Selecting a Specialty for Residency: Anesthesiology


Are you currently in medical school or looking to start? You may be wondering what medical school specialties you might want to pursue.

Anesthesiology is the branch of medicine dedicated to pain relief for patients before, during, and after surgery.

We asked Dr. Tory Cange, a recent graduate; Dr. Aaron Benotas, who’s in his second year of residency (a CA-2); and Dr. Justin Roberts, a current chief resident, what led them to choose anesthesiology, what a day in the life of an anesthesiologist is like, how you can stand out in this field, and more.

Read what they had to say, and learn how anesthesiology can be a rewarding specialty.

6 Questions and Answers from Anesthesiologists

Your path to Residency starts at St. George’s University. Are You In?

1: What led you to choose a career in anesthesiology?

Dr. Tory Cange, a recent graduate who matched at St. Joseph’s University Medical Center for his medical school residency, originally wanted to pursue surgery. But once he got into his surgical core rotation, he found it to be too repetitive for him.

He scheduled an anesthesiology rotation and discovered it was a perfect fit. “There’s tremendous case variety. So you could be doing an orthopedics case in the morning, then be doing neurosurgery or cardiothoracic pediatric, so you're constantly challenged to manage all these different comorbidities and different types of patients.”

Dr. Aaron Bernotas, a CA-2 at Robert Wood Johnson University Hospital, was exposed to the field of anesthesiology early in life as his father was a Certified Registered Nurse Anesthetist. He added that during his rotations, “Nothing grabbed me like anesthesia did, so for me, I primarily chose anesthesia because it’s a specialty that allows you to be a specialist but basically treat everybody. So you can treat anyone from a newborn to somebody who’s 80-90 years old.”

2. How did medical school prepare you?

Dr. Cange said that the curriculum prepared him well for anesthesiology from the foundational basic sciences the first two years of his medical degree program to the emphasis on the pillars of anesthesiology: pharmacology and physiology.

He pointed out that his classes and labs did a great job of preparing him for the medical exams. “All of our exams are written in the same style as the board exams which makes you extremely comfortable when it comes time to take the actual exam,” he said. “I felt more than prepared for my board exams.”

Dr. Bernotas added, “The background you have in your basic sciences and clinicals gives you a good foundation to be able to get your foot in the door for a lot of programs.”

The Office of Career Guidance and Student Development (OCGSD or OCG) proved to be extremely instrumental as well, particularly in their ability to connect medical school students with alumni practicing in their chosen field.

In addition, the medical school’s extensive clinical network provides students with a large network to choose from for clinical rotations. Medical students also have access to a voluntary tutoring system from the Department of Educational Services.

3. What Does A Day In The Life Of An Anesthesiologist Look Like?

If you like variety in your day, anesthesiology might be a perfect fit. The doctors all noted that no two days are the same, since anesthesiologists care for patients from newborns to the elderly with vastly different comorbidities.

In general, an anesthesiologist arrives at the hospital early in the morning, often before 6:00am. The type of rotation they are treating determines how early. For example, for cardiac cases, the anesthesiologist will arrive earlier than for non-cardiac cases like a pain rotation.

Dr. Justin Roberts, a chief resident at Robert Wood Johnson University Hospital, said, “The day is highly variable; you need to be ready for anything. ...One minute, you can be doing an epidural, the next minute you can be in the ER.”

Dr. Bernotas agreed. “I typically come in around 6:00am. I’ve had days where I’ve gotten out at 11:00am and I have had days where you get out at 7:00 or 8:00pm or sometimes be on call for a full 24 hours. So it really is completely varied.”

4. What Are The Subspecialties Within Anesthesiology?

There are five main subspecialties within anesthesiology, three of which are accredited, meaning a doctor will be board certified after completing one of these accredited fellowships.

The three accredited subspecialties are:

Pediatrics: This is a very respected and sought after subspecialty as you are caring for very small children with various comorbidities. There are further subspecialties within pediatrics like pediatric cardiac and pediatric pain management.

Adult cardiothoracic: These anesthesiologists are working with heart and lung patients including pathologies, open heart and valve surgeries, heart and lung transplants, etc.

Pain medicine: Dr. Justin Roberts notes that “this subspecialty is rapidly evolving and diversifying.” Patients are being offered different modalities in terms of interventional pain (like spinal cord stimulators) and medication.

These next two subspecialties are working towards accreditation:

Regional anesthesia: Should a patient be unable to undergo general anesthesia for some reason, regional anesthesia allows for the numbing of just the required area for the surgery. There are currently a handful of accredited regional fellowships.

Obstetrics: This is a growing field, and residencies are beginning to expand.
One more subspecialty that is growing is neurosurgery anesthesiology, treating diseases and disorders of the brain, spinal cord, and peripheral nerves.

5. Did Graduating From An International Medical School Influence Placement Options For You?

All three doctors were emphatic that graduating from a Caribbean medical school had no bearing on their placement options.

When Dr. Cange was asked if he had experienced any stigma for being from an international school, he said, “The answer is no. On my interview trail, all the questions that I got were in an extremely positive light. They wanted to know about my experience. And for me that was one of my favorite questions because my face always lights up every time I talk about the school and my experiences.”

As someone who interviews potential residents, Dr. Roberts was asked if school prestige had ever been used to determine between two different applicants. He quickly said, “Never. I thought I was going to get that question when I interviewed. But if you’re sitting down for an interview, you’ve already passed the sniff test. You’ve already passed all the other things. They want to get to know you as a person. I was ready for that question, and the only question I was asked was how I enjoyed the beaches.”

But Dr. Roberts also stressed that you have to do your part. The medical school “will provide you all of the tools that you need to be successful but if you do not take advantage of it, that is on you. That is not on the school.”

6. How Can Others Stand Out In The Field Of Anesthesiology?

Dr. Roberts stressed the importance of having strong board scores, adding, “It is getting even more competitive to get into anesthesiology.” He also shared the significance of relationships during the placement process. “If you know what you want to do, go after it. Make it be known. Having people to talk to, people to reach out to and talk with is huge, and the OCG definitely facilitates this. ...Relationships are everything.”

Dr. Cange adds, “You really want to get strong letters of recommendation. That comes from doing rotations and proving your commitment to the field, showing a lot of passion, being professional, and showing a true interest in the field.” Dr. Cange also suggested having your personal statement reviewed by as many people as you can to make it the best it can be.

Dr. Bernotas agreed, stating that “showing your interest and getting good letters of recommendation” are both important. He also said, “Going on the interview circuit and applying broadly and smartly, knowing what you have and what is out there.”

Finally, don’t get discouraged. Dr. Roberts said, “Realize that if it’s not going to be you, it’s going to be somebody else who gets the spot. The spot has to be filled. ...I don’t say all of these things to deter you, but you should have a proper view of what you’re getting yourself into. It’s very attainable, you just have to do well. And every day when you wake up, you say, ‘I still want to do this’ and chase after that dream. And you will get it.”

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