MD Courses – Anesthesiology

Fourth year

Electives

M10 805 ANESTHESIOLOGY
Instructor(s): Jake Aubuchon, MD; Tracey Stevens, MD; and Thomas Cox, MD
Location: Barnes-Jewish Hospital, South Campus; Department of Anesthesiology, Third Floor
Elective Contact: Maurice Rackley, 314-362-2446
Other Information: Please contact the department student secretary, Maurice Rackley, 314-362-2446 prior to the elective for specific instructions. Students should meet in the Clinical Simulation Center, 3rd floor Barnes-Jewish Hospital Service Building, 8:30 a.m. first day of elective.
Enrollment limit per period: 2
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This clinical elective is designed to familiarize the student with basic aspects of anesthesiology practice. The primary teaching method is patient care in a clinical setting (one-on-one). The student will learn the basics of preoperative evaluation of surgical patients, the use of intraoperative monitoring in patient management and postoperative care. During the 4 week rotation, the student will learn airway management skills, practical perioperative fluid and electrolyte therapy, along with general and regional anesthetic techniques. As an integral part of the anesthesia care team, the student will participate actively in the anesthetic management of surgical patients. The student’s specific requests to be assigned to certain types of cases will be honored as time and availability dictate. The rotation will include 3 clinical simulator sessions using a simulator mannequin for practical management of airway problems, resuscitation and trauma emergencies. By the end of the rotation, the student should be able to independently (under supervision) provide anesthesia for uncomplicated surgical procedures. NOTE: Presence and participation in the three Friday Simulator Sessions and the Presentation on the last day of the rotation are required to receive a grade. If there is a conflict with attendance,  prior arrangements can be made to accommodate the student.

Student time distribution: Inpatient 85%, Conferences/Lectures 15%; Subspecialty Care 100%
Major teaching responsibility: Jake Aubuchon, MD
Patients seen/weekly: 15

On call/weekend responsibility: Medical students are required to take one call shift during their rotation, either in the main operating rooms or in the obstetrical suite any evening or weekend during the rotation.


M10 811  CARDIOTHORACIC ANESTHESIOLOGY

Instructor(s): Rashmi Rathor, MD, 314-362-5111
Location: Barnes-Jewish Hospital, South Campus
Elective Contact: Lydia Swink, 314-362-1196
Other Information: Students should meet at the offices of the Division of Cardiothoracic Anesthesia, 3rd Floor Barnes-Jewish Service Building, 9:30 a.m. first day of elective.
Enrollment limit per period: 2
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This clinical elective offers practical experience in the perioperative assessment and management of surgical patients undergoing cardiothoracic procedures. The student, as an integral part of the cardiothoracic anesthesia team that is composed of faculty members, fellows and residents, will learn basic principles of airway management and lung ventilation, essential aspects of pharmacologic treatment of hemodynamic abnormalities and cardiac dysrhythmias, and management of intraoperative coagulation disturbances. Emphasis will be placed on the interpretation of intraoperative hemodynamic data, echocardiographic finding (TEE), and laboratory results. During this rotation, the student will also gain practical experience in endotracheal intubation as well as the placement of intravenous lines and invasive monitoring lines, including radial artery and pulmonary artery catheters. Students will learn how to use these parameters in clinical decision making during anesthesia. At the conclusion of the rotation, the student will have a better understanding of invasive monitoring and data interpretation, as well as a more systematic approach to the management of intra- and post-operative hemodynamic, pulmonary and coagulation abnormalities. The students are expected to attend the didactic sessions of CTA and the Department of Anesthesiology. A presentation will be assigned.

Student time distribution: Inpatient 100%; Subspecialty Care 100%
Major teaching responsibility: Rashmi Rathor, MD
Patients seen/weekly: 15
On call/weekend responsibility: None

M10 812 PEDIATRIC ANESTHESIA
Instructor(s): Kelly Chilson, MD; Gary Hirshberg, MD; Tessa King, MD; and David Murray, MD, 314-454-6215
Location: 5th Floor, St. Louis Children’s Hospital
Elective Contact:  Kelly Chilson, MD, 314-454-6215, John McAllister, MD
Other Information: Students should contact Samantha Gurney, 314-454-4572, one week prior to the start of the elective.
Enrollment limit per period: 3
Valid start weeks for 4-week blocks are: Weeks 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This clinical elective is designed to teach the theory and practice of pediatric anesthesiology and pain management. It features individualized instruction with faculty who specialize in the perioperative care of pediatric patients. The elective consists of four weeks of active participation with pediatric anesthesiologists at St. Louis Children’s Hospital and St. Louis Shriners Hospital learning preanesthetic assessment, the performance of routine anesthetics (which includes instruction and practice in pediatric airway skills), learning other technical skills such as intravenous line placement and the management of post-anesthesia care and pain therapies. The final week may be tailored to meet the student’s individual interests, needs and career goals. Possibilities include exposure to sedation and anesthesia for procedures outside of the operating rooms, and to subspecialties including cardiovascular anesthesia, neurosurgical anesthesia, and acute and chronic pediatric pain management. Students also will have an opportunity to learn the management of some common medical emergencies in the Clinical Simulation Center.

