Episode 8: Colleen McCally D.O. Anesthesiologist; This woman will not put you to sleep!

Dr. Colleen McCally graduated from the New York College of Osteopathic Medicine in 2006 and went on to specialize in anesthesiology. She completed her residency at St. Luke’s-Roosevelt Columbia Hospital and her fellowship at the New York School of Regional Anesthesia. In addition to practicing clinical anesthesiology, she is also the assistant director of East Shore Ambulatory Surgical Center.

In this episode, we will discuss her career successes and her fulfilling work-life balance.

Transcript

Hi, my name is Tianyu She. I'm a third year medical student at the New York Institute

of Technology, and you're listening to Do or Do Not.

Welcome to our eighth episode. Today we have Dr. Colleen McAuley. Dr. McAuley graduated

from the New York Institute of Technology College of Osteopathic Medicine in 2006 and

went on to specialize in anesthesiology. She completed her residency at St. Luke's Roosevelt

Columbia Hospital and her fellowship at the New York School of Regional Anesthesia. In

addition to practicing clinical anesthesiology, she is also the assistant director of the

East Shore Ambulatory Surgical Center. In this episode, we will discuss her career

success and her fulfilling work-life balance. All right, Colleen. First of all, thank you

so much for being with us today. I know you just had a baby. That's crazy. Fun times.

So how many, again, a little personal, I'm sorry, but like how many days old is the baby?

The baby is five days old. So the baby is five, you just gave birth five days and you're

doing an interview for us. That's really cool. Very cool. I'm very excited. I appreciate

it. I appreciate it. So tell me, like, what are you doing? Like, did you get some time

off for, I know you said you wanted to go back to work, but you got some time off for

the baby. Like how much time and what are you doing? My colleague and your friend Steve

was teasing me that I can come back in two days, but I'm taking the full 12 weeks because

I've learned in life that's time you'll never get back and you could always work. And then

I had some accrued vacation time. So I added that to that. That's amazing. Right. But I

told them, if I feel good, I'll come back and do administrative stuff. And they said

to bring the baby. So it all works. That is very cool. Yeah. That's cool. You could bring

your baby to work. You can't get better than that, right? To an office. Yeah. All right.

So tell me, like, imagine this, pretend this is like a regular day. Like, I don't know,

let's make it like 12 months ago. I like before you walking around with a baby, like you're

an anesthesiologist. Tell me, and you, you know, as I understand you run a surgery center.

So tell me a little bit about where your responsibilities are, what your day might be like, what kind

of cases you would do, like that type of thing. So my responsibilities stem from a lot because

our place is very new, even though it's, this will be our third year running. So I still

probably do more than I should because everyone's still trying to get their feet wet. But from

an anesthesia standpoint, I am what we call, quote unquote, the float person. So I'm usually

out of the hour covering CRNAs, either three CRNAs to four CRNAs max. I'm sorry to interrupt,

but just for, you know, for our audience, some of them are students. So a CRNA is a

is a nurse that actually works as an anesthesiologist, but needs to be supervised. Is that right?

In New York state, the rules are different across state lines, but in New York state,

they need to be supervised by an anesthesiologist. So I'll cover them in the rooms. They start

cases with me, call me for important stuff and end cases with me if it's a general anesthetic

with a breathing tube. So what kind of cases are you supervising? What's amazing is how

things have changed. Our center for I think still to this day is one of the only free

standing centers on Long Island that does total joints, which most medical students

will learn at some point is a really big procedure. Years ago, even just in my residency 10 plus

years ago, patients would stay for four or five days in a hospital. So we do same day

total joints, which is replacing people's total hips and total knees. We do pediatrics,

healthy Peds, not under the age of two, we do tonsils and adenoids, we do ton of plastics,

but it's all breast reconstruction from breast cancer. And we do same day lap colies lap

appies on healthy patients. And then our bread and butter is all orthopedic. So anything

orthopedic. So and then we base our patients on a certain guideline, the ASA classifications,

which is classifying patients based on their comorbidities that have the ability to be

at a freestanding center. So when I say freestanding is we're not attached to a hospital. So a

lot of other hospitals on Long Island will do same day joints. But if there's a problem,

they just wheel them over to the main OR to the main hospital. But for us, we would, you

know, it'd be a whole different format. Right, right. So so your day is, is you're a flow

person, you're supervising your there's three ORs running at one time, you're supervising

all these people, that sounds stressful. And then it sounds like on top of that, you do

some administrative work also, is that right? Five beds. So even though I'm covering my

