Post Graduate branch advices

Please ask questions in the COMMENTS SECTION below:

 

I have been getting a lot of queries regarding Anesthesia as a branch for Post graduation.

Please ask your questions in comments section. Will try my best to answer all of you

Will consolidate the rxpg thread here:

Qn. I have taken anaesthesia. 
I have certain questions which by d way if it’s wrong dont mistake me 
Wat are the things I must concentrate on after joining? 
What are d things I must not do? 
How we must prepare for foreign education and what other options are der after MD ANAESTHESIA 
Thank you once again for your help

Ans. Wat are the things I must concentrate on after joining?

Do not run after procedures like canulation, spinal, epidurals.
Skills are a small part of anesthesia.
Develop your observing skills first.
Acutely observe each patient from breathing pattern to heart rates to blood pressure in OT.

Try to see what emergency drugs are and where they are kept to help your senior in emergency.
learn drug dilution and dosages first.

ppl who run after procedures are not liked by anyone. Almost all will develop the skills sooner or later.

2.Foreign preparation are different and some basic books are there which are usually not much followed in india.
Some MCQs books are there for FRCA etc. which you can try solving from 2nd year onwards but basics first in first year. There is lot to learn in first year
Intensive care is lacking in India as very few anaesthesiology professors are well trained in managing ICUs, so you have to learn it on your own by giving adequate time in ICUs (this is true for 80pc colleges)

3. After MD:

DM courses like CARDIAC, NEURO, CRITICAL CARE
FELLOWSHIPS IN CHRONIC PAIN MANAGEMENT
FELLOWSHIPS IN REGIONAL ANESTHESIA

 

Qn. What are the scope after diploma anesthesia?

Ans. Have to finish DNB SECONDARY to pursue further studies or endeavours.

Personally i feel 2 years is just enough to become skill oriented.
But in depth understanding of anesthesia needs little more time.

So don’t jump into practice immediately after diploma.
Get your DUB
be well prepared to face the world and avoid exploitation.

Any diploma candidate will get lesser salary than MD even in corporate.
Except in free lancing where you earn as soon as you pass

Qn. Sir what are the books to get in first year anaesthesia

Ans. 1. Morgan
2. Dorsch and Dorsch
3. Paul Merino ICU
4. Icu protocols is also a good step wise book
5. If you see good at studies then MILLERS AND BARASH
6. Stoelting Coexisting is bread and butter
7. STOELTING pharma and physio for pharma only
Respiratory Physiology from Wyllie and others from Morgan and if time permits then Miller or barash

Qn. Having essential tremors rules out a person to not opt for anaesthesia nd go on a nonclinical?

Ans. Better avoid, IV cannulation, arterial lines, central lines etc may become risky with shaky hands. Not to frighten you but just my view. Ppl always overcome their problems and do surprise everyone but what i said is a generalized view.

Qn. what is the scope for dnb anaesthesia?? is it considered equal to md?

Ans. DNB is tough to pass but better chance right now.
After DNB mci has a clause that you cannot be considered asst prof unless u passed dnb from a institute that already has UG teaching or MD MS course running simultaneously!!
So you need to join as senior resident and get 2 years teaching experience
Apart from that hospital and consultant under whom you work is essential, and how he teaches you.

Qn. Sir I started my MD Anesthesia from 1st May 2017, but seeing my seniors breaking vials, dilute them, injecting them very fast, I felt so much depressed. 
I am feeling that this can’t be done by me, I feel myself very slow, I feel that I’m not for this branch. How can I learn drug dosages, any book for dilution. 
Seniors have them on tips and I feel that I just know nothing. 
kindly help sir, can I too excel in this field, can I too learn the dilution n dosages on tips. One more thing I feel that wen I can’t know drug dosages even, how can I perform procedures. Can I also become fast in procedures like my seniors or it is only individual inner instinct or depends on practice? kindly help sir, I’m very depressed, I am feeling like I’m opt wrong branch for me.

