Stanford Combined Internal Medicine/Anesthesiology Residency

Transcription

1 Stanford Combined Internal Medicine/Anesthesiology Residency The combined internal medicine-anesthesia residency is seeking applicants with outstanding clinical abilities who show potential to be leaders in internal medicine and anesthesiology. Our program aims to train physicians who are excellent in two independent fields of medicine. Graduates are board-eligible in both specialties. Residents in this combined program are fully-included members of both departments including mentoring, research, global health opportunities, resident colleagues, department retreats, etc. describes a resident s experience in the program. The structure of our program is as prescribed by the ABA and ABIM guidelines. 1 PGY-1 PGY-2 PGY-3 through PGY-5 12 months of medicine internship ( 12 months of anesthesiology ( 6 months per year devoted to each specialty, alternating in three-month periods through senior-level rotations Candidates should apply to (and need to interview at) both internal medicine and anesthesia residencies via ERAS as if they were applying independently to those residencies. They may then rank the combined medicine/anesthesia program independently of the other Stanford internal medicine and anesthesia residencies. The NRMP code for the Stanford combined medicine-anesthesiology program is C0. Sample schedule Number of 4 wk rotations per year Hospital PGY-1 PGY-2 PGY-3 PGY-4 PGY-5 Stanford University Hospital Veterans Affairs Palo Alto Health Care Santa Clara Valley Medical Center Lucile-Packard Children's Hospital* *Pediatric anesthesia & adult obstetric anesthesia rotations are at LPCH Other PGY1s in the combined program participate in once a month online module: the Stanford Successful Transition to Anesthesia Residency Training (START) program along with the other anesthesia interns ( Residents in the combined program: o Transition to medicine within the first 3 months of their PGY-3 year, to avoid 18 straight months of anesthesia. 1

2 o Continue to have an IM primary care continuity clinic throughout the five year residency. During medicine blocks, this clinic is 2-4 times per month. During anesthesia blocks, this clinic is once per month. Vacation time is taken proportionally equal to time spent in each residency in a given year. Residents are encouraged to attend all teaching conferences for both departments regardless of which department they are rotating through. They are expected to attend one teaching conference in each specialty at least once per month. Medicine teaching conferences include daily resident reports and noon teaching conferences, as well as weekly grand rounds. Anesthesia conferences include weekly grand rounds and weekly didactic lectures by class. Residents in the combined program take written exams for both residencies. Residents will take the medicine In-Training Exam (ITE) on an annual basis, and the anesthesia ITE on an annual basis starting in PGY-2. Residents will also participate in simulation programs provided by the both departments. Anesthesia Crisis Resource Management (ACRM) and EVOLVE take anesthesia residents through various crisis scenarios in the operating room. SCARED and SMART train medicine residents to deal with a variety of code and pre-code situations in the hospital. FAQs Question: What will graduates of this program do? Answer: Most of the current residents are interested in critical care. However, with ongoing and future changes in medicine and healthcare, our trainees interests are just as dynamic. Certainly, graduates will be trained broadly to play an important role in organizing and providing care to the sickest and most complex patients. On one end of the spectrum the graduate could practice anesthesia full time and at the other end could practice internal medicine full time. In between are other exciting possibilities: for example, critical care, pain medicine, hospitalist work, and perioperative management of surgical patients. Question: Will residents in combined program have faculty mentors? Answer: Yes. Stanford faculty members with expertise in both disciplines will serve as mentors. One example is Dr. Cliff Schmiesing ( who trained in medicine and anesthesia and now has important leadership roles in preoperative assessment of high risk patients as well as hospital informatics. Question: For the application itself, is there a preferred number of letters of recommendation and distribution between anesthesiology letters, medicine letters, or letters from other specialties? Answer: Please apply as if you were applying to each residency separately with separate letters and essay (you may mention interest in combined program, of course). This is because the faculty in both departments will want the applicant to fully fit in their own programs, and because if the person doesn t match in the combined program, we still strongly consider them for either a medicine only residency or an anesthesia residency only. Question: What is the process for coordinating the application process between the two departments? Answer: Once both residencies invite you for an interview, we work with the applicants to facilitate interview dates that are convenient. 2

