July 14, 2025 • 26 mins
What began as a pre-med journey toward orthopedic surgery took an unexpected turn when Sally Hoang, CAA discovered the immediate impact and work-life balance offered by a career in anesthesia care.
With remarkable candor, Sally Hoang walks us through her typical 16-hour shift—from arriving at 6:30 AM to set up medications and equipment, to meeting patients in pre-op, to the collaborative dance of putting patients to sleep alongside attending anesthesiologists. Her descriptions paint a vivid picture of a profession that combines technical precision with human connection during patients' most vulnerable moments.
The conversation reveals surprising aspects of the CAA profession that make it uniquely appealing: the ability to work across all surgical specialties, from vascular to neurosurgery; the introvert-friendly environment where you can choose your level of social interaction; and the luxury of actually leaving work at work—something increasingly rare in healthcare. Sally shares breathtaking moments from her career, including an emergency case where her team administered an astounding 87 units of blood to save a patient's life during an abdominal aortic aneurysm repair.
For pre-health students considering their options, Sally offers thoughtful perspective on why she chose the CAA path over becoming an anesthesiologist or CRNA. The 2.5-year master's program offered a faster route to practice high-level medicine with immediate impact, without sacrificing personal interests and balanced living. Through her social media channels, she's now helping others discover this rewarding career path that combines autonomy, teamwork, and meaningful patient care.
Whether you're exploring healthcare careers or simply curious about what happens while you're under anesthesia, this episode provides rare insight into the professionals keeping watch over your vital signs and ensuring your safety when you're at your most vulnerable. Join us for this eye-opening conversation about finding fulfillment in medicine without sacrificing yourself in the process.
Follow @anesthesiasal across all social platforms and visit her YouTube page for more!
Virtual shadowing is an important tool to use when planning your medical career. At Shadow Me Next! we want to provide you with the resources you need to find your role in healthcare and secure your place in medicine.
Check out our pre-health resources. Great for pre-med, pre-PA, pre-nursing, pre-therapy students or anyone else with an upcoming interview!
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Ashley (00:00):
Hello and welcome to Shadow Me Next, a podcast where
I take you into and behind thescenes of the medical world to
provide you with a deeperunderstanding of the human side
of medicine.
I'm Ashley, a physicianassistant, medical editor,
clinical preceptor and thecreator of Shadow Me Next.
It is my pleasure to introduceyou to incredible members of the
(00:22):
healthcare field and uncovertheir unique stories, the joys
and challenges they face andwhat drives them in their
careers.
It's access you want andstories you need, whether you're
a pre-health student or simplycurious about the healthcare
field.
I invite you to join me as wetake a conversational and
personal look into the lives andminds of leaders in medicine.
(00:44):
I don't want you to miss asingle one of these
conversations, so make sure thatyou subscribe to this podcast,
which will automatically notifyyou when new episodes are
dropped, and follow us onInstagram and Facebook at shadow
me next, where we will reviewhighlights from this
conversation and where I'll giveyou sneak previews of our
upcoming guests.
What if you could protectpatients during the most
(01:07):
vulnerable moments in theirlives and then leave work
completely at work?
Today's guest is Sally Hong, acertified anesthesiologist
assistant, whose role in the ORis equal parts precision, calm
and critical thinking.
From giving 87 units of bloodduring a trauma case to finding
(01:27):
career satisfaction throughflexibility, teamwork and
autonomy, sally gives us a rarelook inside the anesthesia world
.
We talk about her decision topivot from pre-med to CAA, the
emotional and technical highs ofher job and why she created one
of the only social mediachannels highlighting the CAA
(01:47):
profession.
Anesthesia Sal.
If you've ever wondered whatreally happens behind the
surgical curtain or what kind ofhealthcare career values your
time and still allows you tomake a massive impact, this
episode is for you.
Please keep in mind that thecontent of this podcast is
intended for informational andentertainment purposes only and
(02:10):
should not be considered asprofessional medical advice.
The views and opinionsexpressed in this podcast are
those of the host and guests anddo not necessarily reflect the
official policy or position ofany other agency, organization,
employer or company.
This is Shadow Me Next withSally Hong.
Thank you so much for joining meon Shadow Me Next today.
(02:31):
I have been looking for ananesthesiologist assistant and
here you are.
I cannot wait to talk to you.
Thank you for joining us today.
Thank you for reaching out.
So, in my head, a CAA, which isa certified anesthesiologist
assistant is what we're going tobe talking about.
A CAA is very similar to a PA,which is a physician assistant
(02:53):
in the realm of medicine on ourown, on our own teams.
So first, before we get intothat, will you walk us through?
Maybe growing up, did you?
Did you know you always wantedto be a CAA, or is this
something that you discoveredlater on?
Sally (03:06):
Oh yeah, I didn't figure out about the anesthesia like
anesthesiologist assistantprofession until probably my
junior year of college when Istarted undergrad at the
University of Georgia.
I majored in exercise sportsscience because I wanted to
become an orthopedic surgeon andthat was kind of my pre-med
(03:29):
route.
So I took all of thepre-medical courses, got
involved with the medicalorganizations, I volunteered at
St Mary's Hospital for a littlebit and then worked as a scribe
at Mercy Health Center in Athens.
But then later on I became amedical assistant for an
orthopedic surgeon and that kindof gave me the firsthand
(03:50):
day-to-day reality of what itwould be like.
And then over that year Ifollowed the patients through
their entire course of care, sofrom injury to surgery, to
castings afterwards and thenphysical therapy after that.
They would always come back forcheck-ins so I would see them
(04:11):
and talk to them and see howthey progressed.
Even though I found that processvaluable, the long timeline and
delayed feedback of the patientcare wasn't really the type of
impact I wanted to have.
And that's when I learned like,oh, this might not be the right
choice for me, but he had hisown anesthesiologist on his team
(04:32):
and that's where I met theanesthesiologist and I would
watch him come to work, do histhing and then, once the case
was over, he was done for theday.