Ans. This feeling comes to all.
one girl kept crying whole first year in our batch and then she did very well 2nd year onwards. I didnt know IV canulation and was frustrated initially but within a year you learn most techniques. Just be cool. More than procedures try learn basics and if a complication arises how fast you can help your senior. Get acquainted to al OT drugs and equipments.

Qn. Is doing a pdcc in pediatric anaesthesia worth it ?

Ans. Any course is worth it. you will become confident andd dont measure courses to correspond to your salary, Study and do courses to become a better anesthesiologist money will come automatically!

Qn. Sir can we do dnb post md anaesthesia? and having dnb help to work overseas? or is MD enough ?

Ans. After MD anesthesia DNB is done by simply giving the exam! Prepare for that exam pattern and clear the exam, no need to work in a DNB institute to apply for DNB exam so if you are confident you can clear the exam immediately after your MD exam! Thats the time you are flowing with abundant theory knowledge just after exams.

Qn. Hello sir, very thankful to you for starting such a thread, I m interested in critical care sir, which will be better sir, MD Anesthesia or MD General medicine?

Ans. In acute patient deterioration and management none comes close to an anesthesiologist!! Thereafter the management depends on how updated and vast your knowledge is in critical care.
I will say Any day we are better provided you keep reading medicine simultaneously during critical care fellowships. Intensivist who single handedly manages ICU has to be strong in both!!

But a medicine MD always will struggle in acute conditions whereas a anesthesiologist just needs to build upon the theory part.

Qn. If I do dnb anaesthesia from good place in delhi or mumbai after passing will job opportunities be similar to md??

Ans. No problems at all on job front to anesthesia ppl.
Everywhere vacancy!!

Only problem for dnb grads is as i stated above. In a med college they wont be considered equal to MD

Qn. In freelancing and private hospitals are da more preferred than dnb??

Ans. DA is least preferred bro. My friend who did DA and then DNB told that everywhere they will try to give slightly less offer for DA.
Usually MD and DNB doesn’t matter in a corporate hospital.
But if u have a closed group of surgeons who prefer you then DA DNB and MD doesn’t matter in freelancing.

Qn. Sir I took dnb anaesthesia this year But I have no interest in it. I wanted to do medicine. But I could get only anaesthesia at my rank Now my doubt is,
1.is it possible for me to continue anaesthesia and gain interest in it, since I have no interest in it previously and very much interested to pursue medicine
2.is there any pay differences between anaesthesia with some
Further degrees and medicine with some superspecailities.may I know how much both are paid
3.is it a good choice to leave this seat and pursue with my preparation for next year neet to do medicine

Ans. My initial choice was medicine but i cleared PG in 3rd attempt so my main aim was NO FURTHER STUDIES and i considered anesthesia as a dead end subject with no struggle in getting jobs so i went for it but it was a informed decision after weighing all pros and cons!!

2. ANesthesia is basically 50% medicine and 50% all other subjects with additional SKILLS or Procedures

3. Regarding salary or income
first tell me whats a doctors source of income?

Salary wise i get more than any fresher except radiology!!

But we dont have much extra income that you may or may not consider ethical!
NO CUTS FROM ANYWHERE
NO MED REPS SPONSORS
NO PHARMA DRUG CUTS
NO USG MRI CUTS
NO PATHOLOGY CUTS

So i hope its clear that anesthesiologist will never be able to earn as much as a medicine or any other hard core clinical subject with the above associated payment structure!!

http://www.businessinsider.in/tech/the-20-best-high-paying-jobs-in-america-for-2017/slidelist/56478718.cms

See the above info for salary structure in USA but this is India so it will vary but still we are in lot of demand, More the awareness grows more will be the demand.

FOR YOU I WILL SUGGEST NEVER TAKE A BRANCH IN WHICH YOU HAVE ZERO INTEREST,, LEAVE IT IMMEDIATELY.  I HAVE SEEN STUDENTS SUFFER HEAVILY FOR THIS. TAKE MY ADVICE PREPARE ONE MORE YEAR AND SEE HOW IT GOES, TILL THEN TRY TO GAIN SOME KNOWLEDGE OF ANESTHESIA IN THE MEAN TIME.