CRNAs, my colleagues, if I have other attendings in the other rooms, I see all their patients

as well. So at any point, I'm seeing five patients every five minutes at a time. Wow,

that sounds stressful and hard. But I like being super organized, so it works. And then

the administrative stuff is every patient that comes through our ASC, our Ambulatory

Surgery Center, I screen every chart. So I make sure that all the paperwork is correct,

that they have everything that they're safe to be done at the center. And then when I

have any questions, even though they've already been interviewed by a nurse practitioner in

our pre surgical testing, which is called PSTs, I still screen the charts again to make

sure everything is safe to be done in an ambulatory center. Sounds like a big job. And then I

do all the ordering. And that that stuff gets very detailed, but it's good. I like being

busy. All right. So tell me, start at the beginning, where did you go to college, Colleen?

So I actually went to Georgetown University down in Washington, DC, which became an obsession

of mine. My parents took me on a trip over Thanksgiving when I was 13 and seventh grade,

and I got to walk the campus. And that's when I said this is where I'm going. Okay, you're

smiling. So I take it that you love Georgetown, right? I mean, I, I would pray that my kids

can get in there at this point, but I had an amazing experience. And, and did you know

you want to go to medical school, like right when you got there? Or was that? I did. I'm,

I'm one of four and all my siblings have no interest in medicine. My father is a physician.

He's a urologist. He's an old school surgeon who is still practicing taking call at 74.

And when I was five years old, I have pictures in his office doing urine cultures on Petri

dishes. That's cool. That's really cool. I always knew I wanted to do medicine, but I

never put any thought into what type of medicine I wanted to do, which became a struggle when

I was a fourth year. So you told me, you know, we spoke a little bit before we interviewed

and you told me that you had applied to some Caribbean schools. Is that right? Correct.

I probably applied. I can't even remember at this point. I think I saved all my rejection

letters probably to like 15, 20 medical schools, Georgetown. I was waitlisted at, which I explained

to you. And then I, my father's generation always talks about how it was the hardest

year to get into medical school with Vietnam war. And a lot of his friends were foreign

medical grads. So the stigma for me wasn't a big deal because all my parents' friends,

most of them were foreign medical grads, learned second languages, went to Italy, Brussels,

Mexico. So I ended up applying to Grenada and I got in. I was super excited about being

in the Caribbean because I love warm weather. So funny. And then I just was holding on this

wait list forever. And then last minute nine 11 happened. My parents didn't want me leaving

the country. There were other issues going on. And my dad being in the medical field

said there's a school called Nikon on Long Island, which was literally down the street

from where I grew up. And he said, you should apply there. And I said, no, horrible right

for a podcast, but this is a true story. But I had, I wasn't educated on it. I didn't know

anything about it. But the funniest thing is, and like we discussed is it was probably

the best experience of my life. And I wouldn't be where I am had I not been there and had

those opportunities open up. And I had amazing friends and I had wonderful teachers. So you

get but you got an acceptance letter, obviously. And then you started in school and you said

you loved it, right? I mean, everything was great. Yeah, I mean, I just felt like I met

the warmest bunch of people that were all very smart, talented. And like I said to you,

everyone had a reason and a story. And I think the biggest thing with all of the people whether

I've kept in touch with and haven't kept in touch with, but most of all my friends are

very successful is everyone had a passion for what they wanted to do. Everyone wanted

to be there. It wasn't that, you know, their parents thought they should become a doctor

or so and so or they were falling into some tradition. Everyone was passionate and getting

to their end goal. And I think that made a difference in people's, you know, drive to

learn. And a lot of people that we that we met along the way, it was their second career.

