Why I DIDN'T... Anesthesiology

[@Anton-fh8xr]

An anesthesiologist told me: if OR is your favorite place in the hospital - become an anesthesiologist. if OR is your favorite place in the world - become a surgeon.

[@hasti81193]

I love this

[@gamesforever4841]

Love it :)

[@henriquelaydner4080]

As an anesthesiologist myself, I totally agree with it. I’d add that anesthesiologists spend almost full time in the ORs, each and every day, while surgeons have to deal with their clinic and inpatient care.

[@intrepidtomato]

@@henriquelaydner4080 As a patient who has undergone anesthesia several times, thanks for all you do! The 'bedside manner' and calm of you anesthesiologists and your team make all the difference.

[@LS-ry5ey]

Anesthesiologist are sooooo calm and niiicceeeee

[@yourfavoriten3rd]

What people forget about anesthesia is that we're in the OR all day. If you see an anesthesiologist on their phone in the case when the patient is stable, think about when you're in your workroom between writing notes etc and take a break to be on your phone. It's the same for us, we're literally always in the OR, it's our office. Also as mentioned elsewhere we do many kinds of nerve blocks, have great POCUS skills, place central lines and swans, and our airway skills include awake fiberoptic intubation, bronchoscopy, double lumen tubes/bronchial blockers etc. I don't really know what other procedures there are. Also, don't forget that we also work in the ICU and L&D, it's a great place to be a bit of a specialist and a bit of a generalist if that's something you want.

[@mas3ymd]

We only work in ICUs if we did fellowship in critical care medicine. And that would primarily be for surgical ICUs. For medical ICUs, you need internists with CCM training. Without extra training, we are wholly unqualified to manage ICU patients.

[@sigma697]

I love Anesthesia. As an Anesthesiologist, I love the skills that you develop to deal with any surgical procedures (in ANY surgery specialty) and/or emergencies where you can show your experience, your education and your training. I also love procedures being that you can do ultrasound guided nerve blocks, invasive monitoring lines, trans esophageal echocardiograms, spinals/epidurals or pain procedures. I don’t like to be standing up for hours (like the surgeons), my legs would hurt without any movement. But what I love the most is being able to do the Anesthetics for the sickest of patients and deliver those persons back to their families alive and well (and hopefully without pain!!). What’s not to love!

[@WiseSteward777]

Do you notice any burn out from fellow Anesthesiologists? If so what would cause that? Long hours? Standing up all day?

[@mas3ymd]

Anesthesiologist here. You grossly overstate the nature of our work. 99% of our cases involve pushing the same three medicines and sticking a breathing tube in someone’s throat, with little variation. And the “procedures” we perform are simple and mundane. If putting a central line or doing a nerve block excites you, then you are far too easy to please.

[@hevinamber]

Waking them up safely is my favorite part!

[@mas3ymd]

@@hevinamber You mean turning off the gas and waiting for them to breathe on their own?

[@hevinamber]

@@mas3ymd pretty much. I guess what I mean is that most of the patients are not afraid of the surgery but when I introduce myself and tell them what I will be doing they get very anxious and tell me, just make sure I wake up. They all tell me that they are afraid of the anesthesia. When I did my MBA in healthcare Management, I studied anesthesia errors and the patient I studied committed suicide two weeks after surgery recovery because he was not properly anesthetize. So that always sticks with me anytime I perform anesthesia. Also if it is a procedure that allows, I tend to keep them breathing on their own as much as possible

[@intrepidtomato]

I think these are extremely useful. Even if your pros and cons don't line up with somebody else's, it is good to hear an honest, unbiased opinion from somebody who has done those rotations.

[@Buzzzy-bee]

It’s biased because of his biases….

[@TheTheaterThug]

Surgeons are the captain of the sailing ship, anesthesiologists are the captain of the sinking ship

[@gil5111]

This might be the best anesthesia analogy I've heard.

[@konkeydonged]

If both ships make it to their destination, anesthesiologists have a tougher job -- much easier to control a ship that's sailing than one that's sinking.

[@tgreetsy1201]

@@konkeydongedother than having to pre round and manage post ops with weekly clinic. Surgeons lifestyle is more difficult, which is why I went gas haha.

[@fuzzybutkus8970]

Well done and so true.

[@merelymaterial]

while the beta surgeon who needs to compensate by feeling like the 'captain' is fiddling with some bowel for 5 hours, the chad anaesthesiologist is chilling trading stocks on his phone and chatting up the nurses

[@Aquamayne100]

2nd in command until Anesthesia cancels the case 😂

[@henriquelaydner4080]

About who’s the first and second in command, that’s only an ego issue. A mature and healthy professional relationship between surgeon and anesthesiologist always put patient’s safety in first place and decisions are made in common ground. In some aspects I think of my job as being the surgeon’s Jiminy Cricket, counterbalancing their almost uncontrollable desire to operate, which sometimes can blur their best judgment.

