The residency is devoted to training physicians to become outstanding anesthesiologists. In the first clinical anesthesia year, residents learn basic anesthesia skills on routine cases under close faculty supervision in the general operating room. Residents spend about half the year at the Stanford University-Packard Children's Hospital complex and the remainder divided between the Veterans Administration (VA) Palo Alto Health Care System and the Santa Clara Valley Medical Center (SCVMC). Residents take night and weekend calls with in-house faculty supervision as soon as their level of training permits.
During the second 6 months of the first year, all first-year residents receive 2 months of subspecialty experience. Residents are trained in our Preop Clinic and Anesthesia Simulator Center from the beginning of the residency.
The second year is devoted to more extensive experience in anesthetic subspecialties.
The Lucile Packard Children's Hospital Department of Anesthesia is the primary pediatric teaching program for the residents of the Stanford University Department of Anesthesia. The Packard Children's Hospital’s Department of Anesthesia provides care for over 12,000 infants, children, teens and young adults a year. These young patients need anesthesia for a wide variety of surgical and medical procedures, including solid organ transplantation, complex cardiac surgery, radiation therapy, and diagnostic and invasive radiological procedures.
The Pediatric Pain Management Service treats infants, children, and teens with acute surgical pain, pain from trauma, and acute and chronic pain complicating medical diseases, and manages drug withdrawal or side effects from drug therapies in children.
You can find more information on the Pediatric Anesthesia web site.
Obstetric Anesthesia occupies approximately 2 months in the Stanford Anesthesia Residency Program, usually during the second and third years. Approximately 4,500 deliveries are carried out annually at the Johnson Center for Pregnancy and Newborn Services. A significant proportion of these are high-risk cases and 32% require cesarean sections. Residents obtain extensive experience in regional anesthesia, with approximately 82% of laboring patients and greater than 95% of cesarean section patients receiving neuraxial analgesia and anesthesia respectively.
Educational activities include a daily didactic tutorial program given by specialists in obstetric anesthesia as well as an obstetric anesthesia journal club. During one of the obstetric anesthesia rotations, residents participate in NeoSim, a simulation-based neonatal resuscitation program delivered at the Center for Advanced Pediatric and Perinatal Education, where they become certified in NRP (Neonatal Resuscitation Program). Residents also have the opportunity to participate in an OBLS course (Obstetric Life Support) as well as in an obstetric simulation course (scheduling dependent). Additional obstetric anesthesia experience is obtained at Santa Clara Valley Medical Center where there are more than 3,500 deliveries per year.
During rotations on the Cardiovascular Anesthesia service at Stanford University Hospital or the Santa Clara Valley Medical Center, residents learn basic anesthesia for cardiac and vascular operations as well as invasive (PA catheterization, TEE), non-invasive cardiovascular monitoring techniques, and the management of patients requiring CPB, mechanical circulatory assist, and ECMO. Residents are also exposed to anesthesia for heart and lung transplantation, complex reoperations, major thoracic aortic operations, endovascular aortic repair (TEVAR and EVAR), complex thoracoabdominal aortic surgery, transcatheter aortic valve replacement (TAVR), CPB with circulatory arrest, off pump CABG, minimally invasive mitral valve repair, and arrhythmia operations.
The Stanford University Pain Service sees about 350 patient referrals per month in a multidisciplinary pain clinic, which evaluates and treats chronic pain in outpatients. The Pain Service also consults on hospitalized post-surgical patients requiring pain management, and an inpatient Chronic Pain Service integrates with the Acute Pain Service..
Residents are given an opportunity for 1 month rotations on each pain service.
Techniques taught include diagnostic and therapeutic nerve blocks, selective spinal analgesia, patient-controlled analgesia and other novel analgesic techniques.
For more information, visit the Pain Service web site.
Critical Care Medicine
Critical Care Medicine is an important part of anesthesia residency training and takes place in the 48-bed adult intensive care unit at Stanford University Hospital and the 14-bed adult unit at the Palo Alto Veteran's Administration Medical Center. A multi- disciplinary team of residents from the Departments of Anesthesia, Medicine, Surgery, and Emergency Medicine manage a diverse population of both medical and surgical patients. Residents become the primary physicians for these critically ill patients and are responsible for all aspects of patient care under faculty supervision. All residents receive at least 3 months of Critical Care Medicine training. Rotations are available in the medical, surgical, and cardiothoracic intensive care units.
For more information see the Critical Care Medicine website.
