Career Advisor's Background and Career Information

Background

Name: Mark A. Rosen, M.D.
Career Advisor for: Anesthesiology
Title(s): Professor, Vice Chair and Residency Director, Department of Anesthesia and Perioperative Care
Best way to contact (e-mail, phone?): rosenm@anesthesia.ucsf.edu
Undergraduate & Graduate Degrees/Institutions: B.A. & B.S. University of California Davis M.D. University of California San Francisco
Clinical Interests/Duties: Obstetrical anesthesia Anesthesia for fetal surgery
Research Interests/Duties: Anesthesia for obstetrics

Career Information

1. What can students do in the 1st and 2nd years to explore and/or prepare for this career? Students can easily arrange to visit with myself or other faculty in our department and shadow them in the operating rooms and other places we provide clinical care.

2. What common variations exist in the length/content of residency programs for this career? Currently, the residency program is 3 years in duration after a year of 'internship.' Although the internship year is not in the field of anesthesiology at present, future plans by the American Board of Anesthesiology are to include this year.

3. What common variations exist in this career after training? Anesthesiologist provide care in the operating rooms, out-patient surgery centers, intensive care units, labor and delivery units, pain clinics and a variety of other places in hospitals (interventional radiology, neuroangiography, MR and CT scanners, cardiac cath labs, endoscopy suites). Some anesthesiologists sub-specialize in critical care medicine, pain management, pediatric anesthesia, obstetrical anesthesia, cardiac anesthesia, neurosurgical anesthesia or transplant surgery anesthesia, but the majority of anesthesiologists have careers that encompass patient care for many, most or all of these areas.

4. What is a typical work day for you (or someone else representative)? Typical work days for anesthesiologists begin early. We arrive in the operating rooms before 7 AM to prepare for surgeries that begin at 7:30. The work day is highly variable depending on the procedures being performed for which an anesthetic is provided. Some procedures last many hours (craniotomies, for example) and an anesthesiologist might be involved in only one or two cases during the day, and some last just a few minutes (myringotomies in children, for example), and one might be involved in numerous cases during the day.

5. What is the "culture" of this career? Anesthesiologists in general are very friendly people. We enjoy our work and involvement in patient care very much. We develop rapid and intense relationships with our patients, even though they are typically for a short duration. We have an abundant opportunity to allay fears and provide compassionate care to patients facing the prospect of surgical intervention. We work very closely with other physicians (typically surgeons) in situations that are very dynamic. We typically work together with other physicians and nurses in a team, where affability is highly valued. We tend to be very organized people as we deal with considerable technology and machinery and many very potent drugs to manage patient physiology during potentially very dangerous procedures. We train ourselves to respond to crises and emergencies in a very organized fashion; we don't panic!

6. How compatible is this career with raising a family? How is this different for men and women? This career is very compatible with family life for both men and women.

7. How important, individually, are each the following for admission to a competitive program:

a.Extra-curricular/volunteer work?
b. Research/publications?
c. Honors in third year? I believe Honors in medicine and other core clerkships is more impressive than honors in anesthesiology. Typically, anesthesia clerkships do not provide the opportunity for an evaluator to see the student's ability to demonstrate synthesis of knowledge or clinical judgment.
d. AOA?
e. A sub-internship?
f. An externship?
g. (Other important elements to the application?) Of course, all programs will review an applicant's grades and board exam scores, and the higher they are, the impressive they will be to program directors. Evidence of excellence in other endeavors also can be important, for example research, volunteer work or even achievements outside of medicine, such as music or sports. Anesthesiologists must be capable of utilizing a large fund of knowledge about physiology and pharmacology in a rapid and decisive fashion. They must have the ability to do technical procedures, interact with colleagues, provide compassionate care to patients and remain focused and vigilant. Many have compared anesthesiologists to pilots, particularly in the way we train using simulators.

8. What are the most important qualities or character traits for a person in this field? See above.

9. How competitive are the residency programs in this field? Of course, top programs are very competitive, but there are many programs in the US, almost all of which will provide good training in this field.

10. How competitive is the job market after residency? Professor, Vice Chair and Residency Director, Department of Anesthesia and Perioperative Care.

11. What programs would you consider to be in the 1st tier, 2nd tier, and 3rd tier? UCSF and two of the Harvard programs (Mass Genl Hosp, Brighman & Women's Hosp) are the top programs in the country. There are many other very fine programs thoughout the US, including a very good program at Stanford University.

12. What resources (web, books, etc, besides the AMA and AAMC sites) would you recommend for students interested in learning more about this field? American Society of Anesthesiologists; several standard textbooks that have been written by members of the UCSF faculty; Best resource: UCSF faculty.