Q. What particular personal qualifications and characteristics will allow you to become an effective consultant in pediatric anesthesiology, and why is it important to you to become a pediatric anesthesiologist? Pediatric anesthesiology is one of the most intriguing and challenging subspecialties I have come across during residency. After having completed my anesthesiology residency in India, I moved to the United States and had the opportunity to pursue an anesthesiology residency at UT health Houston. During my time at this institute, I developed a passion towards pediatric anesthesiology. I got a chance to work with an exceptional team of pediatric anesthesiologists that took care of very sick children undergoing complex surgeries. Although one does get to work with the most adorable patient population, this specialty certainly isn’t for the faint hearted. Learning to tailor the anesthetic management while taking in to account the changing physiology through different age groups is of the essence. Difficult airway or routine tasks such as placing IV lines can be more challenging than in an adult and one must make decisions swiftly with almost no room for error. One of the toughest challenges pediatric anesthesiologist faces is seeing children and families suffer and a negative clinical outcome can be psychologically devastating not only to the parents but also to the physicians involved. Pediatrics, in general, requires a certain aptitude to work with parents. Empathy and good communication skills are the key to deal with all the anxiety and frustration that is experienced by parents of sick children. Working with this unique and fragile population has been one of the most exhilarating and gratifying experiences of my residency so far. I believe that I have all the attributes required to become a great pediatric anesthesiologist. I am able to work under tremendous pressure and can efficiently navigate through complex perioperative problems. I have always found the experience of providing anesthesia during complex surgeries such as CDH repair, spine surgeries or airway challenges in patients with multiple congenital anomalies to be exciting and intellectually stimulating. I am very patient and personable especially when it comes to interacting with anxious parents. I strive to make the entire process of their loved ones undergoing surgery, comfortable and less stressful. There have been several occasions where I have been successful in diffusing tense situations with parents by being a patient listener and addressing their concerns. As physicians we always strive for excellence, however, bad outcomes do occur, and we may not always be in control of the situation. Such outcomes in the operating room can be devastating for pediatric anesthesiologist. Emotional stability is essential to deal with the sadness and stress associated with these situations. I have a very strong support system which consists of my loving family and friends who continue to inspire me and help me be resilient in the face of such adversities. In short, I am hard working, a team player, and constantly determined to strive for perfection. I also believe in being part of the solution and making a positive difference. These traits are my driving forces to become better and help my patients and their families. This subspecialty aligns with my personality and allows me to work with my favorite patient population. I am seeking a fellowship program that will promote a good learning culture, provide ample opportunity for research and help improve my clinical skills.Question 2: Please choose two of the following questions and answer each one. Please be sure to copy and paste the question you have chosen to answer just above each response. 2a. How will completion of a pediatric anesthesiology fellowship allow you to further your goals?A fellowship in pediatric anesthesiology will provide me with a strong foundation to continue in providing excellent patient care and allow me to pursue scholarly activities. Pediatric cardiology is a complex subject, which is why I find pediatric cardiac anesthesia fascinating and intellectually stimulating. Advances in diagnostic modalities and treatment options have revolutionized patient care in patients with congenital heart disease. An increasing number of these patients reach adulthood, thus posing new challenges to non-CV anesthesiologists. Hence, I am considering pursuing Pediatric CV anesthesiology in the near future. Over the last few years I got the opportunity to pursue clinical research at UT Health. Some of the studies that I worked on, utilized national inpatient sample database (NIS) where we were able to analyze large samples of data obtained from hospitals all over united states. I managed to examine temporal trends of specific medical conditions or procedures and utilize the database for risk stratification. Being involved in clinical research has not only enhanced my understanding of clinical medicine but it is also a great way to learn about critical thinking. Therefore, I am seeking a fellowship program that will provide me with ample clinical and research opportunities to help me grow into a role of a strong clinical scientist. I would also like to work in an academic setting as I enjoy teaching and would like to continue mentoring medical students and residents, while promoting a good learning culture. 2d. Describe a challenging situation in your life or career and what you learned from it.I would say the most challenging situation I have encountered in my life would have to be back home in India where I worked at an underserved hospital in a rural area with minimal resources. I was the only anesthesiologist on call one night when we had a pregnant patient come to the hospital in labor with a ruptured uterus. While we were getting ready to transfer the patient to a tertiary hospital, she lost consciousness and coded. We immediately started CPR and the surgeon decided to go ahead and perform exploratory laparotomy to control the bleeding. Due to limited resources at this community hospital, it took 2-3 hours to acquire blood products from the closest center. It was one of the most challenging situation I have had to face as a physician as we were working with a skeleton crew of 2 nurses, a surgeon and an anesthesiologist, trying to resuscitate a patient who was profusely bleeding, while awaiting for blood to arrive. Thankfully, through perseverance and persistent efforts of my team we were able to save the patient. This incident made me realize the importance of anticipating and being prepared for all possible outcomes when working without a full team and limited resources. Now, I always come up with a thorough plan for each and every case I am assigned to and anticipate what I would do in potential worst-case scenarios if I were alone in an emergency situation.
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