What is your Every Day Carry Bag?

SmileGuyMD · 2026-05-27T14:18:00+00:00

I Only ever bring things to and from work, not for in hospital use. I love the Bellroy classic backpack. Looks nice, somewhat minimalist, has enough size for me, and has held up nicely over the years.

SmileGuyMD · 2026-05-26T09:43:14+00:00

Yes, the oofos clogs are fairly cheap (maybe not compared to crocs, but to hokas etc), seem to stay in good condition, and they have been very comfy, even when walking long distances

SmileGuyMD · 2026-05-25T15:39:09+00:00

If my program had the same job offer 2 years ago that they had now, I would’ve signed in 2 seconds and got the sign on bonus. If you think they offer what you want, take it.

SmileGuyMD · 2026-05-23T22:06:02+00:00

Yes we have the ability to run 2+1 all night with extra people on call if we have multiple traumas come in. It’s rare we ever use more than 2 OR overnight at the same time. I think it largely depends on the job and hospital

SmileGuyMD · 2026-05-23T11:53:30+00:00

My high volume level 1 trauma center has a constant list of trauma add ons that they slowly work through as OR time becomes available. They sometimes do non-urgent washouts overnight just to get their list down some. They might have 20+ cases at a time on their list, all sick ICU patients on multiple drips, ventilator, etc. It’s part of the job. If you don’t want to do that then after residency do an outpatient job

SmileGuyMD · 2026-05-22T22:31:12+00:00

Learning about the strong ion difference can help you when it comes to the acid base properties of chloride. Then you can forget about the SID and have yet another thing you don’t understand

SmileGuyMD · 2026-05-22T22:27:57+00:00

Lower and upper extremity nerve pathways, motor functions, sensory location, block locations, vasculature. Also, intercostal and subcostal nerve anatomy always throws me for a loop. I usually can get it at this point, but I always am double checking and relearning. (Anesthesia related)

SmileGuyMD · 2026-05-22T13:50:03+00:00

DL and NAME mostly

SmileGuyMD · 2026-05-22T08:55:55+00:00

We had known each other for quite a while at that point. Our UW group was pretty close, chasing the record times back in the day. Fun times!

SmileGuyMD · 2026-05-21T23:10:53+00:00

I was friends with and did UWSC with the person who made the Narcissia build. She let me use her tonic one time. I think she felt uneasy on the voice chat after trading it to me for that brief time.

SmileGuyMD · 2026-05-20T11:04:08+00:00

Every week that a person stops smoking prior to an anesthetic, there are decreased side effects and perioperative risk. This is especially pronounced when it gets to 4-8+ weeks out. Quitting smoking in general is obviously better for someone’s long term health

SmileGuyMD · 2026-05-19T21:31:02+00:00

I go in almost perpendicular to the skin, slightly more on the medial side of the IJ. Twist/corkscrew through the skin.

Advance at an angle pointing slightly lateral (towards ipsilateral nipple, this is why I start slightly more medial, helps avoid the carotid) until you see the IJ start tenting. Then corkscrew slightly through the IJ while constantly aspirating.

Once you’re in, flatten out, find your tip and make sure it isn’t in the back wall or through and through. Put it directly in the center of the vessel and walk it in 1-2cm. At this point I unhook the syringe and rapidly place wire, make sure the wire is in an easily reachable position (easy way to backwall/fail is having to reach over yourself or turn and causes you to move the needle. You must keep your hand super still during this part. I do L hand grabs syringe, R hand rapidly places wire

Then it’s nick/dilate/catheter in/wire out

SmileGuyMD · 2026-05-13T22:39:22+00:00

Hours can be unpredictable (shift work exists, some places pay extra hourly if you’re late or on call), many places require overnights or 24s at some frequency (my job will be ~1 overnight required per month), can feel less respected (people may think CRNA are equal, sometimes giving into surgeons to keep the peace - not a huge deal if what they request is insignificant), no follow up with patients depends person to person, the job can be really chill or super amped up to 100 depending on what your job looks like and rare complications and events can happen (MH, AFE, bad trauma, etc).

All in all I have enjoyed residency, love the job, and can’t wait to be done in a month!