So they were even more focused. Just can you tell me do you have a couple of people in

mind like I have like my anatomy group that I was really close with and I can tell you

what they did. Do you have like a group of friends? And can you just tell me what they're

doing? One person in particular, Artashir Restenahad, he was my anatomy fellow, he called

him Art. He was a brilliant guy. He would build computers on his own, like from the

bottom up. He was very tech savvy. He became an anatomy fellow. Then he got into urology,

which was very competitive. And then he basically created a program. I think it was at LIJ was

Dr. Smith, Bitlani Smith, who was a very well known urologist at the time. He did a lot

of research with him. And he ended up they ended up like creating an interventional urology

fellowship for him. He's just a brilliant, smart guy, technically, you know, great hands,

great surgeon. And now he's moved around. But I think he's at in Sinai now in the city,

you know, just a really smart guy who did really well. And he's a DO.

Awesome. So when did you decide you wanted to do anesthesia? What was so interesting

to you about anesthesia? And then tell me about your application process to anesthesia

residency.

Absolutely. So like I said earlier, I always knew I wanted to do medicine, but my parents,

nobody really focused me on what I wanted to do. So I actually ended up being a fourth

year med student, just clueless. Like I had no idea. I liked everything I like, except

for Peds and OB kind of. I liked Peds. I just didn't like the parents.

Right. That's a lot of people feel that way.

I think I even told you, I did a GI rotation at Lenox Hill with a great guy and was, I

loved procedures. I loved plastics, burn plastics at Numick, which is Nassau County, the University

County Hospital here. They had a one spot where instead of doing five years of general

surgery, you go straight into plastics. But part of me started realizing like that's one

spot. Like how being a DO, how am I going to get that? All it takes is for someone to

drop like 30 million. And I was like, I didn't think I could survive five years of general

surgery because I never wanted to be a general surgeon if I didn't get into a specific fellowship.

So my dad said, look into, of course, what you would expect for being a female and more

of a lifestyle. He said, look into anesthesia, radiology, ophthalmology.

That's called the road to success. Have you heard that? Radiology, ophthalmology, anesthesiology,

dermatology.

Right. So I ended up applying for a couple of anesthesia rotations and a bunch of the

phone calls that I got were, we don't take DOs. And I was sticking to the New York area.

I didn't apply outside of New York. And the one in particular that I told you that stood

out where I really wanted to try to do a rotation was at St. Luke's Roosevelt, which is now

Mount Sinai West in the city.

So what year, what year was that, Colleen?

So that was 2005.

Okay. And was anesthesia really competitive at that point?

Yes. I think when I applied, you know, they take 12 per year and they were saying they

had over, you know, 1400 applicants. They were interviewing like a hundred and like something

insane people for 12 spots. I said, I called to set up a rotation and the woman's first

response to secretary was like, we don't take DOs. Click. And hung up. And I was like, okay.

Now were you stressed? Were you like upset? Were you crying?

No, I'm not a crier. No, I would cry. I'm a crier. Yeah, I would cry.

It motivated me more. I was like, okay, which I thought was so funny. So 30 seconds later,

nonetheless, I call back. I don't even wait. I don't disguise my voice. I just say, Hey,

this is Colleen. I'd love to speak with your chairman.

That's amazing. And what did he say?

So I just gave myself my pitch. I said, I'm a hard worker. I said, I love your program.

I said, I, I love that, you know, you guys are at the forefront of doing regional anesthesia,

which I had read about, had some inclination of what it was. I said, I would really like

to just shadow and learn, you know, I understand you don't take DOs. And then he said, no problem.

Nice guy proceeded to put me back on the phone with his secretary and set up a rotation.

That's awesome. And then you ended up doing your residency there?

Yes. So when I was there, the resident director, who now I'm very friendly with, John Wasnick,

he point blank said to me one morning, he's like, we'll never take a DO here. And I was

like, okay. And I don't know why I was so confident.

Right. That's great though. I just, I just was like, okay. I mean, I still showed up.

So I was the pain in the ass med student. I was the first person who got there every

day and the last person who left. I learned how to do all the OR setups, like for the

first year residents, like setting up their OR. So I would set up all their ORs in the

morning. I was a little crazy, but you know, you realize you needed to stand out.

So when it came time to apply to your residency, did you know, or did you have a good feeling

that that was going to work out? So I finagled the system with, I can't remember

how many electives you could take, like one had to be surgical, one had to be whatever.

