Anesthesia Residents

Oxygen Delivery Devices: A Full Overview By Dr. Gurusanthiya

by with No Comment Anesthesia
0
0

Estimated reading time: 3 minutes

Today we will discuss one of the most critical devices utilised by anesthetists and throughout the anesthetic communities—the oxygen delivery devices. From anesthesia circuits, nasal prongs, and basic face masks to ventilators in the ICU environment, these devices are integral to guaranteeing optimal oxygen delivery. It is important to understand these devices in determining the oxygen flow, the needed fraction of inspired oxygen (FiO2), and categorizing these devices according to patient requirements.

Significance of Oxygen Therapy

Oxygen is crucial to life, and its administration becomes important in the management of hypoxemia, which may occur because of hypoventilation, ventilation-perfusion (V/Q) mismatch, atelectasis, or anesthetic-induced respiratory depression. Oxygen therapy is important for:

  • The management of hypoxemia and enhancement of tissue oxygenation
  • Carbon monoxide poisoning
  • Maintaining survival during low atmospheric pressure environments, e.g., mountaineering
  • Aiding patients undergoing anesthesia who cannot breathe on their own

The World Health Organization (WHO) has indicated that an FiO2 of 80% is acceptable, though in the majority of ICU environments, 50-60% FiO2 is usually acceptable. Oxygen delivery can be administered via simple face masks, nasal cannulas, or invasive ventilatory assistance based on a patient’s ventilatory needs.

Classification of Oxygen Delivery Systems

Oxygen delivery systems can be classified into two general categories:

  1. Normobaric Oxygen Therapy – Oxygen is delivered at atmospheric pressure.
  2. Hyperbaric Oxygen Therapy – Oxygen is administered at greater-than-atmospheric pressures.
Additional Classification Based on Patient Dependency
  1. Low Dependency Systems: Supplemental oxygen alone is adequate to correct hypoxemia in spontaneously breathing patients.
  2. Medium Dependency Systems: Patients need further assistance like Continuous Positive Airway Pressure (CPAP) or High-Flow Nasal Cannula (HFNC).
  3. High Dependency Systems: Patients need mechanical ventilation or Non-Invasive Positive Pressure Ventilation (NIPPV).
Low Dependency Oxygen Delivery Systems

Low dependency systems are subdivided into:

Low Flow Devices:
  • Nasal Cannula: Supplies variable oxygen concentration (FiO2 varies with respiratory rate and tidal volume).
  • Simple Face Mask: Supplies more FiO2 than a nasal cannula but less accurately.
  • Reservoir Masks:
    • Partial Rebreather Mask: Permits some rebreathing of exhaled gases, which raises FiO2.
    • Non-Rebreather Mask: Fitted with one-way valves to avoid rebreathing, providing increased FiO2 levels.
High Flow Devices:
  • Venturi Mask: Offers a constant and reliable FiO2 irrespective of patient effort.
  • High-Flow Nasal Cannula (HFNC): Provides warm, humid oxygen at high flow rates (max. 60 L/min), facilitating improved oxygenation and comfort.
Determinants of Delivered FiO2

Several factors affect the actual FiO2 that a patient inhales:

  • Equipment Factors: Oxygen flow rate, mask volume, quality of fit, and effectiveness of mask seal.
  • Patient Factors: Respiratory rate, tidal volume, peak inspiratory flow rate, and intrinsic respiratory disease.
  • Other Factors: Whether or not humidification is present, patient compliance, and external air entrainment.
Conclusion:

Knowledge of oxygen delivery devices is essential to maximize patient care, especially in ICU and anesthesia environments. Selecting the appropriate oxygen therapy modality according to patient requirements and levels of dependency ensures proper oxygenation, reduces complications, and improves overall treatment outcomes.

Stay updated, stay ready, and keep moving forward in the specialty of anesthesiology and critical care!

Share

Medicine Residents

Liver Tumors: Understanding and Detailed Explanation with Dr. Karthik K

by with No Comment Medicine
0
0

Estimated reading time: 3 minutes

Liver tumors are one of the most critical health issues in the world, with hepatocellular carcinoma (HCC) being the most common type. Liver cancer is the fourth most frequent cancer in the world and the number one cause of cancer death in the United States. Among liver tumors, hepatocellular carcinoma constitutes nearly 90%, followed by rare forms like intrahepatic cholangiocarcinoma, childhood hepatoblastomas, and fibrolamellar HCC. Since it carries such a high death rate, liver tumors and their causes need to be studied well to manage them and prevent them effectively. 