There was no clinical backlogor extensive post-op care, it
was just acute hands-on medicine.
And then the instant feedbackof knowing like, okay, I did my
job, I did it right, and thenyou go home.
(04:54):
And that kind of resonated withme and I was like, oh, this is
what I want to do.
Ashley (05:01):
I love the way that you just described that, because it
is so clear, it is so wellarticulated the differences in
scope, really, between what amedical doctor, what an NP
perhaps, might be doing and thenwhat an anesthesiologist is
doing and what a CAA is doing.
I do love the fact that at theend of the day, you really do
(05:21):
leave work at work, and I don'tknow how many people in medicine
can say that.
Probably not many, probably notmany, in my experience at least
.
So, sally, tell us about, tellus about a CAA.
Describe it for me.
You know, what does theschooling look like?
What is your scope of practiceas a CAA generally?
And then we'll dive into a dayin your life, because that is
(05:44):
what I'm really excited about.
Sally (05:46):
Okay, so a CAA.
It's very similar to aphysician assistant as far as
the schooling to get there.
It's a two and a half yearmaster's program.
You do all of your clinicalswithin that two and a half year
program and then you graduateand then you immediately start
working that two and a half yearprogram and then you graduate
(06:07):
and then you immediately startworking.
Another similarity with thephysician assistant role is that
you work under an MD, a medicaldoctor In this case it would be
an anesthesiologist.
It's a very team-based kind ofmedicine For schooling.
Ashley (06:19):
For PA school it is one year of basically book work.
We call it didactic study,books and lectures.
Nobody uses books anymore.
But I year of basically bookwork.
We call it didactic study,books and lectures.
Nobody uses books anymore, butI still call it book work.
And then it's another year ofclinical rotations.
So is it the same for CAAschool or is it kind of
intermixed?
Sally (06:35):
throughout the whole two and a half.
As soon as you start theprogram, there are didactics,
and it's a little bit heavierthe first year, but clinicals
are two days a week right offthe bat.
Wow, gradually throughout theprogram it becomes increasingly
more so it's like three days aweek and then as a second year
it's every single day and flipsto where you only have didactics
(06:59):
maybe once a month for, like,just testing and review.
So it's kind of like a inverse.
Ashley (07:07):
Yeah, I like that.
That's a really cool way tolearn.
What kind of classes would youtake while you were doing like
your didactic work?
What would be some of thethings that like the course
schedule or the course names?
Sally (07:17):
Just like your standard anatomy and physiology, basic
physics.
And then we got into kind ofthe more anesthesia heavy
subjects.
So anesthesia, cardiac peds,pharmacology, a lot of
pharmacology and then just basicmachines and instrumentation
(07:39):
because we deal a lot withmonitoring in the OR.
So it was all anesthesia,Anything.
Anesthesia was a class.
Ashley (07:49):
PAs, we can work in just about any medical specialty as
long as we have a supervisingphysician who's willing to
oversee us right.
So literally anything.
I could be in a hospital.
I could be in an OR and inhospital.
I could be in clinic.
I could be in rural medicineworking at a very small urgent
clinic.
As a CAA, are you guys alwaysin a hospital operating room or
(08:12):
does your place of work look alittle bit different?
Sally (08:14):
The majority of us work in a hospital setting, but we
can work in outpatient settingsand clinics as well and then
kind of offside position that wecan be in is teaching.
Ashley (08:29):
So all of the AA programs you can work there too
here, for I'm so excited youwake up and you realize that it
is your job to protect thesepatients while they are getting
surgery.
Tell me what a day in your lifelooks like as a CAA.
Sally (08:45):
It's probably four to five days a week and cases start
at 7.30 at most hospitals.
So you arrive at the hospitalat probably 6.30, depending on
how much you have to set up, butyou're assigned your case and
you're attending the nightbefore, so you know what you're
(09:05):
getting into.
Oh, that's nice.
You can either be the generalanesthetist in any specialty as
far as surgery goes, you can dovascular one day, the next day
you can do neurosurgery orplastics, like it's random.
So every day is different,which kind of changes things up
and makes it a little moreexciting.
You meet different people everysingle day and you work with
(09:27):
different attendings.
Also, every day you go to thehospital, change into your
scrubs and you go get your drugsand these are your narcotics
and just any other specialmedications that you might need
for the surgery.
You go to your OR room and thenyou set up for the case.
You do a machine check, youpull up your drugs, you do an
(09:50):
airway setup, kind of geteverything ready for the surgery
, and once your room is done youwalk to pre-op and that's where
your patient is going to be,and you meet them.
You say hey, my name is Sally,I'm with the anesthesia team.
I have to get an IV started onyou.
So you do the IV.
Hopefully they brought theirveins Some people.
(10:12):
It's just a little bit moredifficult.
You have to pull out theultrasound to get an IV.
So not only is your casedifferent and your team is
different, but then yourpatients are also.
You don't know who you're goingto meet.
So after that the IV is done,everybody else kind of meets the
patient and does theirinterview and then, once that is
it, it's probably going to belike 7.20 AM right now and you
(10:35):
take the patient back to theoperating room.
You're pushing the structureit's your job to do that and at
7.30, you hook up the patient toall the monitors and then you
call your attending, say hey,we're ready to go to sleep, and
then the attending comes on inand then you guys both work
together to get the patient offto sleep.
Usually the anesthetist is theone intubating the patient If
(11:00):
the procedure calls for generalanesthesia, and the
anesthesiologist will be the onekind of giving the medications.
But sometimes they want tochange it up and then be like,
hey, can I intubate today?
So we'll like swap roles.
It's very I don't know verychill, very relaxed, very
team-based.
So whatever you want to do, youcan kind of pitch it to your
(11:20):
attending and you know it's acollaborative effort.
But once that case is done andthat also, it varies you can
have a one-hour surgery or youcan have a 15-hour surgery.
Ashley (11:33):
What happens if you have to go to the bathroom?
Sally (11:35):
Yeah, so in anesthesia one of the greatest perks is
that you get breaks all the time.
