I can still clearly remember the moment when I discovered that I liked Anesthesia. We had received our North American average of 1-2 weeks of Anesthesia lectures and this was capped off by an afternoon visit to an OR with an Anesthetist. After introductions were made the staff Anesthetist pointed out the patient's vital signs -- his blood pressure was slightly low -- and then he showed me his bloodwork which also revealed that he was slightly hypocalcemic. He drew up a vial of calcium gluconate, told me watch, and then injected it into the patient's IV. Sure enough, 3 minutes later the patient's heart rate and blood pressure increased on the monitor. I was fascinated by not only the inotropic qualities of calcium but the instant gratification of seeing the results of one's actions. A teacher once told me that a general anesthetic is akin to performing a live physiologic experiment on a human being. Giving an anesthetic requires knowledge of physiology, pharmacology, disease processes, and surgical procedures and the sometimes complex interplay between the four.
Although I was interested in Internal Medicine and found it intellectually very challenging I wasn't particularly enthused by the fact that you don't seem to "cure" people too often and that a large part of the workload is often devoted to managing chronic diseases. Cynically, Internal Medicine is like a revolving door where patients come in, get a little bit better, get out, get worse, and come back. On the other hand, as another teacher pointed out to me, the chances of giving a patient a successful anesthetic are very, very high and you get to see the fruits of your labours very quickly. There are few specialties in medicine where you can see a patient, come up with a plan of treatment, execute that plan, see the results within a single work day, and then be able to do this the day after and day after that. An Internal Medicine resident once mockingly told me that "Anesthesia is Internal Medicine for people with short attention spans" which has an ounce of truth to it.
With my interest piqued I decided to do several rotations in Anesthesia. I soon found myself doing more reading and enjoying the rotations. Most importantly, after a hiatus of a few months, I later discovered that I missed doing Anesthesia. With this realization I knew for certain that I had found my calling and I started focusing my efforts on getting in to Anesthesia.
Only graduates from medicine can know the feeling of relief that comes from discovering the specialty you want to pursue. Unless you were in the minority who knew what they wanted from the get-go you had to muddle your way through medical school in the hopes of discovering what you want to do with the rest of your life. Throw in the pressure of competition for popular specialties and you've got a pressure cooker for the last year or two of medical school. I do remember seeing the crushing disappointment of classmates who went "unmatched" and failed to get into their desire specialties.
Yet, I thought I was one of the lucky ones. It's not uncommon for students to "discover" Anesthesia late in medical school; as a young specialty it has had to compete with the more established specialties like Internal Medicine or Surgery for classtime in medical schools. However, I was able to figure it out early enough in medical school that I could plan for and direct my clerkship towards applying for Anesthesia. Lastly, by looking at the statistics for previous years I found that Anesthesia wasn't supercompetitive like Dermatology or Ophthalmology. So, I went into the CaRMS match feeling almost confident that I would get into Anesthesia somewhere. When I did match to the University of Toronto for Anesthesia residency I was not only happy that I got in but I also felt lucky that things lined up and worked out well.
The irony is not lost on me.
