In anesthesia school they almost always teach you with the MAC starting out. After my first three months in I switched to the Miller and have never looked back. I personally feel like it takes much less lifting and straining, which I see a lot of Doc's and CRNA's doing with the MAC blade. There are only three instances where I use a MAC blade and they are as follows: 1. Double lumen tube insertion, 2. Blood in the airway, 3. Large tongues that I feel will slip off the that little straight blade. Securing an airway should never look like a struggle. It should be SMOOTH, quick and with confidence. After a few hundred you will get to this point. Now I'm not saying I don't have difficult airways come into my operating room but if I can't get it with my trusty Miller I sure as heck don't go to the MAC, I go straight fiberoptic.