Qn. Sir,,I am very much intrested towards anaesthesia,,,so kindly please guide me how to get into foreign countries like U.K,European,Australia or US,,as these countries have more demand and pay,,am planning to settle abroad,,,whether chosing MD anaesthesia ll be a good option???Kindly guide me sir

Ans. Anesthesia in UK is 7 years course, its like 3 years MD and # years SRship and then only you become a consultant!
For going abroad Anesthesia is a good option no doubt.
But you will need to prepare early for FRCA in UK or USMLE etc for USA. 
Australia and NewZealand critical care and anesthesia is quite in demand right now.

Qn. Sir, I m getting Anesthesia md @ a good govt college. I have no interest as such for any branch.
1.Is Anesth fun to learn nd manage after md as compared to any other clinical branches?
2. Prospects of private practice in own multi speciality hospital at district level?
3. Is Anesth a good combination with obg ( as my wife is persuing it) for private practice ?
Thanks in advance.:)

Ans. After taking Anesthesia and reviving resuscitating so many patients which I never thought was possible in UG. Sometimes we feel we are SUPERMEN and we can give Mr YAMARAJ a run for his money.
I absolutely love my branch as it’s real fun if u like PHARMA. It’s like preparing a cocktail for your patients by selectively mixing and matching drugs.

In very bad cases not got for GA OR SPINAL I selectively do nerve blocks so that patient undergoes surgery safely. It’s so much satisfying!!

Wife OBG means still better to take up anesthesia.

But remember in India we shouldn’t have too much ego.

In any hospital we get called to revive collapsed people but usually we finish our jobs behind closed icus so no recognition. But who cares I am loving it.

About private practice if you can do a fellowship in Pain management you can open your own Clinic and get referred cases from Ortho and Neuro people
So daytime anesthetist and night time Pain reliever!! All the best for your future and decision.

Qn. Sir how to get into a fellowship post MD , is it based on merit and interview alone or does the brand value of the college play a role in getting fellowship?? Thanks in advance.

Ans. See right now craze and competition is for DM courses.
Fellowships mainly can be got through just applying at respective hospitals.
If heavy demand then viva and few centres conduct a MCQ test prior to viva.

Qn. Hello sir, Thank you for your guidance.
What would be your suggestion to newly joined anaesthesia resident sir?
Kindly help.

Ans. 

1. Don’t get frustrated with slow learning curve of procedures
2. Observe and assess a patient clinically like you may not have done in UG
3. Familiarise with OT SETUP AND ARRANGEMENT.
4. Spend time inside OT to know all the equipments available
5. Be friendly with OT and Anesthesia Technicians and don’t hold ego above them. They know more about anesthesia than you. Some technicians will try to dominate but try to be good as far as possible.
6. Your seniors will trust the technicians more than you. ACCEPT THAT
7. WHAT THE MIND DOESN’T KNOW EYES CANNOT SEE!!
READ READ AND READ
STOELTING COEXISTING FOR DISEASES AND ALL OTHER BOOKS
Many more things to say but right now can write this much.

Qn. Is there any way i can go for Pain management fellowship if i have done only DA? Or do i HAVE TO do Secondary DNB first? Would be grateful for any guidance. Thank you

Ans. i think for fellowship no hindrance
you can contact DARADIA INSTITUTE in kolkata
One of the best teachers for pain in India

Qn.sir I hv got md radiotherapy but in nxt round will get md anaesthesia.
should I stick to radiotherapy or go with anaesthesia?? which is better branch??

Ans. Radiotherapy limited only to big onco centers
Very difficult getting a job in any city
You will be shifting to metros to find a decent job and salary.

Qn. Sir if my aim is intensive /emergency care. What should I choose anaesthesia or emergency medicine ?

Ans. Anesthesia and DM Critical care.

Emergency Medicine is a shortcut and you will be paid in a shortcut way too.

Qn. Sir surgical subject is not my cup of tea ,but my family and few other consider surgery as a main branch ,dats y in dilemma wat ,to do now ,don’t knw much abt prospects of anaesthesia ,sir kindly help me in dcsn making ,thanks again fr ur reply.