I managed to have two or three of my electives be anesthesia. And we considered one of them

like kind of a surgical. So I did a bunch of anesthesia rotations at Monte, MIMO, the

old St. Vincent's downtown and St. Luke's Roosevelt. Of those four places, St. Luke's

Roosevelt was just way ahead of the game in terms of doing nerve blocks and regional anesthesia.

So I made that my number one. And when I spent the month there, I think it was a month you

get to spend, there was a first year anesthesia resident taking all this video footage. She

was creating a little snap video to show the interviewees like a day in the life of an

anesthesia resident at St. Luke's Roosevelt. So she's taking all this video footage and

I just said to her, I'm like, who's editing all this? It's like hours of video footage,

you know? So she goes, oh, I never really thought about that. So I said, give me the

video, I'll edit it. Awesome. That's awesome. So that's kind of the

equivalent of the medical student, Tian Yu, who's helping me with this podcast. This is

like, you know, maybe a message to him, keep working with stewardship, maybe it'll turn

into something one day. Exactly.

So you get into St. Luke's, that's awesome. And you start your residency. Was there any

issue being a DO? Were there any other DOs in the program at that point? Did you feel

like different or? I was the only DO in my class, but the year

ahead of me, they ended up accepting one DO. Stacey Sierbaninski, she was one year ahead

of me. So even though the program director said they would never take one, they took

one a year ahead of me. So I was the second one in my program. But there were no issues.

I mean, like my dad would always say, once you get started, once you're a good doctor,

nobody asks you really where you went to school. I just kept kind of thinking about that. But

once you were there, it was all about doing paperwork. And my residency program director

would always say he loved having women in our program. He's like, because you guys always

turn your paperwork on time. He's like, you don't dilly dally, you pass your test, you

don't need to be reminded, blah, blah, blah. So in my residency for the 12 people, 10 of

us were women. Wow. Now, did you do fellowship after that?

So there was one spot for the fellowship offered at my program, which is why I made that my

choice. It was called NISORA, which stands for New York School of Regional Anesthesia.

And my year became extremely competitive to get that one spot. So I had my eye set on

it as a first year resident, you know, always working with the regional attendings, doing

extra work, research projects. And then my year, they had all these applicants more than

ever. And I was like, great, I'm never going to get this. And they ended up taking two

fellows that year. That's awesome. That was a great experience

too. It was amazing. I mean, the best part about it is because every fellowship in this

country for regional anesthesia is very different. A lot of programs, it's more based on teaching

you how to do blocks, because there's not a standardized program in all residencies

where you learn X amount of nerve blocks. Like in some really litiginous hospitals,

they don't want nerve blocks because of other medical issues, things that medical students

will learn about compartment syndrome, lawsuits, et cetera, nerve injuries, which is all not

an issue if you're a well-trained regional anesthesiologist. But my program was like,

if you come to our program, it's not about learning how to do nerve blocks. We expect

you know how to do them already. It's more about doing research and teaching. So that

one year in my fellowship, we went to India, the Philippines, Rome, everywhere, you know,

that's cool, to teach other doctors in residence, which was amazing. So some personal questions

like, do you mind telling us like when you met your husband or, you know, kind of when

you got married and started having kids and how this all fit in with this amazing career

plan that you had? Absolutely. So I always say I was lucky enough to meet my husband

because I was so busy and so dedicated. So when I was at St. Luke's Roosevelt as a med

student, I met him out through a friend. And I remember telling him in an organized way,

like, hey, I get to work at like 545-56. I don't leave till nine, like trying to give

him times. And he took it as like, this girl's blowing me off. But I was telling him like,

these are my windows of like available time to go out to dinner or something. So I taught

him my fourth year of med school. And by the time I took my step three, he sent me flowers.

And he's like, he goes, thank God there's no more boards. Oh, that's so funny. And he's

not a doctor. I take it. What does he do? He's a chef and a restaurant owner. And I

think our first Valentine's day together, we made, I made him a t-shirt that said he

wears a white cap. I wear a white cap. He wears clogs. I wear clogs. He holds a knife.