Student time distribution: Inpatient Surgery 5%, Outpatient Surgery 80%, Conferences/ Lectures 15%; Subspecialty Care 100%
Major teaching responsibility: Attending, fellows and senior anesthesiology residents; students will generally spend most of each day with a single attending or senior anesthesiology trainee (fellow or resident).
Patients seen/weekly: 25
On call/weekend responsibility: None

M10 819 CARDIOTHORACIC CRITICAL CARE
Instructor(s): Charl de Wet, MD, Course Master; Michael Avidan, MD; Keki Balsara, MD; Heidi Coco, DO; Julianne Donnelly, MD; Daniel Emmert, MD; TJ Graetz, MD; Mohammad Helwani, MD; Faraz Masood, MD; Clare Ridley, MD, and Adnan Sadiq, MD
Location: Barnes-Jewish Hospital, Southwest Tower
Elective Contact: Maureen Arends, 314-747-4155
Other Information: Students should meet in the Cardiothoracic Intensive Care Unit, 5600 ICU, 5th Floor Southwest Tower Physician Workroom, 6:30 a.m. first day of elective.
Enrollment limit per period: 3
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This clinical elective offers practical experience in the postoperative management of cardiothoracic patients. The student will be fully integrated into the intensive care team and have the opportunity to contribute to the management of critically ill patients. Students will be afforded the opportunity to follow specific patients over the course of their stay on the ICU, during which time they will gain insight into holistic management of patients with multi-organ dysfunction. The CTICU environment is both challenging and exciting. Cardiorespiratory physiology and pharmacology will be demonstrated at the patients’ bedside, an invaluable and unforgettable learning experience. Students will have numerous opportunities to learn and sometimes assist with procedures, such as central lines, chest tubes, bronchoscopy and pulmonary artery catheter insertion. Principles of management and resuscitation of hemodynamically unstable patients following surgery will be emphasized. Students will also see and help manage patients on ventricular assist devices, ECMO and following heart and lung transplantation. At the conclusion of the rotation, the student will have a better understanding of shock, sepsis, multi-organ failure, organ system support and compassionate withdrawal of life support. In addition to bedside teaching, there will be informal teaching sessions on a wide variety of topics as well as teaching on interpreting cardiac echo exams. Students will be encouraged to present on their patient at morning ward rounds, during which constructive feedback and interactive teaching will occur. Students will present on a topic related to one of their patients at the end of the block.

Student time distribution: Inpatient 100%; Subspecialty Care 100%
Major teaching responsibility: CTICU attendings
Patients seen/weekly: 21
On call/weekend responsibility: During the 4-week rotation, you are asked to take a weekday call (day of your choice). You will come in at 4:00 p.m. and leave the next morning after you have presented your patients on morning rounds. In addition during the 4-weeks rotation, you are asked to take a weekend call (again your choice) Saturday or Sunday shift 6:00 a.m. to 7:00 p.m.


M10 820  CRITICAL CARE

Instructor(s): Heidi Coco, DO, Course Master, 314-362-1196; Enyo Ablordeppey, MD; Chukwuma Apakama, MD; Walter Boyle, MD; Grant Bochicchio, MD; Sara Buckman, MD; Julianne Donnelly, MD; Eleanor Drew, MD;  Anne Drewry, MD; Stephen Eaton, MD; Daniel Emmert, MD; Alex Evers, MD; Brian Fuller, MD; Thomas J. Graetz, MD; Mohammad Helwani, MD; Richard Hotchkiss, MD; Kareem Husain, MD; Obeid Ilahi, MD; Jacob Keeperman, MD; Paul Kerby, MD; Justin Knittel, MD; John Kirby, MD; John Mazuski, MD; Tiffany Osborn, MD; Christopher Palmer, MD; Patricia Penkoske, MD; Clare Ridley, MD; Adnan Sadiq, MD; Doug Schuerer, MD; William Symons, MD; Isaiah Turnbull, MD; Jessica Zenga, MD; Brian Wessman, MD
Location: Barnes-Jewish Hospital, South Campus
Elective Contact: Barbara McKinney, 314-747-3581
Other Information: Students should meet in the 4400 Surgical Intensive Care Unit, 4th Floor of Barnes-Jewish Hospital at 7:00 a.m. on the first day of the elective.
Enrollment limit per period: 4
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