You have so many breaks there'smorning break, afternoon break,
lunch break, dinner break andthere's like kind of a running
joke where everybody else isstill in the operating room.
You know they're scrubbed in.
They can't break on our fifthbreak.
(11:57):
So when we're in their closingwe kind of start to titrate the
anesthesia off and once thesurgery is done we call our
attending hey, patient's wakingup.
Sometimes they come into theroom, sometimes they don't.
It kind of depends on theacuity of the patient and how
difficult they were.
But we'll extubate when thepatient is ready and then take
(12:22):
them to the recovery area, givereport and then if you have
another case scheduled in yourroom, then you kind of rinse and
repeat and do the same thing.
Ashley (12:32):
I really love how you are so involved in every single
step, from the pre-op room allthe way through.
That's very cool and, honestly,I would imagine, quite
comfortable for the patient tooto know that from the minute
they arrive, you know the firstperson to really start poking at
them is you, and they knowyou're going to be with them
throughout most of the start,except for your breaks.
Sally (12:53):
That's got to be comforting.
Yeah, so my schedule.
I work long hours so I'll do 16hour shifts from 6am to 11pm.
Honestly, the patient, whoeverI take care of, I'm there from
beginning to end for the mostpart.
Some cases go to like 2am whichI won't be there for.
Yes, I do see most of mypatients throughout the whole
(13:15):
case, but then some anesthetiststhey leave at three o'clock and
that's the end of their day.
So everybody has differentschedules and I think that's
like a great part of being ananesthetist.
There's so many schedules outthere that can work with your
life outside of work.
Ashley (13:32):
There does seem to be a lot of flexibility, a lot more
flexibility than I was expecting, so that's definitely a
pleasant surprise.
Well, the coolest sounding dayfor sure.
I love the fact that you're ona bunch of different cases.
I think it's probably quiteinteresting that you get to see
a lot of different medicinewhile you're there.
If you're working with avascular surgeon one day, maybe
a gynecologic surgeon the nextday and everyone in between, and
(13:53):
I would imagine you're alsocommunicating with the attending
, ie the surgeon, during thesurgery when necessary, right?
You're not just sectioned offbehind the curtain, right.
Sally (14:06):
Um, so I'm a very introverted person.
There are some days that I justdon't want to talk to anybody.
So you have the option of kindof just being in your corner at
the top of the head justmonitoring the patient doing the
anesthesia and speaking whennecessary to your team, but
otherwise you can kind of justsit in a corner.
(14:26):
That was also one of the thingsabout anesthesia that I love.
Some days I'm super social andI just want to talk to everybody
and you can, because you meetso many different people every
single day.
But then you can also, ifyou're tired, you're socially
drained, then you can just kindof retreat back and nobody you
know nobody kind of worriesabout it, because they know some
(14:50):
people are talkative and somepeople are focused.
Ashley (14:52):
Yeah, I'm so glad you brought that up because it is
really important for our moreintroverted people to realize
that there are elements ofmedicine where you don't have to
talk all day, every day and beon your a game literally every
minute of every day.
That's, that's nice.
Thank you for bringing that up.
I appreciate that.
Let's pivot a little bit.
We have a segment on the showcalled quality questions.
It's where, if you have eitherbeen asked a weird interview
(15:15):
question or a good interviewquestion, or you ask questions,
this is basically a way for ourpre-health students to develop a
cache of interview questionsthat they might hear, like
either you know, before school,before they get their first job,
before we hear what Sally'squality question is.
Keep in mind that there's moreinterview prep, such as mock
interviews and personalstatement review over on
(15:37):
shadowmenextcom.
There you'll find amazingresources to help you as you
prepare to answer your ownquality questions.
Sally (15:45):
There is a program who asks more technical questions,
like just really right off thebat very textbook questions that
, like a undergraduate studentprobably won't know the answer
to.
And that's on purpose, becausethey're just trying to stump you
to see how you kind of processthe stress and see how you react
(16:05):
.
Ashley (16:06):
Sally, you are so impressive.
You work these 16 hour shifts Idon't know how you do it and
you have this fabulous socialmedia online presence.
So you have a YouTube and anInstagram channel.
Tell us a little bit aboutthese two things.
Is it?
Is it just an enjoyable outletfor you?
Sally (16:23):
Yes, so I'm.
I'm a very creative person, soI love modeling and music and
kind of just being able tocreate.
And when I was applying to AAschool like there was none of
this social media TikTok day inthe life reels that you could
watch an anesthetist go throughto see if that's what you wanted
(16:46):
to do I was literally just likeat night Googling AA.
Reading Reddit forums from fouryears ago through the threads
is like this crazy rabbit hole.
So I don't know, I just figuredI had this kind of ability to
share because this professionhas honestly changed my life.
But it was also super fun tolike, do and have this content
(17:09):
that nobody else really hadaccess to.
So I started doing my YouTubechannel, I started the Instagram
and I I'm a new mom now so Ijust don't have time to edit my
YouTube videos Like I would backthen.
So there, I haven't posted inprobably a year and a half, but
(17:32):
that's probably the most fun forme.
Ashley (17:34):
It's such a great way for students to get more
information, but it doesn'treplace getting to actually see
people doing things in live time.
It's why shadowing is soimportant and there are so many
options now for shadowing.
I would imagine it's probablyquite difficult to get shadow
in-person shadows where you'reat I mean, I think, hospital
systems it can be hard to tapinto.
Sally (17:55):
Um yeah.
Ashley (17:57):
So the only way to do it really is to chat with you
face-to-face, to listen to youinterview, like we're doing
today, and then to jump on yourInstagram, which I'll tag in the
show notes below, and yourYouTube and get a great idea of
what a day in your life lookslike and the challenges that
you're kind of working throughand maybe some of the wins that
you've experienced.
It's a great option forpre-health students.
(18:18):
So thank you for doing that.
Thank you for putting all ofyour time into this.
I know it's a lot of work.