Risk Factors for Liver Tumors

Liver tumors largely occur in the context of decompensated liver disease that may be either infectious or non-infectious. Among the infectious etiologies, hepatitis B and hepatitis C infections are most important, carrying an annual risk of 3-8% for cirrhosis of the liver to develop into HCC. Ethanol-induced liver disease (alcoholic liver disease), non-alcoholic fatty liver disease (NAFLD), and uncommon metabolic disorders such as Wilson’s disease and hemochromatosis are also important causes. Although viral infections are the most important risk factor, non-viral causes also play an important role in the development of liver tumors.

Viral Etiology and Their Contribution to HCC Development

Hepatitis B and C viruses have a well-established relationship with HCC. Hepatitis B virus (HBV) causes HCC in about 60% of the infected population, while hepatitis C virus (HCV) causes about 30%. Nevertheless, the contribution of HCV to HCC development has diminished because of improvements in antiviral treatment that decrease the development of liver cirrhosis and decompensation.

For hepatitis B, the presence of viral DNA and hepatitis B e-antigen (HBeAg) status has a correlate of increased HCC risk. Further, hepatitis B virus genotype C is more especially linked to a greater risk of transformation to HCC. For hepatitis C, genotype 1b with advanced fibrosis and cirrhosis (by the Metavir classification as F3 fibrosis or cirrhosis) tremendously elevates the risk of having HCC.

Genetic and Environmental Factors in HCC

Although viral infections and metabolic disorders are major factors in the development of liver cancer, genetic influences also play a role in HCC development. Interestingly, a gene polymorphism called PNPLA3 has been identified as a direct cause of transformation of fatty liver disease (NAFLD/NASH) to HCC without going through the intermediate phase of liver cirrhosis. This gene variant is a significant marker for the identification of patients at increased risk.

Environmental determinants, including exposure to aflatoxins (synthesized by fungi), are also involved in HCC induction. Aflatoxin exposure is related to TP53 mutations, which have been reported to initiate hepatocarcinogenesis. Insight into these interactions at the genetic and environmental levels will facilitate the development of focused screening and prevention.

Conclusion

Liver tumors, most notably hepatocellular carcinoma, are a heavy burden of disease worldwide. The main risk factors are viral hepatitis infections, alcoholic and non-alcoholic fatty liver disease, metabolic disorders, and genetic polymorphisms. Progress in antiviral treatments has enhanced the prognosis of HCV-related liver disease, but early diagnosis and risk evaluation are still imperative for all risky patients with HCC. Further research and optimized screening programs are critical in order to overcome increasing incidence of liver tumors as well as decrease their related mortality rates.

Share

Surgery Residency

Steps of Renal Transplant Discusses by Dr. Pawan Kandhari

by with No Comment Surgery
0
0

Estimated reading time: 3 minutes

Renal transplantation is a lifesaving intervention in end-stage renal disease (ESRD) patients. Here we take you through the key steps in a kidney transplant, from donor selection to ureteric anastomosis.

Step 1: Donor Selection

The initial and most important task of conducting a renal transplant is to find an appropriate donor kidney. There are two categories of donors:

  • Live Donor: In India, live donor transplantation is the most common technique. A living individual willingly donates a kidney to the recipient. The donor nephrectomy (removal of the kidney) may be performed open or laparoscopically. Laparoscopic nephrectomy is favored because it is minimally invasive, resulting in faster recovery and fewer complications.
  • Cadaveric Donor: A cadaveric kidney is obtained from a brain-dead donor. Cadaveric transplants entail the retrieval of more than one organ, which is not the case with live donation. This is practiced to a lesser extent in India because of the lack of an established cadaveric organ donation program.
Step 2: Bench Dissection
  • After obtaining the kidney, it receives a bench dissection before transplantation. This entails:
  • Stripping off fat and fibrous tissue.
  • Recognizing and separating out the renal artery and vein.
  • Perfusing the kidney with custom preservation solutions to remove any lingering blood and guarantee viability before transplantation.
Step 3: Implantation in the Recipient

The recipient receives an open renal transplant, usually in the iliac fossa instead of the kidneys’ initial anatomical site. This is known as heterotopic transplantation, in which the kidney is transplanted to a site other than where it originally existed within the body.

