly just focused on step1 and research rn
Just left a comment for you in the 24-hour call video!
Subscribed on the first video, love the content! If I may recommend a topic I would recommend something on the subject of stress managment as a doctor. This due to the fact that mental illness and the suicid rate is over-represent amongst doctors compered to the general population. I find this a fascinating and important topic. Have a great day Mr Feinstein!
Thanks for the nice feedback! I think that's a great suggestion, and it's especially appropriate for anesthesiology where the rate of suicide is higher than any other medical specialty last time I checked (unclear the extent to which that's intentional suicide vs. accidental drug overdose -- either way still a very important topic).
@@MaxFeinsteinMD Did not know that. Thank you for the answer!
@@MaxFeinsteinMD
Dr. Feinstein, I think psychiatry is first and oncology is second in suicide rates. Agree mental hygiene for doctors (and nurses) would be an excellent topic!
You need to talk about CRNA’s and the very possibility that you might have just wasted 4 years of med school and 4 years of anesthesia plus or minus a fellowship to supervise someone else doing your job.
It sounds like I need to talk about how both fellowship and non-fellowship trained anesthesiologists have excellent career options in spite of 20+ years of people speculating that nurses will supplant physicians. But thanks for the suggestion!
@@MaxFeinsteinMD I’m an attending physician trained in ICU. I am a full time intensivist not only because I love it but because Of the facts I stated in my earlier comment. I provide anesthesia on a prn basis and have yet to step foot in the OR to do an actual case on my own. This is the trajectory of the anesthesia filed in my opinion. And because of this, I also find that it is not a respectable field to be in anymore. I guess you’ll find out once you become an attending.
Well, that is not encouraging to hear from an anesthesia trained intensivist. The attendings I’ve worked with haven’t expressed this concern, if anything the opposite based on the current job market in the NYC area. I also keep an eye on job listings through Anesthesia Ready which is similarly encouraging. So, I guess I’ll find out one way or another after I graduate.
@@MaxFeinsteinMD I practice in Florida. The model in this state is very heavy on CRNA’s. This obviously differs per state. Anyway, I’m not trying to be a Debby downer here but these are issues that I feel need to be addressed, especially when medical students are deciding what specialty they would like to pursue. Good luck with everything.
I appreciate your perspective and will spend more time asking attendings about their experience and take on the future of anesthesia, especially as I start thinking more about fellowship or not. I had gotten a lot of attending input as a medical student (in Ohio) several years ago and felt very reassured. At any rate, best wishes to you as well.
The nsgy residents doing 100-120hrs for 7yrs OOOFFF thats a lotta hours
Yeahhhhhh I wanted a work-life balance so didn’t go that route. It doesn’t get much better for them after residency.
best resource to figure out hours, quality and research?
Why 25 % only? Does that depend on whether program chose you or not?
Please put captions for the deaf people
Captions are processing and should be available shortly! Edit: They're available now
Hey I love ur UA-cam channel information is very helpful thank uh so much I’m medical student from India studying bsc in anesthesia technician your videos are very helpful can u please suggest a good forgein country to apply for job 😍found ur videos so helpful hope u ll reply
Hi Sana, thanks for the nice feedback and for following along with my channel! I wish I had more experience to be able to recommend where is a good place to apply for a job. I don't even know much about applying for anesthesiology jobs in the US because I'm still several years out from completing my training. Maybe in a couple years I'll have more information I can share!
Max Feinstein, MD thank u so much n all the best
Wow your wife is beautiful. What made u decide on the scarest job in medicine? I've always had full respect for all the anesthesiologists who put me under. Have to admit though its sky high anxiety when I get a rude nasty one. But I bet you will be awesome!
Yes she is! I'm a lucky guy.
I don't know that anesthesiology is the scariest job in medicine - I think a lot of the surgical subspecialties would give me anxiety to do - but I take comfort in the training I'm getting. As long as I'm diligent with studying and detail-oriented at work, I believe my training should help me navigate even the most concerning situations in the OR. Thanks for the vote of confidence!
UCSF is the best!??!?!?!?!?
Videos are Great thanks also videos of Dr rohin Francis also Dr Mike Hansen video s are good also Jerome Kim expert director general international vaccine institute experts Korea Asian Boss Jerome Kim expert director general international vaccine institute experts Korea Asian Boss Jerome Kim videos are grand you need to listen to this leading vaccine
Your dog needs grooming it doesn't look happy
Haha you are right. Rest assured, he received a haircut shortly after this was filmed.
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