Sally (18:22):
There's some people that will message me and I'll just
answer their questions and lateron there'll be like oh my gosh,
I'm an AA student, now I'mabout to graduate because of you
.
So it feels good havingimpacted all of these people and
I know they're going to have agreat life because this job has
been so good to me.
Ashley (18:41):
Yeah, it just sounds like the coolest job ever.
And you're absolutely right.
Getting to not only do what ourjob is I mean, this is what we
are paid to do is work as a CAA,is work as a PA but then
getting to share that with otherpeople, it just makes the job
that much sweeter.
Plus getting to see how excitedcertain students get when they
either see what you're doing oryou have the comment on
(19:03):
something that you do andthey'll say that's so cool.
And I'm like, oh, you know whatthat is so cool, I forgot.
Sally (19:09):
I know it's refreshing to get the new students in and
that energy back, because youknow you work in a hospital for
eight, 10 years.
It kind of you get kind ofdrained a little bit and becomes
just a job.
So having the students it'sjust like a reminder of oh yeah,
this is what I.
It's pretty cool.
Ashley (19:29):
Absolutely, Absolutely.
I tell my shadows all the time.
You guys are giving me morelife than I'm giving you right
now.
I can guarantee it.
Your job as a CAA is.
It is so technical and thethings that you're doing.
You mentioned pharmacology, youmentioned dealing with machines
, things like that, but when itcomes to patients and when it
comes to making memories in yourjob, is there anything that
(19:51):
really stands out to you?
That just blew you away?
Sally (19:54):
So far I've been lucky to not have a code or lost a
patient on the table.
I think those are from what yousee in the movies.
That's the big thing thathappens in the operating room.
But one case that I'll neverforget was early on when I
started working maybe two yearsin I was doing a open AAA.
(20:15):
It's like a abdominal aorticaneurysm repair.
It's a vascular case and it wasan emergency add-on.
The patient was flown in byhelicopter at like 9 pm and it
turned out into this whole likemassive all hands on deck
situation because the patientwas bleeding.
We ended up giving 87 units ofblood and that's a lot.
(20:36):
Normally the average case it'slike maybe six units you know,
10 units, but this is 87 units.
I'll never forget that number.
It was so much.
And there's two anesthetists inthe room.
My attending was in a room thewhole time and we're just like
verifying the blood, pushing theblood, managing the blood
(20:56):
pressure, charting, trying tokeep the patient stable for the
surgeon to finish up what he wasdoing, and we probably didn't
finish till five in the morning,but the patient made it to ICU.
Ashley (21:09):
Wow, wow.
I imagine, like with everysingle bag of blood that was
passed over to you, you'reprobably thinking like this is
the last one.
Sally (21:18):
It was like I was giving the blood and then you look at
the field and the blow is comingout.
Oh my, I remember at the end ofthe case, when the patient was
gone, we looked at the room andit was a bloody mess.
The floor was just puddles ofblood.
It was crazy.
Ashley (21:38):
And they get onto your table and the surgeon's just
like, all right, I'm going toget to work.
And he looks at you guys andhe's like keep this patient
alive.
It's unreal to me.
It is so cool.
Sally (22:00):
What you do is just, it blows my mind, yeah, but I don't
want to scare everybody andhave them think you know this is
every day.
You can work at a traumahospital and maybe you're going
to do these cases more often,but there are also standard
elective cases that are a breezeand you just you know, goes
everything the way you plan thepatient's healthy so you can
have easy days as well.
Ashley (22:19):
You need them, otherwise , could you imagine doing that
all the time you would?
You would.
Your body would actually breakdown, I think.
I think you would just meltinto a puddle of blood yourself.
Sally (22:29):
That one was a big one, yeah, but outside of kind of the
high trauma cases, there are alot of other surgeries that kind
of stick with me for differentreasons.
Like earlier this week I had aneye trauma case.
The patient had like a foreignbody got hit into his eye.
And that's just a reminder towear eye protection when you're
cutting metal or wood.
You know just like come on,guys, wear eye protection when
(22:50):
you're cutting metal or wood.
You know just like, come on,guys, wear eye protection.
Ashley (22:53):
You see so much in medicine like that, those
cautionary tales.
Sally (22:56):
I'm on the neuro team, so I do a lot of brain surgery and
aneurysms, brain tumorresections, and then those cases
kind of make me realize, youknow, cancer doesn't
discriminate.
It can happen to anybody, ifyou're like 20, if you're 60,
and it can happen fast, out ofnowhere too.
So it's just a good wake upcall about how short life can be
(23:19):
and how crazy life can be.
Same thing with cancer cases.
We do a lot of those too.
It reminds me not to take myhealth for granted and not take
my family for granted too,because they're healthy right
now.
Ashley (23:32):
No, you're absolutely right, sally.
I just so appreciate youspending time with us today.
Before we wrap up, I do haveone last question, if there is
someone listening that is tornbetween becoming a CAA and then
maybe going to PA school or CRNAschool which we didn't even
talk about the difference therebut PA school, crna school,
(23:54):
medical school, things like thatwhat questions do?
Sally (23:55):
you think they should ask themselves when they're trying
to figure all this out.
So it's different for everybody, depending on when they're
making that decision.
Like if they're early on highschool, you know they can go any
route.
But then if they're making asecond profession, like career
change, that time becomes likean issue for a lot of people too
(24:15):
.
I can just speak on whathappened to me and then maybe
they'll kind of like gather Idon't know, make a decision or
learn from that.
But so I figured out about theAA program my kind of early
junior year, so the only kind of.
I know for sure that I wantedto be in the anesthesia field
(24:37):
and because I found out so lateabout it in undergrad, the two
paths were either become ananesthesiologist or an
anesthesiologist assistant.
Pursuing the CRNA route didn'tmake sense because then I would
have to start all over and getmy BSN.
But then for me to decidebetween AA route versus the MD
(24:59):
route, the two and a half yearprogram structure kind of just
like won me over because I wasweighing that against the fact
of four years of medical school,three years of residency and
then maybe a fellowship yearafter that.
