Are there any subspecialties of anesthesia that I will not have an opportunity to do a rotation in until my CA-3 year?

This is an interview question you can ask the interviewer. This is an important question to ask interviewers as programs often do not reveal detailed information about residents' schedules. Many programs don't allow you to do a rotation in one or more subspecialties, most commonly regional anesthesia, until your CA-3 year. If you are considering going into a fellowship for a field that you will not get to see until your CA-3 year, you will be in a challenging position. Apply to the fellowship as a CA-2 without having seen the field or wait to become a CA-3 so that you can see the field before applying. If you chose the latter, there will be a one-year gap between the end of your residency and the start of your fellowship.

What qualities make a drug an anesthetic?

"A good anesthetic drug will cause amnesia, analgesia, sedation, and/or muscle relaxation. The drug should also be easily reversible or have a relatively short half-life."

This is a common question. While you don't need to know at this point which drugs have which properties, you should know the goals of anesthetic drugs. Amnesia or memory loss is needed to prevent patients from remembering moments in their surgery which my otherwise traumatize them. Analgesia or decreased ability to feel pain is necessary as both intubation and surgery are very painful processes. Sedation or diminished consciousness is needed so the patient will not have to live out the nightmare of being awake for their own surgery. Muscle relaxation is important because it allows for easier intubation, decreases the patient's ability to fight the ventilator, and assists surgeons with their incisions.

"Analgesia, sedation, muscle relaxation, and amnesiac."

What would you tell your adult patient who is scared of anesthesia?

"I would ask him if there was a specific concern such as the safety of anesthesia, having needles poke him, or being awake for surgery and unable to move. Once I identified the source of his concerns, I would provide a reasoned explanation and reassurance. For example, if he is concerned about waking up during the surgery, I would assure him this is a very rare phenomenon, mostly seen in movies but not in real life. We have several monitors to help us detect if you're moving from deep sleep to lighter stages of sleep including the BIS monitor which monitors electric activity in your brain."

This is a common problem you will run into. Unfortunately, because of hospital benchmarks requiring fast case turnover, you will not get to a ton of time to talk to patients in the preoperative area. Nevertheless, patients are almost always scared before surgery and are trusting their lives to you, a person they've just met. Therefore, you should quickly identify the source of the concern and address it appropriately.

How would you counsel a patient about the risks of anesthesia?

"I would explain the risks of anesthesia using simple language and using a teach-back method to assess that the patient understands the information from the consent process. I would discuss all minor and major risks including death and allow the patient time to ask questions."

You will have to counsel all of your patients about the risk of anesthesia in order to get them to sign a consent for anesthesia form. The consent process must be in their native language so you may need a translator. You must present the risks in an easy-to-understand way and provide a comprehensive overview of what kinds of risk are possible.

What qualities make an excellent anesthesiologist?

"I believe many qualities make an excellent anesthesiologist. You must be compassionate, patient, and dedicated to working in this field. It takes time to complete many years of training, and when done, anesthesiologists must take the time to listen to their patients' fears and concerns while providing compassionate care. Excellent anesthesiologists also have problem-solving and critical-thinking skills, which help in the event of an emergency on the surgery table. I possess these skills and know they will help me succeed as a neurologist."

Excellent anesthesiologists are patient, compassionate, curious, empathetic, and dedicated. They are committed to their profession and have exceptional critical-thinking, problem-solving, and communication skills. Describe what you believe are the top qualities that will help you succeed in this field and make you an excellent anesthesiologist. The interviewers want to hear what you think makes a fantastic anesthesiologist, as you will most likely name traits you possess yourself.

What are you looking for in a residency program?

"I am looking for an academic program in an urban setting. I believe this will provide me with research and learning opportunities as well as the ability to work with diverse populations. I appreciate that your program is a level 1 trauma center because that will give me opportunities to work in the most emergent cases. I also appreciate that your program has a fellowship in obstetric anesthesia as I enjoy working with pregnant women and anticipating and dealing with challenges unique to this population such as the potential for significant hemorrhage and hemodynamic instability with caesarean section and swelling in the airway of pregnant women."

This question is also asking 'Why do you want to come here?' It is important that you have researched the program and identify a few unique features of the program that are important to you when selecting a residency program. Be descriptive in your response, highlighting what the program offers that is appealing to you.