I hold a scalpel. He calls himself a chef. I call myself a doctor. That's so funny. But

I don't think we ever wore it out. People always ask about work-life balance. And you

talked about that a little bit in your choice of specialty. I know you told me you were

thinking about GI at one point. You mentioned that also and decided maybe that wasn't for

you because you wanted some work-life balance. Number one, do you feel like that influenced

your decision? Number two, do you feel like you made the right decision? And how hard

is it to have a family and be a physician? I think the big thing was number one, and

my advice always when I talk to people is pick something that you like and you're passionate

about and then make it work into your lifestyle or your career. I think the problem with some

medical students and residents that I see along the way is they want to start off with

the lifestyle as a resident. And to me, that doesn't work. I love that my residency program,

that my chairman was so hardcore. He would not hire nurse anesthetist, which we explained

our trained nurses that can administer anesthesia in our residency program. So a lot of other

programs would have residents get relieved at three in the afternoon by nurse anesthetist

to go do studying paperwork, go to the library. But a lot of them wouldn't do that. They'd

just go home, work out and not do work. I love that my program was so intense. My feeling

was I wanted to learn as much in my three to four years, work as hard as I could, even

if it was 120 hours a week, so that I felt comfortable when I came out. But I realized

that in anesthesia, you do have the ability and like some other fields, ER, to manipulate

your hours. With that said, there's a sacrifice in pay, which I was okay with. My one teacher

always taught me in my fellowship, if you're not happy on a hundred thousand dollars, you'll

never be happy. Right. I think that's good advice. Yeah. And I really just felt like

I put the time in. I explained to you that I saw the big picture and did a fellowship

that nurse anesthetists are not trained in. So it separated me from them. And ironically,

with the way healthcare is changing, regional anesthesia is really sought after because

it provides patients sometimes with 24 hours of pain free. So they're able to go home with

insurance companies or sending patients home sooner and sooner. So I really built a niche

for myself. So after I think 10 years of taking call and 24 hours and three weekends, you

know, a month of working, I finally asked for a new position at my old job and said,

I don't want to take call and this is what I want to make. And this is the hours I want

to have. And it worked out. I think you realize, and what I said is you can't be the best researcher,

the best anesthesiologist, the best mother. You can't have it all. You just need to figure

out where you're willing to compromise, but you can't expect going in to start at that

point. You know, I think the big thing is you need to build your foundation first till

you get to your end point or your, as I say, your big picture. I think that's great advice

for everybody listening, whether it's a medical student or a resident, you know, all the way

through. Can you think of any piece of advice that you got, whether it was in college or

medical school or doing residency fellowship, just general advice that you feel has really

helped you that you would pass on to people listening to the podcast?

I think it's twofold. We spoke about the one thing when I was in high school, a teacher

explained looking at the big picture and not being so, you know, pigeonhole looking, you

know, directly what you want now, but what you want 10 years from now was huge for me,

which I think led me to getting a career and a specialty that really allowed me years down

the line to not have all the hours and loads of work. And the other advice is really do

something that you love and you're passionate about because, you know, at the end of the

day, it's really most people, you're not going into medicine for money. You do need a bottom

line to pay back loans and to be practical, but at the same time, I love what I do, which

is probably why having a one week old baby, I could see myself going back to work just

for two hours a day just to help out and keep things moving. I think finding something that

you really enjoy and being able to look a few steps ahead is what I would say.

That's great. Now, did you take loans for school?

I did. Everyone's born into different situations. I was fortunate enough that my parents paid

for college and I didn't have to have that burden. My parents did tell me though I would

be responsible for my next level of education. So I had loans. I think my husband reminded

me, I graduated with 200 plus. My parents made me live at home. They're like, we're

not paying for an apartment and I didn't want to take out a loan. And my advice is any help

you can get, you know, as much as it's nice leaving college and to continue living on

your own, you could suck it up and live at home or live on someone's couch or live on

someone's roof top. Minimize your debt, right? Because you got to pay for it later. And was

your husband like, was he a little freaked out when he's like, he's like, I love this

girl. She's great. She made me a t-shirt, but now I'm coming into, I'm getting married

to $200,000 worth of debt. He was my sugar daddy for a long time. So yeah, he always

makes jokes about how much debt I have. But you know, like you say, it's one of those

things. You pay over time, you get low interest. If you pay a certain amount on time, your

interest, you know, it decreases your payments even a little bit more. But yeah, it's, it's

terrible how much, and I think it limits the amount of people who sometimes apply because

it is so overwhelming to think about taking out that kind of money.