But the AA route, you know Istill get to practice high level
(25:19):
medicine, hands-on procedures,and would be in the OR
immediately after two and a halfyears and start working.
So that to me was like kind ofa deciding factor.
In addition to that, there'salso the risk of not matching
residency.
I just didn't want to deal withall that stress.
(25:40):
I'm like life is short, I'mgoing to go work after two and a
half years and I have a lot ofother hobbies and interests that
I'm into.
Time was more valuable to me todo other things while still
being able to practice medicine.
Ashley (26:02):
Sally, thank you so much for joining us today.
You are amazing.
The information you've providedis just absolute gold.
Thank you so much, anesthesia.
Sal, sally, you're the bomb,thank you, thank you.
Thank you for having me.
Thank you so very much forlistening to this episode of
shadow me next.
If you liked this episode or ifyou think it could be useful
for a friend, please subscribeand invite them to join us next
(26:22):
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access.
You want, stories you need.
You're always invited to shadowme next.
Hello and welcome to Shadow Me Next, a podcast where
I take you into and behind thescenes of the medical world to
provide you with a deeperunderstanding of the human side
of medicine.
I'm Ashley, a physicianassistant, medical editor,
clinical preceptor and thecreator of Shadow Me Next.
It is my pleasure to introduceyou to incredible members of the
(00:22):
healthcare field and uncovertheir unique stories, the joys
and challenges they face andwhat drives them in their
careers.
It's access you want andstories you need, whether you're
a pre-health student or simplycurious about the healthcare
field.
I invite you to join me as wetake a conversational and
personal look into the lives andminds of leaders in medicine.
(00:44):
I don't want you to miss asingle one of these
conversations, so make sure thatyou subscribe to this podcast,
which will automatically notifyyou when new episodes are
dropped, and follow us onInstagram and Facebook at shadow
me next, where we will reviewhighlights from this
conversation and where I'll giveyou sneak previews of our
upcoming guests.
What if you could protectpatients during the most
(01:07):
vulnerable moments in theirlives and then leave work
completely at work?
Today's guest is Sally Hong, acertified anesthesiologist
assistant, whose role in the ORis equal parts precision, calm
and critical thinking.
From giving 87 units of bloodduring a trauma case to finding
(01:27):
career satisfaction throughflexibility, teamwork and
autonomy, sally gives us a rarelook inside the anesthesia world
.
We talk about her decision topivot from pre-med to CAA, the
emotional and technical highs ofher job and why she created one
of the only social mediachannels highlighting the CAA
(01:47):
profession.
Anesthesia Sal.
If you've ever wondered whatreally happens behind the
surgical curtain or what kind ofhealthcare career values your
time and still allows you tomake a massive impact, this
episode is for you.
Please keep in mind that thecontent of this podcast is
intended for informational andentertainment purposes only and
(02:10):
should not be considered asprofessional medical advice.
The views and opinionsexpressed in this podcast are
those of the host and guests anddo not necessarily reflect the
official policy or position ofany other agency, organization,
employer or company.
This is Shadow Me Next withSally Hong.
Thank you so much for joining meon Shadow Me Next today.
(02:31):
I have been looking for ananesthesiologist assistant and
here you are.
I cannot wait to talk to you.
Thank you for joining us today.
Thank you for reaching out.
So, in my head, a CAA, which isa certified anesthesiologist
assistant is what we're going tobe talking about.
A CAA is very similar to a PA,which is a physician assistant
(02:53):
in the realm of medicine on ourown, on our own teams.
So first, before we get intothat, will you walk us through?
Maybe growing up, did you?
Did you know you always wantedto be a CAA, or is this
something that you discoveredlater on?
Sally (03:06):
Oh yeah, I didn't figure out about the anesthesia like
anesthesiologist assistantprofession until probably my
junior year of college when Istarted undergrad at the
University of Georgia.
I majored in exercise sportsscience because I wanted to
become an orthopedic surgeon andthat was kind of my pre-med
(03:29):
route.
So I took all of thepre-medical courses, got
involved with the medicalorganizations, I volunteered at
St Mary's Hospital for a littlebit and then worked as a scribe
at Mercy Health Center in Athens.
But then later on I became amedical assistant for an
orthopedic surgeon and that kindof gave me the firsthand
(03:50):
day-to-day reality of what itwould be like.
And then over that year Ifollowed the patients through
their entire course of care, sofrom injury to surgery, to
castings afterwards and thenphysical therapy after that.
They would always come back forcheck-ins so I would see them
(04:11):
and talk to them and see howthey progressed.
Even though I found that processvaluable, the long timeline and
delayed feedback of the patientcare wasn't really the type of
impact I wanted to have.
And that's when I learned like,oh, this might not be the right
choice for me, but he had hisown anesthesiologist on his team
(04:32):
and that's where I met theanesthesiologist and I would
watch him come to work, do histhing and then, once the case
was over, he was done for theday.
There was no clinical backlogor extensive post-op care, it
was just acute hands-on medicine.
And then the instant feedbackof knowing like, okay, I did my
job, I did it right, and thenyou go home.
(04:54):
And that kind of resonated withme and I was like, oh, this is
what I want to do.
Ashley (05:01):
I love the way that you just described that, because it
is so clear, it is so wellarticulated the differences in
scope, really, between what amedical doctor, what an NP
perhaps, might be doing and thenwhat an anesthesiologist is
doing and what a CAA is doing.
I do love the fact that at theend of the day, you really do
(05:21):
leave work at work, and I don'tknow how many people in medicine
can say that.
Probably not many, probably notmany, in my experience at least
.
So, sally, tell us about, tellus about a CAA.
Describe it for me.
You know, what does theschooling look like?
What is your scope of practiceas a CAA generally?
And then we'll dive into a dayin your life, because that is
(05:44):
what I'm really excited about.
Sally (05:46):
Okay, so a CAA.
It's very similar to aphysician assistant as far as
the schooling to get there.
It's a two and a half yearmaster's program.
