Ever since his grandfather’s surgeon invited him to visit the OR as a teenager, Ty Slatton, MD, FASA, has had the bug. Now he’s bringing that enthusiasm to his work with medical students, exposing them to the realities and opportunities of practicing in a rural areas and non-academic settings. In this Member Spotlight, he shares his philosophy to teaching and mentorship and explains why completing an entire residency in internal medicine has made him a better anesthesiologist.
You are a big proponent of education and getting our specialty exposed to medical students early on, especially in rural areas and non-academic settings. What are your suggestions for how to go about this?
When most people think of rural medicine, they do not tend to think about anesthesiology. Personally, I work at Pikeville Medical Center, which is a Level-2 trauma facility in rural eastern Kentucky. Our hospital is a referral center from many smaller hospitals within the region. The nearest tertiary medical centers are approximately 2-2.5 hours away in all directions, so our hospital has become a prime destination for those patients who do not want to travel to get specialized care. Our hospital has done an amazing job at recruiting surgeons within all the surgical subspecialties, which ultimately means that anesthetic care will be needed.
I love when I have students rotating with me and they tell me they never imagined what all we did here at my hospital, or what all areas of the hospital that often request anesthesia assistance in managing patients. Today, more than ever, specialty care at non-academic centers is growing in rural and non-urban areas. With better minimally invasive techniques, procedures once felt could only be done at academic centers are now being done at regional medical centers throughout the country.
This also in itself becomes more challenging for anesthesiologists as our patients, who once would not have been ideal candidates for surgery, are becoming the baseline patients we see daily. Add the fact that most of my patients do not regularly follow with a primary care physician, and one can see the challenges I face, often being the first physician that a patient has seen in years.
Regional techniques are allowing us to perform these surgeries safely and efficiently without the need for referral to larger medical centers. Another advantage of medical students rotating with me in the rural setting is often they are getting to assist me with procedures and getting to learn techniques firsthand without the presence of residents or fellows.
My love for educating students led me to become a mentor for the Rural Access Scholarship program through the ASA. I have been able to mentor some fantastic students who have all gone on to match at anesthesiology residency programs, a fact that I am extremely proud of. I tell all my students that my goal is not only to expose you to the wonderful field of anesthesia, but to give you the confidence, as a student, to shine on your audition rotations by having the knowledge of physiology and pharmacology and the ability to apply this knowledge in the clinical setting along with ability to perform procedures confidently and successfully.
I have also found that students are exposed to a different patient subset in the rural areas (no primary care as mentioned before in a lot of cases). For those interested, I would suggest contacting the ASA if interested in helping with this program. It is a great way to give back and to continue pass along enthusiasm for our specialty.
Tell us about a personal mentor that had a particular impact on you. What do you learn from him/her?
In medical school, I had the privilege of rotating several times with Dr. Thomas Roy, a pulmonary/critical care physician who was one of the most fantastic teachers I have ever had. Dr. Roy always had a way of making you think one step further. He never ridiculed you for not knowing an answer but always had a way of making you want to learn more about something you did not know. He was a big believer in “see one, do one, teach one” methodology, so I was exposed to procedures early on in my medical training.
Dr. Roy knew I was interested in anesthesiology, so during rounds, he would always be sure to point out issues with the patients that might present as a problem for the anesthesiologist and his suggestion on what they may want to do. He made me confident in blood gas analysis and evaluating PFTS by having me evaluated all of them on rounds in front of everyone. To this day, I owe my intense interest in critically sick patients to Dr. Roy and his mentoring.
Before training in anesthesiology, you completed a residency in internal medicine. Why did you choose to switch, and how has your previous area of focus informed your current practice?
I did complete a residency in internal medicine before my anesthesiology residency. Once I completed my preliminary year in medicine, I realized that completing an entire residency in internal medicine would only help me in my desire to pursue anesthesiology and make me a much more competitive applicant as well as an extremely well-trained physician.
I have always been interested in anesthesiology and never imagined my route would be through internal medicine, although I would do it the same if I were to do it all over again. Internal medicine has allowed me to bring a unique skill set to the field of anesthesiology, especially with intraoperative management of issues or crises. As anesthesiologists, we are the intensivists of the operating room, as well as the PACU, so having this additional training has only helped me bring the best possible care that I can to my patients.
What first drew you to a career in medicine? If you had it to do over again, is there anything about your career path that you would change?
My path to medicine began in an interesting way. My grandfather, a Vietnam veteran, was diagnosed with prostate and colon cancer when I was in high school. I had entertained the idea of being a physician, but was still testing the waters of various careers I was interested in. I went with my grandfather to one of his clinical visits, and the surgeon asked me if I had thought about what I would like to do when I grew up. I told him I had considered medicine but was not exactly sure at that moment. He offered me the opportunity to shadow him on my grandfather’s surgery.
My grandfather was ecstatic and would not accept no for an answer from me. After completing all the appropriate paperwork and going through a quick tutorial on OR dos and don’ts, I found my way to the OR where my grandfather was scheduled to have a colectomy/prostatectomy. I was nervous and scared but filled with excitement on what I might see. Early in the operation, I noticed that I was drawn to the other side of the curtain where the anesthesiologist was taking care of my grandfather. It was as that moment, that I knew I wanted to be an anesthesiologist.
To this day, I still run into the surgeon who helped exposed me to the wonderful world of medicine. Regarding any other careers, I would consider – I cannot imagine myself doing anything else aside from anesthesia. I love the interactions I have with my patients and the acuity of the operating room. True, the training is long and intense, but it is so worth it in the end.
Is there anything you would like to add that we have not yet touched on?
I would just like to remind all physicians to “pay it forward” when it comes to medical education and education in general. At all times, there is someone watching and being mesmerized at what we do daily. Do not forget that you were once that medical, college, or high school student who had not the first clue on what to do. All of us remember that first physician who took us under their wing and guided us down the intense pathway that is medical education. And for those considering anesthesiology as a career, there is no better specialty that allows you to apply your knowledge in a “real time” setting while also being an advocate for your patient when they cannot take care of themselves.
Ty Slatton, MD, FASA, is a staff anesthesiologist at Pikeville Medical Center in Pikeville, Kentucky. He currently serves as site director/clerkship mentor for ASA’s Rural Access to Anesthesia Care Scholarship.
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