title: The new generation of graduating anesthesia residents: what is the impact on a major tertiary referral private practice medical center?
abstract: OBJECTIVE
  The new graduate entering the private practice arena faces many challenges. Expectations regarding both the professional environment and personal lifestyle have changed from previous generations, and these are reviewed and discussed. The challenges for both professional and personal development and the responsibilities of the new graduate to continue to learn and stay on top of the specialty are enormous.
  
  
  RESULTS
  The best graduates add to the reputation and performance of a department. Marginal graduates have a much tougher experience; their career in a tertiary care, level 1 trauma center environment is unlikely to be sustainable. The motivation and expectations of the new graduates, as they relate to lifestyle, schedules, and reimbursement, have changed. The expectations of the practice, the institution, the payers, and the public have also changed and are increasingly focused on performance, efficiency, and safety.
  
  
  CONCLUSIONS
  Anesthesiology continues to attract some of our best physicians, and this is vital for the survival of anesthesiology as a medical specialty. The new generation challenges us to make the necessary changes in practice pattern and lifestyle to sustain this goal. The new generation is also challenged by an environment of performance-based expectations.
authors.affiliation: Department of Anesthesiology & Pain Management, Baylor University Medical Center, Dallas, Texas 75246, USA. docram@baylorhealth.edu
authors.forename: Michael
authors.initials: M
authors.lastname: Ramsay
mesh_terms: D000776:Anesthesiology; D006801:Humans; D016901:Intergenerational Relations; D007396:Internship and Residency; D011157:Population Dynamics; D011331:Private Practice; D012017:Referral and Consultation