Friday, March 29, 2019

Anesthesia Spotlight: Q&A with First-Year Residents

Alisha Ling, MD, PhD, Elisa Walsh, MD, and Lucy Li (left to right)

(left to right) Alisha Ling, MD, PhD, Elisa Walsh, MD, and Lucy Li, MD

Lucy Li, MD, Elisa Walsh, MD, and Alisha Ling, MD, PhD, are part of the resident class of 2021 in the Department of Anesthesia, Critical Care and Pain Medicine (DACCPM) at Massachusetts General Hospital. In celebration of Women’s History Month, and their first year in the Anesthesia Residency Program, this group of extraordinary residents shared their advice for women pursuing a career in medicine, the mindsets that keep them motivated in their work and their experience so far as residents at Mass General.


So far, what has your experience been like with Mass General’s Anesthesia Residency Program?

Dr. Li: I feel very fortunate that every day I walk into work, I am surrounded by a group of individuals who love to learn, question and investigate with the ultimate goal of caring for our patients to the best of our abilities. I am also very grateful that many of my colleagues have become my close friends — it is a real treat to work clinically with so many people who I admire and to also have fun together outside of work.

Dr. Walsh: It's been an incredible ride! Anesthesia is a field that truly marries mental dexterity with life-saving procedural skills. One must think and act fast. It’s been so gratifying to see my progress over less than a year of training, from comically struggling to keep track of a very basic checklist to now managing complex perioperative physiology. Despite being one of the largest anesthesia residency programs in the country, we’re a tight-knit crew and look out for each other.

 

What have been your greatest accomplishments in the program?

Dr. Li: I am amazed by how much my knowledge and skills have grown from their unimpressive baseline. It is all thanks to the incredible staff and early exposure to varied cases we get at Mass General.

Dr. Ling: With all of the clinical skills I have gained in this short amount of time, I almost don't recognize myself. What I am most proud of is my ability to keep patients safe in the operating room, such that patients regard the practice of anesthesia as routine.

Dr. Walsh: At the request of our patient, my attending physician and I managed to convince the operating room (OR) team to sing “Lucy in the Sky with Diamonds” as our patient went under general anesthesia. His procedure went very well!

 

Why did you pick Mass General’s Anesthesia Residency Program?

Dr. Li: During my interview day, I found that every resident and attending I met was caring, down-to-earth, motivated and incredibly dedicated to their patients. I knew then and there that I wanted to become a clinician like them and my choice has been reaffirmed every day since then.

Dr. Ling: The culture at Mass General embodies the values of teamwork, dedication and excellence. This environment inspires people to become their best professional selves.

Dr. Walsh: Coming from a scientific and research-focused background, I sought a residency program that would continue to foster the same rigor of training. I absolutely loved the Mass General philosophy of "deliberate practice," wherein we are encouraged to push ourselves at the edge of our own competency in order to gain expertise.

 

What is one thing that has most surprised you about your time here at Mass General?

Dr. Li: Despite Mass General’s size, there is an intimate environment of support. It is the standard here that if someone is going through a hard time, they’ll get dozens of visits or messages checking in on them — even from people they do not know personally.

Dr. Walsh: It was one thing to hear about the collaborative environment at Mass General but another to experience it in person. Every operation, I am welcomed with open arms by not only our own department, but also the entire perioperative team.

 

What is one thing that motivates you every day?

Dr. Ling: Our department emphasizes a learning paradigm over a performance paradigm. The focus on continuous improvement applies to everyone, from the most junior to the most seasoned people on the team, and keeps me looking forward to coming in every day.

Dr. Walsh: My patients and their families motivate me. Each day, I meet strangers at their greatest time of vulnerability and ask them to trust me with their lives. It’s a privilege that demands the best that I have to offer.

 

What is one challenge you’ve experienced as a resident, and how did you overcome it?

Dr. Li: In our onboarding, we experience our first formal exposure as independent clinicians. It was one of the most intense experiences I have gone through. In the end, I made it through with patience, hard work and lots of support from my family, friends, mentors and colleagues.

Dr. Ling: The transition into residency is always a period of tremendous growth, adjustment and hard work. I am fortunate to have wonderful co-residents and mentors. The day-to-day practice of anesthesia is vastly different from anything I had ever done, but now I cannot imagine doing anything else.

Dr. Walsh: As residents, we’re afforded a great deal of independence and with that comes the need to have conviction in my own decisions. As a petite and fresh-faced trainee, I’ve found it difficult to not internalize others’ assumptions that I am inexperienced or unqualified. However, with experience and encouragement from my mentors — especially fellow female anesthesiologists — I have begun to find my voice, own my role as an essential part of the OR and manage expectations across the curtain. I’ve also learned that I’m not alone in grappling with these feelings. I want to support my peers and future students in reminding ourselves that yes, we truly belong.

 

Where do you see yourself in 10 years?

Dr. Li: My parents are both professors, and their love of learning has always set a great example for me. I hope to practice in an academic center, conduct clinical research and volunteer my time abroad in the care of patients and facilitation of knowledge exchanges with clinicians in other countries.

Dr. Ling: In 10 years, I see myself as a physician-scientist, taking care of patients and improving future care. As an attending physician, I look forward to mentoring and teaching residents and medical students.

Dr. Walsh: My dream is to practice in a large academic center, surrounded by colleagues and students who will inspire me to always better myself.

 

What does the future of anesthesia look like to you?

Dr. Li: I see anesthesiology branching out, beyond the physical limitations of the OR and temporal limitations of the immediate perioperative period. I believe that our roles will expand in areas such as the management of pain and palliative care in clinics, the practice of critical care in emergency crises and greater collaboration with providers in the inpatient and outpatient settings.

Dr. Ling: Anesthesiology has dramatically changed in the past few decades. Tools that were unimaginable mere decades ago are now ubiquitous and routine. The pace of technological development is not slowing down and I’m sure there will be changes we can’t even imagine.

Dr. Walsh: As the ultimate intensivists, anesthesiologists play an integral role in caring for the increasingly complex patients who present to modern hospitals. I believe that we will continue to expand our practice outside of the operating room. Additionally, there are many tools on the horizon that will make care ever safer for our patients, ranging anywhere from more widespread use of instruments for better visualization, such as transesophageal echocardiography and video laryngoscopy, to innovation in drug delivery systems that use automation or predictive algorithms to better provide anesthesia.

 

March is Women’s History Month. What would you say to young women with similar aspirations to your own?

Dr. Li: In a world replete with both blatant and subtle gender biases, it is hard to not let it get under your skin and hold you back. Remember to work hard, be kind, be humble and stand tall. When things get tough, turn to the colleagues before you, both women and men, who have pushed open stubborn doors and are keeping them open for all the women coming after them.

Dr. Walsh: No one will have the perfect answer for you. Expect to have many mentors throughout your life, each in a different arena. That said, a couple pieces of advice:

  • Lean into challenges and take them as learning opportunities
  • Have confidence in your decisions
  • Always choose kindness

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