[@casebased8391]

By that logic, the scrub tech being first or second in command is also “only an ego issue”. Obviously everyone in the team is putting the patients’ well-being first.

[@user-hq6gt6wr9k]

Anesthesia PGY1/CA0 here-- great vid 😊 Don't forget about nerve blocks as part of the procedures we get to do-- there are so many different kinds and I'm eager to master this area of multimodal pain control and the ultrasound we use to achieve it!

[@mas3ymd]

No. There really aren’t that many different kinds. Eight or nine main types. And they are all subject to surgeon approval - especially the ones for pain control after. They are all exceedingly simple, mundane tasks.

[@joshbritton]

Always looking forward to these videos, as it helps me hear from someone’s personal experience about the good and bad. Thanks for making quality content!

[@tmellis8]

For me I love that anesthesia combines basic science and procedures. I also really like that I work with a wide range of specialties. Keeps in interesting

[@nicholasbraganca5710]

One big phrase I’ve heard about anesthesiology is “Hours of boredom, minutes of panic.” I can’t stand the boredom, which is why I am trying for surgery 😁

[@iasian246]

Great stuff, lol some of the cons were pros for me, hence ended up becoming an anesthesiology resident. No ward rounds, no clinic was already enough to win me over.

[@richiemd777]

You talked about procedures and patient ownership in terms of General Anesthesiology. You subspecialize in Critical care, Cardiac or pain, you're doing a ton of procedures.

[@jaredkhan8743]

I’m applying to med school now with the goal of being an anesthesiologist and all these “cons” made me wanna do it even more!! I’ve been shadowing anesthesiologists a loot and work for a surgeon so I have a good feeling I will enjoy this career when I eventually get to it!!!

[@kgrfirdjy]

I thought it was fascinating seeing how my pain management anesthesiologist also was trained in niche surgical procedures including placing a couple of spinal cord stimulators in me for severe abdominal pain. This quality of life approach has a deep sense of intrigue to me as a registered nurse who has worked in emergency medicine. I want to learn more about pain management nursing once I go back to work while I am awaiting a pancreas transplant. I would love to attend CRNA school after working a few years.

[@andy2445]

The bad things that you listed are the reason there is a high demand for anesthesiologists right now. Many new graduates can make 500k right now with 100-150k sign on bonus.

[@truthteller2711]

Midlevel encroachment is a HUGE issue that isn’t talked about as often! Recently optometrists are lobbying in California to be able to perform surgery!! Pls make a video talking about this issue more 🙏

[@paulvangogh9125]

Whaaat?

[@bluethunder9102]

A very small minority just don’t try and spin it as all optometrist want that

[@vanessavarela01]

I work at an optometry office in California and thank god my doctor isn’t like this. Optometrists 100% aren’t qualified to perform surgeries. That needs to be left to the ophthalmologists.

[@vanessavarela01]

@Timmy Tran I would say assessing glasses prescriptions. Ophthalmologists can also do this, but most patients they’re seeing aren’t coming in for that. Most patients an optometrist is seeing are, so they’re getting a lot more experience with it.

[@mustang8206]

Optometrists shouldn't be doing surgery but they aren't mid-levels

[@gaspasser]

The days of surgeons yelling at anybody are long gone. 😂. That’s coming from an anesthesiologist.

[@Alex-op4ty]

With anesthesia you still have call and weekends, plus OR cases always start super early in the morning in America (this was actually the biggest con for me, I'm not trying to wake up at 5am as an attending). Lifestyle is still better than surgery but probably not as great as strictly outpatient specialties

[@gil5111]

For what it's worth as a soon to graduate med student, for me, the outpatient specialties had some of the worst lifestyles on my rotation. Many times they would be 8-5 schedule, but always run late. Then they had hours of charting still to do at the end of the day. I'd much rather have work 7-3 or even 7-5 but then truly be done afterward, not still having work to do.

[@intrepidtomato]

As a patient, I've come across some that work in centres that only do outpatient procedures (brief elective surgeries). I think that would be very compatible with a family and hobbies, they start early and end in the not too late afternoon.

[@ckrgksdkrak]

This is partly false. Most people wake up at 6:00-6:30 to get to work. You have a choice to take call or not. You can work 40hr/week no call most anywhere you go now and make 400k easily. If you work 45hr/week with calls you start off at 500k. Also many places you currently do not have to supervise. If you supervise, you can make more than above.

