ANES 7185

Anesthesiology Advanced Elective

Contact

Sydney Gorski
Course Coordinator
gorsk023@umn.edu

Campus: 
Curriculum focus: 
Clinical level: 
Requirement: 
MS year: 
Hands-on: 
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Credits: 
Prerequisites: 

    Details

    Catalog Description:  

    Students will learn more advanced concepts by being exposed general anesthesiology and a combination of specialties including cardiothoracic, regional, pediatric anesthesiology, and pain medicine. The medical students will be expected to perform a preoperative evaluation and develop an initial plan prior to meeting the patient. These rotations will be in one- to two- week blocks depending on availability.

    Sample Schedule:
    East bank -general ORs -week 1
    Regional Anesthesiology East Bank – week 2&3
    Chronic Pain week 4
    The medical student will develop a greater understanding of perioperative cardiovascular physiology/hemodynamics, pulmonary physiology, and interpretation of data from multiple monitors in adult and/or pediatric patients.
    The medical student will further develop skills including mask ventilation, placing peripheral intravenous catheters, and endotracheal intubation and be exposed to advanced skills including central line, and arterial line placement (in more complex cases and in cardiac anesthesiology).
    Daily medical student-anesthesiology attending interactions include discussion of pre-operative evaluation, anesthetic plan, implications of the plan, and care of patients in the post-operative period. The student will spend most of his/her time in the operating room or in the pain clinic as part of an anesthesiology team paired with an anesthesiology resident or subspecialty anesthesiology fellow and an anesthesiology attending.
    The medical student will be assigned a mentor to assist in guiding the medical student through the four weeks of their clerkship. The medical student will spend at least one day working directly with the mentor.

    Assignment:
    Towards the beginning of the rotation, the medical student will choose an interesting anesthesia-related topic to research in-depth and present at the end of the elective to available faculty (in person or on Zoom). The presentation should be about 20 minutes in length. The medical student may choose the presentation modality. Your mentor will assist in picking a topic and develop the presentation.
    An oral exercise will be administered by your assigned mentor at the end of the rotation.
    Medical students will be expected to review basic anesthesiology topics via recorded PowerPoint lectures posted on Canvas. Advanced topic learning materials will be posted on Canvas.
    Materials for subspecialties will also be posted on Canvas. You will be responsible for reviewing those materials only if you are assigned to that particular subspecialty.

    Sites:  

    • FU:
      • East Bank Hospital - M Health Fairview UMMC Perioperative Area -3rd floor, 500 Harvard Street SE, Minneapolis, MN 55455
      • West Bank Hospital - M Health Fairview UMMC & Masonic Children’s Hospital, 2450 Riverside Ave, Minneapolis, MN 55454
      • Ambulatory Surgery Center, M Health Fairview Clinics and Surgery Center, 5th Floor 909 Fulton St. SE, Minneapolis, MN 55455
      • Ambulatory Surgery Center, M Health Fairview Clinics and Surgery Center, 14500 99th Ave N, Maple Grove, MN 55369
      • Pain Clinic, M Health Fairview Clinic and Surgery Center, 4th floor, 909 Fulton St. SE, Minneapolis, MN 55455
    • VA:Minneapolis VA Health Care System, One Veterans Drive, Minneapolis, MN 55417

    Required session attendance:

    Typical weekly schedule/Delivery Mode:  

    Grand rounds: Most Tuesday mornings from 6:30-7:30AM
    Typical OR weekly schedule: 6:00AM-3:00PM, M-F
    Another East bank OR shift from 3:00PM (or after didactics) to 11PM may be implemented
    Typical Pain Clinic schedule is from 8:00AM-4PM, M-F

    The medical student will be expected to attend CA-1 didactics and simulations that typically start at 4PM. CA-2 and CA-3 lectures are encouraged, but optional.
    On your subspecialty weeks, you will be expected to attend subspecialty didactics that may occur. For example, during your weeks of cardiac anesthesiology, you will be expected to attend the Cardiac Fellow Core Sessions and ECHO rounds.
    Cardiac Anesthesiology: Medical students will take one to two calls with a post-call day off.
    The resident/fellow lecture schedule can be found at https://www.ethernetmn.org/

    Direct patient care:  Yes

    Consent Requirement (arranged or open to student scheduling):  Arranged.  Please submit a request to schedule using the form linked below.

    ANES Arranged Electives Form

    Course Objectives:  

    By the end of this rotation, medical students will be able to: ​

    Core Anesthesiology Objectives

    1. Develop a focused​ ​preoperative evaluation, including examining the patient and development of a comprehensive plan ​​with an emphasis​ ​on addressing ​anesthetic​ concerns​.
    2. Develop a differential diagnosis for intraoperative hypotension and manage it including the use of vasoactive medications.
    3. Discuss options for intraoperative fluid management.
    4. Manage the mechanical ventilation of an adult patient.
    5. Apply the extubation criteria to an adult patient emerging from anesthesia.
    6. Have a greater appreciation for the subspecialties within anesthesiology.

    Cardiac Anesthesiology

    1. Understand the impact​ ​of​ ​various​ ​anesthetic​ ​drugs ​on​​ ​normal​ and abnormal ​physiology and physiological changes occur during cardiothoracic surgery.
    2. Discern the different phases of cardiac by-pass surgery and anesthesia implications.
    3. Have a greater appreciation for specialized monitors and type of access needed during cardiac surgery.
    4. Identify the utility of cardiac transesophageal echocardiography and basic views obtained during cardiac surgery.

    Regional Anesthesiology

    1. Recognize the indications and benefits/risks for placement of regional and neuraxial anesthesia single shots and catheter placement.
    2. Comprehend the basics of ultrasound technology.
    3. Evaluate the risks and benefits of different​ ​anesthetic​ ​management ​options.
    4. Develop basic multimodal pain regimens for the treatment of acute surgical pain.

    Pain Medicine

    1. Obtain a history and perform a physical exam that emphasizes identifying the etiology of pain conditions including chronic pain syndromes.
    2. Describe the pathways that contribute to acute and chronic pain and develop a multimodal analgesia plan for patients.
    3. Discern different medical therapies to treat common causes of pain, indications and risks and benefits.
    4. Recognize common procedures used to mitigate pain, indications, and risks/benefits.

    Pediatric Anesthesiology

    1. Develop a focused​ ​preoperative evaluation, including examining the patient and development of a comprehensive plan ​​with an emphasis​ ​on addressing ​anesthetic​ concerns​ in pediatric patients.
    2. Recognize unique considerations for induction of anesthesia, utility of patient and parental preparation, and premedication.
    3. Compare and contrast differences in airway management in pediatric patients versus adult patients
    4. Understand the impact​ ​of​ ​various​ ​anesthetic​ ​drugs ​on​​ ​normal​ and abnormal ​physiology and physiological changes occur during pediatric procedures under anesthesia.
    5. Discuss fluid management strategies in pediatric patients.
    6. Risk stratify pediatric patients with upper respiratory infections.

    Graded Components: 

    • Feedback from anesthesiology attendings who worked directly with the medical student will be the primary means (80%) of evaluating the medical student. Feedback from other members of the perioperative team including residents and fellows will be considered.
    • Ten percent of the grade will be determined by the presentation.
    • Ten percent of the grade will be determined by completion of the oral exercise at the end of the clerkship.

    Grading Scale:  H/E/S/N

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    Allow repetition of course:  Repetition not allowed

    Limited to Student Type:  No

    Course equivalency:  N/A

    Related curricular experience:

    Secure Exam:

    Course evaluation: MedHub