Surgical Incision and Preparation
  • The surgeon performs a hockey-stick incision in the lower abdomen.
  • The peritoneum is retracted, and dissection is carried out in the retroperitoneal space.
  • The iliac vessels are exposed, and overlying lymphatic tissues are dissected to prepare the vascular bed.
Step 4: Vascular Anastomosis

The transplanted kidney must be anastomosed to the recipient’s blood vessels to function properly. The anastomosis (surgical connection) is carried out as follows:

Arterial Anastomosis
  • The renal artery is anastomosed to either the external iliac artery or the internal iliac artery:
    • Internal Iliac Artery: End-to-end anastomosis.
    • External Iliac Artery: End-to-side anastomosis.
  • The selection of the artery is based on the vascular anatomy and health of the recipient’s vessels.
Venous Anastomosis
  • The renal vein is anastomosed to the external iliac vein with an end-to-side anastomosis.

These vascular anastomoses provide sufficient blood supply to the transplanted kidney.

Step 5: Ureteric Anastomosis

The transplanted kidney’s ureter has to be anastomosed to the recipient’s bladder in order to facilitate drainage of urine. The best method for this is the Modified Lich-Gregoir technique:

  • A small cut is made in the bladder wall.
  • The detrusor muscle is dissected carefully, and the ureter is implanted so that reflux (urine backflow) is avoided.
  • The ureter is fixed in position to maintain optimal function and avoid complications such as leakage or obstruction.
Final Steps and Post-Transplant Care

Following successful implantation, the wound is closed, and the patient is carefully observed for evidence of organ rejection, infection, or vascular or ureteric anastomotic complications. Immunosuppressive therapy is commenced to avoid rejection, guaranteeing the survival of the transplanted kidney.

Master Renal Transplantation with Conceptual Surgery!

It’s highly important to know surgical techniques in detail for any future surgeon. Conceptual Surgery offers excellent, systematic education to residents as well as practitioners in the form of vital surgical concepts through real-life case discussions and video demonstrations.

Become a part of Conceptual Surgery now and learn to become a better surgeon!

Share

Radiology Residency

Imaging of the Appendix: A Complete Guide By Dr. Zainab Vora

by with No Comment Radiology
0
0

Estimated reading time: 3 minutes

Appendix is a small, blind-ended tubular structure from the cecum, and its inflammation, appendicitis, is a frequent cause of acute abdomen needing surgery. Imaging is important in the diagnosis of appendicitis and in the differentiation from mimics. This blog discusses the imaging modalities to evaluate the appendix and their utility in diagnosis.

Role of Imaging in Appendicitis

The main function of radiology in appendicitis is to exclude the removal of a normal appendix. This calls for proper localization of the appendix and identification of signs of inflammation. Ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) all have a role to play in assessing appendicitis, each having its own strength and weakness.

Imaging Modalities
1. Ultrasound (US)
  • Initial imaging modality, particularly in children and pregnant women.
  • Uses a graded compression method to outline the appendix by pushing aside overlying bowel loops.
  • US features of appendicitis:
    • Blind-ending tubular structure with origin from the cecum.
    • Non-compressible, aperistaltic, with a gut signature (hyperechoic mucosa, hypoechoic muscularis, hyperechoic serosa).
    • Diameter >6 mm indicates inflammation.
    • Hyperemia and stranding of periappendiceal fat, and free fluid.
    • Probe tenderness, which is parallel to peritoneal inflammation.
  • Tips for finding the appendix on US:
    • Begin with a curvilinear probe for survey.
    • Begin with identification of the ileocecal junction.
    • Look 2–3 cm caudal to the ileocecal junction for the appendix.
    • Use a high-resolution linear probe for clear imaging.
    • Left lateral decubitus positioning may be considered if the appendix is not seen initially.
2. Computed Tomography (CT)
  • Senti and specificest modality for the diagnosis of appendicitis (>95% sensitivity).
  • Usually done as a contrast-enhanced CT (CCT) abdomen in India.
  • In a few facilities (e.g., in the U.S.), a limited appendicitis CT (from subhepatic region to pelvis) can be done.
  • CT Features of Appendicitis:
    • Dilated appendix (>6 mm in diameter).
    • Wall thickening and enhancement.
    • Stranding of periappendiceal fat.
    • Appendicolith (in certain cases).
    • Abscess or perforation in complicated cases.
  • No oral contrast required; there is no reduction in accuracy with or without oral contrast.
3. Magnetic Resonance Imaging (MRI)
  • Used almost exclusively for pregnant patients in whom radiation exposure cannot be tolerated.
  • Routine sequences are T1, T2, and diffusion-weighted imaging (DWI).
  • Findings are the same as on CT but have longer acquisition times.
Clinical Considerations
  • Mantrell Score: A clinical scoring system that is utilized to determine the probability of appendicitis. A score of ≥7 indicates a high likelihood of appendicitis.
  • Common Positions of the Appendix:
    • Retrocecal (most common, easy to visualize).
    • Pelvic, paracecal, pre-ileal, and post-ileal (potentially more difficult to visualize).
  • Mimics of Appendicitis:
    • Mesenteric adenitis, Crohn’s disease, ovarian pathologies, and diverticulitis.
Key Takeaways
  • Ultrasound should be the initial imaging in pediatric and pregnant patients.
  • CT is the most reliable modality and must be utilized when ultrasound is not conclusive.
  • MRI is reserved for situations in which radiation exposure is a problem.
  • Radiologists need to be familiar with false negatives and positives, identify complications, and include alternative diagnoses in the report if appendicitis is not suspected.