[@Fhshaoaksbd]

It’s mind blowing to me that something as arbitrary as waking up at 5-6 a.m. would even factor into your decision making. Lol wild

[@mustang8206]

The average of anesthesiology might be $378k but I have seen many, many, jobs offering 500-700k

[@ckrgksdkrak]

378k is medscape which is not accurate. You need to look at MGMA which is 450-600 but shhh we like keeping it hush

[@genesis1831]

I think 378k is more than enough. I think I’ll be okay lol

[@mustang8206]

@@genesis1831 Oh for sure but depending on how much and how quickly you want to pay back those loans 375k and 500k would make a big difference

[@vqxm7]

What about surgeons?

[@habib580]

6:41 is exactly how I felt when I shadowed an anesthesiologist. I liked what they do but I kept looking over at the surgery

[@henriquelaydner4080]

Actually that’s another pro for anesthesia. You have a privileged viewpoint of the surgery, almost like you’re doing it yourself, but without the hustle of wearing a full surgical scrub nor standing up for hours. Not to mention that ultimately you’re at control of the music set list.

[@emze563]

@@henriquelaydner4080 'almost like you’re doing it yourself' not even close to doing it yourself

[@a.taurean2296]

@@emze563 true ahhahahahhahaha

[@merelymaterial]

to each their own, when i was a student watching a surgeon fiddle with a piece of bowel for 3 hours was the worst part, seeing the anaesthesiologist banter with people the whole time attracted me to the specialty 😁

[@Buzzzy-bee]

@@merelymaterialBAHAHA

[@Kenterly15]

How are anesthesiologists second in command if they can end/ not start a case? I’ve heard surgeons complaining about it and there was nothing they could do.

[@jillharrell3256]

As it should be. It's their job to keep the patient alive . Not sure where the "second in command" thing started. Not where I work.

[@mustang8206]

There's no set chain of command but as Kevin said it's the surgeon's surgery so the surgeon will naturally become the leader for that reason. Not to say that anesthesiologists don't ever get to make calls or that they shouldn't be making calls

[@mustang8206]

@@jillharrell3256 read my other comment

[@thesneakygamer4343]

@@mustang8206 tbf most anesthesiologists don’t interact with surgery at all. They kind of just do their own thing

[@nvldab]

In real life is kind of a mixed thing. Like surgery going " The patient is moving, I need more paralytics", anesthesia going "how much longer do you need so I can choose my drugs" I've seen some crush/bad situation and it's usually an open communication between the mda who tells wether or not and how longer he can keep the pt under vs the surgeon who states what needs to be done urgently/what he can do later when the pt is more stable.. They are usually buddies tho

[@rsjunior05]

Do “Why I didn’t do Psychiatry?”

[@hubby_medical5454]

These videos are interesting overall, maybe more so as a medical student. As a business owner, you are killing it, while you didn't use your MD for patient care, your page in a way is contributing to patient care by encouraging/exposing doctors now and in the future for years to come. Great page, really wish you would finish your medical training for the selfish reason of I bet you would make killer plastic surgery learning content.

[@WiseSteward777]

Surprised to see burn out rate that high for Anesthesiologists. I haven't seen a video yet from an anesthesiologist saying they feel burned out; are there long hours at times yes, high level emergencies from time to time like you mentioned yes, but nothing to constitute burn out.

[@diverdoug2]

My time in the OR as an anesthesiologist has a lot of similarities to flying a high performance jet aircraft. Higher stress levels at take-off and landing. Things can go wrong in the middle quickly, but usually a steady vigilant hand keeps things under control. Also the number of sensory inputs you need to be mindful of are similar. Anesthesiologists usually spend more time "in the saddle". For the past 30 years I have tracked my time spent in the OR (not including pre-op, post-op, ICU...) and I average just over 2,400 hours per year (total work time is obviously higher). On the other hand, the time I invested in training to become a "flight suit insert" pales in comparison to my training time required to become a "gas passer".

[@sabinhong0307]

I just discovered this channel and I wish you had a UK counterpart :( 8:42 by the way, a anaesthesiologies I respect very much once said: "anaethesiology has plenty of patient contact, contrary to popular belief. It's just that we are able to terminate that patient contact when we want to"

[@migueltorresiii6826]

Cant watch yet but i can just hear the word “nuance” already

[@kevinjubbalmd]

😂

[@ArthurChociai]

There gotta be a nuance counter on Kevin’s videos haha

[@ekisseka]

“Nuance is key” 😂

[@critterwatcher8009]

Being surprised by the level of burnout perhaps indicates that hours are longer than you realize, or work-life balance isn't as cush as it seems, or understanding pressure to do cases where the patient isn't adequately prepared (trying not to pull the nuclear card of canceling a case unless really necessary), or taking call that often results in being up much of the night (all it takes to be up all night is 1 labor epidural or being awakened at 0230 for a crash c-section), and then there is the price paid for being 'nice' to a mouthy surgeon who has more than enough ego. It's a good specialty, but there are reasons for burnout.

