Anesthesia Residency Call: A Day (and Night) in the Life of a G4 Resident

Success in anesthesia residency goes beyond textbooks. Residents must navigate long shifts, learn on the fly, and prepare for high-stakes exams. In this article, Dr. Andy Nguyen shares his first-hand perspective of a 24-hour call. His story highlights the realities of anesthesia residency life – patient care, teamwork, and resilience, while also showing how on-call experiences connect directly to the knowledge tested on exams. Whether you’re a prospective anesthesia resident or just beginning your training, Dr. Nguyen’s “day in the life” offers a realistic preview of residency and provides actionable tips for navigating it successfully. Continue for an insider perspective on the anesthesia residency lifestyle.

The Reality of a 24-Hour Call in Anesthesia Residency

The night before a 24-hour call always feels like the calm before the storm. I pack my go bag with the essentials: snacks, coffee, a protein shake, electrolyte drinks, and my chargers. I’ve learned the hard way that if you don’t prepare, you’ll regret it halfway through the day.

By 6:45 AM, the OR board is already stacked with add-on cases. My first assignment is a cystoscopy. Before I even finish, another one is waiting. Just as I get into a rhythm, an ovarian torsion shows up and I’m switching rooms. Not long after, an ectopic pregnancy is on the board. That’s how call goes—no matter how much you plan, the schedule has a way of turning upside down.

Understanding Anesthesia Call Structure and Resident Tiers

• G4/G3 residents (CA1–CA2): That’s where I fall. We usually handle the “bread and butter” cases: appendectomies, cystoscopies, colonoscopies, and straightforward traumas. These are the cases that keep the OR running through the night.
• G2 (late CA2/CA3): They take on more complex cases—vascular procedures, higher-risk traumas, even cardiac cases.
• G1 (CA3): They’re essentially the junior attending for the night. They triage, assign cases, run inductions and extubations, and handle codes throughout the hospital. Unless it’s a huge case like a liver transplant, they’re not tied to a single room.

We also always have two attendings on duty, and in my program, a pediatric call resident as well. It’s a system that works because everyone knows their lane—but you also lean on each other constantly.

A Day in the OR: Cases You’ll See on Call

Call is unpredictable, but there’s a rhythm to it. You’ll see plenty of straightforward procedures like cystoscopies, laparoscopic appendectomies, and orthopedic trauma cases. But then a heart transplant or an organ procurement will land on the board, and the pace shifts immediately.

The funny thing is, these same “bread and butter” cases and emergencies show up again later, on exams. That’s why I make a point to connect what I see in the OR with practice questions. I make it a priority to reinforce the clinical reasoning I’ll need on test day. For me, TrueLearn’s SmartBanks have been one of the best ways to do that. I’m able to link what I’m seeing in real time to the material I know I’ll be tested on.

Resident Survival Guide: How I Get Through a 24-Hour Call

A 24-hour call can feel relentless. If you’ve handled calls, you know exactly what I’m talking about. The board fills quickly, cases shift without warning, and breaks aren’t very frequent. What makes the difference is your preparation and pacing. Over time, I’ve built a few habits that keep me steady through the chaos. Here’s what helps me most:

• Pack smart. Snacks, hydration, coffee chargers. The list is pretty basic, but when you’ve been on your feet for 14 hours, you’ll be glad you thought ahead.
• Keep the essentials close. Emergency drugs like succinylcholine and phenylephrine stay in my pocket, along with an airway kit. Having them ready means I can move fast if an urgent situation arises.
• Take small resets. My call room has a clean bed, a fan, a humidifier, and a white-noise machine. Even a five-minute micro-break can feel a bit restful.
• Lean on the team. No anesthesia resident gets through a call alone. Attendings and co-residents cover for each other, whether that looks like flipping a trauma room or giving someone a few minutes to grab food. Those moments of support make the schedule manageable and keep the call system running. 

Balancing Residency with Exam Prep

One of the hardest parts of residency is juggling the reality of 80-hour weeks with the need to prepare for board exams. I don’t always get long study sessions, but I’ve found that even a few practice questions between cases or during downtime pays off.

Instead of overwhelming myself with a 3-4 hour study session when I’m already exhausted, I find that knocking out a quick set of questions is still really beneficial. In 10-20 minute slots, I can get detailed explanations and see how I’m tracking compared to peers across the country. It’s efficient and makes me feel like I’m still moving forward academically even when my clinical schedule is overwhelming. 

When a 24-hour call ends, I’m usually wiped out, but I also feel accomplished. It’s a very rewarding experience. I know I’m playing a necessary role on the team, no matter what tasks I have to take on. I’m learning, growing, and taking on responsibilities that matter.

If I can leave you with something, it’s this: every case will help shape you into the anesthesiologist you want to be. Every call will help build your endurance. Even the mundane, routine tasks (that might get pushed off to you as the resident) are part of a bigger picture in helping your patients. Don’t be afraid to experiment in finding the right balance for yourself with a mixture of preparation, teamwork, and smart studying. Even the toughest call days will play a vital role in moving you towards your end goal. 

Andy Nguyen, MD

CA-1 Anesthesiology Resident at Yale New Haven Health

Andy Nguyen is a current CA-1 Anesthesiology resident at Yale New Haven Health. Graduating from the Medical College of Georgia’s 7 Year Combined BS/MD track, he also used his over a decade in professional digital media experience to merge creative media with medicine by curating platforms on YouTube, Instagram, and TikTok focusing on medical education, specialty exploration and mentorship, and showcasing the unique experiences that have shaped incredible physicians at all levels of training. His professional interests are in student outreach and mentorship, simulation education, and pediatric anesthesia.