Name: 8 個麻醉亞專科詳解 💉 您是否應該專攻？ (8 Anesthesia Subspecialties Explained 💉 Should You Specialize?)
Uploaded: 2025-09-27T18:10:09.000Z
Duration: 13 min 31 s

There's a lot more to anesthesia than putting people to sleep and waking them up.

麻醉的作用遠不止讓人入睡和醒來。

Let's explore the fellowship options for anesthesiologists, including when additional training is required.

讓我們來探討一下麻醉醫師的研究金選擇，包括何時需要額外培訓。

Because after 4 years of medical school, an intern year, and 3 years of specialized anesthesia training in residency, adding yet another year or two to your education can feel daunting.

因為在經歷了 4 年的醫學院學習、一年的實習和 3 年的住院醫師專業麻醉培訓後，再增加一兩年的教育可能會讓人感到畏懼。

Let's start with the benefits and drawbacks of additional training for an anesthesiologist.

讓我們先來看看麻醉醫師接受額外培訓的好處和壞處。

General anesthesiologists are already in high demand throughout the country, so you won't struggle to find work if you choose not to do a fellowship.

全科麻醉師在全國範圍內的需求量已經很高，是以如果您選擇不參加研究金計劃，也不會很難找到工作。

If you want, you can finish residency and go straight into the OR, where you'll earn an average salary of over $490,000 and enjoy a solid work-life balance.

如果你願意，可以在完成住院醫師培訓後直接進入手術室工作，在那裡，你將獲得超過 49 萬美元的平均工資，並享受穩固的工作與生活平衡。

But for some, subspecialization opens doors to academic careers, even higher pay, niche practice settings, or simply the kind of clinical work they love most.

但對有些人來說，亞專業為他們打開了通往學術生涯、更高薪酬、特殊執業環境的大門，或者僅僅是他們最熱愛的臨床工作。

Consider pursuing an anesthesia fellowship if you want to deepen your expertise, feel like you need more structured training before practicing independently, want to open doors at big-name academic hospitals, want to boost your income potential, want more predictable hours, or you want to tailor your work to only the niche cases you enjoy most.

如果您想加深自己的專業知識，覺得自己在獨立執業前需要更有條理的培訓，想在大牌學術醫院打開一扇門，想提高收入潛力，想要更多可預測的工作時間，或者您想只針對自己最喜歡的特殊病例開展工作，請考慮攻讀麻醉研究員學位。

Doing a fellowship also means yet another year of training, another year not making a full attending salary, potentially moving for at least one year for fellowship training, which can be a deal-breaker if you have kids, and in some cases, not much of a bump in salary compared to the opportunity cost of more training.

獲得研究金也意味著又一年的培訓，又一年不能拿全職主治醫生的薪水，可能至少要搬家一年才能獲得研究金培訓，如果你有孩子的話，這可能會讓你望而卻步，而且在某些情況下，與更多培訓的機會成本相比，薪水的提升並不多。

So what are the subspecialty options for anesthesiology?

那麼，麻醉學有哪些亞專科選擇？

Join me as we dig into 8 exciting anesthesiology career paths.

和我一起探討 8 條令人興奮的麻醉學職業道路。

First up is adult cardiothoracic anesthesiology.

This fellowship puts you at the center of high-stakes cardiac surgeries, which often have the highest risks and rewards.

該研究金使您成為高風險心臟手術的中心，而這些手術往往具有最高的風險和回報。

You'll master transesophageal echocardiography and become the go-to expert for unstable patients on cardiac bypass.

您將掌握經食道超聲心動圖，併成為治療心臟搭橋術中病情不穩定患者的專家。

Transesophageal echocardiography, or TEE, is an ultrasound of the heart.

經食道超聲心動圖或 TEE 是一種心臟超聲檢查。

But instead of placing the ultrasound probe directly on the patient's chest, the probe is carefully navigated into the patient's esophagus, providing a more detailed view of the heart while the surgeon is operating.