Ans. 1. Very difficult question since social aspect involved
2. Anaesthesia will never earn more than a famous surgeon
3. Anesthesia has limited scope in view of pharma sector cuts, pathology cuts, and all those things that’s banned by MCI
4. Anesthesia or any subject nowadays is not completely away from invasive procedures.
Similarly in anesthesia u will need to learn
No few invasive techniques.
You need to love pharmacology
You need to have sound knowledge of few medicine subjects and physiology of body
Recognition in society is lacking untill u tell them u manage ICUs icon_wink.gif

Qn. Thx sir fr ur kind gesture ,sir I think I shud choose anaesthesia cz preparing fr mch/fnb exam demands patience and lil bit of luck ,sir a last ques to u other Dan few 10% surgeon do anaesthetist earn well and have a decent lifestyle, cz sir I don’t want to repent in future dat I took anaesthesia over surgery thx again sir.

Ans. Earning wise you won’t repent but if you calculate the under the table money they get then it’s a different story.
No one knows how much a doctor gets cuts.
So those aspects are there.
Salary wise no issues or even if you do some Pvt cases you will earn decently.

Qn. Sir is it wise to to take dnb anaesthesia? I know it depends on the institute we take but do give your opinion on taking anaesthesia in dnb.

Ans. No problem at all. I am in favour of it.
But sometimes I see DNB candidate are not trained or confident in using old instruments in little lower setups.
So sometimes Pvt practice is bit difficult for few.
But that’s all in initial stages
Slowly u learn the trick or quit doing in small setups and stick to bigger corporates.

 Qn. Sir, kindly help in choosing between md anaesthesia ms general surgery and ms ophthalmology. iam not much interested in these branches.i can’t get my dream branch md general medicine at my rank. This is my 3rd attempt and i doesn’t want to extend preparation for one more year.In anaesthesia as there is no opd based treatment, iam in dilemma to choose among them. kindly help to overcome this. Thanq sir.

Ans. We have a pre anesthetic check up room.
We diagnose lot of cases and get it confirmed.
Few days back got a Ocular Myasthenia Gravis diagnosed but opthalmic and pediatric ppl couldn’t confirm it.
Finally came out to be myasthenia only!!!
Gives satisfaction that I was right!!
If u want to prove to others that u diagnosed and are a medicine doctor then don’t join.
If u want satisfaction from within then most welcome
Most cases from surgical opd are referred without any investigation or resuscitation.
So everything is managed by us.
We are basically perioperative physicians who take care before, during and after surgery.

Qn. sir what is the duty hours of anaesthesia??
9am-5pm?? how many emergency per wk??

Ans. After MD monthly 5-8 duties depending on where you work and how many staff present. Corporates are flexible. Friends have working hours 9-3, 3-10, etc.

Qn. I’m totally confused… MD anesthesia aiims versus md Opthalmology aiims…pls guide me I was actually interested in dermatology initially… Bt now I have joined to take one among these… N I’m am exploring possibilities about both these subjects…I’m really confused pls guide me.

Ans. Both are good branches with future.
Ophthalmic​ fellowships, Retina surgeries, Squint
But anesthesia is like a Medicine speciality
We handle all body.
We handle emergencies
We have multiple challenging cases
Dunno if opthalmic is that challenging. But yeah anesthesia is still emerging from its dark past. So decide what gives u happiness.
Anesthetist may not be celebrated but we do a lot of job that others sincerely can’t imagine. It’s the most underrated subject in India among clinical sciences!!

Qn. What r the prospects of md anaesth in own 50-70 bedded semi urban peripheral setup? I mean, even if u call surgeons to operate to ur door….can u see opd cases well enough competently! And does even patient come to u…i mean do u gain ample knowledge to prescribe drugs for general opd management….!

Ans. See basic medicine anyone can manage.
A 6 month residency under a medicine person can help you in brushing up the diagnosis part.
Rest anything you can manage.
But legally how safe it will be I cannot tell you.
I am seeing people manage like that though.

