The clinical base year in anesthesia at the University of Iowa is structured to prepare you for clinical training in Anesthesiology and Peri-operative Medicine. The goal is to give you a wide exposure to the clinical specialties that will help you take care of your patients in the operating room while you learn the system at the University of Iowa Hospitals and Clinics. This will help you develop collegial relationships with faculty and house staff members on teams you will work with later as an anesthesia resident.
During this year, you rotate through: Surgical Neuroscience Intensive Care Unit/Cardiovascular Intensive Care Unit (SNICU/CVICU), Neonatal Intensive Care Unit/Pediatric Intensive Care Unit (NICU/PICU), Emergency Medicine, Surgery (Trauma Surgery and Pediatric Surgery), Internal Medicine (Renal Consults, Cardiology and General Medicine), Palliative Care Medicine, either Radiology or Pain Medicine, Advanced Clinical Medicine, Safety and Quality and Anesthesia. All our interns do the block of anesthesia in June so that the transition to the anesthesia residency is smoother.
The Safety and Quality (SAQ) Rotation is unique and new at the University of Iowa. It is a required 4-week rotation that was integrated into the internship for the first time in 2014-2015. The goals of the rotation are: 1) orient trainees to the UIHC quality, safety and performance improvement programs; 2) teach system thinking through shadowing; 3) teach patient safety through relationship building; 4) enable empowerment by being agents of change. Interns participate in activities such as: shadowing (SNICU nurses, MRI technicians, Emergency Department, Main OR Pharmacy, Perioperative Units); meeting with hospital safety and quality officers and legal counsel; attending meetings of the Safety Oversight Team, Council on Quality and Safety, M and M conferences in the Department of Anesthesia and Internal Medicine; participating in RCA and FMEA processes; completing the 16 on-line learning modules for the basic certificate of the Institute for Healthcare Improvement; participating in a group quality improvement project. This required rotation is novel for anesthesia training programs and provides trainees with uncommon access to hospital leadership concerned with safety and performance improvement.
The Palliative Care Medicine Rotation is another relatively unique rotation for anesthesia trainees. The goals of this rotation include: 1) understand the principles of palliative/hospice medicine; 2) define and apply effective strategies and techniques for communicating with patients and families (especially when the communication is related to "bad news"); 3) identify and apply effective management strategies for non-pain symptoms (for example, nausea, dyspnea, anorexia, delirium and terminal restlessness) in patients at the end of life; 4) appropriately prescribe opioid and non-opioid drugs for treatment of pain; explore the emotional and psychosocial aspects of the illness experience and physician grief; work with patients regarding goals of care. On this rotation residents develop a close working relationship with the faculty physicians. Residents participate actively in patient evaluation, management, and education.
Interns also are assigned to participate in the EKG course created by the Department of Cardiology. This 2 week course is conducted 3-4 mornings per week and concludes with an EKG examination. The content includes rhythm strip and full 12-leak EKG interpretation. Interns are expected to recognize rhythm abnormalities, AV blocks, junctional rhythms, brady and tachy dysrhythmias, LVH, WPW, and ST and T wave abnormalities.
During May and June, you will participate in the Advanced Clinical Medicine (ACM) rotation and have your first rotation in Anesthesia. During these two blocks, you will have an orientation to the department, workshops, simulations, and basic lectures on anatomy, physiology, pharmacology, machines/monitors, communications, leadership, and the basics of anesthesia. Faculty from the Department of Anesthesiology and other UIHC departments and CA3 residents provide the educational content. You will also perform anesthesia procedures in the OR.
Our Interns also participate in the R1 Reading Program. You will receive a series of readings and associated open-book quizzes on topics including anatomy, diseases, patient management, physiology and pharmacology. This exposure will help you develop the foundation of knowledge essential to learning anesthesia.
PGY-1 Rotations include (block = 4 weeks):
|Surgical Neuroscience Intensive Care Unit or Cardiovascular ICU (CVICU)
|Medicine (General Medicine ward, Cardiology, Renal Medicine)
|Surgery (Trauma, Pediatric)
|Safety and Quality/EKG
|Advanced Clinical Medicine
|Emergency Medicine||1 Block|
|Pediatrics (NICU/PICU)||1 Block|
|Pain Medicine (or Chest Radiology)/EKG