但超聲探頭不是直接放在病人的胸部，而是小心翼翼地進入病人的食道，在外科醫生進行手術時提供更詳細的心臟視圖。

This procedure is especially important in valve replacements or bypass surgeries, and mastering TEE is a big part of the fellowship.

這種手術在瓣膜置換或旁路手術中尤為重要，掌握 TEE 是研究金的重要組成部分。

It's one of the key tools that make you essential in the OR for complex heart surgeries.

它是手術室中進行復雜心臟手術必不可少的重要工具之一。

This fellowship is most commonly a one-year ACGME-accredited program, and it's especially valuable if you want to work at a major academic center or national heart hospital where the sickest patients go.

這種獎學金通常是為期一年的 ACGME 認證項目，如果您想在主要的學術中心或國家心臟病醫院工作，那麼這種獎學金尤其有價值，因為那裡的病人病情最嚴重。

The pay is higher than in general anesthesiology, but expect longer hours and more high-intensity cases.

薪酬高於普通麻醉科，但工作時間更長，高強度病例更多。

Most anesthesia fellowship programs are ACGME-accredited, which means they're officially recognized, standardized, and lead to board certification.

大多數麻醉研究金項目都通過了 ACGME 認證，這意味著它們得到了官方認可、標準化，並可獲得委員會認證。

However, some anesthesia fellowships aren't ACGME-accredited, which means that although you get the extra training and master key skills, they don't offer board eligibility, and you might not be as readily accepted if you move to a different hospital.

不過，有些麻醉研究員職位並沒有通過 ACGME 認證，這意味著雖然您可以獲得額外的培訓並掌握關鍵技能，但這些職位並不提供董事會資格，而且如果您換一家醫院，也可能不那麼容易被接受。

If you're looking for structured training with formal certification, ACGME is the better option, though they tend to be more competitive to match into.

如果您想接受有正規認證的結構化培訓，ACGME 是更好的選擇，不過它們的競爭往往更激烈。

Next is pain medicine, which is the most popular anesthesiology fellowship, and for good reason.

其次是疼痛醫學，它是最受歡迎的麻醉學獎學金，這是有道理的。

A pain medicine fellowship-trained anesthesiologist often trades the OR for the clinic.

受過疼痛醫學研究培訓的麻醉師通常會把手術室換成診所。

Their day involves treating patients with chronic pain by performing image-guided procedures like epidural steroid injection, nerve blocks, and spinal cord stimulators.

他們每天都要在影像引導下對慢性疼痛患者進行治療，如硬膜外類固醇注射、神經阻滯和脊髓刺激器。

One of the most common procedures is a single-injection lumbar epidural steroid injection.

最常見的手術之一是腰部硬膜外類固醇單次注射。

Under fluoroscopy, a needle is guided into the epidural space near a compressed nerve root, and steroid medication is injected to reduce inflammation and pain.

在熒光透視下，一根針被引導進入受壓神經根附近的硬膜外腔，注射類固醇藥物以減輕發炎和疼痛。

These steroid injections can delay or prevent spine surgery for some patients, making them an important step for those with chronic back pain.

這些類固醇注射可以延緩或避免某些患者接受脊柱手術，是以對慢性背痛患者來說是非常重要的一步。

Pain medicine is precise, outpatient-heavy, and procedural, and the lifestyle is great.

疼痛科醫療精準、門診量大、程序化程度高，生活方式也很好。

Many pain specialists work four-day clinic weeks with minimal to no call.

許多疼痛科專家每週出診四天，很少甚至不出診。

As it tends to be more procedure-based than other fellowships, it's one of the most lucrative subspecialties in medicine.

與其他研究金相比，它更傾向於以手術為基礎，是以是醫學界最賺錢的亞專科之一。

Many graduates end up in private practice with higher autonomy and income than those in OR-based anesthesiology.

與在手術室工作的麻醉學專業畢業生相比，許多畢業生最終選擇了私人執業，擁有更高的自主權和收入。

The tradeoff is less acute care, less OR time, and more clinic-based work.