Qn. I M doing my DNB anaesth,& in 3rd yr..my experience is anaesthesia is a very good subject & there is no stigma of dnb/MD atleast in corporate set ups..but I just get the feeling that only MD/dnb is not all enough to cross 1.2 lacs mark straightway..so my query is what subspecialty like fellowship in pain/ regional anaesthesia would let u earn better?& Also if I would like to go abroad for decades or pain fellowship or simply to work there what is the way to prepare?I mean how should I start?kindly revert back sir..regard 

Ans. Straightaway after MD my salary was 1.2, when I gave resignation I was offered 1.5 and that depends how u worked.
Regional anesthesia doesn’t earn u more money but gives u confirdence to do lot of complicated cardiac cases also under minimal risk!! 
For going abroad clear FRCA AND start preparing MCQs
Pain is an excellent option right now.
Try attending few cadaver hands on courses to know if u get a hang of it.

Qn. Thank you for nice informative thread.I worked in icu 3 years in corporate and 3 years in Govt institute.After 6 years of journey through icu I took admission in MD Anaesthesiology this year though my preference was to get medicine.Now I am interested to spend my whole life as critical care specialist.Should I focuss on FNB critical care or DM critical care?DM seats are very few.

Ans. Aim for stars
You will land on moon
So aim for DM
I doubt preparation is any different.
But your bread and butter will be your primary Anesthesia degree so don’t lose your focus from that.
First u have to become an Anesthetist and then critical care specialist
Keep that in mind

Qn. Sir how is Dnb Anaesthesia at Medanta Medicity Gurgaon..??
Heard that its one of the best pvt hospitals in our country.
But does this reputation convert when it comes to training and academics??

Ans. Anesthesia I feel I all about seeing and managing complications.
The more you encounter during your training the more you learn and manage about what to do next!!
I don’t think medanta will be bad in any ways.
Basic problems in DNB will be there but you will get to see the best people in Anesthesia there so exposure will be good.
You may not see many complications though as almost all care will be taken since it’s a expensive setup.

Qn. Sir i joined dnb anaesthesia in Rajiv gandhi cancer institute Delhi…is it good sir vth repect to exposure nd post dnb job oppurtunities as i would be dealing vth cancer cases only..
Plus also want to know dat so many anaesthesia seats increased dis year…so vll it amt to saturatn in dis branch??..

Ans. 1. You will be master in difficult airways and Pain management!!
You are lucky.
Yeah lot of many other surgeries are there were you need to know the steps so those exposure also matters but nothing that can’t be learnt doing a quick year of senior residency in a good college!
2. Calculate total no of surgical seats that’s increasing.
If they get cases to operate then you will too!
There are more than 6-8 branches that we cater to.
So for every 10 surgeon passing there’s a single Anesthesia graduate.
Don’t worry not in our life time anesthesia will get saturated.

Qn. sir I was on the brink of resigning but after lot of counselling from seniors and parents have decided to continue MD anaesthesia.
But I want to prepare for dm critical care and fnb.
Pls help me how to proceed amidst 60hrs duty per wk.

Ans. Don’t think sooooo far.
I have told repeatedly first year is never the time to think of superspecialisation.
Let’s focus on anesthesia for first year.
Basics of anesthesia will be asked in DNB entrances as well, don’t forget that!

Qn. Which books to read in first year

Ans. 

Basics:
1.Morgan
2.STOELTING 3.COEXISTING
STOELTING pharma physiology
4. Dorsch and dorsch instruments
or
5.Wards equipment
Advanced:
1. Miller or Barash
2. ARC post graduate manual
3. Chang Mechanical Ventilation
4. Yao and artusio problem solving

Qn. Sir , I’m going to join Md Anaesthesiology in a pvt. medical college. Still doubtful whether doing skillful sub like anesthesia in a less amount of patient is good or bad decision? Thank u in advance sir.I heard in dat college only less amt of emergency cases and critical care cases would come so very much in dilemma

Ans. Get the degree and do a year of senior residency and you will be good to go.
Don’t waste a year.

Qn. sir I have almost completed 1 month of MD anaesthesiology yet still feeling depressed and frustrated every time I enter OT.
I am not liking it at all.
Should I continue or quit??

