Second Year

Fall Semester (Sept-Dec)

For reasons unbeknownst to me, this semester proved to be most challenging for me. Even to this day, I don’t quite understand or know why I had such a hard time with getting through this semester. I did well academically and clinically, but I just personally struggled to get through this semester. I had heard comments from previous students of that one semester that they had great difficulty with and I guess this was the one for me. Of course, everyone’s response and experience was wildly different. For some students, the very first semester of the program was the hardest experience. For others, it was the last. I never quite understood what they were saying to me, but the beginning of my senior year was certainly the most challenging.

Weekly quizzes and class lectures run by students were introduced in this semester. In addition all of the new reading material we had to go over, we had to pore over old material and prepare ourselves for a weekly quiz. Basically, we would go over 50-60 pages of material to be given an 8-10 question quiz. In addition, students were paired up and required to lecture on the material for an hour in front of the class. Needless to say, it was strenuous and exhausting.

In any case, I did a regional rotation at the Balboa Naval Station in San Diego in September. It was a great experience in a didactic sense because I spent a lot of time discussing the anatomy and the techniques involved with each type of block with my preceptors along with the Navy SRNAs, who I have to say are an interesting bunch of individuals. Very smart group of individuals and very open to trying out new techniques or using atypical drugs to do a block. I had a great time there. I only wished I had more opportunities to do regional blocks, but the fact that the SRNAs and I would go over the blocks in great detail and have long, lengthy discussions about what kind of blocks we would do for certain situations more than made up the lack of blocks. I think I only got to do about 20 blocks during my month at the naval base.

I spent October in Hawaii doing a general rotation. Not sure what to say that you’re already thinking. It was absolutely splendid. Only a handful of students are allowed to go on this rotation (and are stupid enough to take on more debt to fund their lifestyle in Hawaii), but I figured, what the hell? What’s another $3,000 of debt, which I don’t regret, but I will admit is an absolutely stupid way of approaching money. What’s $3K here? What’s $3K there? I’ll be making $xxx when I’m a CRNA and the next thing you know, you’ve racked up $50,000 in debt. I certainly don’t encourage anyone to take on more debt especially if you’re not making any money to pay off that debt. Anyways, back to Hawaii. It was a general rotation so I got to do a wide variety of different cases. I actually got to perform my first thoracic epidural and fifth double lumen tube case there. All I can say is holy crap, was that scary for me. It was on an 88 year old female as well. All in all, I had a great time there. The people at the hospital were nice. The anesthesia providers were excellent. It was one of the few clinical rotations that I felt truly comfortable in.

November was spent back in San Diego at the Balboa Naval Base. I completed my OB rotation there. That was probably the nadir of my experience in the program. I think a lot of it had to do with being isolated from everyone. I only had class once a week, but by the time I finished class, I would be on my to San Diego to work 4 12 hour shifts. Most of these shifts were spent in the evening so my sleep pattern was interrupted in a big way. At night, I was the only anesthesia provider on the floor. My preceptor would be in bed and the only time I would call is if there was an emergent C-section. I remember having a preceptor around me for 3-4 epidurals, but soon after, I was on my own. It was very scary at first, but eventually, I was able to get my epidural procedure time down to 5 minutes, which I thought wasn’t too shabby for someone practicing on his own. This rotation was the first time I actually felt confident in myself as a provider. In one 12 hour shift, I placed 8 epidurals and did 1 c-section by myself. Not bad for someone who had only practiced anesthesia for 10 months and was barely 2 weeks into his OB rotation. It was the first time I developed efficacy and it was a great feeling.

December was spent in a hospital in the projects. All I can say is, the patient population I took care of there was vastly different from any other population I came across. My first patient sustained wound damage on his left hand. I remember asking him what exactly happened? His reply was, he was minding his own business that morning and when he left his home, someone had inexplicably attacked him with a machete. Not sure what to say to that, but okay then. To me, that experience perfectly summed up my month long experience at that hospital.

At this point in the semester, I was tired and exhausted. Between the 4 day (40-55 hour clinical week), reading several chapters of new material, and preparing for a weekly quiz where I had to pore over 50-60 pages of material, the semester started to feel like a grind…Oh and I forgot to add the several group projects, simulation lab, and oral boards that I had to participate in…That just threw me over the edge.

Spring Semester (Jan-May)

My clinical rotations for this semester included 2 general surgery rotations, a near rotation, and a trauma rotation (which ended up not being anywhere close to a trauma experience). Otherwise, in terms of didactic experience, it was a continuation of last semester. While we weren’t learning anything new, classroom instruction involved a more in-depth look at case management (e.g., thyroidectomy, pheochromocytoma, etc.). The weekly quizzes remained and let me tell you, it felt like a grind…a non-stop grind of going to clinical early in the morning and studying afterward and going back to clinical and back to studying…At this point, you’re so burned out, it’s hard to really care about anything anymore. That’s how exhausted I was. I would have a few bursts of energy when I thought about how close I was to being done with the program.

Summer Semester (June-Aug)

My last clinical rotation ultimately ended up being where I currently work at. However, this particular site was different from all of the other sites I visited the past 18 months. There was an emphasis on off-site procedures (e.g., cath lab, MPU, IR, etc.). It was definitely a change of pace for me and you learn that being off-site is nerve-wracking. VIGILANCE is key! You sometimes get lulled into thinking things are fine because not a lot is going on (not true) during the procedure. One moment everything is fine, but in the next moment, all hell breaks loose and you realize that your support staff isn’t quite like the OR (through no fault of their own). So…exercise extreme vigilance!

Didactics…This was also a terrible but necessary semester because in the last 8-10 weeks of school, we basically reviewed EVERYTHING we covered in the last 2 years. Our weekly tests comprised of several random topics. Difficult as it may be, it ended up being a great way to force us to study for boards because by the time we graduated, we were all board prepared. I ended up taking mine 2 weeks after the end of school. Thank goodness it’s over.