這樣做的代價是急症護理減少，手術室時間減少，診所工作增加。

For some anesthesiologists, these are deal breakers.

對於一些麻醉師來說，這些都是致命的弱點。

But if you want a lifestyle-oriented and procedure-heavy specialty with strong earning potential, pain medicine is hard to beat.

但是，如果你想擁有一個以生活方式為導向、程序繁多、收入潛力巨大的專科，疼痛科是很難超越的。

Next up is pediatric anesthesiology, which prepares you for everything from neonates in the NICU to teenagers needing routine tonsillectomy surgery.

接下來是兒科麻醉學，從新生兒重症監護室的新生兒到需要進行常規扁桃體切除手術的青少年，你都要做好準備。

By the way, whenever you see the suffix "-ectomy," know that it means the surgical removal of that organ or tissue.

順便說一下，只要看到後綴"-ectomy"，就知道這意味著通過手術切除該器官或組織。

The physiology of pediatric patients is different.

The dosing is different, and the emotional stakes are most definitely different.

劑量不同，情感上的利害關係也絕對不同。

Children have higher metabolic rates and smaller blood volumes, so even a minor loss of fluid during surgery is dangerous.

兒童的新陳代謝率較高，血容量較小，是以在手術過程中即使有輕微的液體流失也是很危險的。

And anesthesia drug dosing becomes all weight-based, meaning tiny errors matter more.

麻醉藥物的劑量完全以體重為基礎，這意味著微小的誤差也會變得更加重要。

Even basic procedures, such as intubation or IV placement, become more challenging due to narrower airways and smaller blood vessels.

由於氣道變窄、血管變小，即使是插管或靜脈注射等基本程序也變得更具挑戰性。

This fellowship is all about high precision and high empathy, creating constant demand at top children's hospitals.

該研究金的特點是高精度和高同理心，這也是頂級兒童醫院的持續需求。

That said, the pay may be slightly less than general anesthesia, as most pediatric procedures are reimbursed at a lower rate since they are assigned fewer relative value units, or RVUs.

儘管如此，由於大多數兒科手術的相對價值組織、部門（RVUs）較少，是以報帳比例較低，是以兒科手術的費用可能略低於全身麻醉。

對醫生的薪酬方式感到好奇嗎？

Watch our video on the RVU payment system linked in the description.

觀看描述中鏈接的有關 RVU 支付系統的視頻。

Next up is critical care medicine, which involves managing ventilators, titrating pressors, and leading multidisciplinary teams within the ICU.

接下來是重症監護醫學，包括管理呼吸機、滴定加壓藥以及上司重症監護病房內的多學科團隊。

You'll learn procedures like bronchoscopy, chest tube placement, and advanced line placements.

您將學習支氣管鏡檢查、胸導管置入和高級管路置入等程序。

It's a one-year fellowship, and the demand is high, especially because intensivists are always needed to help run ICUs.

這是一項為期一年的獎學金，需求量很大，尤其是因為重症監護室總是需要重症監護醫生來幫助管理。

Also, as an anesthesiologist, you'll already be an expert on resuscitation and life-saving measures compared to the other specialists applying to critical care fellowship programs.

此外，作為一名麻醉師，與其他申請重症監護獎學金項目的專家相比，您已經是復甦和救生措施方面的專家。

This often means more fellowship interviews and better control over where you end up.

這通常意味著更多的面試機會和更好地控制你的最終去向。

另一個好處是工作與生活的平衡。

There are plenty of jobs where you are scheduled for one week in the ICU, one week in the OR, and then one week off.

有很多工作安排你在重症監護室工作一週，在手術室工作一週，然後休息一週。

This fellowship is also one of the few ways an anesthesiologist can branch back into inpatient medicine if you're looking for a balance between OR and inpatient.

如果您希望在手術室和住院病人之間取得平衡，該獎學金也是麻醉醫師重返住院醫療領域的少數途徑之一。

But since not many anesthesiologists are interested in shifting back towards inpatient medicine, critical care tends to be one of the less competitive fellowships.

