Building an Early Bridge to Anesthesiology: How a First‑Year Medical Student Found a Home in Research & How You Can Too

by Fady Attia, University of Virginia School of Medicine, Charlottesville, Virginia

When I started my first-year of medical school at the University of Virginia School of Medicine, my exposure to anesthesiology was very limited to just brief glimpses of the operating room during pre-med shadowing and a chapter or two in textbooks. I knew anesthesiologists were “in charge of keeping patients asleep and stable,” but I had little sense of how a student without clinical rotations could meaningfully explore the field. As the months unfolded, I discovered, I discovered that the bridge to anesthesiology can be built much earlier than the first day of clerkships through things like research and patient-facing experiences that are fully accessible to the typical M1. 

Finding Anesthesiology Through Questions, Not Rotations
My path to the field of anesthesiology was not shaped by an OR rotation, but rather by questions.
I had spent many years working in the realm of imaging, tissue engineering, and cardiovascular disease as a biomedical engineering undergraduate. I think there was something about the process of taking the intangible physiological principles and making them tangible and visual and measurable that really appealed to me. Whether it was the 3D-printed joint, the cleared tissue under the microscope, the data visualizing the way the tissue reacted to injury and disease – there was something very appealing to me about the way these fields interacted.
Coming in as a medical student, I was immediately aware that I was attracted to the various medical fields and the way they interacted with this realm of physiology, technology, and decision-making in the moment. Anesthesiology was the first to pop to mind, and the questions were: How do the decisions we make in regional anesthetic technique impact the patient's neurologic outcomes? How can we use these tools to make sure the patient understands, for example, what is going to happen to them during the course of the case? These were the questions that first brought me in touch with the department of anesthesiology long before I was able to step foot into it.

Research as an Early Window into the OR
Soon after starting M1, I joined a retrospective study within our anesthesiology department that focused on nerve injury following lower extremity surgery and the role of regional anesthetic techniques in this process. The purpose of this study is to better understand the role of nerve blocks in the context of surgery and patient comorbidities.

While I had not yet had the opportunity to utilize nerve blocks or intraoperative anesthetic management, this study required an analytic approach typical of anesthesiology. Every case became an exercise in trying to piece together the anesthetic plan. How did this nerve block fit into the anesthetic plan? What potential complications were considered when choosing this nerve block? How does a nerve injury secondary to surgical traction differ from a potential injury secondary to regional anesthetic technique? 
Undoutably, this experience has continued to show me how research, as a first-year medical student, can be a truly invaluable window into the OR. Not only does it allow us to learn the language of the specialty, but it also gives us a unique opportunity to appreciate the processes of decisions that are made before incision and how they echo into the postoperative period. 

Patient-Centered Experiences that Translate to the OR
While my research pulled me closer toward anesthesiology, my experiences in free clinics and primary care settings kept me anchored to the patient’s perspective. As a volunteer at a free community clinic, I embodied the role of the physician when allowed. I spent time taking histories, performing physicals, and presenting to attendings. These opportunities undoubtedly allowed me to meet patients with stories and conditions that one would never find in the textbooks. These encounters taught me two lessons that I now see as central to anesthesiology. Firstly, the quality of preoperative care is incredibly shaped by the trust that patients place in their clinicians. Many will remember the anesthesiologist as the person who met them at a vulnerable moment, explained complex risks in plain language, and promised to keep them safe and in no pain. Secondly, social determines of health do not stop at the OR door. Food insecurity, transport barriers, and limited health literacy all influence how patients prepare for surgery, understand consent, and recover afterward.

Having a patient-centered approach in anesthesiology research work has also helped me keep the work grounded by recognizing that every chart analyzed in the study represents an actual person whose care is the target for improvement.

Practical Advice for Fellow and Future First-Year Medical Students Interested in Anesthesiology
For other M1s who feel drawn to anesthesiology but have not yet set foot in the OR as a rotating student, there are several concrete steps you can take now:

1) Reach out early: You should strive to make contact with faculty members in the anesthesiology department who are engaged in research or education. You should be able to express your interest and ask how they might be able to make a contribution that is relevant to your level of training.

2) Using your existing skills: Regardless of your prior experience – engineering, music, teaching, or public health, there is usually an opportunity to apply your skills to anesthesiology-related work, such as simulation, device work, quality improvement, or patient education. So, build such those skills and opportunities.

3) Using simulation: Students should look for simulation opportunities, such as skills labs, ultrasound labs, airway labs, etc. While it is not always easy to get into the OR as a first-year student, you will learn by watching and by being in the environment.

4) Continuing patient-related activity: You should continue to be engaged in clinical activity, mentoring, or community work. The skills that you develop through these experiences will make you a much more effective medical student and future anesthesiologist, or more generally, physician.

It is not necessary for the first-year medical student simply to wait for clinical years to become engaged in anesthesiology. By being engaged in research, simulation, and patient-related activity, we are able to develop a conduit into the specialty that will facilitate progression into the OR as we become clinical students and ultimately professional practitioners.