Ans. QUIT

Qn. sir isnt it risky to leave with just 5 months left for neet.
Can rank improve in such short time??
I am trying hard to like anaesthesia since last 3 weeks due to this fear of improving rank but not able to like anaesthesia.
Plus I don’t have a job at hand and already I have lost many years.

Ans. We enjoy a subject when we get a good teacher.
The problems you said are for u to sort out. I don’t think it’s impossible to crack meet if u have done once.
See if u can get 6 months break without quitting the course.
In that case you will have to repeat the 6 months and give exam after the 3 yrs.

Qn. Sir I have decided to continue with md anaesthesia.
Leaving md seat in govt college is way to risky coz I have no backup.
I hope sooner or later I fall in love with anaesthesia

Ans. I wish u had left.
Ppl who are indecisive take this lovely branch and keep on cribbing and downgrading the science behind it.
I may be harsh sounding but it’s truth.

Qn. 

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Categories: Medical Blog

22 replies »

  1. I do search sir. When I can’t find, I expect answers for it immediately. As I just started my PG, I don’t know where to refer…Book & the Chapter( Not in all case) Even this reversal of neuromuscular blockade… Everywhere I saw about TOF & other tests…But I couldn’t get any criteria or prerequisites apart from these tests. So I started asking in General discussion groups.Anyways Thank u for the response Sir. I will find answers by myself.

      • Thank you Sir. My PG told me to Find it.
        Sir, Do u have any discussion forums for academics in Anaesthesia?
        Like the doubt I asked..

      • As a teacher when I ask question my objective is not the answer but to see if the PG is going and trying to read from textbooks. Don’t take shortcut

  2. Hi Sir,
    I have been allotted DA,but after reading various posts I am confused whether I should continue with it as you have preferred MD or dnb instead of da. Pls help me clear my doubts about future after DA

    • Hi Rix. If u are from rural place and want to settle there then DA rocks.
      If you want to do cases in nursing homes then DA rocks.

      If u want to stay in corporates and in cities then be prepared to finish secondary Dnb after finishing DA. That will be another 2 years course. Instead of the regular 3 years.

      • Thanku sir for your response. One more query post diploma dnb entrance would involve all neet subjects or just anaesthesia?

      • Yes. And u have to compete with fresher’s again. But somehow many friends have done it without much fuss but I can’t say for sure what will be situation 3 years down the lane

  3. Thank you so much sir.
    Can you help me with choosing thesis topic? Where to find? Before knowing the branch..Before exploring the depth of Anaesthesia… How am I supposed to choose topic for thesis sir?? 😦

  4. Sir, I took MD Anaesthesia in a Government college, Tamilnadu. I did my UG in a Private college- Bad clinical exposure. So Iam scared of everything. Seniors don’t understand that I need time to accustom for both the branch(My dream branch was General Medicine, unfortunately I couldn’t get at my rank ) & place. How to tackle this? How to start studying? What should be must done routine for a MD Anaesthesia PG?

    • Hi June even though I did ug from a govt college even I had really bad clinical exposure. I feel Pvt college students are up to date with latest gadgets etc.

      But trust me these are just 1st 6 months complexes.
      You have to be persistent.
      Seniors have the habit and for that matter even faculty ppl to ask questions that they know. It’s not to embarrass you but to force your inner student to keep studying and find answers.

      Start reading MORGAN physiology of each system in 1st year.
      Don’t do too many textbooks like I did.
      Stick to Morgan even though it has some errors regarding to numerical values but your concepts will be clear and it’s much easier to assimilate.

  5. Hello air, so glad i stumbled upon this thread. I am allotted M. D. Anaesthesiology at IMS BHU in the first round. Are mumbai colleges better than bhu for anaesthesia? If yes, can you please provide an order of preference so that i can fill that up in the second round? Thanks in advance sir.

    • You can stick to BHU. Central institutes have their weight. Plus you can be better prepared for their D.M courses in pain.
      Mumbai case load may be high but I think you won’t get to see high end gadgets.
      If you are from Mumbai and want to stick to your city then it’s a different choice

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