3 Contacts in the Combined Medicine/Anesthesia Program Associate Program Director: Carlos Brun, MD Dr. Brun completed his Internal Medicine residency at Legacy Emanuel and Good Samaritan in Portland, Oregon. He then spent one year at the Montreal Heart Institute. Afterwards, he came to Stanford and graduated from the Critical Care Medicine fellowship and then the Anesthesia residency. Dr. Brun currently works at the VA Palo Alto in the OR and ICU. His teaching interests include difficult airway management and peri-operative ultrasound. His research interests are in peri-operative patient management, and resident and fellow teaching. Associate Program Director: Angela Rogers, MD, MPH Angela Rogers is an Assistant Professor in the Department of Medicine, Division of Pulmonary and Critical Care Medicine. She completed Internal Medicine residency at Brigham and Women s Hospital, and fellowship in Pulmonary and Critical Care Medicine at the Harvard Combined Program. She attends at Stanford University Hospital. Her research interests include using genetics and genomics methodologies to identify novel ARDS pathobiology. Current Residents PGY-4 Michael Lin PGY-2 Jai Madhok Amy Kloosterboer Jason Leong Nick Eglitis PGY-1 Natalie Bodmer Tiffany Lee Adam Tiagonce mikelin@stanford.edu jmadhok1@stanford.edu aklooste@stanford.edu jhleong@stanford.edu eglitis@stanford.edu nbodmer2@stanford.edu tiffany7@stanford.edu atiagon2@stanford.edu To start in 2016 Emma Li Patrick Sullivan 3

4 Appendix A: Sample schedule for a combined medicine/anesthesia residents by year PGY-1: Intern Year Weeks Medicine wards (any site) 24 Nights 4 ICU (VA) 4 Oncology inpatient 4 General cardiology inpatient 4 Geriatrics elective 2 CCU/Heart Failure 2 Other electives 8 PGY-2: CA-1 Year ASC 2 Urology 2 Abdomen 2 Bariatrics 2 Orthopedics 2 Trauma 2 ENT 2 Cardiac Echo 2 EP 2 Stanford MSD 10 Neuro 1 (Cranis) 4 Neuro 2 (Spine) 4 Acute pain 4 Cardiac 8 MICU 4 PGY-3-5: Senior Rotations in 3-month periods in each department Anesthesia MSD 8 Liver 4 Thoracic 4 PACU 2 SAU 2 Regional 4 Chronic pain 4 Cardiac 8 Pediatric 8 Obstetrics 8 SICU 4 CVICU 4 Clinical Electives 22 4

5 Medicine Medicine wards (any site) 16 Hematology Inpatient 4 MICU 4 CCU 4 ICU (VA) senior 4 Nights 6 ED 4 General Cardiology senior 4 Clinic block 2 Research 4 Clinical electives 38 Appendix B: Core Medicine/Anesthesia Electives Endocrinology Gastroenterology Inpatient Hepatology ICHS Infectious Disease (Stanford) Cardiology consults (VA) Nephrology Inpatient Outpatient Heme Palliative Care SUH Pulmonary Rheumatology Pulmonary Hypertension Surgical Comanagement Appendix C: More detailed ACGME, ABA, and ABIM Program Requirements for Combined Residencies MEDICINE A minimum of 4 months of critical care (MICU, CCU) rotations A minimum of 1/3 of Internal Medicine training occurs in ambulatory setting, and minimum of 1/3 in inpatient setting A longitudinal continuity clinic of 130 one half day sessions over the course of training, including one clinic per month. The continuity clinic includes evaluation of performance data for resident s panel of patients. Exposure to each of the internal medicine subspecialties and neurology, and an assignment in geriatric medicine An emergency medicine experience of four weeks Electives available in experience in psychiatry, allergy/immunology, dermatology, medical ophthalmology, office gynecology, otorhinolaryngology, non-operative orthopedics, palliative medicine, sleep medicine, and rehabilitation medicine. 5

6 ANESTHESIOLOGY Two one-month rotations in obstetric anesthesiology, pediatric anesthesiology, neuro anesthesiology, and cardiothoracic anesthesiology A minimum of one month adult intensive care unit during each of the last 3 years Three months of pain medicine, including one month in acute perioperative pain, one month in chronic pain, and one month of regional analgesia/peripheral nerve blocks One month in a preoperative evaluation clinic One-half month in a post anesthesia care unit No single subspecialty, excluding critical care medicine, exceeds six months total Appendix D: Financial information Department-specific benefits apply to the time which is spent in that department. As an example, below is list of monies/stipends anesthesia residents receive: Pre-tax stipends One-time Stanford moving allowance from hospital of $3,000 (as PGY-1 or CA-1) Housing stipend from anesthesia department of $3600 per year PGY-2 through PGY-4 Housing stipend from hospital of $6000/year Education stipend from hospital of $1000 per year Hospital GME bonus $2,000/yr (intended for parking, phone, etc) Education stipend from anesthesia department of $775 per year PGY-2 through PGY-4 ipad mini as new resident Other funds ASA membership dues of $75 per year Call meal money (dining dollars) of $10 for each 12-hour call shift worked DEA registration fee of $550 California medical license and renewal fee of $895 Reimbursement of travel and conference fees for research presented 6