The beginnings of a career in anesthesia are quite organized and regimented: first an undergraduate education, then medical school, then residency, capped off (possibly) with a fellowship. Each step is a challenge, but the path is at least clear and well defined. Thus, it is often disorienting for the budding anesthesiologist when this path abruptly ends and all of the administrative resources shepherding them through their career suddenly vanish.
Life After Residency is written to help ease this transition. It attempts to address the most common scenarios a resident may face as they start their career as an attending. Sections are devoted to planning the job search, conducting interviews, and evaluating employment offers. The authors take the time to describe the mundane aspects of a medical practice that are nevertheless often totally unfamiliar to residents (e.g., issues around credentialing, malpractice insurance, maintaining licensure, continuing medical education, etc.) There is also extensive discussion of financial issues that new graduates are likely to face—not only financial issues directly related to their medical practice, such as buy-in to partnerships, but also personal financial issues, such as buying a home, investing for retirement, etc.
The authors describe typical practice arrangements found in academic, government, prepaid group, and traditional private practice. While this book is intended for a wide audience, much of the information presented will likely be of particular use for graduates seeking employment in the last group, traditional private practice. Given the heterogeneity in scale, patient population, governance structure, etc., of private practices, evaluating opportunities with these groups can be particularly challenging. Furthermore, it should be noted that while the book was written by anesthesiologists, by design the presentation is general enough to be useful to physicians of any specialty. In fact, the authors make a point of describing common interview questions seen in different fields, including anesthesia, surgery, pediatrics, and internal medicine.
The first edition of Life After Residency was released in 2009 and was primarily concerned with the financial, organizational, and legal issues encountered by young physicians. The second edition has updated and expanded these sections, in particular discussing new payment and reimbursement models that have become more common in the decade since the original was published. The second edition arrives at an interesting time; in the post-COVID era, with increasing shortages of anesthesiologists and certified registered nurse anesthetists, private practice economic models continue to change rapidly. A third edition may become necessary once some sort of new equilibrium is finally reached!
Other sections are completely new. Anesthesiology groups are frequently being asked to expand the range of services offered within the hospital and becoming increasingly important to core hospital operations. Thus, a section on managing relationships with hospital administrators has been added. Technological changes inside and outside the hospital have also been profound; electronic medical records have become ubiquitous in the past decade, and the rise of social media has created new ways to advance (or torpedo) one’s career. An entire chapter is devoted to the legal, ethical, and economic issues surrounding the use of social media by physicians. Last, awareness of physician burnout has grown in the past decade, and the final chapter discusses the often overlooked topic of physician self-care.
Of course, no work on the postresidency challenges seen by anesthesiologists can be definitive, given that entire careers are often devoted to (to take one example) designing physician contracts. Nevertheless, this work provides a useful survey of the common issues that arise for attending anesthesiologists in community practice and can act as a useful starting point when weighing major decisions. It is likely to be particularly valuable to recent residency graduates who are starting their careers in a location geographically remote from their residency sites, as they are likely to have a less robust alumni support network to help them navigate common issues. It is also very likely to be useful for individuals who are first-generation professionals, who may lack the social network to advise on saving and investing. Overall, this work fills a valuable niche, attempting to survey all of the practical, nonclinical knowledge required to navigate life postresidency.