What will you bring to our residency?

"Having worked extensively with pediatric patients and their families prior to medical school and during medical school, I believe my experiences will help me in providing comfort to patients of all ages as well as their families prior to surgery. This includes anticipating their concerns and often understanding unstated concerns in the preoperative area."

This question can be thought of as 'Why should we choose you?' It helps to approach this question by thinking of qualities that would be desired by anesthesia residency programs such as effective communication, diversity of experiences, and unique education (e.g., MBA).

Anesthesiology is a highly competitive residency to match. Why should we choose you over other applicants?

"You should choose me over applicants because of my dedication, research experience, and leadership skills. I applied for an away rotation with your program and demonstrated my work ethic to house staff and my attending physician. They saw my attention to detail and communication skills and highly recommended that I be accepted into your program. I have clinical research experience and published a peer-reviewed article on point-of-care ultrasound use in emergencies. Also, I have demonstrated my leadership skills as an AMA medical student outreach leader and student member of the AMA Foundation Board. I am excited about this opportunity and hope to match with your wonderful residency program."

In 2022, less than 42% of applicants were matched to an anesthesiology residency program, making it a highly competitive field. The interviewers want to hear why they should choose you over others competing to match. While there are many qualified candidates, you must let the interviewers know why you are a top-notch applicant. Tell the interviewers about your away rotations, research experience, volunteer work, USMLE scores, and any other achievements or accolades that will make the interviewers remember you.

What do you want to call EBL? 10 cc?

"If I disagree with that estimate, I will tell the surgeon and show the way I estimated blood loss. If we continue to disagree, I will record what I believe is the right amount and inform my attending."

This is a question you will be asked by surgeons daily. This question is typically asked near the end of the case as both the surgery and anesthesia teams must record estimated blood loss (EBL), amount of IV fluids and blood products, and amount urine output. Surgeons often prefer minimizing this estimate to make the surgery seem like it went very well and to avoid blame for some devasting post-operative complications (e.g., myocardial infraction).

Your five-year-old patient in the preop area starts crying and won't let anyone touch him. What can you do?

"I would work with the child and his or her guardians in the room to try to calm the child. If unsuccessful, I would allow the guardian to come into the OR with the child and have the child fall asleep on a gas anesthetic."

Comfort the child. Let the child sit in their parent's lap. Avoid examining them more than necessary. Most hospitals allow parents or guardians of children to enter the OR with them so children can sit on their parent's lap as they fall asleep. While you always would like to have at least 1 IV before taking a patient into the OR, in children, you may not have one and must rely on gas anesthetic in the OR with flavored scents to induce sleep. Don't suggest giving oral Versed/midazolam (a medication to calm them down) in the preoperative area right away. Non-medication approaches are always best, but this option exists if you need to control a child.

While under anesthesia, your patient goes into cardiac arrest. What would you do?

"I would quickly check my patient for a pulse, then begin chest compressions if no pulse was found. I would have a colleague begin ventilation and assign another to take over chest compressions while calling a Code Blue. I would see if the patient had a shockable rhythm and defibrillate them if they were. I would follow Advanced Cardiac Life Support (ACLS) guidelines for drug administration depending on the patient's rhythm."

In 2021, the National Anesthesia Clinical Outcomes Registry reported that the incidence of cardiac arrest associated with anesthesia is approximately 5.6 per 10,000 cases. The interviewers want to assess your critical thinking, problem-solving, teamwork, leadership, and communication skills in an emergency. Describe what steps you would take if you had a patient go into cardiac arrest while under anesthesia.

What does the future of anesthesia look like?

"Manufactures of intraoperative anesthesia monitors are currently researching ways to predict hemodynamic instability before it occurs. This would allow anesthesiologists to respond to these warnings and potentially avoid or at least reduce the extent of hemodynamic instability. I think the future of anesthesia will involve an increased focus on developing models to predict poor intra-operative outcomes."

Although the basic process of anesthesia for most surgeries will likely remain the same: put the patient to sleep before the surgery and wake them up after the surgery, there are still several areas of active growth in the anesthesia field. One of these areas is the ability to identify regions of the body to anesthetize with local anesthetic. The ability to numb and immobilize a region of the body (e.g., the foot) that the surgeon will operate on allows for better post-operative pain control and potentially allows minimizing systemic analgesic and sedation drugs and their toxicities.