For further in-depth discussion of imaging in practice, subscribe to Conceptual Radiology and get ahead on your radiology education!

Share

obstetrics gynecology residency

Ace Your OBG Residency: Study Hacks Every Resident and Budding Practitioners Must Know

by with No Comment OBG
0
0

Estimated reading time: 4 minutes

One of the most frequent questions asked by obstetrics and gynecology residents, especially those who are beginning their residency, or even later in life, is, “How do I study when I don’t have time to study?”

Once you start your obstetrics and gynecology residency, your daily schedule is full of hospital work, taking care of patients, paperwork, and innumerable case documents. By evening, fatigue catches up, leaving minimal time for focused study sessions. Unlike your days as an undergraduate or an intern, with a dedicated study space, obstetrics and gynecology residency is a completely different game. 

Converting Day-to-Day Experiences into Learning Experiences

The secret to successful studying throughout your OBG residency is incorporating learning into your daily hospital activities. Every second in the hospital is a chance to learn. 

Here’s how:

1. Learning in the Wards

Whether you are posted in the antenatal, postnatal, or general gynae ward, each case you attend is a learning experience. Writing a case sheet? That’s learning. Seeing a patient with preeclampsia? Learning from their treatment chart is more than reading about it. Work with patient files proactively, challenge the rationale behind management plans, and discuss cases with seniors.

2. Maximizing Labor Room Postings

Your obstetrics gynecology residency will see you get long exposure to labor rooms. At least six months of labor room posting is mandated by the National Medical Commission (NMC) during your OBS-GYN residency, here’s where you get that rich hands-on training. 

If your hospital arranges these postings uninterruptedly or in phases (two months at a time as a first-year, second-year, and senior resident), ensure you maximize this time. The labor ward is where you will hone your skills in performing deliveries, handling obstetric emergencies, and taking rapid clinical decisions.

3. Maximizing OPD Postings

You may not be given outpatient departments (OPDs) independently at first, but sharing it with senior residents and consultants is a great learning experience in learning patient interaction, history-taking, and examination skills. 

Skills to learn in OPD postings are:

  • Good patient communication
  • Conducting speculum and vaginal examinations
  • Taking Pap smears
  • Grasping treatment and diagnostic guidelines
4. Observing and Learning in the OT

Your exposure in the obstetrics and gynecology residency program also takes place in the operation theatre (OT), where you learn surgery, instrument handling, and learn about sterilization procedures. Though you may not comprehend the steps of surgery properly at first, pay attention to:

  • Recognizing instruments utilized during various procedures
  • Learning incision procedures and suture techniques
  • Grasping intraoperative management of patients
5. Learning Beyond Docs – Teamwork is Key

Knowledge in your obg residency goes beyond what teaching faculty impart. Nurses, ward staff, and even general duty assistants (GDAs) are potential sources of practical knowledge beyond textbooks. Have an open mind, ask, and learn from all those people around you.

Maximizing Limited Study Time

As study time is limited, here are some tips of practical use:

  • Utilize small breaks productively: Catch up on the cases you encountered during brief breaks or after your shift.
  • Technology-based learning: Subscribe to respected medical websites and utilize mobile applications for brief revision of topics.
  • Peer discussion: Discussing and sharing cases among peers reinforces learning.
  • High-yield topics of importance: Revisit important clinical conditions and protocols for emergency handling.