[@noname_joe4854]

I love your honesty.

[@ToastbackWhale]

Not a med student, and won't be, but I love these videos. And most of your content, really.

[@marving8907]

I just shadowed a orthopedic spine surgeon 3 days ago and during the surgery he asked me what music I wanted to play. We played Kendrick Lamar, j cole, and Kanye. Such a vibe, didn’t expect it at all 💀 especially when alright and stronger started playing 🔥🔥

[@kevina.2269]

How did you get to shadow him/her ?

[@andreasviken2949]

Where I live, anesthesiologists also work in the ICU, and a lot of the tasks you mention here are done by anesthesia nurses. Different worlds.

[@ChrisQuelch]

Whilst I honestly believe work-life balance is important, I would also rather do something I love 60 hours a week, than settle for something I don't mind doing 45 hours a week. Thanks for the video Kevin :)

[@thesneakygamer4343]

One thing I didn’t think about going into med school is not just the number of hours but control over schedule/flexibility. Some surgical or call heavy specialities have terrible flexibility

[@chrisr5649]

Thought I was going to get triggered, but good job on the video! Informative, and quite balanced despite the disclaimer at the beginning. Also I'm about to submit my ERAS for anesthesiology in a couple of weeks!!

[@user-hq6gt6wr9k]

Good luck! From an anesthesia PGY1 😊

[@linnsoltwedel]

In the surgeries I have had I am more fan of the Anesthesiology personal, both doctors and nurses. They are the once taking care of me, the surgeons are just doing a thing to me witch I off course appreciate, but the "love" comes from the Anesthesiologist.

[@GB-ic1im]

I was waiting for you to do this!!! Finally!!! ❤❤❤

[@jacobtorris3428]

I would never consider a CRNA equivalent to an anesthesiologist and certainly would not want to be called a nurse anesthesiologist. I agree with you that CRNAs are important and can handle most of what an anesthesiologist can but but once you get into the advanced end of practice it really becomes important to have an anesthesiologist. I think most CRNAs understand this difference and do not want to encroach on anesthesiologist practice.

[@GoneChatting-iOS]

Explain the level 1 traumas and cardiac cases that are run by solely CRNA groups.. 27 states nurse anesthesiologist work independently.. studies show no significant difference in patient outcomes between the two groups🤷‍♂️ maybe it’s all those codes and meds ICU nurses are forced to be exposed to before getting their PHD.. don’t forget DRs graduate med school with zero bedside experience.. can’t tell you how many times as an ICU nurse I had to push a new resident out of the way who was shitting their pants during a code

[@elcoracer]

@@GoneChatting-iOS ya man! after working as an anesthesia tech, EMT, and ER tech at stoke/stemi hospital..the most respect and admiration I have is for the RN's... ICU/ ER CRNA nurses... I agree with you about the residents... the stroke/stemi hospital i worked at in SF..,..ya, there's been plenty a times of telling a resident or moving them out of the way cause they are CLUELESS... thats great you have all the school knowledge...but nothing beats clinical experience, especially in an emergency situation, where you dont have time to look things up, i tip my hat to you

[@elcoracer]

almost every resident flips during a code lol

[@Fhshaoaksbd]

@@GoneChatting-iOS/yawn. These same old tired crna wives tales.

[@meganthomas1475]

Anesthesia combines basic science and procedures and its true

[@Sara-ig5ep]

MD........or a DO! Please Make sure to mention that

[@brianmack6040]

As an anesthesiologist for the better part of 20 years, this information is just plain wrong. Of all the notable things about my career, the notion of a “controllable schedule” couldn’t be further from the truth. This is actually the biggest gripe I have had…I literally have no control. I am done when the surgeon or OR is done. I can’t leave for errands at “lunch”, I can’t block out an afternoon from the office. If I am on call and a case comes in, I do it. I rarely know when I am going to be done for the day. Sometimes it is early, often it is late. Making plans for after work is difficult

[@apolokaggwa6521]

Well, I don't blame you, Kevin. Imagine studying for 12 years at university, 4 years as an undergraduate, medical student and resident, then at the end of it all, working Monday to Saturday or more for an average of 55 hours a week or more, which amounts to 2,860 hours a year; (52 weeks x 55 hours = 2,860 hours) for an average of $378,000 a year, only to make $135 an hour ($378,000 divided by 2,860 hours = $135 per hour). I am also cognizant of the fact that in their 4 years of residency, their pay could be as much as $16 per hour or less (assuming that one is paid $45,000 to $50,000 a year working for 60 hours a week). By the way, that $378,000 is ordinary income which is taxed very heavily, approximately 50% of it going to the government (50% of $378,000 = $189,000). It means that the good doctor takes home approximately $189,000 on average or $66 per hour. ($189,000 divided by 2,860 hours = $66 per hour). I say that physicians are grossly underpaid. They deserve a lot more compensation or more tax exemptions than they get.