How would you describe your bedside manner?

"I would describe my bedside manner as nurturing, comforting, patient, and caring. I approach all patients the same. I introduce myself, ask their names, and explain the anesthesiology process. I take the time to actively listen to their concerns, showing them I care about them and want to help them. I believe all healthcare professionals should treat patients the way they want others to treat themselves or loved ones."

Bedside manner is a physician's approach or attitude toward a patient. The interviewers ask this question to determine if you have the qualities they seek in a resident. They want to hear that you are kind, patient, friendly, compassionate, and caring. Now is the time to describe how you treat all patients with respect, empathy, kindness, and compassion.

Describe a day in the life of an anesthesiology resident.

"I appreciated that you described the day in a resident's life on your website, which helped me understand what my first year as a resident will look like. As a resident, I will review cases the night before with my attending, then arrive the following morning at 6 a.m. to set up my operating room. From 6:30 to 7 a.m., I will attend a morning teaching conference, then meet my first patient and complete my history and physical after the conference. My first case starts at 7:30 a.m., and I will continue working until relieved at 5 p.m."

Every specialty will have a slightly different day in the life of a resident. The interviewers want to see that you have done your homework and understand your daily life as an anesthesiology resident. Some programs describe what a resident's day looks like on their website. If the program you applied to does not have that information, speak with former or current fellows and residents or visit the university or medical center and talk to staff. You should understand what your day entails before starting the program so there are no surprises.

What made you choose our residency program over others?

"I chose your residency program over others for several reasons. First, my mentor was a resident in your anesthesiology program and highly recommended the training and guidance he received. Secondly, your program was ranked number one based on student activity reported in the AMA Residency and Fellowship database. After researching your program in greater depth, I decided this is the program I want to attend."

There are currently 159 anesthesiology residency programs in the United States. The interviewers want to hear that you have researched their program in depth and that you have also compared their program to many others. When responding to this question, highlight unique aspects of their anesthesiology residency program that stand out from others. You may want to participate in their program because of their stellar reputation, dynamic and interactive training program, or because they are a research hospital. Let the interviewers know your reasons for choosing their residency program over others.

Is it customary for attendings or residents at this institution to call patients at home the day before surgery?

"No, it is not customary for attendings or residents at your institution to call patients at home the day before surgery. However, if you allow me to do so, I prefer calling patients the day before surgery. I like to remind them not to consume anything by mouth after midnight and ask if they have any questions."

This is an interview question you can ask the interviewer. While this is not the norm in many residency programs, it is important in private practice and doing so shows a commitment to your patient. If the program doesn't do this, you can sound like an all-star resident by suggesting that you would like to do so in order to get a complete history, provide instructions (e.g., NPO at midnight), and answer the patient's questions.

What kind of research opportunities exist in the anesthesia department?

"I saw on your website that you offer basic science to clinical outcomes research opportunities, including critical care, coagulation, respiratory physiology, and regional anesthesia. If matched with your residency program, I am interested in researching respiratory physiology along with molecular science and patient outcomes associated with general anesthesia."

This is an interview question you can ask the interviewer. Aside from test scores, research is one of the few ways you can stand out from your colleagues when applying for fellowships. If research opportunities exist in the program, it is important to clarify which ones exist as getting authorship of a publication on prospective clinical studies or basic science research can take many years while getting one in a retrospective clinical study, particularly one that already has a database built, can be done relatively fast.

Are there any types of surgeries or anesthesia, such as one-lung ventilation or coronary artery bypass surgeries, that residents feel like they don't get enough experience in at this institution?

"After interviewing several of your fellows and residents, I can say they do not feel they have enough experience with organ transplants at your facility. However, they explained your facility is not one of the top organ transplant institutions, so the transplant numbers are very low."

This is an interview question you can ask the interviewer. This question is a more useful one than the typical 'what are residents' case numbers like?' since virtually every program has no problem getting their residents to do more than the numbers required. This question assesses any weaknesses in the program that may conflict with your goals. For example, a common response is that the program may not do some types of organ transplants.