As opposed to undergraduate learning, residency in obstetrics and gynecology is more a matter of learning by doing. Although you do not necessarily have uninterrupted study time, every encounter with the patient, each procedure, and each clinical judgment counts as an opportunity to learn. Remain attentive, be assertive, and make every minute count in OBS-GYN residency board preparations.

Share

Medicine Residency

How to Approach Medicine Residency: A Complete Guide

by with No Comment Medicine
0
0

Estimated reading time: 3 minutes

Beginning of medicine residency is exciting and intimidating. The path is full of long working hours, vast learning, and enormous responsibility. To gain the best from your residency training, you require a planned approach that reconciles clinical responsibilities, academics, and personal health.

Let’s discuss how to get through your Medicine residency without any problems.

1. Strong Clinical Foundations

Medicine residency demands a good grasp of internal medicine principles and their practical application. Here’s how to achieve it:

  • Review fundamental medical information from core textbooks like Harrison’s Principles of Internal Medicine.
  • Stay up to date with medical developments by perusing journals.
  • Learn diagnostic and decision-making skills from case discussions and patient rounds.
2. Master Time Management Skills

Balancing patient care, academics, and personal life can be challenging. Use these time management strategies:

  • Prioritize tasks according to your schedule.
  • Your study schedule should include daily revision and practice questions. For study management,, you can use the Conceptual Medicine platform, which will help you manage your studies. 
3. Improve Your Clinical and Procedural Skills

Your practical skills will define your competence as a physician. Focus on:

  • Mastering intubation, central line placement, and lumbar puncture as basic and advanced clinical skills.
  • Drilling bedside skills in history-taking, clinical exams, and communication with patients.
  • Obtaining mentorship from the senior residents and faculty members to hone your skills.
4. Remain Academically Active

Academic brilliance is essential for MD Medicine residents, particularly for career opportunities ahead.

  • Participate in case presentations, journal clubs, and other seminars.
  • Prepare for exit exams and subsequent specializations through practicing MCQs and clinical case reviews.
  • Conduct research and publications to strengthen your academic portfolio.
5. Look After Your Well-being

Residency can be draining, so pay attention to your mind and body:

  • Keep a good sleep schedule despite extended shifts.
  • Get regular exercise and maintain a balanced diet to keep your energy up.
  • Reach out to colleagues and mentors whenever you feel overwhelmed.
6. Plan Your Future Career Path

If you wish to have a super-specialization in Medicine, private practice, or academia, plan early:

  • Explore alternative career pathways such as DM, fellowships, or research.
  • Begin preparation for competitive exams (such as NEET SS or USMLE) if you are planning to pursue further specialization.

Strategizing your Medicine residency will enable you to thrive academically and in the care of your patients. A balance between clinical competencies, time management, and wellness can ensure that your residency is an enriching experience. Remain present, seek counsel, and learn continuously—your destiny as a physician is on the line!

Share

Surgery Residency

How to Select a Topic for Your Thesis?

by with No Comment Surgery
0
0

Estimated reading time: 2 minutes

Selecting the thesis topic is an important task for first-year postgraduates of MS surgery and DNB surgery. Your thesis protocol must be submitted within the first month, first to the departmental research committee and subsequently to the institutional ethics committee for clearance. As a thesis is compulsory for the award of your degree, selecting the appropriate topic is important for both academic success and career prospects.

Importance of Choosing a Good Thesis Topic
  • A thesis is required to clear MS surgery and DNB surgery.
  • The duration of the thesis writing is usually two to two and a half years, subject to institutional policy.
  • A well-researched thesis can result in publications in quality journals, enhancing your academic profile.
  • A follow-up study over the long term from your thesis can increase your research credibility.
  • Your thesis project can evolve into a postdoctoral study or even a PhD research project.
Important Points for Picking the Topic of Thesis
  • Interest: Pick one that relates to your area of interest and eventual career plans. 
  • Clinical Significance in surgery: Select one having clinical importance towards patient management. 
  • Availability: Verify that the study is doable with enough patient access and supporting facilities.
  • Guidance Availability: Think about your mentor’s knowledge and ability to oversee the research.
  • Data Collection & Follow-Up: Choose a topic that enables efficient data collection and follow-up over the long term.
  • Scope for Publications: A good thesis can result in conference presentations and peer-reviewed journal articles.
The Role of a Thesis in Career Development
  • Recognition in surgery: A well-conducted thesis can make you an expert in the field.
  • Enhanced Curriculum Vitae (CV): Published work enhances residency and fellowship applications.
  • Potential For Future Research Opportunities: Your thesis can serve as a platform for further research in specialized areas.
  • Chances of International Exposure: Publishing your results at international and national conferences can provide the opportunity for more research collaborations.
Conclusion: An Opportunity