So a couple of general anesthesia questions. And again, you know, of course, you know,

I'm a gastroenterologist, so I work with anesthesiologists a lot. You know, my first question is I've

heard anesthesia is 99% boredom and 1% oh my God, like stress. Do you think that describes

anesthesia as a specialty? Is that something that, that makes you want to do it? Is there's

a lot of stress when things aren't going perfectly right? Is that true?

Absolutely. I mean, sometimes I think we're not paid enough for what we do, you know,

stopping people's breathing and hoping you can place a tube at points. But I actually,

I don't really even see it as that. I guess, sure, if things are going well, the exciting

parts are the beginning and the end. But you know, the patients that I'm taking care of,

I remind the residents and the nurse anesthetist, sometimes the sedation cases are the hardest

cases because you're finagling someone who does not have a sustained airway. They're

breathing on their own. You're trying to make them comfortable enough that they don't move,

but not too much where they don't breathe. So I always say those are the most dangerous

cases because then in the middle of it, they just decide to vomit. So, you know, I think,

I think it can be described like that, but I just don't see my day like that.

Okay. All right. That's good. That's a misconception on my part. And my, another question, it's

interesting to me as far as how students pick their specialties. I feel like for GI, for

example, for a while it was very non-competitive and then it became very competitive. And you

know, I think all things kind of cycle. I feel like anesthesiology has been like that.

I know when I was in medical school, it wasn't competitive. And then about the time that

you applied, it was very competitive and maybe a little less so now. Do you have any advice

on students as far as, and I know you mentioned, you know, pick something you love, but the

competitiveness coming out of a DO school as far as fellowship.

I mean, the way I look at it is it's like Harvard. My dad used to say, you don't want

to go there. He's like, you won't fit in there. He's like, you're not at that level. Like

for me, I don't think it would have been realistic being a DO to say, Hey, I want to do dermatology.

Like I just don't think, though there were, you know, two kids from my class, but they

were just functioning at another level of like research and you know, scores that I

just wasn't going to get. So I think you have to be realistic with yourself. But the way

I saw it when I finally started realizing what I wanted to do is, do you like doing

certain procedures or do you like doing lots of medical management? And I love medicine

because I love the storytelling of someone's medical history and problem solving and, you

know, trying to figure out what's wrong. But I realized that I loved a little bit hands

on and I get that in anesthesia doing the nerve blocks procedures that we get to do,

but it's not obviously as involved as being a surgeon. So I think you also have to be

realistic about what's going on at your time and what's competitive, you know, cause you

also don't want to set yourself up for complete failure.

If you could go back in time, like obviously, you know, your, your dad is an MD applied

to Granada. You're all ready to go in this nine 11 thing happened and you kind of ended

up at NICOM to stay in the U S would you change anything? Do you think anything would have

been different if you'd gone to an ME school?

I mean, I wonder what would have happened, but I would never change anything for the

way things ended up. I mean, the experience I had in medical school was great. The people

I met, I loved my residency program. They used to make fun of my class in particular.

They're like, you guys are just too nice to each other. So if I was a first year and on

call, I would set up all my friends ours, which was the rest of my class, their hours

in the morning to give them like an extra 15 minutes to either sleep in, have a cup

of coffee or eat breakfast before they saw their patient. I just, I think I just really

lucked out with being around nice people who really wanted to learn. So I don't, I don't

think I would have changed it. I mean, the fact that I don't think I would have ever

gotten the fellowship or my residency had I not made that video, the video I ended up

editing, of course had my name edited by medical student Colleen Colley. And it was shown at

grand rounds to everyone. So I don't, you know, I, I wouldn't change it. I loved my,

my program and my experience at Nikon. That's great. All right, Colleen, I think that's

all I have be today. Awesome. Yeah. Thank you so much. Chatting with me. This concludes

our episode of do or do not send all inquiries, comments, suggestions, and even let us know

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