Tell us something about yourself that is not found on your CV.

"Something I am very skilled at that is not found on my CV is that I love playing the piano. I have played since I was three and picked it up quite easily. I would spend hours a day perfecting solo pieces, highlighting my dedication to a craft. I also enjoy playing the piano because it helps me clear my head and focus strictly on the piece I am playing. It enhances my dexterity, coordination, hand strength, and fine motor skills. I feel all these skills will transfer nicely into my profession as an anesthesiologist."

The interviewers would like to learn more about you as a person. While you cannot share everything about your personal life and accomplishments on your CV, there must be something you are proud of that you would like to share. If possible, share something about yourself that shows the interviewers you would be a good fit for the residency program. For example, if you share that you compete in bodybuilding competitions, the interviewers will see that you are dedicated and diligent, both essential qualities for residents to possess.

Do you have plans to pursue an anesthesiology fellowship?

"No, I do not have plans to pursue an anesthesiology fellowship after my residency. My goal is to enter private practice as an anesthesiologist after I complete my residency."

Roughly 45.6% of anesthesiology residents pursue fellowship training after completing their residency. The interviewers are curious about your career goals after you complete the residency program. They want to see if a sub-specialty interests you and why you chose to pursue a fellowship. There is no wrong answer, and this is not a trick question. The interviewers just want to get to know your future goals a little better.

What will be the most challenging part of your first year as a resident?

"The most challenging part of my first year will be learning advanced pharmacology and the nuances of certain anesthetics. But, I developed a plan in medical school that helps me learn and retain large amounts of information, so I plan to do the same in my first year of residency. I dictate the information I want to learn and listen to it while exercising, cleaning the house, and running errands. When I hear the information repeatedly, it sticks with me better than reading it from a book or making flashcards."

In the first year as an anesthesiology resident, there is a steep learning curve reported by a first-year resident. There is advanced physiology and pharmacology to learn, new medical terminology, procedural skills, and nuances to different anesthetics. Other challenging aspects include relocating to a different city or state, making new friends, money struggles, and lack of sleep. The interviewers want to hear what you will find most challenging and how you plan to work through the challenge. Describe what you feel will be your most significant obstacle and your plan to overcome it.

Why did you want to go into medicine?

"I went to medical school because I wanted to provide acute care in which I made decisions that could save a patient's life. I also wanted to have deep and meaningful conversations with my patients and their families. During my time in medical school, I experienced some of these during my ICU rotations. My goals most aligned however, with the role of an anesthesiologist or critical care doctor in the OR, where quick decisions based on constantly changing information needed to be made. I also found in anesthesia that my conversations with patients required a strong level of trust and confidence as a majority of my patients would be put to sleep through their surgeries."

This question from medical school interviews frequently resurfaces in residency interviews. The goal of this question is to assess if your reasons for pursuing medicine are consistent with your reasons for pursuing a career in anesthesia. While they don't have to be the same reasons, they should at least be complementary.

What are some challenges in the field of anesthesia?

"One of the challenges I have observed from my anesthesia rotations is disagreements between the surgical and anesthesia teams on issues such as intraoperative fluid management. For myself, I will try to talk to the surgeons before more complex surgeries, such as traumas or organ transplants to reduce the risk of intraoperative disagreements. I also will focus on reading anesthesia texts so that I can make evidence-based arguments during these disagreements. In the event that I have a disagreement with the surgery team that I cannot resolve and has potential to affect my patient's care, I will call my attending for guidance."

This question assesses your familiarity with the field and your ability to notice subtle problems with the field. The unstated question here is also 'how should they be fixed?' Describe challenges you have seen during your rotations and clinical time.

Why do you want to pursue a career in anesthesiology?

"There are two aspects of anesthesia that appeal to me. The first is the opportunity to work in an environment where vitals and organ functions, particularly the heart and lungs, are highly volatile and thus require anticipation of critical changes and careful titration of medications. This requires a deep understanding of cardiopulmonary pathophysiology as well as an ability to make decisions and act quickly. I find this academic component of anesthesiology exciting and congruent with my goals of working as a critical care provider of the OR. The second aspect is being able to explain to patients and their families about the anesthesia experience while instilling comfort and confidence in their care. I believe one of my biggest strengths is having these conversations as I would take the opportunity to have similar conversations during my ICU and anesthesia rotations."

