Anesthesiology, Perioperative and Pain Medicine

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Q&A with Stanford Anesthesia's Residency Director

February 2009

Faculty Teaching Scholars

Question
Now that I have completed the entire interview process and have been able to evaluate the programs I visited, I am making my final rank order of programs. Can you tell me more about the Teaching Scholars Program that you mentioned in your morning talk?

Answer
Many medical students tell me thay are a bit stressed out in February as they must submit final rank order lists to NRMP by February 25th. Once applicants are comfortable that the clinical training at a particular residency program is what they are looking for, they often then prioritize different factors (geography, family, fellowship availability, cost of living, etc) not directly connected to the education of residency. Often these are quite important in where medical students end up on Match Day. The old advice of rank em in the order you want to be there still holds true!

In terms of the Faculty Teaching Scholars thank you for asking. Many of our residents aspire to an academic career in large part because they enjoy teaching, and they can get involved in the project the faculty member is working on. The background for the Teaching Scholars Program is outlined in the article: Macario A, Edler A, Pearl R. Training attendings to be expert teachers: the Stanford Anesthesia Teaching Scholars program. J Clin Anesth. 2008;20(3):241-2
full article: Download file

Keep in mind that faculty members want to achieve the same high level of expertise (in education) as that expected of research faculty (in clinical or laboratory investigation). But often times teaching faculty have not had formal training in being a good teacher. Expanding and refining the teaching toolbox of faculty is needed as graduate medical education in anesthesia evolves. To help meet this challenge the Dept. of Anesthesia at Stanford supports the Teaching Scholars Program to further train and empower faculty to improve residency education.

This one-year faculty career development award provides recognition and funding and non-clinical time for the Teaching Scholar to attend the Dr. Kelley Skeff medical education seminars at Stanford (http://www.stanford.edu/group/SFDP/), as well as another off-site education related meeting. Previous Teaching Scholars have participated in the Society for Education in Anesthesia Meetings and the ACGME Annual Educational Conference. For 2007-2008 the Faculty Teaching Scholars (projects) were:

  • Dr. Collins---"Construct a summative performance assessment tool for the difficult airway management rotation"
  • Dr. Chen---"High-fidelity simulation to improve intra-op anesthesia teaching during pediatric rotation"
  • Dr. Ramamoorthy---"Teaching the ACGME core competency curriculum in the OR"
  • Dr. Adriano---"A feedback system for first year residents during their month long Orientation"
  • Dr. Harrison---"An instructional program (including assessment) for ultrasound guided regional anesthesia"
  • Dr. Oakes---"An instructional program (including assessment) for TEE"

    One way we evaluate the Teaching Scholars program effectiveness is to look at the educational improvements (e.g., active learning techniques) that have been implemented by program graduates.


    For 2009 the Teaching Scholars are: Download file


    thank you,

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  • Away rotations

    Applicant question
    What is your advice on away rotations? Some people have told me it helps you get into a program and other people think it doesn't!

    Answer
    This question arises every year. The best reason I believe to do an away rotation is if you have identified a program you would like to train at and would like an in-depth experience there before you make a 3 or 4 yr commitment. Planning an away rotation can be a lot of logistical work. An away clerkship also takes time away from other medical school activities or rotations you could be doing. The biggest advantage is that an away rotation does provide a more realistic snapshot of your future life as a resident in that program, both in and out of the work culture. For example, you can assess first hand the location of the hospital, the quality of the physical plant, the didactic program, faculty-resident interaction, workload, resident happiness and your compatibility with the existing housestaff. In addition, you can evaluate close-up important markers such as available housing options in different parts of town, cost-of-living, what there is to do in surrounding areas, and the potential commute, among other things.

    Many visiting students sign up for a Stanford clerkship as a way to have the program get to know them better, and to raise their profile during the selection process. There is no doubt that we take the evaluations of visiting students seriously. We even have a special form for the faculty and the residents to fill out assessing these potential future residents. Getting to know the person up close for 2 weeks or a month provides much more detail about the candidate's personality and abilities.

    At the end of the interview day the selection committee reads these evaluations in detail, and incorporates that information in the final overall rating given to an applicant. We typically see several scenarios. Sometimes the medical student has performed average in medical school and then is a star as a visiting medical student. While this can certainly boost their chances, it leads to such questions as --- if they did such a good job on the visiting rotation why didn't they do better in the core clinical electives of 3rd year? What a person achieves in several years in medical school is likely more reflective of the person's future capabilities than the impression they may leave after just a few weeks here when they may be super-motivated to shine.

    Other times a student did very well in medical school, and for some reason does not making as positive an impression. I often wonder why this happens. There may be a multitude of reasons including large lead times to make the adjustment to a new and foreign environment or even culture. Maybe the applicant is trying too hard to impress everyone and these well intentioned efforts can unintentionally come across negatively. Unfortunately, sometimes such a student's final ranking is lowered strictly because of a subpar performance on the visiting rotation. In this case, the student obviously would have been better off not coming (strictly from a rating of the applicant point of view).

    Let me finish by saying that although in the past we offered interviews automatically to all applicants that did visiting rotations this is no longer possible because of the high number of visiting students, and the larger number of non-visiting students applying with exceptional achievement. The bottom line is do an away rotation if you think you might match there and want to make sure you know what you are getting into. Also, an away rotation makes sense for other reasons such as to get more experience in anesthesiology, or to embrace the challenge of being in a new hospital and surgical environment.

    thank you,

    alex_small.jpg

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