The thesis is not just part of academics, it is way more than that. It is an opportunity to 

contribute positively to the surgery speciality. A well-designed research study can open new opportunities in your career, offer enriching learning experiences, and increase your prospects of academic and professional advancement.

Be inquisitive, be determined, and make your thesis journey a worthwhile one!

Share

Radiology Residency

Getting the Best out of Conceptual Platforms: Advice for Busy Residents by Dr. Zainab Vora

by with No Comment Radiology
0
0

Estimated reading time: 3 minutes

Residency is the most demanding but rewarding part of a physician’s career. With balancing responsibilities, personal life, studies, research, and exam pressure, residents tend to lose their way. This is where the eConceptual platforms step in, offering systematic guidance to keep you on the right path with your studies without getting overwhelmed. Here’s how you can utilize them to the fullest:

1. Consistency is the Key – One Video per Day

Your calendar is full, but the secret to being regular with studies is making it a routine to listen to at least one video per day. Even when you can’t spare time for focused studying, you can tune in on passive mode during meals, for quick breaks, or while working on tasks that are not highly focused. Eventually, this minute routine will make your foundation robust and give you greater confidence.

2. Adjust to a Lifetime Learning Mindset

As opposed to NEET PG, where you have full-time concentration devoted to studying, residency involves learning in practice. Your studies are incorporated into your daily life. Don’t expect to return home, sit down with textbooks, and study for hours. That’s not usually feasible. Rather, apply Conceptual as a means of perpetual learning by taking advantage of the convenience of video lectures, case discussions, and quizzes.

3. Use DNB Papers & Model Answers

Most Conceptual platforms have solved the DNB papers available now. Ensure you read and revise them multiple times to get used to model answers. This will assist you in organizing your theory answers well when the time for the exam arrives.

4. Engage in Case Discussions & Spotter Quizzes

Participation in discussions and quizzes is important. In radiology, for instance, spotter quizzes get you prepared for exams right from day one. Participating actively in such will make you adapt to the exam pattern and minimize stress in the actual exam.

5. Adopt a Systematic Approach to Videos & Books

With so much content out there, it can be hard to choose what to learn. Either learn through the live sessions as they occur or stick to a methodical approach by learning one topic a day. And the Conceptual books are an excellent foundation for theory preparation—use them to reinforce your understanding and include relevant updates from videos and discussions.

6. Learn on the Job

Residency is all about learning by doing. Even when you think you’re doing routine tasks, keep in mind that every little experience counts towards your learning. Stay focused, ask questions, and maximize your time in the department.

7. Overcome Challenges in the Workplace

Workplace toxicity is occasionally a problem. Be aware of your boundaries—speak up when you need to, but also prioritize your development. Residency is short-term, but your career is a lifetime. Cultivate toughness and put learning first.

Conceptual is here to help. If you have feedback or ideas, let the team know to enhance your learning process. Residency is tough, but with the right strategy, it can be an enriching journey. Stay consistent, stay curious, and make the most of the resources available to you. All the best!

Share

Orthopedics Residency

9 Must Know Rules of Residency by Dr. Apurv Mehra

by with No Comment Orthopedics
0
0

Estimated reading time: 3 minutes

Residency is a life-changing period in the life of every doctor, an exciting journey that shapes your professional skills, personal development, and long-term career goals. Here are the 9 rules that can guide residents through this difficult but rewarding period effectively.

Steps to Success in Residency
1. Take It Slow

The first instinct upon entering residency is to do everything at once. However, before getting into the deep end, take time to understand your environment, adapt, and settle in. Recognize your physical and mental limits, avoid burnout while keeping an ambitious mindset.

2. Enjoy the Moment

Residents often get caught up in chasing the next milestone—whether it’s mastering a skill, completing a case, or planning for post-residency goals. Pause and appreciate how far you’ve come. Celebrate small wins along the way, as these moments shape your journey.