For this question, you need to discuss qualities that are unique to anesthesiology and why these qualities are important to you. It is not necessary to say you knew you wanted to pursue this field since a very young age.

The majority of people who are put to sleep during their surgery are kept asleep by gas anesthetics. How do gas anesthetics work?

"While many anesthetics work on the GABA receptor or on the sodium channels of nerves, nobody knows how gas anesthetics work."

This is a common trick question. Even in the 21st century we don't understand how gas anesthetics work as their mechanism of action has not been identified. We do know how other anesthetics work. Local anesthetics act directly on the sodium channels of nerves and thus are injected directly adjacent to nerves. Most pain medications work on the opioid receptors. A notable exception is Ketamine which works with a wide variety of receptors. Propofol works on the GABA receptors.

What role do you see nurse anesthetists playing?

"As I have not yet worked with nurse anesthetists or in anesthesiology, I have not formed an opinion. I have only learned of the opinions of those around me during my clerkships."

There are currently more than 56,000 certified registered nurse anesthetists (CRNAs) in the United States. But you want to be careful answering this question! This is an extremely hot-button topic in anesthesia, and virtually all anesthesia providers have very strong opinions on this subject. Some providers don't believe the profession should exist and that nurse anesthetists are a danger to patient care. Others believe they serve an important role. Stay politically correct and acknowledge your limitations in that you do not have sufficient knowledge and experience in anesthesia to make a fully informed judgement yet.

Your patient is excited for surgery right before you give them Versed; the patient begins slurring words and they no longer want surgery. You are certain he wants surgery and has already signed the consent forms. What do you do?

"I would tell the surgery team and my attending that I would like to delay the surgery for several hours until the effects of Versed wear off. Once the patient demonstrated competency, I would reconsent him."

Due to a character limit on our interview questions, we had to limit the above interview question. Here is the full interview question: 'You see your patient in preop for routine surgery. Your patient is excited for his surgery and has no reservations about surgery or anesthesia. After you give Versed, which produces an effect similar to inebriation, your patient begins to slur his words and says he no longer wants to go for surgery. He doesn't provide a reason. You are certain that he actually wants surgery and has already signed the consent forms for anesthesia and surgery. What do you do?'Although Versed's effects are similar to alcohol and it is likely that the patient truly wants to go forward with surgery, he has the right to revoke his consent at any time and this must be honored even if there is question about his mental status at the time of revocation.

How do you determine when a patient can go home after general anesthesia?

"I monitor my patients closely after surgery to ensure they respond appropriately to my treatment. Once my patient is awake, they will be monitored for several hours after surgery unless they stay overnight in the hospital. I determine they can go home when their vital signs are stable, and they are alert and oriented."

This question is asked to gain insight into your competency level and ensure you know when it is safe for a patient to go home after anesthesia. Many sedatives can have lasting effects on the patient after surgery, and every patient will respond differently to the effects. Show the interviewers that you can diagnose when a patient is not ready to go home and that you err on the side of safety before releasing a patient.

Suppose you catch one of your colleagues pocketing a bottle of fentanyl. What would you do?

"I would notify my program director immediately. If I could not reach my program director, I would notify an anesthesia attending."

Anesthesia is the highest risk field of medicine for providers developing substance abuse problems. Among anesthesiologists who abuse drugs, fentanyl is the most common drug of choice. If you catch a colleague diverting controlled medications or otherwise acting suspicious, you should not handle the situation alone. You need to bring this to the attention of an attending you trust or your program director immediately.

Doctor, your patient was chewing gum in the preop area. He spits it out now and says he hasn't eaten anything since midnight. What would you do?

"I would talk to the surgery team about postponing the case by 2-4 hours if it is not scheduled as an urgent or emergent case as chewing gum increases salivation which can fill the stomach, especially in diabetic patients who may have delayed gastric emptying."

Chewing gum causes increase salivation and thus the patient is not NPO since midnight. While some anesthesiologists will accept the increase risk of the patient aspirating gastric contents into the lungs during intubation, you are expected to follow standard guidelines unless otherwise instructed by your attending.