You do all of your clinicalswithin that two and a half year
program and then you graduateand then you immediately start
working that two and a half yearprogram and then you graduate
(06:07):
and then you immediately startworking.
Another similarity with thephysician assistant role is that
you work under an MD, a medicaldoctor In this case it would be
an anesthesiologist.
It's a very team-based kind ofmedicine For schooling.
Ashley (06:19):
For PA school it is one year of basically book work.
We call it didactic study,books and lectures.
Nobody uses books anymore.
But I year of basically bookwork.
We call it didactic study,books and lectures.
Nobody uses books anymore, butI still call it book work.
And then it's another year ofclinical rotations.
So is it the same for CAAschool or is it kind of
intermixed?
Sally (06:35):
throughout the whole two and a half.
As soon as you start theprogram, there are didactics,
and it's a little bit heavierthe first year, but clinicals
are two days a week right offthe bat.
Wow, gradually throughout theprogram it becomes increasingly
more so it's like three days aweek and then as a second year
it's every single day and flipsto where you only have didactics
(06:59):
maybe once a month for, like,just testing and review.
So it's kind of like a inverse.
Ashley (07:07):
Yeah, I like that.
That's a really cool way tolearn.
What kind of classes would youtake while you were doing like
your didactic work?
What would be some of thethings that like the course
schedule or the course names?
Sally (07:17):
Just like your standard anatomy and physiology, basic
physics.
And then we got into kind ofthe more anesthesia heavy
subjects.
So anesthesia, cardiac peds,pharmacology, a lot of
pharmacology and then just basicmachines and instrumentation
(07:39):
because we deal a lot withmonitoring in the OR.
So it was all anesthesia,Anything.
Anesthesia was a class.
Ashley (07:49):
PAs, we can work in just about any medical specialty as
long as we have a supervisingphysician who's willing to
oversee us right.
So literally anything.
I could be in a hospital.
I could be in an OR and inhospital.
I could be in clinic.
I could be in rural medicineworking at a very small urgent
clinic.
As a CAA, are you guys alwaysin a hospital operating room or
(08:12):
does your place of work look alittle bit different?
Sally (08:14):
The majority of us work in a hospital setting, but we
can work in outpatient settingsand clinics as well and then
kind of offside position that wecan be in is teaching.
Ashley (08:29):
So all of the AA programs you can work there too
here, for I'm so excited youwake up and you realize that it
is your job to protect thesepatients while they are getting
surgery.
Tell me what a day in your lifelooks like as a CAA.
Sally (08:45):
It's probably four to five days a week and cases start
at 7.30 at most hospitals.
So you arrive at the hospitalat probably 6.30, depending on
how much you have to set up, butyou're assigned your case and
you're attending the nightbefore, so you know what you're
(09:05):
getting into.
Oh, that's nice.
You can either be the generalanesthetist in any specialty as
far as surgery goes, you can dovascular one day, the next day
you can do neurosurgery orplastics, like it's random.
So every day is different,which kind of changes things up
and makes it a little moreexciting.
You meet different people everysingle day and you work with
(09:27):
different attendings.
Also, every day you go to thehospital, change into your
scrubs and you go get your drugsand these are your narcotics
and just any other specialmedications that you might need
for the surgery.
You go to your OR room and thenyou set up for the case.
You do a machine check, youpull up your drugs, you do an
(09:50):
airway setup, kind of geteverything ready for the surgery
, and once your room is done youwalk to pre-op and that's where
your patient is going to be,and you meet them.
You say hey, my name is Sally,I'm with the anesthesia team.
I have to get an IV started onyou.
So you do the IV.
Hopefully they brought theirveins Some people.
(10:12):
It's just a little bit moredifficult.
You have to pull out theultrasound to get an IV.
So not only is your casedifferent and your team is
different, but then yourpatients are also.
You don't know who you're goingto meet.
So after that the IV is done,everybody else kind of meets the
patient and does theirinterview and then, once that is
it, it's probably going to belike 7.20 AM right now and you
(10:35):
take the patient back to theoperating room.
You're pushing the structureit's your job to do that and at
7.30, you hook up the patient toall the monitors and then you
call your attending, say hey,we're ready to go to sleep, and
then the attending comes on inand then you guys both work
together to get the patient offto sleep.
Usually the anesthetist is theone intubating the patient If
(11:00):
the procedure calls for generalanesthesia, and the
anesthesiologist will be the onekind of giving the medications.
But sometimes they want tochange it up and then be like,
hey, can I intubate today?
So we'll like swap roles.
It's very I don't know verychill, very relaxed, very
team-based.
So whatever you want to do, youcan kind of pitch it to your
(11:20):
attending and you know it's acollaborative effort.
But once that case is done andthat also, it varies you can
have a one-hour surgery or youcan have a 15-hour surgery.
Ashley (11:33):
What happens if you have to go to the bathroom?
Sally (11:35):
Yeah, so in anesthesia one of the greatest perks is
that you get breaks all the time.
You have so many breaks there'smorning break, afternoon break,
lunch break, dinner break andthere's like kind of a running
joke where everybody else isstill in the operating room.
You know they're scrubbed in.
They can't break on our fifthbreak.
(11:57):
So when we're in their closingwe kind of start to titrate the
anesthesia off and once thesurgery is done we call our
attending hey, patient's wakingup.
Sometimes they come into theroom, sometimes they don't.
It kind of depends on theacuity of the patient and how
difficult they were.
But we'll extubate when thepatient is ready and then take
(12:22):
them to the recovery area, givereport and then if you have
another case scheduled in yourroom, then you kind of rinse and
repeat and do the same thing.
Ashley (12:32):
I really love how you are so involved in every single
step, from the pre-op room allthe way through.
That's very cool and, honestly,I would imagine, quite
comfortable for the patient tooto know that from the minute
they arrive, you know the firstperson to really start poking at
them is you, and they knowyou're going to be with them
throughout most of the start,except for your breaks.
Sally (12:53):
That's got to be comforting.