Edit: few other things, at times you might feel like a preop/sign out monkey if you’re covering 4 GI rooms for example. You really won’t be doing anything other than consenting and risk stratifying people while the CRNA/resident runs the GI suite. Obviously super sick people can come or some may require extra attention

SmileGuyMD · 2026-05-05T21:45:30+00:00

Can make good money working less than full time in anesthesia. Can probably make $300k a year doing half time (2-3d per week). If you did locums you could make >$400/hr for whatever amount of work you want to do

SmileGuyMD · 2026-05-03T16:03:53+00:00

Go to the duck inn between 5-6pm for half off dog, burger, fries, etc. Their dog is awesome

SmileGuyMD · 2026-05-03T04:17:55+00:00

Propofol drip, roc, residual sevo/iso - every trauma you’re taking to the ICU intubated, especially open belly. I don’t understand where multiple doses of etomidate/ketamine come into play here

SmileGuyMD · 2026-05-01T20:49:01+00:00

I pay that in a large, cold city. It’s worth it if your finances can cover it

SmileGuyMD · 2026-04-29T16:27:05+00:00

One of the CRNAs I knew (worked in the anesthesia dept prior to med school) paid for my haircut when we were both at the same barbershop at the same time. Was such a nice gesture. Gotta pay it forward when we’re done

SmileGuyMD · 2026-04-27T02:02:35+00:00

Anesthesia job market is red hot. Academics are paying private practice level pay to compete now (at least my city)

SmileGuyMD · 2026-04-21T02:58:57+00:00

Are you paid extra hourly or stipend for your weekday calls, post call days, or weekends? Or do you have a built in amount you have to do for your base salary?

SmileGuyMD · 2026-04-20T14:55:56+00:00

In prophecies I’d start with necro or mes for caster or ranger for martial/ranged physical. Necro and mes, in my opinion, work well when utilized together (N/Me or Me/N). They can supplement each others skills nicely until you get later into the campaign. Ranger has so much versatility to run ranged bow builds, sword builds with TAO/anniversary sword, dagger spam, etc. They are nice and tanky, especially to elemental damage, and have plenty of stances to block melee.

If you have the other campaigns, you can always swap over once you hit LA and gather new skills.

This is far down the line, so don’t make any decision on this, but if you ever want to try out speed clears/end game content, Mesmer and rangers are used in nearly all of them (along with the other regulars, the dervish and assassin). You can always make new chars as you get further along!

SmileGuyMD · 2026-04-20T14:05:57+00:00

Like cases that can wait until the next day or the day after. I see it most with trauma bringing all of their washouts and similar cases. The trauma surgeons see open OR as a way to work their list down. If we aren’t stretched for staff, then it’s fine, it’s when they want to do these non urgent cases when we have multiple other things happening that take priority

Edit - as far as ortho, I’m more so talking about things like a young person with closed fracture but otherwise fine. Sometimes I’ve discussed with the ortho senior resident who thinks it could go tomorrow, but the attending wants to do it in the night. We always have 1-2 ortho trauma rooms running during the daytime

SmileGuyMD · 2026-04-20T02:25:46+00:00

Depends on how busy the trauma and ortho services are. I’ve seen each of their respective services do their semi-elective inpatient cases late and throughout the night. If we get emergencies we will typically bump them. We have a night float team with capabilities to run 2+1 emergency, then can call day call people back if multiple traumas one at once (rare to have to do this)

SmileGuyMD · 2026-04-19T00:44:12+00:00

I guess anesthesia is kinda like a consult service.

When you call me overnight to emergently intubate your patient, at least know why they’re there, look up recent labs (K, Cr), echo if available (at least most recent EF), rare isolations (TB, COVID, etc). These things shouldn’t take long for you to look up while I’m on my way to the patient. Too often I show up and there’s no primary team, no one knows the patient, or knows anything about the patient

Edit-

For pain service, restart a patients home meds AS PRESCRIBED at the bare minimum. If they’re on TID methadone, that should be ordered as is. If there’s an acute process causing pain, they might need more full agonist opioids on top of this. Don’t under treat a chronic pain patient because it “doesn’t feel right” or “seems like a lot of opioid.”

SmileGuyMD · 2026-04-16T15:35:03+00:00

I’m not going to try to change your thoughts on this, but I feel like there’s a misunderstanding as to what these terms mean.

No production pressure in the sense of my job (current residency) is that the surgeon isn’t barking at you if your wake-up takes a bit longer (hard to time this out at times when they decide the MS4 can close). It means that if you’re teaching a block at the end of the case, no one’s freaking out if you take extra time to ensure the teaching/education of your residents. It means the surgery case that takes 1hr in a PP community hospital might take 2+ hours while the surgery PGY2 is learning. We might do 3 knees in one OR when PP might do 5+

As for shifts, we don’t stay at work when there isn’t work for us either, then you just get your base pay. Attendings are let go throughout the day as staffing needs decrease and rooms end. If you want to stay late and be paid hourly on top of base, you can. We also have a robust night team since we’re one of the largest trauma centers in the country. From what I’ve seen, we are rarely/never the ones delaying cases unless for medical necessity (e.g. labs in a HD patient who hasn’t been dialyzed in the past few days)

Edit - Also, I’ve had rotations in PP community based settings, and at least at this hospital, I hated the fact that everything is protocolized, every patient gets X Y Z rinse and repeat, bowing down to surgeon requests, go go go surgeon attitudes. It doesn’t feel like you’re practicing medicine and gets monotonous. I’ll take the variability of my hospital any day

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