Medical Students Overview

A typical day on the elective may start the night before with a page and phone conversation with a resident preceptor.  The student will meet the resident in the morning to prepare the operating room for the day’s cases.  The first patient is then seen and examined and brought to the OR for induction of anesthesia. The student is expected to participate in all aspects of the patient’s care, including the pre-operative assessment, monitor placement, airway management, intravenous catheter placement, anesthetic and emergence plan and post-operative care and pain management.

The resident and attending physicians will provide informal teaching throughout the day. When the resident goes on a break, the student should stay for one-on-one teaching with the attending. Topics of teaching will vary depending on the case or specialty. They may include anatomy, pharmacology, physiology, anesthetic techniques and resuscitation.

After this elective, students should expect to understand:

• How to evaluate a patient pre-operatively and assess the ASA class and appropriateness of the patient’s medical comorbidities for surgery
• How to optimize patient’s medical comorbidities prior to surgery
• The informed consent for anesthesia
• Available anesthetic techniques for different surgeries and how to chose what might be most appropriate for each patient
• How to evaluate the patient’s airway and appropriateness for airway management techniques
• Anesthetic administration, including the functions of the anesthesia machine and monitors; suitable premedication for the patient; the pharmacology and pharmacodymanics of intravenous, inhalational and regional anesthetic agents; the differential diagnosis and management of common intraoperative complications, including the difficult airway, hypotension, hypertension, hypoxia, hypercapnia, hypothermia, delayed emergence
• Fluid management and basic transfusion concepts in the surgical patient
• How to manage common post-operative complications, monitoring and pain management

At the end of the elective, students should be able to:

• Give organized presentations of ASA class I and II patients to a resident or attending
• Formulate an anesthetic plan for ASA I and II patients
• Place IVs
• Understand effective mask-ventilation
• Place endotracheal tubes and supraglottic devices

Students are expected to arrive daily at 6 a.m. to participate in daily didactic lectures or resident simulator sessions. For three weeks, students will be assigned to patients in the operating rooms of either of Feinberg, Lavin or Prentice Pavilions and are expected to stay until cases are competed, approximately 5 p.m. Weekday or overnight calls may be given at the discretion of the course director, with strict adherence to ACGME Duty Hours. Although there are fewer resident-only conferences in May and August, students will have more opportunities to do procedures because new residents start in June and July.

Students will attend all of the following didactic series during their respective elective month:

• Tuesday CA-1 Conference (weekly, September-February)
• Wednesday CA-2/3 Conference (weekly, September-April)
• Thursday CA-1 - CA-3 Simulation Conference (weekly, September-April)
• Friday Grand Rounds (weekly, all 12 months)
• New resident conference (daily, June-July)

For an entire week, students will have an opportunity to gain exposure to many of the subspecialty fields, including obstetrics, pediatrics, critical care medicine and pain medicine.

Independent reading from Miller’s Basics of Anesthesia (made available to each student) will be assigned throughout the course, culminating in an end-of-rotation exam that, along with formal evaluations, will determine the student’s final grade. According to Feinberg policy, students are not able to earn a high pass grade for an elective rotation, so students can only only earn a pass, fail or honors grade.