[@نورالامة1000]

That is partially untrue You can very easily work 40h/week for 450k+ Look at gas work to have a feel for the salaries

[@نورالامة1000]

Also in what world are you taxed 50% of your under 400k income in the usa that is simply false also all resident are underpaid cuz they are training they are not attendings

[@fatmanurarslan6023]

It shouldnt be allowed to apply anesthesia solely by someone other than a doctor. Anesthesia looks simple to people who dont know much about it. If you think other way,Many nurses can also do appendectomy if they were allowed to do,that doesnt make them a surgeon who can diagnose and decide what to do. Dont be confused,many of CNRAs and surgeons only know what they are involved in.

[@davidmoon1483]

Pro: No clinic Con: No continuity there seems to be a disconnect here lol

[@lukasloh2509]

He was saying clinic hours vs developing doctor-patient relationship. I think he was pertaining to kid patients

[@ironfistgaming8945]

why did you drop out of plastic surgery and what are you doing rn? like some fellowship or something??

[@tonyconiglio6941]

Things aren't going to snap back. There's a shortage of physicians that is not going to be fixed. The future of medicine is ACPs being supervised by MDs. i remember when I was younger there were arguments about whether the training pathway should be shortened. Many people said this was impossible, completely undeterred by the fact that in the UK, medical school is an undergraduate major, just like being a PA. Those with academic aspirations can go further to a doctorate. It turned out that the Brits were just right, we re-created their system piecemeal. Only a tiny fraction of care can be delivered by senior attendings. In fact, you can only get to be a senior attending by performing care on people who would have been better off with someone more experienced. Supervision, graduated responsibility, and so forth, are the only ways to keep the system going. There's no reason that can't apply to ACPs as well as residents and economic constraints will dictate that it does. The key is having standards for merit-based expansion of the scope of practice and more transparent credentialing.

[@jcjcviews]

The anesthesiologist is like chilling, man, with the sunglasses. He doesn't need no light, man. All he has to do is to keep one ear bug in and one out and listen to the music. Just think of the egos on the other side as squares, man, and all is good. I miss Cheech and Chong, man. He's the real Dr. Feel Good.

[@tajastajas1697]

Do Trauma Surgery next! great review as always, thanks!

[@MrMHA88]

Currently in anaesthesia intro (danish thing) and I worry a lot about mid-level encroachment. I typically supervise 2-3 OR with CRNAs. Now while I do like the idea of being sort of like a pilot; most active during take-off and landing and letting them be autopilot. I do feel like some of them especially the older CRNA are VERY independent. This certainly is a help being new in the job but with experience I could see there being conflict over tasks. I have experienced several of them question my authority and straight up go against ordinations. The CRNA's do alot of the jobs that the younger docs typically do (simple cases) and I fear it will be more in the coming years. Especially since once certain knowledge/skills and tasks drifts to the CRNAs it becomes harder to reclaim them. I think the only comfort is that there is nursing shortage at the moment.

[@Nman92]

Radiology plz

[@hennashabnum3354]

At 11:12, would like to add, DO anesthesiologists as well :) great video overall!

[@Bastakology]

broooo the UK has shot themselves in the book and are letting PAs do surgery.. while the Core Surgical Trainee is stuck on the ward and ED. It's utterly sickening. Surgery is not safe.

[@Jamaicanflava11]

Working in endoscopy anesthesiologist aren’t seen as second in command, because if the pt is in distress the GI physician has to then take orders from anesthesia. It might be the GI doctor’s pt, but it’s anesthesia’s airway.

[@AlanZablocki]

Night call can be onerous- OB, trauma, emergency cases.

[@tgreetsy1201]

Second in commands until shit hits the fan and then we take over. Let’s not get it twisted. Unless you are a trauma surgeon or ENT, once hemodynamics or airway compromise occurs, any other surgeon can get the fuck outta the way and take a back seat so we can save lives.

