How long does it take to lose OR skills if one is practicing in the ICU?

[chocomorsel]

Just wanted to get the consensus out there as far as what you guys think. I am trying to get back to the OR and some locums companies seem to think that it will be difficult with all my time spent in the ICU over the past couple of years. Would you guys be comfortable with someone coming from the ICU to the OR without any supervised or remedial training? I mean, other than speed, I can't see the problem and I think this thinking is draconian and outdated. Or patients are a lot healthier than ICU patients. I mean, it's not like I have been practicing palliative care.
I guess I can keep working in the ICU but I am looking at other ways of making money and eventually getting out of medicine altogether in the next few years anyway, but I find this to be some BS.

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[aneftp]

My opinion is you need to sit your own cases for at least 2 weeks to get comfortable.

As for credentials. Many places want to see actual clinical Or work for at least the last 90 days.

The saying is an average of 8 hours a week over a 52 week period. That’s why chairs at academic dept cough cough try to make it look like they are clinically involve one day a week “supervising” star CA-3 senior resident 1:1. Just to pad their numbers

So real life. 2 weeks solo cases

Real world needs an average 8 hours a week clinical work.

 

[Katheudontas parateroumen]

I just finished fellowship and haven’t done anesthesia in almost 1.5 years since end of CA3. I did feel rusty for maybe a couple days trying to remember how to do machine checks, where everything is in the OR. Definitely feel rusty about regional peripheral nerve blocks. I supervise in my job so I find all the opportunities to break my own rooms, start the cases, intubate, put lines, and just be very present whenever to get back into the groove of things. But there is no way any “loss of skill”. In fact, my colleagues who have been practicing OR for years come to me for many complicated patients even as a new grad just because they know I attend the ICU.

 

[vector2]

Just wanted to get the consensus out there as far as what you guys think. I am trying to get back to the OR and some locums companies seem to think that it will be difficult with all my time spent in the ICU over the past couple of years. Would you guys be comfortable with someone coming from the ICU to the OR without any supervised or remedial training? I mean, other than speed, I can't see the problem and I think this thinking is draconian and outdated. Or patients are a lot healthier than ICU patients. I mean, it's not like I have been practicing palliative care.
I guess I can keep working in the ICU but I am looking at other ways of making money and eventually getting out of medicine altogether in the next few years anyway, but I find this to be some BS.

I would first try to see if any of the hospitals where you have done ICU have any anesthesiologist needs. That's the easiest route because at least you have some familiarity with those systems already. The next best is probably trying to get an anesthesia gig at the last place where they remember you doing anesthesia before you started doing ICU FT.

Barring that, I'm sure the recruiters know of practices which are so in need that they don't care how long ago you did anesthesia as long as you're still board certified.

 

[nimbus]

I just finished fellowship and haven’t done anesthesia in almost 1.5 years since end of CA3. I did feel rusty for maybe a couple days trying to remember how to do machine checks, where everything is in the OR. Definitely feel rusty about regional peripheral nerve blocks. I supervise in my job so I find all the opportunities to break my own rooms, start the cases, intubate, put lines, and just be very present whenever to get back into the groove of things. But there is no way any “loss of skill”. In fact, my colleagues who have been practicing OR for years come to me for many complicated patients even as a new grad just because they know I attend the ICU.

We’ve hired more than a few ICU fellowship new grads over the years. They all do fine.

 

[aneftp]

To add. If you are in icu and routinely intubating. Than there shouldn’t be any issues going to the or. It’s just mental memory learning the machines.

 

[Planktonmd]

The issue maybe that if you got used to think like an intensivist you might have trouble going back to the Propofol, Sux, Tube routine anesthesia practice.

 

[Katheudontas parateroumen]

The issue maybe that if you got used to think like an intensivist you might have trouble going back to the Propofol, Sux, Tube routine anesthesia practice.

This is actually kinda true haha

 

[Ezekiel2517]

OR, no problem. OB, might take a couple days to get comfortable. This was how it was for me at least, after fellowship

 

[chocomorsel]

My opinion is you need to sit your own cases for at least 2 weeks to get comfortable.

As for credentials. Many places want to see actual clinical Or work for at least the last 90 days.

The saying is an average of 8 hours a week over a 52 week period. That’s why chairs at academic dept cough cough try to make it look like they are clinically involve one day a week “supervising” star CA-3 senior resident 1:1. Just to pad their numbers

So real life. 2 weeks solo cases

Real world needs an average 8 hours a week clinical work.

As opposed to supervising? Absolutely agree. I hate supervising. I want to work alone. I am looking for a job working alone. Apparently I am not qualified. Really weird. It’s not like I ever do anything remotely related to anesthesia in the ICU right?

 

[chocomorsel]

We’ve hired more than a few ICU fellowship new grads over the years. They all do fine.

Exactly. My application has literally been denied from a hospital, university of all places once they found out I had been attending the ICU. S hit is weird.

 

[chocomorsel]

To add. If you are in icu and routinely intubating. Than there shouldn’t be any issues going to the or. It’s just mental memory learning the machines.

Literally the only thing I can see being the problem. I do everything besides passing gas.

 

[chocomorsel]

The issue maybe that if you got used to think like an intensivist you might have trouble going back to the Propofol, Sux, Tube routine anesthesia practice.

I am looking forward to intubating in that fashion and not worrying about possible codes due to sick ass patients. I mean I have had so many people crash on induction in the past four years than I did the previous 9 years. I want boring!

 

[aneftp]

I am looking forward to intubating in that fashion and not worrying about possible codes due to sick ass patients. I mean I have had so many people crash on induction in the past four years than I did the previous 9 years. I want boring!

Try to go to some desperate places. There are academic places that need locums badly. Just get some case numbers up. And u don’t even have to staff ur own rooms.

 

[dabears505]

How long have you gone without doing anesthesia?

 

[chocomorsel]

Try to go to some desperate places. There are academic places that need locums badly. Just get some case numbers up. And u don’t even have to staff ur own rooms.

I was supposed to be getting credentialed at an academic place that was supposedly desperate. They withdrew my application.

 

[chocomorsel]

How long have you gone without doing anesthesia?

A year and 3 months for only a week. But before that it was ICU for about a 8 months.

 

[aneftp]

I was supposed to be getting credentialed at an academic place that was supposedly desperate. They withdrew my application.

That’s so unusual. Especially if u are board certified in both anesthesiology and critical care. Try another academic place. Lots of them. Obviously the big names may care but the run of the mill do not care.

 

[McPoyle]

I feel like it was that difficult. Things happen at a little bit different pace, and having to do things as opposed to simply make a plan was a little different, things moved at a slightly different pace. But, the technical skills were no issue at all.

 

[deleted1147063]

I was supposed to be getting credentialed at an academic place that was supposedly desperate. They withdrew my application.

They were not desperate enough, or (more likely) somebody from your past said something (e.g. your wonderful residency program).

 

[chocomorsel]

They were not desperate enough, or (more likely) somebody from your past said something (e.g. your wonderful residency program).

I have never had a problem being credentialed before due to my probation. However it’s possible. But it’s more likely they weren’t desperate enough even though they told me they were down 20 FTEs mostly docs.

 

[dabears505]

I would try and get into just a private practice locums first instead of academics. Less hoops.