Virtual Careers

I am a physician anesthesiologist. I am affiliated with three hospitals in Temecula Valley, Rancho Springs Medical Center, Inland Valley Medical Center, and Temecula Valley Hospital. I provide anesthesia care for patients undergoing surgery and other medical procedures. I care for patients undergoing a wide range of surgeries - orthopedic surgery, general surgery, neurosurgery, bariatric surgery, trauma surgery. This involves the administration of medications that place patients under general anesthesia. Also involves performing procedures such as epidurals and spinal anesthetics for pregnant patients in labor or need a cesarean section for the delivery of the baby. Specialized areas in anesthesia include further training in pain management and pediatric anesthesia.

The career path requires a high school diploma and a college degree. This will include a certain number of classes in a variety of subjects often times referred as “Pre-Med” curriculum. The next phase to earn a medical degree (doctor of medicine) at a medical school. This is typically done over four years. The next phase consists of actual training in a chosen area of medicine, also called the residency. This ranges from four to six, years, sometimes more depending upon the speciality. After completing residency, there is the option for further training in a specified field within the residency or joining a medical group or practice to began the professional career.

There are no Normal days in medicine. Since things can be unpredictable and schedules can change moment to moment, it is crucial to establish some consistency in the day. For me that entails waking up early to have a cup of coffee and take time for meditation and prayer, usually through reading a devotional book and reflecting on my life and expressing gratitude to the universe. I like to get my workout done in the morning as well, before I go into the hospital. This time in the morning is a priority for me. Even though it means I wake up between 4:30am-5:00am, it helps me for the rest of the day.

Surgical cases usually began around 7:30am-8:00am in the morning so I am usually at the hospital a little bit after 7 am to prepare for the cases. I will then meet my patients to obtain consent and review the anesthetic plan for the surgery. Depending upon the operating room I am assigned to and if I am on call or not, I will do several cases in the day. If I am on call- I will be responsible any emergency cases that are booked in the 24 hour period. Some days I will only work 6 or 8 hours, some days 12 or 18, really depends on the cases and hospital.

I did not realize that medicine is a very competitive business and there is a lot of money and profit that is at stake in Healthcare. As naive as this may sound, I just never thought of the business aspect and how large a role it plays in the delivery of healthcare. There are a numerous business entities that are involved and each one is trying to make a profit. This is not discussed much in medical school or training, so It was surprising to me to see how big a role business plays in healthcare. Medicine is a beautiful and rewarding profession but it is a nasty business.

Conscientiousness: Attention to detail, thoughtful of other members of the healthcare team, organized, punctual, be aware of the impact actions have on the entire team.

Agreeableness:Must be able to cooperate with other members of the healthcare team, high level of empathy for others, be a team player, willing to help others do their job, think of ways to help accomplish the goal as a member of a team.

Openness: The key here is being flexible and open to other ways of doing things and other ideas. It is crucial to be open to feedback and constructive criticism. Being open to asking for help from colleagues is very, very important.

Medical School Education and Anesthesia Residency Training. Medical School Education involves the acquisition of knowledge. The time to acquire and build a knowledge base of the basic clinical concepts and subjects - for example physiology, anatomy, pharmacology- the medical school curriculum. Essentially there exists a body of knowledge that must be mastered.

Anesthesia Residency Training involves the mastery of technical skills required in the delivery of anesthesia care while incorporating the acquired knowledge learned in medical school into caring for patients. This is an ongoing process that continues beyond school and training and it is done over many many years through caring for patients and learning from each experience.

The opportunity to connect with and relate to other people on fundamentally human level while being able to help and care for them during very difficult and challenging time in their lives. Being a part of the healing process for other individuals who are facing illness, injury, disease and death.

Witnessing the health disparities that plaque the people who are a part of the communities that we live in. The violence, the trauma, the addiction and everything else that happens because as a result of these disparities. It can be emotionally draining. Most recently, in the face of this pandemic, there has been some concern being exposed to the corona virus. Seeing patients who are infected, in the hospital, alone, sometimes with no family members or loved ones around. That has been difficult.

The most important hard skills are those acquired through all the years of formal education and training. The ability to apply the knowledge base and integrate the technical skills in various clinical situations. The interpretation of various lab values, patient symptoms, clinical signs and develop a plan to correct the identified problems. This is accomplished through repetition and life long dedication to learning.

Important soft skills are intimately related to the personality traits mentioned above. Although they are different entities, soft skills encompass ones ability to work well with others, be open to feedback, a willingness to be open to other ideas, be a team player. I have always felt that excellent medical care is the ultimate team sport, especially in the operating room. The ability to effectively communicate with other members of the healthcare team.

Keep things in perspective. I will give you three examples on what I mean. Sophomore year in high school I tore my ACL- blown knee. It was devastating to me and for several weeks I got really depressed. My grades dropped as a result. I was so wrapped up in being a football player that I lost perspective on the big picture of my life.

My first college football game- I torn my ACL in the other knee- another blown knee. I found my self in the same position. I got depressed, my grades that semester dropped as well. I lost perspective on the big picture of my life and my future.

When first began my professional practice. I earned my board certified physician. I was partner in an anesthesia group. I was finally earning an excellent income. But again, I lost perspective on the big picture of my life. The initials in my name… The D.R. and the M.D. were in large font- poster size, while my name, me, Ricardo was in tiny font, barely visible. My entire identity as a person was wrapped up into being a physician, being a doctor. So when I had a challenging case, a bad outcome, or a patient died or did not do well, I would feel like a failure and it would effect how I felt about myself.

If you are going to enter medicine as a career make sure you are doing for yourself. Make sure you are doing it because you have a sincere passion to be a part of peoples lives in such an intimate manner. Do not enter medicine as a career because someone in your family wants or expects you to - your parents, relatives, friends or anyone else.

Do not enter medicine because of money, a paycheck or a presumed lifestyle. If you are interested in medicine because you think you will make a lot of money or become rich, chose another profession.

To remember that this is a career. It does not define who you are as a person. Keep perspective as you continue on in your studies. Maintain balance in your life with every area- family, spirituality, mental and physical health, friendships. Must have balance or other areas in your life will be impacted in a negative way.