Something you will never know as an AA is this. In smaller hospitals you have to be able to do it all, independently. You might be placing an OB epidural, managing a vent in ICU, doing postop or chronic pain management or maybe a surgical airway in ER. I do many critically ill patients and am in a rural practice. I make the decision of who needs further work up, what is the best anesthetic and such. I've found that the initials after your name mean nothing at all. The point is, there is nobody backing you up. You cannot get help because, you are IT. So your premise is faulty. Doing AAAs or open hearts in a team environment is just not impressive to me.