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Transitioning from residency into private practice can be difficult. Being aware of some of the difficulties you may encounter can help to ease that transition. Throughout residency, we are trained to manage different types of cases and patients, but under the supervision of an experienced attending that can provide assistance and knowledge to ensure safe and effective patient care. When entering into private practice, depending upon the group, you can find yourself as the lone anesthesia provider at a surgical center with the expectation of doing cases with little or no support system. Also, you can find yourself assigned to cases which you had limited experience in managing as a resident and feel uncomfortable performing them due to familiarity. These situations can be overwhelming straight out of residency, especially when you feel that you need to be autonomous immediately. The most important thing to remember is to never be afraid to ask questions and for help when it is needed to ensure therapeutic care and patient safety. Every person in your group started out in an unfamiliar setting at some point in their career and they can be your best resource for advice and direction. If you do not feel comfortable going to your department chair with every little question you have, you can always find another partner or employee in the group whom you trust and can run cases by them if you are unsure. These types of collaborative discussions are expected often when you are right out of residency to ensure safe practice.
During residency, you are used to having an attending watching over you rather than yourself supervising another provider. There is a sharp learning curve when it comes to supervising, and even experience teaching other residents prior to graduation does not quite prepare you for supervising multiple rooms of CRNAs or AAs. When doing a case alone, you become used to controlling most aspects of the patient care to your own preference. When supervising, it is important to accept that there are multiple ways to do the same job and that you may receive push back from someone who has been doing things a certain way for decades. It is important to learn to pick your battles such as standing your ground on points of appropriate patient care and safety while letting some small personal preferences be done in a different manner. Otherwise you may end up in a challenging working environment.
The other consideration with supervision is the number of rooms you may be covering. The average coverage ratio is anywhere from 2-4 rooms. You must learn to manage your time to see all your patients preoperatively as well as be present for all the critical parts of the case i.e. Induction/ emergence. Depending on the practice you may also be responsible for giving breaks in all your rooms. Initially this all may seem overwhelming and difficult to manage but if you try and develop a broad plan at the beginning of the day and ask coworkers for help when needed you will ad- just quickly.
Graduating residency and transitioning in to private practice may seem overwhelming, but every year it is success- fully accomplished by new graduates. If you have survived years of training, then you have the knowledge and skills needed to succeed. You just need to enter with confidence that you can do it, as well as the humility to know when to ask for help.
Date of Publication: Spring 2018