[@leeleyash]

i want to be an anesthesiologist in the future

[@gtg336y]

The ONLY field of medicine where you can make six figs and complete the wordle (a few times over) 95 % of your work days 😂

[@TheMidnightGarnet]

Do you think the pay rate and the openings for anesthesiologist will decrease? I heard from one that there's not that many in the bay area where I live so may be not?

[@davidausterman5915]

Lol on the second in command. In the OR it’s def 50/50 in command with surgeon.

[@HerbertTowers]

Top tip: Use your excellent knowledge to avoid getting into a situation where you have to use your excellent skills.

[@ClumpypooCP]

can you please explain some of these terms? for example, im not entirely sure what you mean by doing "clinic" and "mid level ..." thx

[@lukasloh2509]

I think what he meant by Clinic means clinical duties. It’s like being an outpatient doctors that tends to 8hrs duty. Mid-level means there’s NP (nurse practitioner), CRNA (certified registered nurse anesthesiologist), and PA (Physician asst). They have less clinical hours training vs MD/DO but are now able to perform some duties independently without physicians supervision. Like CRNA doing the Anesthesiology in exchange of MD. Or NP doing what Family doctors do.

[@prannavmahesh9737]

pl do cardiothoracic surgery

[@nicolehessabi5116]

The most exciting speciality by far ♥️

[@pauls2cents448]

Please do why you didn’t ophthalmology next

[@malikaalibdat7079]

Yes please!

[@AB-uv7ne]

i'm an anesthesiologist for 5 years and i hate it.. i'm planning to migrate so i can choose an easier GP work

[@nvldab]

why do you hate it?

[@LS-ry5ey]

Why do you not like it?

[@micah1754]

Why?

[@AB-uv7ne]

⁠you work alone. if you can’t tube it, you’re done. people think they have flexible lifestyles, but you’re tied with several surgical specialists. In my practice, I had an OB and a GS. You have your scheduled cases and emergency cases. They can call you anytime for OR. You can’t say no bec they can choose to drop you if you refuse. I’m now with ED and I love it, no on call and I’m working with a team

[@bajanconcepts]

could not save this to then add to my list for me to share later.

[@rov23]

LOVE the joker scene. Cracked me up.

[@yorkie5831]

"Second in command" can cancel the "first in command's" surgery 😋 They have a better lifestyle and are generally happier. I'll take that any day over being a surgeon.

[@ccheetah48]

Question, why does Dr. Dre equate to the opposite of social justice to you? Kinda weird comparison tbh. Not hating at all, I totally love your videos, I'm just wondering.

[@kevingill5867]

Just in relation to mid levels clinicians, I agree with you in respect to training and education. I really don’t see why we curtail education for specialist roles in non physician programs. I’m an Advanced Paramedic practitioner that holds a BSc Hons and is undertaking an MSc with the bent of hopefully adding to the academic knowledge for the profession. My number one irritant is this insistence to train people with the approach of nice to know/need to know philosophy. As my knowledge base has grown the line of what I define as need to know vs the later has grown exponentially. I think a mid level practitioner can build an equivalent knowledge base to a physician if the goal is to get safe practice. Now Dr.Jabber here’s the shocking twist! Surgeons used to be midlevel practitioners in fact they where the first nonmedical practitioners most where barbers! And that only changed about 150/200 years ago to a dual training in medicine and surgery! In fact the first surgeons to be trained as physicians were students of the Royal College of Surgeons in Ireland. I think the best solution is to allow for an appropriate education base and equal footing for training schemes to allow midlevel specialisms to transfer in to a physician would be ideal

[@malikaalibdat7079]

Why not OPHTHALMOLOGY, please!

[@PharaohYTC]

6:48 it’s okay. that’s just reality. some people love to create their own “realities” and be upset when others don’t abide by it😂

[@bradr637]

I love how you laugh when you talked about nurses lol. I’m a first year med student and I’d like to see more content on what’s safe for the future with nurses and PAs stealing all the jobs.

[@lexieee2443]

There's a shortage of Dr's in the US so jobs are a plenty Brad

[@GoneChatting-iOS]

Stealing 😂 it’s an 8+ year path to become a CRNA and you graduate with a PHD and 3000+ hours of OR experience.. if it seems so easy be my guest.. also CRNAs work independently of MDs.. also fun fact .. CRNAs were the first providers of anesthesia.. and we are now recognizing as nurse anesthesiologist

[@cmill203]

@@GoneChatting-iOS3000+ hrs of experience… That’s all? Yikes… I appreciate the info, Dunning-Kruger. 😂

[@elcoracer]

@@GoneChatting-iOS for sure, i am an anesthesia tech in the OR, EMT on ambulance, and an ER tech in SF at a stroke/STEMI hospital...love how these med students or (im basically a nurse..i took anatomy and physiology) elevate themselves with zero clinical experience.. it my 10+ years, there is no one that i have come to respect the most than RN's.. hands down..(except med surg RN's lol..jk ;) without RN's MD's have nothing

[@its_mil_4816]

@@GoneChatting-iOS 3000 hours of OR experience is what a resident would do in a couple years at worst I expect... which is precisely the point. cRNAs are very inexperienced compared to physician anaesthetists, and have worse patient outcomes.

