Anesthesiology, Perioperative and Pain Medicine

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Q&A with Stanford Anesthesia's Residency Director

February 2014

Upcoming Events 2014

For those of you planning ahead for department events:

May 9 Research Awards Dinner, 6:00 – 10:00 p.m., Sheraton, Palo Alto

May 28 Arts & Anesthesia Soirée, 5:30 – 7:00 p.m., Li Ka Shing, Berg Hall

June 21 Resident Graduation, 5:30 – 11:00 p.m., Law School - Paul Brest Hall - Munger Bldg 4

July 13 Resident Welcome, 11:00 a.m. – 2:00 p.m., Thomas Fogarty Winery, Woodside

August 30: UC Davis Football Game Tailgate

September 6: USC Football Game Tailgate

September 13: Army Football Game Tailgate

October 12 ASA Alumni Reception 6:00 p.m., New Orleans

December 13 Holiday Party, 6:00 – 11:00 p.m., Arrillaga Alumni Center – McCaw Hall

Stanford is #2 ranked anesthesia dept in country for NIH funding for 2013

The Blue Ridge Institute for Medical Research (BRIMR.ORG) provides ranking tables of NIH Funding to US Medical Schools and Principal Investigators and includes direct plus indirect costs but excludes R & D contracts.

The website reports that Stanford is the number 2 ranked anesthesia department in country for NIH funding ($7,887,305) for 2013! as per http://www.brimr.org/NIH_Awards/2013/NIH_Awards_2013.htm
This is up from number 4 ranking in 2012. Congratulations.

I believe that how great the education is in a department depends on how great the clinical care is and how great the scholarship and research is in an anesthesia department.
Thank you,
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The Stanford Anesthesia Fellowship in Global Health

We would like to announce that the Stanford Anesthesia Fellowship in Global Health is accepting applications.

This postgraduate Fellowship after residency is tailored to the individual physician's background and goals but has several core components:
---- Up to 12 weeks working in a medically under-served low or middle-income country.
---- Scholarship project in global health focused on improving infrastructure through improvements in medical education or by forming and answering an appropriate research question.
---- A core curriculum at the crossroads between the multiple disciplines that comprise global health and considerations for delivering peri-operative care in austere environments. Many of the included lectures and seminars throughout the year are available via Stanford's Center for Innovation in Global Health (http://globalhealth.stanford.edu/).
---- Clinical work as an anesthesiology attending in the Stanford Operating Room suite one day a week with 1-2 calls per month
---- Attendance at Global Health Outreach conference in Halifax, Nova Scotia or Seattle, Washington addressing the challenges of administering anesthetics in austere environments.

Upon completion, the fellow will become a global patient advocate with the ability to improve peri-operative healthcare delivery in low resource settings. As opposed to service oriented or volunteer mission trips, the focus is on capacity building through advancement of global health research and educational partnerships. Graduates of this one year fellowship will be poised for program development, policy work, and research within the burgeoning field of global health.

Goals and Objectives for the Global Health (GH) fellow include:
1) Understand and promote global patient advocacy
2) Gain knowledge of the complexities of issues contributing to health care disparities on a global scale
3) Recognize the economic, political, policy, cultural, epidemiology, and infrastructure factors that influence health care delivery in low and middle income countries.
4) Understand the factors contributing to the surgical component of the global burden of disease and then develop and implement effective solutions to the problems.
5) Develop knowledge of the differences in assessing patient needs and delivering peri-operative care in settings with limited resources.
6) Incorporate the global health knowledge and skill set into a career in anesthesia

If interested in applying please contact Fellowship Director Dr. Ana Crawford at ana9120@stanford.edu. Please note a California medical license is required. More information about Stanford Anesthesia Global Health is also available at globalanesthesia.stanford.edu

Thank you,
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Some questions (with answers) that applicants have asked since the end of the interview season

Question: What is the trauma experience like at Stanford and what is the role of the anesthesia resident?
Answer: For the most recent graduating class data from the ACGME reports shows an average of 34 trauma cases were done by each resident by the end of training. The required minimum by the ACGME is 20. Trauma is also a point of emphasis for some of the simulation sessions. A formal trauma experience exists at Stanford Hospital through our ortho trauma rotation, which includes blunt trauma from motor vehicle and cycling accidents for example. At the Santa Clara Valley County Hospital, many emergent trauma cases come in including penetrating trauma. Anesthesia residents are intimately involved with the care of trauma patients from the moment they arrive in the OR to the time they are dropped off in the ICU.

Question: Is there a difficulty airway team or is their an airway pager that the resident carries and what exactly does that mean?
Answer: Our department is the cornerstone of Code Teams at all of our training hospitals. At all sites, the anesthesia resident who carries the emergency airway pager is primarily responsible for securing the airway. Once the airway is secured, we contribute to patient management by placing lines and getting access. “Running the code” is a role usually reserved for ICU fellows and attendings.

Question: Does the program provide money for food at the hospital or provide meals to the residents?
Answer: The hospital-wide graduate medical education office provides a small stipend ($10) to any resident who works more than 12 hrs/day (based on duty hours reports). In addition, our department provides breakfast on weekdays and there are a number of afternoon and evening lectures that provide food to attendees.

Question: This question was for Jorge Caballero one of our Chief Residents. Why did you choose to do you residency at Stanford?
Answer: By Jorge--“Having trained at Stanford from undergrad through residency, I’m often asked why I’ve opted to stay on the Farm for so many years. There are plenty of reasons but they all boil down to one thing: the people. From the time I stepped foot on campus in 2002, I’ve met one remarkable individual after another. Interacting with students, faculty, and staff who are committed to making a difference is inspiring and invigorating. What’s more, the culture at Stanford encourages collaboration rather than competition, which makes it easy to explore novel ideas and discover new interests. As a resident, I’ve enjoyed the camaraderie of my co-residents, many of whom I consider among my closest friends. Given how much support I’ve received from Stanford Anesthesia, it should be no surprise that I’m looking forward to contributing to our department as a member of our research and clinical faculty.”

Question: What training do Stanford residents get as anesthesia "managers" and with supervision?
Answer: The issue of supervision is an important one and wrt to the manager function several rotations come to mind:
1) VA Chief Resident where resident runs the board, helps start cases, does blocks, teaches junior residents etc
2) ASC periop rotation which is similar but is in the ambulatory surgery center here on stanford campus
3) Byers practice management a new rotation in a freestanding surgery center with 2-3 CRNAS
4) VA ICU which has interns on the team
5) EVOLVE, a multi- year simulation-based curriculum for anesthesia residents transitioning into supervising anesthesiologists.
6) The Stanford Anesthesia interns do 1 month of anesthesia and are paired with a resident for a week at a time. The resident supervises the intern delivering anesthesia care in the OR.

Question: Does the Stanford training program have CRNAs?
Answer: There are CRNAs at the County Hospital and at the VA hospital where the residents rotate. At Stanford Hopsital there are CRNAs in the cardiac cath lab, IR lab, and endoscopy suite.

Thank you,
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