News
An Interview with Dr. Ching-Rong Cheng, Anesthesiology Specialist and Assistant Clinical Professor at UC San Diego
June 7, 2007
Ching-Rong (Steve) Cheng, M.D. is an Assistant Clinical Professor of Anesthesiology at UCSD Medical Center. He received his M.D. from Taipei Medical College in Taiwan and his specialty in anesthesiology from University of Louisville. He is in charge of the Simulation Lab. He works at the VA Hospital, San Diego and one of his recent projects was featured in an Union Tribune article: Model Patients.
ScienceAide: Describe your job.
Steve: I divide my time as an attending physician at the UCSD Medical Center and the VA Hospital in La Jolla, but the majority of my time is at the VA hospital. My job is to teach the residents how to perform anesthesia smoothly and safely during the operation. Usually I start the day at 6:30am. We will get together with the residents and attending physicians and discuss difficult cases for the day, or any current research. We then start the cases. The number of cases we perform each day will depend on the difficulty and length of surgery, but on average usually 4-6 cases per day. Typically in teaching hospitals the cases will be more difficult.
The patient gets a pre-op evaluation the previous day, which the resident discusses with me. The resident prepares for the operation the day before. In the morning, we will meet with the patient and explain to them what we are going to do for them. We calm them down and tell them what kind of anesthesia we will give to them. Afterwards, we review the entire procedure with the surgeon. The patient sometimes receives a sedation drug, and then we send them to the Operation room. We’ll the put the IV into the patient, and hook up monitors. Inject the drugs, and the patient falls asleep. Throughout the procedure, we keep the patient’s blood pressure and heart rate stable. We support the patient during operation by administering blood product when needed and carefully monitoring their vitals.
Once the procedure is over, we wake up the patient and send them to the post anesthesia care unit. We need to observe them in the postoperative care unit to make sure their vitals are okay, clear, are they awake, blood pressure, stable. We need to treat some side effects of the drugs, or pain control.
ScienceAide: How much control do you give to the residents?
Steve: That depends on the residents. If I’m confident in them, I will let them have as much responsibility as possible. However, there needs to be a balance between teaching and patient safety because ultimately I’m responsible for the patient’s safety.
ScienceAide: Why did you select academics over private practice?
Steve: In the academic area, you are able to keep learning new things. I like to share knowledge with the residents, I enjoy that very much. In a teaching hospital, you have the opportunity to work with the most brilliant minds; you are always updated with the most advanced techniques and research. This is great for me because I love to continue to learn.
ScienceAide: If you had it to do all over again, would you still become a doctor?
Steve: I think that I would still be a doctor. I enjoy my work and my personality fits this profession well. In the medical field, your personality needs to be stable and calm. You need to be smart, but it’s also important to be stable. It’s very time consuming. You need to make sure you have a good temper, and can handle lots of amounts of stress without losing your temper. You also can’t complain a lot when you don’t get any sleep.
ScienceAide: Why did you choose your specialty?
Steve: It was actually by accident. At first I wanted to be a surgeon because I like fixing problems quickly. But I had a few months of spare time before military service in Taiwan. So I decided to learn something about anesthesia to be a better surgeon. After I studied it I fell in love with it and decided to choose it as my career.
ScienceAide: What do you like about this specialty?
Steve: Anesthesia is very challenging but also rewarding. You need to make decisions quickly and be very vigilant, But after you finish the case, it’s done; you don’t need to worry too much after that. I also like to be more casual, so I don’t have to worry too much about what to wear because I’m always covered in scrubs =). What I like best about anesthesiology is that I can always know what I’m are doing, I’m able to see the immediate response of my actions. If it works, it works, if it doesn’t, it doesn’t. I really like this kind of feeling. However, this immediate response also creates a stressful environment. If you make the wrong decision, you can see the wrong result immediately.
ScienceAide: On average, how many hours a week do you work? How many hours do you sleep each night? How many weeks of vacation do you take?
Steve: It depends. When I was a resident, I worked like a dog. As long as you work 80 hours per week, it’s considered a good week. But when you become a senior person, it gets a little better. However, when you are in private practice, time = money. When you go out to practice, if you want to make more money, you have to work more.
I get about 7 hours of sleep per day. I try to take care of myself and have good sleep. We get about 3 weeks of vacation, and I use it. If you don’t use it everyone will think you are a strange person.
ScienceAide: In your position now, knowing what you do - what would you say to yourself 10 years ago?
Steve: As a resident, you are building up your foundation. Previously, if I had some problems I couldn’t figure out, I would skip them. Fortunately, since I work in a teaching hospital, I can rebuild this foundation. Make sure you build your foundation solidly, not only academically but family oriented as well. It’s important to take care of all aspects of your life.
Scienceaide: For undergrads, advice for career in medicine?
Steve: Of course, you need lots of time to prepare your academics. But I think you should also balance your personal life. What I’ve found is that EQ is equally important. Throughout my career I have had the opportunity to observe many medical doctors. Some of them are all very smart academically, but sometimes they have difficulty balancing their personal life with work. They are worried about personal achievements and things like that. So it is important to train yourself to be a real human being, not just a professional person. This will let you have the most fulfilling career. In undergrad, if you have time, read more books related to humanity, biographies, etc. Try to become a complete person instead of a Frankenstein type of person. Become a well rounded person.
ScienceAide: Is it too early to pick specialty before medical school?
Steve: I don’t think it is too early. Sometimes having a specialty in mind gives you some motivation to pursue that dream. Some people go thru medical school just want a good job and make good money. If you think to be a medical doctor is just to make more money or want to be successful without any higher purpose in life , you will be very disappointed in the future.
ScienceAide: Any advice for aspiring anesthesiologists?
Steve: You need to know your personality. You need to be very action oriented, respond to things very quickly. You aren’t just a thinker but also a doer. Some people will do well as anesthesiologists, and other will do well in internal medicine. So make sure you know yourself. Quick decisions, response quickly. One thing to remember is that anesthesiologists are not the hero types, they are part of the backstage crew. Sometimes people may give applause to the surgeon, not the anesthesiologist. Sometimes applause is internal.
ScienceAide: Anything for fun?
Steve: Hiking Torrey pines, reading, history, church activities. Hopefully some mission work in the future.