[@xniks101x]

I’m shadowing a surgeon right now and I mentioned to him that I’m interested in anesthesiology. The “anesthesiologist” working piped up and was like “oh come shadow me next” and I was like “sweet” and he put his number in my phone. Well the surgery ends and the lead comes off and I saw his badge and homie is a CRNA… bruh

[@xniks101x]

@@itzelr3514 sorry I worded it kind of weird. The surgeon I was shadowing is a different person. The CRNA was working alongside him administering anesthesia to the patient he was operating on.

[@abdullahalameer5557]

Can you make another video on opthalmology… I liked this series more than the objective one🤣

[@kevinjubbalmd]

It’s coming

[@Redhead77]

Why are urologists so burned out?

[@valeryvdw_951]

please make "why i didn't...obgyn"!

[@superduper5949]

I feel Anaesthesiology would be perfect for my ADHD brain😂

[@freshurbanstyles]

In what ways?

[@asyuruu]

EM is known as the perfect ADHD specialty

[@alexisdreher2557]

Can you do Why I Did with Dr. Karen Francois? She does 3 Anesthesia & 3

[@WaleedElShatshat]

What about the ICU Patient

[@vericadjordjevic3203]

Please do WHY I DIDN'T OBGYN

[@tonym4308]

Hahaha I think point 6 of why you didn’t go into anaesthesia might be point 1 my guy 😊 I do agree with point 7 though

[@AmbersDangleenAnkle]

I don't agree that not wanting to hear about "banging hoes in the club" at work makes you a SJW, that was a dumb remark, but every reason you said you didn't like the job was every reason I want the job so thanks for that. Now I know it's where I need to be.

[@njacotin1342]

Do why I didn’t do cardiothoracic surgery

[@sawyermclachlan5049]

Anenesthia is the best speciality no doubt tho I’m not interested in anenesthia

[@Castrrr]

Is that an Ayrton Senna helmet?

[@kevinjubbalmd]

Yes

[@Castrrr]

@@kevinjubbalmd Awesomenes!!!

[@alexisdior90]

8:03 is pure gold 🤣🤣🤣

[@aaronredus6244]

Hey Dr. Jubbal, What do you think about the idea that CRNAs are just as qualified as anesthesiologists at a certain point in time? Maybe an anesthesiologist is more qualified initially due greater clinical hours from residency, but how would an MD with two years of experience stack up against a CRNA with 5 years? The hospitals in my area allow CRNAs and anesthesiologists to manage the same cases. I would personally be inclined to take the more experienced CRNA than the less experienced doc since med school is a very generalist education and doesn’t factor into my calculations. Furthermore, what about a CRNA and an MD both with 10 years of experience? Even if we count 4 years of residency as experience and called it 14 vs 10, do you really think this makes a huge difference? Would love to see the research on this when more comes out. Until then, very interested in your opinion on this argument.

[@mjsdancinggirl]

even though med school is a generalist education, you still specify a lot on physiology and pharmacology. this type of education and understanding of the human physiology can not be reached without going to med school. besides of that, there are a lot of procedures CRNAs are just not getting trained in. eg difficult airwayss, regional analgesia and so on. so yes, an MD with 2 years of experience trumps the CRNA with 5 years. If you don`t think 10 years of experience in a MD or a CRNA make a difference, you belong to the minority he talks about.

[@richiemd777]

There's going to be mid-level encroachment in most non surgical specialties. NP and PA running ER and ICU is becoming common with little to no supervision.

[@samuelcoffman8088]

@@mjsdancinggirl In order to be accepted to a CRNA program, nurses are required to have 2 years of ICU experience and then during the course of their 3 year anesthesia residency they take the pharmacology and physiology classes WITH the medical students at their universities. Depending on the program and whether or not there is competition for cases from physician anesthesia students, many programs also provide large amounts of regional techniques and difficult airway practice.