Students on this rotation are integral members of the multidisciplinary intensivist-led critical care team in the Surgical Intensive Care Unit (SICU). Students learn an organ systems-based approach for evaluation and management of critically ill and injured patients, and application of evidence-based principles in delivery of state-of-the-art critical care. Emphasis is placed on critical care knowledge and techniques used at the bedside in the clinical management of serious traumatic and surgical conditions. Students become familiar with resuscitation and cardiopulmonary support, including methods for non-invasive and invasive hemodynamic monitoring, and techniques for airway management and pulmonary support in respiratory failure. Basic knowledge and skills in the management of neurologic injuries, liver and/or renal failure, and life-threatening infections in the surgical patient are also taught, as is the importance of treatments to alleviate anxiety and pain, maintain fluid and electrolyte balance, and provide adequate nutrition. Practical experience is gained in placement of vascular access devices, interpretation of laboratory data, and use of guidelines, protocols and quality assurance tools in the management of critically ill patients.

Student time distribution: Inpatient 80%, Conferences/Lectures 20%; Subspecialty Care 100%
Major teaching responsibility: ICU Attendings and Fellows
Patients seen/weekly: 50
On call/weekend responsibility: Variable


M10 821  PAIN MANAGEMENT

Instructor(s): Folasade Oladapo, MD, 314-747-0202
Location: Barnes-Jewish Hospital, South Campus
Elective Contact: Folasade Oladapo, MD, 314-747-0202, oladapof@anest.wustl.edu
Other Information: Students should report to 14th Floor CAM Building, 8:00 a.m. first day of elective.
Enrollment limit per period: 1
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

Acute pain is the most common symptom of medical illness and is ubiquitous after major surgery.  Chronic pain is the leading cause of worker disability.  Severe pain afflicts most people with advanced cancer.  Learning the fundamentals of pharmacologic, interventional, and multidisciplinary pain management is important for all areas of clinical medicine. Rotation is based at Barnes-Jewish Hospital with focus adjusted to meet student’s interest and career plans.

Student time distribution: Inpatient 30%, Outpatient 60%, Conferences/ Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Attendings
Patients seen/weekly: 70
On call/weekend responsibility: No on-call responsibility


M10 822  ANESTHESIA FOR NEUROSURGERY

Instructor(s): René Tempelhoff, MD,  314-362-2330 and M. Angele Theard, MD, 314-362-1460
Location: Barnes-Jewish Hospital, South Campus
Elective Contact: René Tempelhoff, MD, 314-362-2330
Other Information: Students should meet on 3rd Floor Barnes-Jewish Hospital, South Campus, Department of Anesthesiology, 7:00 a.m. first day of elective.  Enrollment limit per period: 1
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

Students will help care for patients having challenging neurosurgical procedures. Students will become familiar with complex procedures, brain monitoring, cardiovascular support and airway management and will be exposed to all kinds of neurosurgical pathology. Student must be prepared to participate in the intricate anesthetic management of patients undergoing surgery in our novel intraoperative MRI rooms. For those interested, clinical research projects are ongoing and student participation is encouraged.

Student time distribution: Inpatient 80%, Conferences/Lectures 20%; Subspecialty Care 100%
Major teaching responsibility: Attending, fellow, and senior resident
Patients seen/weekly: 8
On call/weekend responsibility: None


M10 823  OBSTETRICAL ANESTHESIA

Instructor(s): Swarup Varaday, MD, 314-362-6252
Location: Barnes-Jewish Hospital, South Campus
Elective Contact: Swarup Varaday, MD, 314-362-6252 or 314-362-2628
Other Information: Students should report to 5400 Labor and Delivery, 7:00 a.m. first day of elective. Enrollment limit per period: 1
Valid start weeks for 2 or 4-week blocks are: Weeks 1, 3, 5, 7, 9, 11,13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, 37, 39, 41, and 43.

The medical students will learn the different analgesia/anesthetic options for the labor patient. They will also learn how the physiological adaptations of pregnancy influence anesthetic management. They will be actively involved in the parturient’s management, i.e., starting an IV, placement of spinal, epidural or CSE (combined spinal epidural) anesthetics. They will also attend the OB anesthesia conferences and interview patients in labor (with an OB anesthesia attending).

Student time distribution: Inpatient 90%, Conferences/Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Attending, Senior Resident
Patients seen/weekly: 20
On call/weekend responsibility: None (optional)