Yeah, so my schedule.
I work long hours so I'll do 16hour shifts from 6am to 11pm.
Honestly, the patient, whoeverI take care of, I'm there from
beginning to end for the mostpart.
Some cases go to like 2am whichI won't be there for.
Yes, I do see most of mypatients throughout the whole
(13:15):
case, but then some anesthetiststhey leave at three o'clock and
that's the end of their day.
So everybody has differentschedules and I think that's
like a great part of being ananesthetist.
There's so many schedules outthere that can work with your
life outside of work.
Ashley (13:32):
There does seem to be a lot of flexibility, a lot more
flexibility than I was expecting, so that's definitely a
pleasant surprise.
Well, the coolest sounding dayfor sure.
I love the fact that you're ona bunch of different cases.
I think it's probably quiteinteresting that you get to see
a lot of different medicinewhile you're there.
If you're working with avascular surgeon one day, maybe
a gynecologic surgeon the nextday and everyone in between, and
(13:53):
I would imagine you're alsocommunicating with the attending
, ie the surgeon, during thesurgery when necessary, right?
You're not just sectioned offbehind the curtain, right.
Sally (14:06):
Um, so I'm a very introverted person.
There are some days that I justdon't want to talk to anybody.
So you have the option of kindof just being in your corner at
the top of the head justmonitoring the patient doing the
anesthesia and speaking whennecessary to your team, but
otherwise you can kind of justsit in a corner.
(14:26):
That was also one of the thingsabout anesthesia that I love.
Some days I'm super social andI just want to talk to everybody
and you can, because you meetso many different people every
single day.
But then you can also, ifyou're tired, you're socially
drained, then you can just kindof retreat back and nobody you
know nobody kind of worriesabout it, because they know some
(14:50):
people are talkative and somepeople are focused.
Ashley (14:52):
Yeah, I'm so glad you brought that up because it is
really important for our moreintroverted people to realize
that there are elements ofmedicine where you don't have to
talk all day, every day and beon your a game literally every
minute of every day.
That's, that's nice.
Thank you for bringing that up.
I appreciate that.
Let's pivot a little bit.
We have a segment on the showcalled quality questions.
It's where, if you have eitherbeen asked a weird interview
(15:15):
question or a good interviewquestion, or you ask questions,
this is basically a way for ourpre-health students to develop a
cache of interview questionsthat they might hear, like
either you know, before school,before they get their first job,
before we hear what Sally'squality question is.
Keep in mind that there's moreinterview prep, such as mock
interviews and personalstatement review over on
(15:37):
shadowmenextcom.
There you'll find amazingresources to help you as you
prepare to answer your ownquality questions.
Sally (15:45):
There is a program who asks more technical questions,
like just really right off thebat very textbook questions that
, like a undergraduate studentprobably won't know the answer
to.
And that's on purpose, becausethey're just trying to stump you
to see how you kind of processthe stress and see how you react
(16:05):
.
Ashley (16:06):
Sally, you are so impressive.
You work these 16 hour shifts Idon't know how you do it and
you have this fabulous socialmedia online presence.
So you have a YouTube and anInstagram channel.
Tell us a little bit aboutthese two things.
Is it?
Is it just an enjoyable outletfor you?
Sally (16:23):
Yes, so I'm.
I'm a very creative person, soI love modeling and music and
kind of just being able tocreate.
And when I was applying to AAschool like there was none of
this social media TikTok day inthe life reels that you could
watch an anesthetist go throughto see if that's what you wanted
(16:46):
to do I was literally just likeat night Googling AA.
Reading Reddit forums from fouryears ago through the threads
is like this crazy rabbit hole.
So I don't know, I just figuredI had this kind of ability to
share because this professionhas honestly changed my life.
But it was also super fun tolike, do and have this content
(17:09):
that nobody else really hadaccess to.
So I started doing my YouTubechannel, I started the Instagram
and I I'm a new mom now so Ijust don't have time to edit my
YouTube videos Like I would backthen.
So there, I haven't posted inprobably a year and a half, but
(17:32):
that's probably the most fun forme.
Ashley (17:34):
It's such a great way for students to get more
information, but it doesn'treplace getting to actually see
people doing things in live time.
It's why shadowing is soimportant and there are so many
options now for shadowing.
I would imagine it's probablyquite difficult to get shadow
in-person shadows where you'reat I mean, I think, hospital
systems it can be hard to tapinto.
Sally (17:55):
Um yeah.
Ashley (17:57):
So the only way to do it really is to chat with you
face-to-face, to listen to youinterview, like we're doing
today, and then to jump on yourInstagram, which I'll tag in the
show notes below, and yourYouTube and get a great idea of
what a day in your life lookslike and the challenges that
you're kind of working throughand maybe some of the wins that
you've experienced.
It's a great option forpre-health students.
(18:18):
So thank you for doing that.
Thank you for putting all ofyour time into this.
I know it's a lot of work.
Sally (18:22):
There's some people that will message me and I'll just
answer their questions and lateron there'll be like oh my gosh,
I'm an AA student, now I'mabout to graduate because of you
.
So it feels good havingimpacted all of these people and
I know they're going to have agreat life because this job has
been so good to me.
Ashley (18:41):
Yeah, it just sounds like the coolest job ever.
And you're absolutely right.
Getting to not only do what ourjob is I mean, this is what we
are paid to do is work as a CAA,is work as a PA but then
getting to share that with otherpeople, it just makes the job
that much sweeter.
Plus getting to see how excitedcertain students get when they
either see what you're doing oryou have the comment on
(19:03):
something that you do andthey'll say that's so cool.
And I'm like, oh, you know whatthat is so cool, I forgot.
Sally (19:09):
I know it's refreshing to get the new students in and
that energy back, because youknow you work in a hospital for
eight, 10 years.
It kind of you get kind ofdrained a little bit and becomes
just a job.
So having the students it'sjust like a reminder of oh yeah,
this is what I.
It's pretty cool.
Ashley (19:29):
Absolutely, Absolutely.
