Course/Rotation Title: Anesthesiology
Date of Last Review/Update
3/07
Course/Rotation Director: David Pomerantz/Carlos Maramag
Location of clinical encounters
Inpatient % time = ____100_______________
(Check all that apply)
[ ]
Wards
[ ]
ICU
[ x]
ED
[x]
Other ( operating room)
Outpatient% time = ________0____________
(Check all that apply)
[ ]
Clinic
[ ]
Home
[ ]
Other (please specify)
Course/Rotation description with educational purpose/value
The intention of this rotation is to provide medical residents with an understanding in the
fundamental principles of anesthesiology, with emphasis on the internist’s contribution to
preoperative patient preparation. Such concepts will include but not be limited to:
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Various types of anesthesia (general, regional, monitored anesthesia care) with basic
understanding of indications and contraindications to each.
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Preoperative assessment: residents will assist with daily chart review for the following day’s cases,
focusing on appropriate work-up and optimization of comorbidities.
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Airway assessment and management
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Intraoperative and postoperative monitoring and assessment
Physiologic changes associated with anesthesia
Inter-relation between a patient’s comorbidities and the impact of anesthesia
Ventilator management
Pharmacology of drugs used in anesthesia including: opiates, sedatives, induction agents,
neuromuscular blockers and reversal agents, volatile anesthetics, catecholamines and other pressors,
antihypertensives and antiemetics
Fluid management
By the completion of the two weeks, it is our goal for medical residents to develop an
appreciation in the field of anesthesiology. Consequently, residents will be able to formulate an
effective plan pertaining to the optimal medical workup and management for patients requiring
surgery. This experience will add to the armamentarium for future general intensivists towards
more comprehensive patient care in their practices.
Types of Clinical Encounters: (PLEASE SPECIFY)
The majority of the clinical experience will involve direct patient care in the operating room
setting. Some time will also be spent on the surgical floor during postoperative rounds as well as
the preanesthesia testing office. Residents may also perform the initial assessments for
anesthesiology consultations.
Types of Patients: (PLEASE SPECIFY)
[ x]
[ x]
[ x]
[ x]
[ ]
Adults of all ages
Male
Female
Children < 18 years old
Other (please specify)
Types of Procedures: (PLEASE SPECIFY)
Airway management (Bag mask ventilation, intubation, LMA placement)
Invasive lines (peripheral IVs, arterial, central)
Describe the level of supervision by faculty
[ x]
[ x]
[ x]
[ ]
Attending staff will supervise and precept all patient care activity directly or indirectly.
Attending staff will provide mid rotation feedback
Attending staff will provide end-of-rotation feedback
Other (please specify)
Competency Based Objectives/Expectations. Please see Roman Numeral II with additional
items specific to this rotation as below
Patient Care:
The majority of this rotation involves direct patient care in the perioperative setting.
Residents will be expected to be able to formulate and discuss a basic anesthesia plan addressing
preoperative, intraoperative and postoperative components. Furthermore residents will learn to
identify and treat unanticipated perioperative issues.
Medical Knowledge:
Residents will learn to integrate anesthetic issues with their medical background.
Knowledge in numerous areas listed above will be increased through reading and direct teaching
by attendings and nurse anesthetists.
Practice-Based Learning:
The majority of teaching during the day will be through actual operative cases.
Interpersonal and Communication Skills:
Effective communication with patients is extremely important in anesthesia. Many
patients are anxious. Some are in pain or distress. Ability to give reassurance in a calming
manor while conveying important medical information is an essential skill. Effective
communication among physicians, nurses, and technicians will also be stressed during this
rotation.
Professionalism:
Professional conduct is absolutely expected throughout this rotation Residents will
assume daily anesthesia duties (approx. 7am-4pm). The only time residents will be excused will
be for conference and clinical responsibilities.
System-Based Practice:
Residents will learn to address the basic anesthetic concepts through a system based
approach.
Check Any Methods Used For Teaching and Assessment
[] Ambulatory Clinic (feedback written & verbal)
[ ] Annual In-service Exam (feedback written)
[ ] Attending Rounds (feedback written & verbal)
[ ] Board Review (feedback written examination)
[ ] Cancer Conference
[ ] Case Management Evaluation (360 degree written evaluation)
[X] Chart Stimulated Recall & Feedback (feedback verbal)
[X] Direct Observation and Feedback (feedback written & verbal)
[ ] GME Core Curriculum
[ ] Interns Report (feedback written & verbal)
[ ] Journal Club (feedback written & verbal)
[X] Medical Record Review (feedback written & verbal)
[ ] Mentor Feedback (feedback written & verbal)
[ ] Monthly End of Elective Exam (feedback written)
[] Monthly Mini CEX (feedback written & verbal)
[] Monthly Competency Based Written Evaluation
[ ] Morning Report (feedback written & verbal)
[ ] Multidisciplinary Rounds Feedback (feedback verbal)
[ ] Nursing Evaluation (360 degree written evaluation)
[ ] Patient Evaluation (360 degree written evaluation)
[ ] Patient Management Discussions (feedback written & verbal)
[X] Procedure Logs
[ ] Performance improvement Multidisciplinary Morbidity and Mortality
(feedback written & verbal)
[ ] Semi Annual Program Director Feedback (feedback written & verbal)
[X] Student Evaluation (feedback written & verbal)
[ ] Supervised Sign-In Rounds (feedback written & verbal)
[ ] Supervised Sign-Out Rounds (feedback verbal)
Other Policies
The Course Director recognizes that the trainee is accountable to all BMC Residency and
GME Personnel Policies and Procedures. The Course Director recognizes that the residents are
expected to attend all continuity clinics and mandatory educational conferences unless excused
by the Program Director or Chief Medical Resident with advanced notice.
Check The Educational Materials Used (beyond direct patient care)
[ x] Reading List (Please Specify):
Selected chapters in: Clinical Anesthesia (Lange)
Anesthesia (Miller)
Anesthesia and Co-Existing Disease (Stoelting)
Clinical Anesthesia Procedures of the Massachusetts General Hospital
[ ] Review of Appropriate Radiology Images (Please Specify):
[ ] Review of Appropriate Pathology (Please Specify):
[ x] Review of Appropriate Laboratory Data (Please Specify):
Laboratory data available through Meditech.
[ x] Articles from the Literature (Please Specify):
As appropriate to certain clinical situations
[ ] Case Studies