Head and Neck Anesthesia / Advanced Airway Management
This rotation gives the residents significant exposure to both simple and complex operations involving the airway. The Head and Neck Anesthesia Division currently includes 8 designated anesthesiologists running 3-6 operating rooms daily. A wide range of surgical cases include:
- major head and neck cancer surgery
- laryngeal surgery including voice restoration
- surgery for obstructive sleep apnea
- functional endoscopic sinus and pituitary surgery
- advanced neurotologic and skull base surgery
- facial cosmetic surgery
- and orthognathic and maxillofacial surgery
The Head and Neck Anesthesia/Advanced Airway Management rotation includes a carefully structured curriculum that addresses the unique anesthetic considerations for the above surgical procedures, and the acquisition of advanced airway management skill sets in real life situations.
For more information see the Head and Neck Anesthesia/Advanced Airway Management website.
Anesthesia for Thoracic Surgery involves a four week rotation. It introduces residents to:
- Bronchoscopy to assess the lower airway.
- Techniques of Lung isolation using Double Lumen Tubes and Bronchial Blockers and management of One Lung Ventilation in patients with significant pulmonary pathology and limited pulmonary reserve.
- Perioperative management of thoracic patients undergoing Open Thoracotomies and VATS procedures including pulmonary resections, esophagectomies and mediastinal operations.
- Pain management techniques including Thoracic Epidurals, ParaVertebral Blocks and Intercostal Nerve Blocks.
- Management of interventional pulmonary procedures needing fiberoptic and rigid bronchoscopy using jet ventilation.
Stanford Anesthesia faculty with a special interest in Thoracic Anesthesia include:
Dr. Vivek Kulkarni (Chief), Dr. Jen Basarab-Tung, Dr. Natalya Hasan, Dr. Chris Painter and Dr. Kristen Telischak.
Residency training in Neuroanesthesia at Stanford includes two rotations. Neuroanesthesia I emphasizes anesthesia for intracranial procedures, while Neuroanesthesia II emphasizes anesthesia for spinal surgery, interventional radiology, and movement disorders. In addition, residents rotating through the affiliated hospitals participate in the anesthetic care of neurosurgical patients at those facilities.
Neurosurgery at Stanford is a very active and research-oriented service, affording residents in Neuroanesthesia a unique opportunity to gain experience with a wide-variety of surgical procedures and anesthetic techniques.
- Hypothermic and pharmacologic brain protection
- Awake craniotomies
- Complex cerebrovascular procedures
- Interventional neuroradiology
- Electrophysiologic monitoring
Faculty research interests:
- Many aspects of neuroprotection
- Intraoperative monitoring
- Mechanisms of anesthetic action
- Pain management
- Spinal cord function
Both clinical and research fellowship positions are available.
Stanford faculty with specific interest in Neuroanesthesia:
- Richard A. Jaffe, MD, PhD
Professor of Anesthesia and Neurosurgery
- Martin S. Angst, MD, PhD
Professor of Anesthesia
- Karl Zheng MD
Clinical Assistant Professor of Anesthesia
- Hendrikus Lemmens, MD, PhD
Professor of Anesthesia
- David Drover, MD
Professor of Anesthesia
- Mark Burbridge, MD
Clinical Assistant Professor
The one-month Regional Anesthesia rotation provides residents with intensive exposure to a variety of regional anesthetic techniques, including ambulatory surgical procedures. Also resident assist at making decisions related to acute pain medicine, drug selections, catheter management and follow up for our ambulatory patients. Residents gain proficiency acute pain medicine and in many peripheral nerve block techniques, such as:
- neuraxial anesthetics
- inter scalene
- supraclavicular and infraclavicular approach
- adductor canal
Residents are supervised and instructed by faculty members with extensive expertise in regional anesthesia.
In addition to this rotation, the division sponsors regular Regional Anesthesia Workshops (12/year), using cadaver dissections, live and inanimate models, daily short lectures, didactics and other methods to teach regional anesthesia techniques in an optimal educational environment. Residents are expected to participate at the journal club planned during the rotation.
Post Anesthesia Care Unit
The Post Anesthesia Care Unit (PACU) is a two week rotation and residents spend the majority of their time involved in direct patient care in the Stanford University Hospital Main OR PACU. Responsibilities include the evaluation and management of common postoperative concerns such as:
- Airway obstruction
- Hemodynamic instability
- Nausea and vomiting
- Pain control using a variety of techniques including epidural catheters and intravenous analgesics