I tell my shadows all the time.
You guys are giving me morelife than I'm giving you right
now.
I can guarantee it.
Your job as a CAA is.
It is so technical and thethings that you're doing.
You mentioned pharmacology, youmentioned dealing with machines
, things like that, but when itcomes to patients and when it
comes to making memories in yourjob, is there anything that
(19:51):
really stands out to you?
That just blew you away?
Sally (19:54):
So far I've been lucky to not have a code or lost a
patient on the table.
I think those are from what yousee in the movies.
That's the big thing thathappens in the operating room.
But one case that I'll neverforget was early on when I
started working maybe two yearsin I was doing a open AAA.
(20:15):
It's like a abdominal aorticaneurysm repair.
It's a vascular case and it wasan emergency add-on.
The patient was flown in byhelicopter at like 9 pm and it
turned out into this whole likemassive all hands on deck
situation because the patientwas bleeding.
We ended up giving 87 units ofblood and that's a lot.
(20:36):
Normally the average case it'slike maybe six units you know,
10 units, but this is 87 units.
I'll never forget that number.
It was so much.
And there's two anesthetists inthe room.
My attending was in a room thewhole time and we're just like
verifying the blood, pushing theblood, managing the blood
(20:56):
pressure, charting, trying tokeep the patient stable for the
surgeon to finish up what he wasdoing, and we probably didn't
finish till five in the morning,but the patient made it to ICU.
Ashley (21:09):
Wow, wow.
I imagine, like with everysingle bag of blood that was
passed over to you, you'reprobably thinking like this is
the last one.
Sally (21:18):
It was like I was giving the blood and then you look at
the field and the blow is comingout.
Oh my, I remember at the end ofthe case, when the patient was
gone, we looked at the room andit was a bloody mess.
The floor was just puddles ofblood.
It was crazy.
Ashley (21:38):
And they get onto your table and the surgeon's just
like, all right, I'm going toget to work.
And he looks at you guys andhe's like keep this patient
alive.
It's unreal to me.
It is so cool.
Sally (22:00):
What you do is just, it blows my mind, yeah, but I don't
want to scare everybody andhave them think you know this is
every day.
You can work at a traumahospital and maybe you're going
to do these cases more often,but there are also standard
elective cases that are a breezeand you just you know, goes
everything the way you plan thepatient's healthy so you can
have easy days as well.
Ashley (22:19):
You need them, otherwise , could you imagine doing that
all the time you would?
You would.
Your body would actually breakdown, I think.
I think you would just meltinto a puddle of blood yourself.
Sally (22:29):
That one was a big one, yeah, but outside of kind of the
high trauma cases, there are alot of other surgeries that kind
of stick with me for differentreasons.
Like earlier this week I had aneye trauma case.
The patient had like a foreignbody got hit into his eye.
And that's just a reminder towear eye protection when you're
cutting metal or wood.
You know just like come on,guys, wear eye protection when
(22:50):
you're cutting metal or wood.
You know just like, come on,guys, wear eye protection.
Ashley (22:53):
You see so much in medicine like that, those
cautionary tales.
Sally (22:56):
I'm on the neuro team, so I do a lot of brain surgery and
aneurysms, brain tumorresections, and then those cases
kind of make me realize, youknow, cancer doesn't
discriminate.
It can happen to anybody, ifyou're like 20, if you're 60,
and it can happen fast, out ofnowhere too.
So it's just a good wake upcall about how short life can be
(23:19):
and how crazy life can be.
Same thing with cancer cases.
We do a lot of those too.
It reminds me not to take myhealth for granted and not take
my family for granted too,because they're healthy right
now.
Ashley (23:32):
No, you're absolutely right, sally.
I just so appreciate youspending time with us today.
Before we wrap up, I do haveone last question, if there is
someone listening that is tornbetween becoming a CAA and then
maybe going to PA school or CRNAschool which we didn't even
talk about the difference therebut PA school, crna school,
(23:54):
medical school, things like thatwhat questions do?
Sally (23:55):
you think they should ask themselves when they're trying
to figure all this out.
So it's different for everybody, depending on when they're
making that decision.
Like if they're early on highschool, you know they can go any
route.
But then if they're making asecond profession, like career
change, that time becomes likean issue for a lot of people too
(24:15):
.
I can just speak on whathappened to me and then maybe
they'll kind of like gather Idon't know, make a decision or
learn from that.
But so I figured out about theAA program my kind of early
junior year, so the only kind of.
I know for sure that I wantedto be in the anesthesia field
(24:37):
and because I found out so lateabout it in undergrad, the two
paths were either become ananesthesiologist or an
anesthesiologist assistant.
Pursuing the CRNA route didn'tmake sense because then I would
have to start all over and getmy BSN.
But then for me to decidebetween AA route versus the MD
(24:59):
route, the two and a half yearprogram structure kind of just
like won me over because I wasweighing that against the fact
of four years of medical school,three years of residency and
then maybe a fellowship yearafter that.
But the AA route, you know Istill get to practice high level
(25:19):
medicine, hands-on procedures,and would be in the OR
immediately after two and a halfyears and start working.
So that to me was like kind ofa deciding factor.
In addition to that, there'salso the risk of not matching
residency.
I just didn't want to deal withall that stress.
(25:40):
I'm like life is short, I'mgoing to go work after two and a
half years and I have a lot ofother hobbies and interests that
I'm into.
Time was more valuable to me todo other things while still
being able to practice medicine.
Ashley (26:02):
Sally, thank you so much for joining us today.
You are amazing.
The information you've providedis just absolute gold.
Thank you so much, anesthesia.
Sal, sally, you're the bomb,thank you, thank you.
Thank you for having me.
Thank you so very much forlistening to this episode of
shadow me next.
If you liked this episode or ifyou think it could be useful
for a friend, please subscribeand invite them to join us next
(26:22):
Monday, as always.
If you have any questions, letme know on Facebook or Instagram
access.
You want, stories you need.
You're always invited to shadowme next.
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