Anesthesiology, Perioperative and Pain Medicine

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Q&A with Stanford Anesthesia's Residency Director

October 2010

Advice for interviews

Question:
What advice or tips do you have for applicants interviewing for residency?

Answer:
This is a timely question as interview season is about to start. Also, I spoke about this at the ASA medical student residency panel in San Diego a few days ago.

The following are things you should do:

  • Say or imply that you are interested in the residency program because it leads to outstanding training.
  • Show positivity/excitement about the specific residency. That energy will fuel a better evaluation.
  • State exactly how the faculty and experience at that program and that might only be available at that program will help you meet your long term career goals.
  • Arrive early and stay late. This will let you get a feel for the culture and atmosphere in the department before and after the formalities of the interview day.
  • Study the faculty in the residency program and see who matches with your interests and ahead of the interview day ask to meet with them.
  • Wear conservative clothing (you don’t want the interviewers discussing your attire when they should be focused on your potential as a physician in their residency).
  • Even though you may be fatigued because you are on your twelfth interview please look alive and interested during the presentation by the chair or program director or others.
  • Send a thank you note by email. There is a movement nationwide to reduce the after interview day communication to a minimum but one thank you email is fine.

    Please avoid these mistakes:
  • Be really nice and communicative to the faculty interviewers and then when they are not around be rude and short with administrative assistants or other people you run into.
  • Be late (may require checking out how to get there the night before).
  • Not talk with other applicants while waiting around for your interview time.
  • Say negative things about your med school, college, or past employers.
  • Have your eyes on floor or ceiling when speaking.

    Journal club

    Question
    What journal club experience do you have?

    Answer
    Stanford anesthesia housestaff participate in several different “journal clubs” during residency. The pediatric, obstetric, and regional anesthesia rotations have their own journal club for residents on that specialty to enhance their abilities in critical thinking and scientific reading. In addition, the FARM research tract residents have their own regular journal club.

    The Stanford anesthesia program also has journal clubs for each class, CA1s (Monday afternoon during protected time), CA2s (Tuesdays), and CA3s (Wednesdays). Each resident leads one of these sessions during their training under the guidance of a faculty member. This journal club affords a real-world example of the application of the principles and practices of evidence-based medicine. The goal is to evaluate scientific or clinical aspects of anesthesia care.

    Residents work with the assigned faculty mentor to help them address a self-determined clinical question (perhaps a difficult patient the resident took care of) through a literature search using various online search engines such as pubmed (http://www.ncbi.nlm.nih.gov/pubmed/) or the Cochrane Library. Online supplemental instruction (for example http://lane.stanford.edu/help/choose-search.html#clinical-all) is available via the Lane Medical Library and Knowledge Management Center (http://lane.stanford.edu/index.html) and the Stanford/Packard Center for Translational Medicine (http://med.stanford.edu/spctrm/).

    The articles chosen from peer reviewed journals include supporting and/or contradictory evidence. The validity of these articles is assessed and discussed with the preceptor and then with their class of peers. The results are presented formally by the resident to the other residents via powerpoint. This peer to peer learning assists residents take better care of patients based on what is known on the topic. All these journall club small group learning activities enable residents to develop skills locating information, using IT resources, assimilating evidence from scientific studies and applying it to our patients’ health problems.

    Stanford ICU rotations

    Applicant question:
    Please describe in more detail the ICU experience for anesthesia residents at Stanford. Thank you.

    Answer:
    Stanford Anesthesia residents rotate through four different ICUs, each with different patient population types. At Stanford University Hospital these ICUs are the:


    • Medical-Surgical ICU: The service assumes primary responsibility for all critically ill Medicine, Medical Subspecialty, and Surgical Subspecialty patients, with the exception of Neurosurgical/Stroke patients co-managed by the Neurosurgery, Neurology, and Critical Care teams.

    • Trauma Surgery ICU: The team assumes primary responsibility for all critically ill trauma patients and co-manages all General Surgery patients

    • Cardiothoracic Surgery ICU: The team co-manages all patients with the Cardiothoracic Surgery team.

    In addition, the anesthesia residents play vital roles on Rapid Response teams and Code teams.

    The fourth site for ICU experience for anesthesia residents is the Medical-Surgical ICU in the Palo Alto VA Medical Center. This service has primary responsibility for all Medicine patients and co-manages Surgical and Cardiothoracic Surgery patients.
    All ICU services are supervised by faculty from Anesthesia-Critical Care, Pulmonary Critical Care, and General/Trauma Surgery.
    All ICU services include full-time Critical Medicine Fellows.
    Anesthesia residents in the ICU work with Internal Medicine, Emergency Medicine, General Surgery, and Neurology housestaff, and are responsible for patient admissions, diagnostic evaluations, care plan development, and interventions.

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