[@GoneChatting-iOS]

You graduate CRNA school with 3000+ clinical hours.. same undergraduate and graduate patho, A&P, and pharm classes.. main difference CRNAs have several years of bedside experience giving titratable drugs, vasopressors, inotropes, chrontropes, anti-arrhythmia, blood and blood products, running codes.. whereas residents graduate with MD title with no hands on experience.. yes you might have passed an exam but you remember way more when you are hands on.. if just getting your degree was effective, new residents would actually be useful in a code situation or a patient that is de compensating.. but normally they are just in the way .. just try challenging a first year med resident to place an IV 😂🤷‍♂️ and the studies are in.. there is no significance in the outcome between MD and cRNA’s. 10,000 hours to be an expert.. Malcom Gladwell.. but hey luckily you don’t pay my checks 🤌

[@Fhshaoaksbd]

@@GoneChatting-iOSyou’re sharing facile anecdotes about straw man argument newbie residents when you could easily make the same stereotype based arguments about nurses… I’ve met countless nurses who are terrible at IV’s, are bad at their jobs etc. I’ve met many ICU nurses who suck at codes and their jobs. These stories are more or less useless. The reality is, the nursing educational model is inferior academically to the medical model. Nurses don’t know this because they have a piece of paper that says Degree on it and think their school/experience equates out to any other school/experience… it doesn’t. It’s inferior.

[@trendzdigest]

you have only mentioned the OR related work of Anesthesiologist....Moreover they also deal with Interventional Pain Medicine, palliative medicine and ICU... And you have to do tons of interventions there...

[@ChristenasBlock]

I just love your voice 😂

[@MrJayharr58]

You said “twat” huhuhuhuh!

[@khalilahd.]

Honestly I don’t blame you

[@nnekaoa9234]

you do look like President Obama Dr Kevin J 😊😊

[@kevinjubbalmd]

😂

[@DrBilly90210]

Another con: Non-trivial risk of becoming addicted.

[@hevinamber]

I'd much rather be anesthetized by a CRNA. The first time I had anesthesia as an adult the anesthesiologist almost killed me. It took 8 hours for me to wake up from anesthesia. Subsequently I always request a CRNA because it's so much safer. They tend to provide less medications, be more gentle with airway, and the patients tend to wake up a lot faster. I've also witnessed CRNAs in cardiac cases where the patient went into full-blown cardiac arrest and the anaesthetist handled the situation far better than the MDA. So the training that CRNAs receive is actually high quality and they receive what an md gets in 4 years, in 2.5-3 years. They already have clinical experience in the ICU. Unfortunately, I've met way too many so-called Physicians who don't know basics. Since I am medical, I always tell all of my family members to please contact me immediately if they ever have to go to the hospital because a lot of those doctors are unsafe and clueless just based on my experience. The only reason they listen to me is because of my experience and that I am a colleague but it blows my mind that they don't know basic tests to order and basic treatment plans for certain conditions. Most of the crnas that I have worked with are exceedingly knowledgeable and I have a lot of respect.

[@Benboy887]

lol you're wild. who paid you to sell this propaganda. You clearly have a poor understanding of academic/clinical rigor of medical school and residency in comparison to CRNA school.

[@trevorg1558]

completely agree. I feel like he underestimates the knowledge and skill that CRNAs have. Most of the information you learn in med school isn't even applicable to anesthesia as a specialty so its a dumb argument to say that just because an anesthesiologist went to med school immediately makes them more qualified. Anesthesia is its own pharmacological practice that can be done just as well if not better by CRNAs without the pride and ego of an MDA.

[@hevinamber]

@@trevorg1558 legit facts

[@Benboy887]

@@trevorg1558 You can confidnetly say that cause you're safe in your ignorance. I got to work with some CRNAs and the non-evidence based medicine practice they carried out was absurd. They pulled out notes they took in CRNA school when they had attended nearly 20 years ago. Also, a seasoned CRNA said if they were concerned for their patient having had a stroke they get a STAT MRI... things you learn in medical school would tell you to get a STAT CT

[@trevorg1558]

@@Benboy887 there are bad exceptions to every position. I’m not saying all CRNAs are perfect I’m just saying that they can be just as professionally skilled and competent as any anesthesiologist in 90% of cases.

[@erikamavrich2962]

You are so very wrong!!!!!!!

[@genaroking8309]

Nurse anesthesiologist is a thing a lol so now there are two types of anesthesiologist,Nurse anesthesiologist and physician anesthesiologist.

[@neilbeni7744]

Neurologists are overrated.. lol

[@ahmedwaleed8366]

They aren’t.. lol

[@brianneelise9598]

It sounds like you are confusing an AA with a CRNA

[@moejoe13]

No he's not.

[@wholeNwon]

Why you didn't do it: You're not lazy and you didn't want to waste a medical education.

[@brianmack6040]

Huh?

[@mas3ymd]

We make a hell of a lot more than $370k. But yeah, as a specialty, it fucking sucks.

[@micah1754]

Fucking sucks? Why?