3. Embrace a Gradual Learning Process

Residency is such that it unravels layer by layer like surgery. Don’t overwhelm yourself by attempting to know everything simultaneously. Break it step by step. Let experience and knowledge grow gradually with time.

4. Value Time & Be Punctual

Arriving five minutes early to responsibilities, OT, wards, or emergencies leaves a lasting impression on seniors, peers, and the hospital system. 

This easy habit creates a reputation for honesty and professionalism traits that make a great doctor.

5. Act on Your Ideas

Most residents have great ideas whether it is writing an article, learning a technique, or even writing a book, but very few act. Know your strengths, plan, and act on it. 

6. Be Prepared for Challenges

Chasing excellence can be a solo act. Not everyone will support your commitment. Be your best critic, be tough, and accept the frustrations that come with improvement.

7. Learning Is Ongoing

Real learning is not merely learning knowledge, it’s also unlearning what is no longer relevant and improving your skills. Imagine yourself as a sculptor, continuously molding your skills in a quest for excellence.

8. Heart and Mind Balance

Residency is not only about brains—it’s a test of passion, patience, and persistence. Personal experiences, people, and emotional setbacks will mold you. Take these encounters as part of your personal development.

9. Sustain Life’s Four Integral Dimensions

Life through and outside residency is contingent on equilibrium in four integral factors:

  • Family
  • Career
  • Relationships
  • Health

Similarly to a car having four wheels so it can operate effortlessly, losing balance in any of these aspects will result in imbalance.

Conclusion:

Residency is the foundation of your professional and personal life. Choices made here determine the next 40-50 years of life, so it is important to develop sincerity, punctuality, and humility. Learn to accept that individuals are different in terms of intelligence, behavior, looks, and economic status. By being positive and helpful, you build a support system that will help your professional life.

Working towards excellence is not simply desiring more, it entails sustained effort, international exposure, and creativity. Those who anticipate ahead of time and stretch boundaries are the leaders who come to the forefront. Residency is challenging, but mental toughness, self-control, and balance will see you grow stronger. Focus, learn continuously, and love the process.

Share

Anesthesia Residency

Best Books, Apps and Tips for Anesthesia Residency by Dr. Jhanvi Bajaj

by with No Comment Anesthesia
0
0

Estimated reading time: 5 minutes

Anesthesia residency is challenging, and keeping books, apps, and study timetables in sync is daunting. The Conceptual Anesthesia App has been developed to guide you along the way, providing a learning pathway from first-year residency through final exams and super speciality preparation.

Book Suggestions for Every Year of Residency
  1. First-Year Residency
  • For first-year residents, a good starting point is Lee’s Synopsis of Anesthesia, a short and easy-to-read book that helps with answering OT questions but is not sufficient for exams. 
  • This book provides a basic understanding of anesthesia.
  1. Second-Year Residency
  • Miller’s Anesthesia: This is also called the bible of Anesthesia, It is a standard reference book, but it is complex and difficult to memorize.
    • To make it more manageable, starting with systemic topics like neuro, respiratory, and cardiac anesthesia can be helpful. 
  • Morgan and Mikhail’s Clinical Anesthesiology: This is an alternative to Miller’s Anesthesia, it is simpler than Miller’s but more detailed than Lee’s.
    • This book presents information in a more understandable format and is useful for exam preparation.
Important Tips:
  •  Miller’s Anesthesia was useful for systemic topics like transplant, cardiac, neuro, and respiratory anesthesia but was not used directly for theory answers.
  • Referencing Miller’s Anesthesia in exams (MD, DNB, DA) impresses examiners.
  • A strategic study approach is to read Morgan and Mikhail’s for six months and make notes. Instead of writing extensive handwritten notes, highlighting key points, bookmarking, or using sticky notes can make revision easier.

Click here to learn more about the Anesthesia books: Conceptual Anesthesia Books

  1. Third Year Residency
  • Objective Anesthesia Review (ARC Book): This book Includes case presentations, explanations, instruments, and machines.
  • Yao and Artusio’s Anesthesiology: Comprehensive case presentation guide. Extra points from this book can be added to the ARC book.
  • Stoelting’s Anesthesia and Co-Existing Disease: Helpful for extra case-related questions.
For Anesthesia Equipment:
  • Dorsch’s Anesthesia Equipment is detailed but difficult to remember.
  • Understanding Anesthestic Equipment & Procedure a Practical Approach by Dr. Baheti and Dr. Laheri: It is simpler and sufficient for exams.

