Each specialty has unique educational challenges. The challenge you will face in our field is that you need to advocate for your own teaching. Anesthesiologists are pulled in many directions, particularly in an academic center with trainees at every level: medical students, residents, CRNAs, sRNAs, fellows, and other operating room orientees. Supervision can be challenging on its own—supervision plus teaching is an especially tricky task. Other specialties have prolonged one-on-one time with their attendings, such as a surgery resident scrubbed elbow-to-elbow with their attending for hours in the OR, or an internal medicine resident who spends much of the day rounding side by side and discussing cases over daily lunchtime conferences.

The solution to this requires (1) self-motivation and (2) meeting your mentors halfway.

Reading on your own is essential. Anesthesia practice covers such a wide swath of medicine that there is truly no topic too general or too esoteric to inform your practice. The era of ChatGPT and OpenEvidence has made reading even more efficient and high yield, so that it should be extremely easy to read about each of the disease processes, anesthetic techniques, and procedures you encounter. You will be surprised at how even the most cursory review of a basic topic (ECG, for example) can debunk many of the common myths you encounter in daily practice. The sheer volume of new conditions and procedures you encounter will make it easy to keep an inquisitive mind.

Because your teachers are pulled in multiple directions, you have to work to become the kind of trainee they want to teach. This is an adult learner skill that you will need to pick up in any specialty, but especially ours. Become an active learner. Read about your patient, be prepared, and show initiative. Approach your case the way you might a PBLD (problem-based learning device), where it is assumed you have some a priori knowledge. This will make building on your knowledge easier for your mentor and learning much more satisfying for you. Try to see the big picture and not focus so much on “getting to do” the procedures you want. I rarely remember if a trainee “got” a line or an airway, but I will definitely remember if they showed initiative.

• Weak: “Is there anything special I should know about this case?” (This statement shows that you have not taken the initiative to learn, but instead are expecting it to be spoonfed. This will not result in a healthy working relationship.)
  
• Strong: “I was reading that poor postoperative pain control is a risk factor for pneumonia after these cases. In addition to the epidural, do you have any other tips?” (Shows initiative, much easier to meet this trainee halfway.)