但由於沒有多少麻醉科醫生有興趣轉回住院醫療領域，重症監護往往是競爭較小的研究獎學金之一。

And then we have obstetric anesthesiology.

From epidurals to emergency C-sections, OB anesthesiologists are vital physicians on the labor and delivery floor, where the pace can instantly swing from slow to chaos.

從硬膜外麻醉到緊急剖腹產，產科麻醉師都是產房的重要醫生，他們的工作節奏可以瞬間從緩慢變得混亂。

One moment, you're placing an epidural catheter, which involves finding the correct lumbar space, carefully threading in a catheter, and delivering continuous local anesthetic to alleviate the tremendous pain of childbirth.

前一刻，您正在置入硬膜外導管，這需要找到正確的腰椎間隙，小心地穿入導管，並持續注入局部麻醉劑，以減輕分娩時的巨大疼痛。

This high-precision catheter helps a laboring mother stay awake, pain-free, and in control, ultimately allowing them to enjoy the precious first moments with their newborn.

這種高精度導管可幫助產婦保持清醒、無痛並掌控分娩，最終讓她們享受與新生兒在一起的珍貴時刻。

But minutes later, you might be rushing to the OR for an emergency C-section, where you will be expected to make decisions that impact both maternal and fetal safety.

但幾分鐘後，你可能要趕往手術室進行緊急剖腹產，在那裡你需要做出影響產婦和胎兒安全的決定。

This fellowship focuses on managing pain during childbirth, maternal comorbidities, and rare but life-threatening emergencies like amniotic fluid embolism.

該研究金側重於處理分娩疼痛、產婦合併症以及羊水栓塞等罕見但危及生命的緊急情況。

It's a niche field, and many general anesthesiologists already do OB without a fellowship.

這是一個利基領域，許多普通麻醉科醫生已經在做產科手術，而不需要研究金。

That said, fellowship makes you the go-to expert in managing complex maternal cases, and at some smaller hospitals, they will schedule their planned C-sections based on your availability.

在一些規模較小的醫院，他們會根據你的時間安排計劃中的剖腹產手術。

Hospitals with high-risk obstetrics often prefer fellowship-trained anesthesiologists, and the extra training comes with a pay bump.

擁有高風險產科的醫院通常更青睞接受過研究員培訓的麻醉師，而額外的培訓也會帶來薪酬的提升。

Plus, compared to general anesthesia, you can expect more predictable hours with fewer overnight surgeries than other fellowships.

此外，與全身麻醉相比，您可以期待更多可預測的工作時間，而且與其他研究金相比，通宵手術更少。

But the emotional pressure is real, as there are two lives on the table.

但情感壓力是真實的，因為有兩條人命擺在桌面上。

Next up is regional anesthesiology and acute pain medicine, which focuses on nerve blocks and catheter placements for postoperative pain control, everything from single-shot femoral blocks to continuous paravertebral catheters.

接下來是區域麻醉和急性疼痛醫學，主要是神經阻滯和導管置入術後疼痛控制，從單次股骨阻滯到連續椎旁導管，無所不包。

Imagine a patient who just had 5 rib fractures from a motorcycle crash.

試想一下，一名患者因摩托車撞車導致 5 根肋骨骨折。

Oral meds aren't enough, and systemic opioids are too risky for the patient's already strained breathing.

口服藥物是不夠的，而全身用阿片類藥物對病人本已緊張的呼吸來說風險太大。

This is where a regional anesthesiologist comes to the rescue.

這時候，區域麻醉師就會出手相救。

In this situation, they can place a continuous paravertebral catheter, a nerve catheter that's inserted along the spine to deliver local anesthetic near the intercostal nerves.

在這種情況下，他們可以放置連續椎旁導管，即沿著脊柱插入的神經導管，在肋間神經附近注射局部麻醉劑。

It can continuously numb that specific region of the body for days, reduce overall opioid use, and help the patient breathe easier and recover faster.

它可以連續數天麻痺身體的特定區域，減少阿片類藥物的總體用量，幫助病人呼吸順暢，更快康復。

It's an extremely hands-on fellowship, and graduates are constantly in demand at ortho-heavy hospitals and surgical centers.