Note: If you are too loaded with your training, thesis and studies the ARC book is the ultimate solution, it also covers equipment, but only enough to pass, not to excel.

For Anesthesia Pharmacology:
  • Stoelting’s Pharmacology and Physiology in Anesthetic Practice covers all anesthetic and related drugs comprehensively.
Subject-specific books for super speciality preparation or deeper understanding:

These are books not only for people who want to take NEET SS but also for those who want to understand the subject in a better way.

  • Neuroanesthesia: Cottrell and Patel’s Neuroanesthesia (comprehensive), if you don’t have the time you can for the shorter version of this book or Handbook of Neuroanesthesia (shorter).
  • Cardiac Anesthesia: Kaplan’s Cardiac Anesthesia, is well written, in detail yet easy to understand.
  • Pediatric Anesthesia: Gregory’s Textbook of Pediatric Anesthesia or Principles and Practice of Pediatric Anesthesia by Dr. Snehalatha and Dr. Nandini Dawe (simpler, Indian perspective).
  • Regional Anesthesia: 
    • Hadzic’s Textbook of Regional Anesthesia and Acute Pain Management– Well-structured with anatomy, sonoanatomy, block procedures, and key takeaways. Ideal for exam answers.
    • Herman Sehmbi’s (MCQs in Regional Anesthesia and Pain Therapy) – Essential for practising MCQs, especially for the regional anesthesia fellowship entrance exam at Ganga Hospital, Coimbatore.
    • Ganga Hospital Handbook – Summarized, well-organized, and useful for specific blocks. Covers:
  1. Indications
  2. Contraindications
  3. Anatomy
  4. Steps of the block
  5. Troubleshooting (complications & supplementary blocks)
YouTube Channels and Other Online Sources for Learning:
  1. NYSORA (New York School of Regional Anesthesia) – Best for regional anesthesia demonstrations (e.g., spinal anesthesia approaches).
  2. ISA Kerala (Indian Society of Anesthesiology, Kerala Chapter) – Offers case discussions and theory videos.
  3. Conceptual Anesthesia: Offers case discussions, theory videos and a detailed explanation of anesthesia topics.
Important Study Tips for Anesthesia Residency:
  1. Morning Schedule – Wake up 30–45 minutes before OT for revision.
  2. Post-OT Sleep Strategy – Take a 1.5-hour nap after OT to refresh before studying.
  3. Group Study – Discuss topics with peers after OT to stay consistent.
  4. Rotation-Specific Reading – Read relevant books during OT postings (e.g., Cottrell for neuroanesthesia, and Kaplan for cardiac).
Critical Care Books:
  1. Paul Marino’s ICU Book – Widely used by intensivists and DM critical care students.
  2. Washington Manual of Critical Care – Concise, easy-to-follow, and reproducible for exams.
Instagram Pages for Passive Learning:
  1. NYSORA Instagram Channel
  2. Follow Conceptual Anesthesia on Instagram for updates.
    • Provides videos, skill demonstrations, short notes, and quick revision material.
Conceptual Anesthesia App Overview:
  • Covers MD/DNB/DA exams and SS preparation.
  • Lectures are based on standard textbooks.
  • Live SS MCQ lectures by experienced faculty (DMs, DNBs, Fellows).
  • Sections included:
    • Instruments & Machines
    • Anesthesia Skills (with live videos)
    • DNB OSCEs (with answers)
    • Case Discussions (mock exams with consultants)
Books Included with Subscription:
  • Past 5 Years’ DNB Papers (Solved)
  • Drugs in Anesthesia
  • Short & Long Cases
  • Instruments & Machines
  • Critical Care
  • Upcoming Books: Systemic Anesthesia (Neuro, Pediatric, Cardiac, Airway)

Click here: Conceptual Anesthesia Books

Additional Perks of Conceptual Anesthesia:
  • YouTube Channel for in-depth video learning.
  • Instagram Channel for the latest updates and information.

Anesthesia residency can be tricky to balance with books, apps, and study schedules, but strategic learning and wise resources make it simple. Streamline your preparation with the Conceptual Anesthesia App, guided book suggestions, and online resources and ace your exams!

Click here to visit the Conceptual Anesthesia website to learn more about the platform and how it can help you during your residency.

Share