Anaesthesiology Residency Interview Questions and Answers

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Anesthesiology, the branch of Medicine that specialises in the management of patients who are either made unconscious or desensitised to pain during medical procedures, is one of the better paying medical specialties in the US. The median clinical salary was $426,000 in the most recent available data. As well as core work in the management of patients during operations and procedures, anaesthesiologists are experts in the management of critically ill patients, and some will combine work in the ORs with further work in ICUs.

Residency Core Requirements

An anaesthesiology residency requires one preliminary or transitional year, and a further three years of Residency, for a total of four years of graduate training. Three years of the training must be in clinical anaesthesia, whilst the first preliminary year is considered a ‘clinical base year’ and must provide a resident with 12 months of wide medical training – and only one month of this period can be spent in anaesthesia. The clinical base is typically the first year after graduation from medical school. There are a range of subspecialties available to those that finish their residency, including: anesthesiology critical care medicine, pain management, and pediatric anesthesiology.

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Application Statistics & Competition

In the most recent available data, there were a total of 2,560 applicants for 1,969 spots, which works out as 1.3 applicants per position. This makes anaesthesiology a relatively competitive specialty. Of 1,267 US MD Seniors who applied, 148 did not match – around 12%. An additional 474 DO Seniors applied, of whom 313 matched. That left 161, or 34%, unmatched. Anaesthesiology is therefore a relatively friendly field for DO students, although there are others which are a little more so.

Sample Interview questions

Why are you interested in anaesthesiology?

I have found anaesthesiology to be one of the most intellectually demanding specialties during medical school, but that it can also be very fast paced. A resident in my third year told me that much of anaesthesiology consists of doing very little – perhaps reading a textbook or chatting to the surgeon – but when you need to act, you need to know exactly what to do, be able to lead, and be able to act under intense pressure. The fact that the field combines this in-depth knowledge and heavy intellectual workload with such a knowledge of critical care medicine stands out to me – the idea of following a branch of Medicine in which I don’t truly feel that I could help an acutely ill patient does not appeal to me; equally I wish to become a true specialist, and be able to continue to learn in detail as my career progresses. Being able to deal with different cases, rather than be hyper-focused on one area – as might be the case for an orthopaedic surgeon, for example – is also hugely appealing, and I believe will allow me to retain something of a general medical knowledge whilst becoming an expert in my field.

What are the criteria to wean an extubated patient?

Patients should be liberated as soon as possible. However, contraindications include:
– acute respiratory failure needing active management
– PaO2/FiO2 less than 150, needing FiO2 over 0.40 or PEEP  >10, minute ventilation requirement >15L per min, rapid shallow breathing index over 150, excessive secretions, worsening chest imaging
– Patients must be able to maintain adequate oxygenation and ventilation with low level respiratory support
– Patient should be able to protect the airway, maintain patency, and have a strong cough

– You must consider mental status, oxygenation, ventilation, and expectoration (MOVE).
– Patient must have no cardiovascular instability
– GCS must be 8 or greater (generally should be alert, awake, able to follow commands)
– no acute brain injury where the injury was the reason for intubation
– no plans for anaesthesia within the next 24 hours
– no current use of paralytic agents
– no open abdomen
– no ongoing therapeutic hypothermia

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Important considerations

It’s important to note that anaesthesiology is a relatively competitive field, so you will need strong scores to ensure that you match. DO students aren’t at a huge disadvantage, but they will be significantly less likely to match than MDs. However, if you are successful, then simply completing the Residency – even without any further postgraduate training – will guarantee you both a rewarding career and a very high salary. 

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