Anesthesiology Residency Interview Questions

Go Back

1. Are there any subspecialties of anesthesia that I will not have an opportunity to do a rotation in until my CA-3 year?
2. What qualities make a drug an anesthetic?
3. What would you tell your adult patient who is scared of anesthesia?
4. How would you counsel a patient about the risks of anesthesia?
5. What qualities make an excellent anesthesiologist?
6. What are you looking for in a residency program?
7. What will you bring to our residency?
8. Anesthesiology is a highly competitive residency to match. Why should we choose you over other applicants?
9. What do you want to call EBL? 10 cc?
10. Your five-year-old patient in the preop area starts crying and won't let anyone touch him. What can you do?
11. While under anesthesia, your patient goes into cardiac arrest. What would you do?
12. What does the future of anesthesia look like?
13. How would you describe your bedside manner?
14. Describe a day in the life of an anesthesiology resident.
15. What made you choose our residency program over others?
16. Is it customary for attendings or residents at this institution to call patients at home the day before surgery?
17. What kind of research opportunities exist in the anesthesia department?
18. Are there any types of surgeries or anesthesia, such as one-lung ventilation or coronary artery bypass surgeries, that residents feel like they don't get enough experience in at this institution?
19. Tell us something about yourself that is not found on your CV.
20. Do you have plans to pursue an anesthesiology fellowship?
21. What will be the most challenging part of your first year as a resident?
22. Why did you want to go into medicine?
23. What are some challenges in the field of anesthesia?
24. Why do you want to pursue a career in anesthesiology?
25. The majority of people who are put to sleep during their surgery are kept asleep by gas anesthetics. How do gas anesthetics work?
26. What role do you see nurse anesthetists playing?
27. Your patient is excited for surgery right before you give them Versed; the patient begins slurring words and they no longer want surgery. You are certain he wants surgery and has already signed the consent forms. What do you do?
28. How do you determine when a patient can go home after general anesthesia?
29. Suppose you catch one of your colleagues pocketing a bottle of fentanyl. What would you do?
30. Doctor, your patient was chewing gum in the preop area. He spits it out now and says he hasn't eaten anything since midnight. What would you do?

Anesthesiology Residency Interview Questions

1. Are there any subspecialties of anesthesia that I will not have an opportunity to do a rotation in until my CA-3 year?

2. What qualities make a drug an anesthetic?

3. What would you tell your adult patient who is scared of anesthesia?

4. How would you counsel a patient about the risks of anesthesia?

5. What qualities make an excellent anesthesiologist?

6. What are you looking for in a residency program?

7. What will you bring to our residency?

8. Anesthesiology is a highly competitive residency to match. Why should we choose you over other applicants?

9. What do you want to call EBL? 10 cc?

10. Your five-year-old patient in the preop area starts crying and won't let anyone touch him. What can you do?

11. While under anesthesia, your patient goes into cardiac arrest. What would you do?

12. What does the future of anesthesia look like?

13. How would you describe your bedside manner?

14. Describe a day in the life of an anesthesiology resident.

15. What made you choose our residency program over others?

16. Is it customary for attendings or residents at this institution to call patients at home the day before surgery?

17. What kind of research opportunities exist in the anesthesia department?

18. Are there any types of surgeries or anesthesia, such as one-lung ventilation or coronary artery bypass surgeries, that residents feel like they don't get enough experience in at this institution?

19. Tell us something about yourself that is not found on your CV.

20. Do you have plans to pursue an anesthesiology fellowship?

21. What will be the most challenging part of your first year as a resident?

22. Why did you want to go into medicine?

23. What are some challenges in the field of anesthesia?

24. Why do you want to pursue a career in anesthesiology?

25. The majority of people who are put to sleep during their surgery are kept asleep by gas anesthetics. How do gas anesthetics work?

26. What role do you see nurse anesthetists playing?

27. Your patient is excited for surgery right before you give them Versed; the patient begins slurring words and they no longer want surgery. You are certain he wants surgery and has already signed the consent forms. What do you do?

28. How do you determine when a patient can go home after general anesthesia?

29. Suppose you catch one of your colleagues pocketing a bottle of fentanyl. What would you do?

30. Doctor, your patient was chewing gum in the preop area. He spits it out now and says he hasn't eaten anything since midnight. What would you do?