Residency
Clinical Anesthesia Training - CA3 YEAR
Options
All residents
are encouraged to master a special area of anesthesiology and
pursue an independent project. Towards the end of the third year,
the resident, in consultation with the Program Director, decides
on the type of training that would be most appropriate. Two possible clinical tracks are available for
pursuit: advanced clinical
track and clinical scientist track.
With the
advanced clinical track, a resident may decide to focus on one or
more of the following areas:
Cardiovascular Anesthesia
Experience
Loyola University
Medical Center is a large tertiary cardiac surgery center where
over 1500 open heart procedures are performed annually. These
procedures represent the full range and include coronary, valvular,
electrophysiological and complex vascular operations, (including
the minimally invasive and Heart Port techniques). The center is
also active in heart and lung transplantation. The critically
ill nature of these patients provides excellent experience in
the management of respiratory and cardiac disease.
Residents
may spend several months assigned to the cardiac operating rooms.
The goal of this period is for the resident to acquire the skills
necessary to become a subspecialist in cardiac anesthesia. These
skills include facility in invasive and non-invasive monitoring,
the use of inotropic and vasoactive medications, and the safe
administration of an anesthetic to the cardiac patient. The CA3
residents will also have the opportunity to perform a clinical
or laboratory research project. An option to spend time on the
Cardiology Service is available. Cardiology rotations include
time in cardiographics, cardiac catheterization lab, postoperative
cardiology service or perhaps some training in echocardiography.
Neuroscience Experience
Residents
may elect to spend extra time in the neuroanesthesia rotation.
A very active neurosurgical department performs various procedures
including craniofacial reconstruction, major spine reconstruction
and instrumentation, posterior fossa and skull base tumor surgery,
vascular aneurysm clipping, and supratentorial craniotomies. The
residents are trained in the use of various neurosurgical monitoring
devices including sixteen lead EEG, processed EEG including Compressed
Spectral Analysis, Density Spectral Analysis, Spectral Edge, etc.
Pain Management
Residents
may elect to rotate for several months in the multi-disciplinary pain
control center. All residents rotate through the Pain Service
before their CA-3 year. During the CA-3 year, residents further
master the techniques of pain control for both inpatients and
outpatients. The residents develop primary patient contact and
participate in research activities in this area.
Pediatrics
During the
CA-3 year, a limited number of qualified residents interested
in furthering their training in pediatrics will have the opportunity
to spend extra months in pediatric rotations. This will be divided
between ambulatory and inpatient locations. Our ambulatory centers
perform a high volume of pediatric cases, particularly in ENT
and GU. Our inpatient Ronald McDonald Children’s Hospital
facility offers opportunities to become more familiar with anesthesia
for orthopedic (including spine), general, neonatal (in conjunction
with our 50-bed NICU), and pediatric open-heart surgical procedures.
Residents may also participate in research studies and presentations
at regional conferences.
Obstetrical Anesthesia
The facilities
at Loyola University Medical Center afford a superior experience
in high risk obstetrical anesthesia. The Labor and Delivery Unit
at Foster G. McGaw Hospital performs over 1500 deliveries per
year, of which over 85% may be classified as high risk. Typical
problems which are routinely encountered include severe juvenile
onset diabetes with retinopathy/cardiomyopathy, valvular cardiac
disease, severe toxemia of pregnancy, multiple births, morbid
obesity, and parturients with corrected pediatric congenital cardiac
anomalies. Procedures performed in this unit include Cesarean
section, cervical cerclage, dilation and curettage and vaginal
delivery. In addition, the management of premature labor is also
performed here.
In obstetrical
anesthesia the rotation for CA3 residents may include assignments in the Labor and Delivery Suite. The goal
of this period is twofold: (1) to acquire the skills necessary
to become a true consultant in obstetrical anesthesia and (2)
to intellectually explore the boundaries of this subspecialty.
The acquired skills include invasive and non-invasive monitoring,
administration of spinal and epidural
analgesia/anesthesia, the
use of obstetric-related drugs, and the safe administration of
both regional and general anesthesia to the parturient under a
variety of medical conditions. In addition, the CA3 resident is
expected to participate in teaching residents and participating
in research.
Regional Anesthesia
During the
CA-3 year, residents often choose to spend a month at Loyola
Ambulatory Surgery Center Oakbrook. Orthopedic operations
predominate and techniques in interscalene, ax axallary and
intravenous regional anesthesia are perfected.
.
