My decision to specialize in Anesthesiology was clear from the very beginning when I undertook to study Medicine. During my white coat ceremony, a well respected faculty member shared a few pearls of wisdom.  He regarded selecting his specialty to be one of the most important decisions of his life, and strongly encouraged students to search for their true interest. His encouragement led me to seek hands-on clinical knowledge while completing the basic medical sciences. Prior to beginning my clinical clerkships I had an amazing opportunity of assisting with countless orthopedic surgeries, shunt placements for hydrocephalus, post-trauma skin grafts, wound debridement, soft-tissue repair, hysterectomies, and cholecystectomies. Before commencement of each of these procedures, I employed a regimented approach of carefully studying the patient’s medical file to gain an in-depth understanding of the case and its links to other medical disciplines. As a result, I was regarded as a very reliable source for pre-operative assessment of patients and I began working in conjunction with the Anesthesiology Department. This invaluable experience has served to further strengthen my convictions to pursue Anesthesiology.                                                                                                    

By the time I began my clinical clerkships, the Anesthesiology Staff had become familiar with my work ethics, capabilities and dedication to the field to an extent that during my Ob/Gyn and general surgery rotations, I was permitted to work independently in the ICU and Anesthesiology Pre-Operative Unit. Due to this exposure, I was able to explore the unique issues related to Anesthesiology within different surgical disciplines while remaining focused on the obligations and educational objectives corresponding to each clerkship. I performed countless epidurals and monitored patients under sedation. During my rotations, I came across many unique scenarios, however, the complications encountered during a prophylactic hysterectomy has remained particularly vivid in my mind. I remember meeting the 38 year old patient and her children prior to the operation.  The anesthetist successfully sedated the patient and the technician and I remained responsible for monitoring. During the operation the patient experienced moderate bleeding which was successfully controlled. Despite the relatively stable vital signs, the electroencephalogram showed spikes and the oxygen saturation appeared to be dropping. I had a strong suspicion that the patient was experiencing a seizure secondary to local anesthetic toxicity. I was ordered to take charge of the situation as the fearful technician continued paging the Anesthetist. My capacity and confidence to make quick and appropriate decisions were put to test. I immediately provided supplemental oxygen and injected a small dose of intravenous Thiopental.  Upon return to the OR, the Anesthesiologist confirmed the patient’s stability and the accuracy of the measures undertaken.   I am forever indebted to the attending physicians who paved the road for my academic and clinical development through continuous challenge and trust in my ability to work on advance tasks. 

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My achievements while on clerkship enabled me to achieve wonderful accolades even before graduation. The Dean of Medicine for instance, formally recognized my effort for clinical excellence as well as in outstanding grades scored during clerkship. Also in 2006 I received the Dean’s award for my academic contribution and participation in the Medical Genetics Conference hosted by my university. I contributed to topics such as Alzheimer’s disease and Down syndrome. Alzheimer is of particular interest to me as I became witness to a loved one’s deterioration to a vegetative state when I was very young. As a result, I have spent nearly fifteen years reading every piece of available medical literature on Alzheimer. 

I have always considered transplant anesthesiology to be a particularly intriguing subspecialty. After graduating from medical school I rotated at the Jackson Memorial Hospital Department of Surgery of the Miami Miller School of Medicine. During the elective, I rotated with Dr. Jose M. Martinez, MD Chief, of Laparoendoscopic and Bariatric Surgery. The overlap between medical and surgical problems allowed me to integrate my knowledge and gain valuable skills in surgery, anesthesia and medicine. I learned the specific anesthetic and physiological considerations related to Laparoscopic donor nephrectomies and I began studying the effect of positioning on respiratory and hemodynamic parameters. During the elective, I also assisted with translation and took great pride in being able to communicate and offer comfort to Spanish speaking patients. 
I hope to gain admission into an Anesthesiology residency program where I can continue to prove my commitment and leverage my wide-ranging skills. I have chosen my career to be the center structure of my life and have developed a strong sense of independence, partly as a result of the wonderful mentor - mentee relationships I have been privileged to experience during my education. My genuine passion, reinforced by my willingness to make the necessary sacrifices, is what drives me to join a community of physicians that, through facing hardships and challenges together can save and enrich the lives of patients to whom they have dedicated themselves.   

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