這是一項實踐性極強的獎學金，骨科重症醫院和手術中心對畢業生的需求量很大。

You'll also gain skills in acute pain consults, multimodal analgesia, and opioid sparing protocols.

您還將獲得急性疼痛會診、多模式鎮痛和阿片類藥物稀釋方案方面的技能。

This fellowship makes you an expert in perioperative pain management without the grind of a chronic pain clinic.

該研究金使您成為圍手術期疼痛管理方面的專家，而無需在慢性疼痛診所受苦受累。

While not currently an official ACGME-accredited fellowship, several established programs offer it.

雖然目前還不是 ACGME 正式認可的研究金，但有幾個成熟的項目提供這種研究金。

Neuroanesthesiologists specialize in brain and spine surgery cases.

神經麻醉師專門從事腦部和脊柱手術。

Think craniotomies, spinal fusions, and aneurysm clippings.

想想開顱手術、脊柱融合術和動脈瘤剪切術。

The most exciting surgeries are awake craniotomies.

最令人興奮的手術是清醒開顱手術。

In these surgeries, anesthesia is titrated carefully so the patient can move limbs, answer trivia questions, and even play a guitar while the surgeon removes a brain tumor.

在這些手術中，麻醉劑量會被仔細控制，以便病人在外科醫生切除腦瘤時可以活動四肢、回答瑣事問題，甚至彈奏吉他。

This may sound like science fiction, but the example of someone playing a guitar during awake craniotomy surgery is absolutely real.

這聽起來像是科幻小說，但有人在清醒的開顱手術中彈吉他的例子卻絕對真實。

The successful procedure was performed by neurosurgeon Dr. Sujith Prabhu.

手術由神經外科醫生 Sujith Prabhu 博士成功完成。

The musical performer and brain tumor survivor was Robert Alvarez.

音樂表演者和腦瘤倖存者是羅伯特-阿爾瓦雷斯。

Neuroanesthesiologists ensure that patients undergoing these procedures feel no pain.

神經麻醉師確保接受這些手術的病人不會感到疼痛。

Having the patient awake and talking helps the surgeon avoid damaging vital brain regions like speech or motor control.

讓病人保持清醒並說話，有助於外科醫生避免損傷重要的大腦區域，如語言或運動控制區域。

It's a delicate balance of sedation, airway management, and pain control.

這是鎮靜、氣道管理和疼痛控制之間的微妙平衡。

You'll master neurophysiological monitoring, cerebral perfusion strategies, and tight hemodynamic control.

您將掌握神經電生理監測、腦灌注策略和嚴格的血液動力學控制。

Fellowships are usually one year and often based at academic centers.

獎學金通常為期一年，通常設在學術中心。

While you can do neuro cases as a generalist, this additional training helps you build a focused niche and gets you into the bigger, more difficult neurosurgery cases.

雖然您可以作為全科醫生處理神經病例，但這些額外的培訓可以幫助您建立一個專注的專業領域，讓您能夠處理更大、更困難的神經外科病例。

And last but not least, transplant anesthesiology.

These specialists are called in for some of the most complex high-stake surgeries like liver, kidney, heart, and lung transplants.

肝臟、腎臟、心臟和肺部移植等最複雜的高風險手術都需要這些專家的參與。

This non-ACGME fellowship is focused on high acuity and deeply procedural anesthesia.

這一非 ACCGME 獎學金側重於高危和深度程序麻醉。

A day as a transplant anesthesiologist could begin at 2am, when a donor organ suddenly becomes available.

作為一名移植麻醉師，一天的工作可能從凌晨 2 點開始，因為這時會突然出現一個器官捐獻者。

You arrive at the OR with short notice, where you immediately begin managing massive fluid shifts, blood products, coagulopathies, and sometimes cardiac bypass.

你在短時間內到達手術室，立即開始處理大量液體轉移、血液製品、凝血病，有時還要進行心臟搭橋。