Department of AnesthesiologyDonald S. Prough, MD
Professor and
Rebecca Terry White Distinguished Chair

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Anesthesiology Electives

The Department of Anesthesiology offers a wide variety of courses for medical students. Students wishing to enroll in an anesthesiology elective should contact the registrar. Students from other universities should complete an application form available from the Registrar's Office (409-772-1215) to confirm eligibility for enrollment. The overall Anesthesiology Electives Course Director is Lisa Farmer, M.D.

Anesthesiology Research
ANER-4001
8 - 12 Weeks (Duration)

Prerequisites: Successful completion of Year 2

Additional Requirements: Pre-selection by course director; It is preferable that students meet with the course director 2 to 3 months prior to the elective. Note: An R form must be submitted 30 days in advance of all research electives.

Responsible Faculty Director:
George C. Kramer, PhD

Other Faculty:
Mike Kinsky, MD, PhD

Location to Report on First Day
Room 2.51, OSB

Periods Offered
3-11 NOT including Period 12 (June), including the holiday vacation Period 13 (Dec)

Maximum Enrollment
4

Goals
Provide research exposure through the participation in experiments. Learn basic and some advance techniques of monitoring cardiopulmonary function in laboratory animals.

Objectives

1. To explore current topics in cardiovascular research, both clinical and basic science from conceptualization through research design, implementation, data collection, and data analysis.
2. (Optional) Author and publish an abstract or manuscript of original research, this generally requires substantial time beyond this elective.

Description of course activities
Educational Methods

1. Reading scientific literature (directed)
2. One-on-one collaboration with Anesthesiology Faculty (Research) Note: Completion of a research project normally requires a commitment of 2-3 elective periods (contiguous recommended) or an equivalent personal effort.

Type of students who would benefit from the course
This elective is designed to be of value to any student interested in scientific research, especially students interested in cardiovascular, pulmonary, physiology and pharmacology. Students contemplating residencies in anesthesiology, surgery, or emergency medicine would particularly benefit.

Advanced Cardiovascular Physiology for Physicians
ANER-4006
4 Weeks (Duration)

Prerequisites: Successful completion of Year 2

Additional Requirements: Pre-selection by course director; It is preferable that students meet with the course director 2 to 3 months prior to the elective. Note: An R form must be submitted 30 days in advance of all research electives.

Responsible Faculty Director:
George C. Kramer, PhD

Other Faculty:
Mike Kinsky, MD, PhD

Location to Report on First Day
Room 2.51, OSB

Periods Offered
1-12 including Period 12 (June), including the holiday vacation Period 13 (Dec)

Maximum Enrollment
8

Goals
To reinforce and supplement students' understanding of the basic science knowledge of cardiovascular function and increase their understanding of the clinical tools to treat cardiovascular dysfunction. The focus is on a quantitative approach to cardiovascular science.

Objectives
Specific objectives are tailored to the needs of the student, e.g. future residency and training plans.

Description of course activities
Basic physiologic concepts are the basis for discussion topics concerning the function of the cardiovascular system during normal and pathological conditions. These could include cardiovascular reflex control, hemodynamics, hypertension, cardiac rhythmicity, exercise, hypovolemia, anesthesia, etc. Each student will be expected to present (PowerPoint) at least one topic in detail and actively participate in discussions.

Type of students who would benefit from the course
This course could be of interest to all students, but could be especially useful to those considering specialties in cardiology, internal medicine, emergency medicine, surgery, anesthesiology, or research.

Clinical (OR) Anesthesiology
ANEU-4001
4 Weeks (Duration)

Prerequisites: Successful completion of Year 2

Additional Requirements: n/a

Responsible Faculty Director:
Lisa Farmer, M.D.

Location to Report on First Day
Anesthesia Dept. 2A JSA, Slocum Conference Room 9:00am, Cherie Barker, Administrative Coordinator

Periods Offered
3-11NOT including Period 12 (June), NOT including the holiday vacation Period 13 (Dec) Maximum Enrollment
5 (2 Period 11)

Goals

1. To provide an understanding of the principles of perioperative medicine needed to identify and manage physiological perioperative stress as related to surgical and anesthetic interventions and modified by coexisting disease.
2. To help develop skills relating to perioperative procedures of airway management and vascular access.
3. To provide an understanding of the principles and components of clinical anesthesia needed to provide insensibility, analgesia, amnesia, and immobility.

Objectives
Students will learn airway management, intubation techniques, start IVs, and deliver anesthetics under supervision.

Description of course activities
At orientation students are loaned textbooks, "Basics of Anesthesia" by Stoelting and Miller and "Anyone Can Intubate: a practical step-by-step guide for health professionals" by Christine E. Whitten.and given a schedule of reading assignments for the rotation. Students are assigned to faculty or residents on a weekly basis. They are also assigned to one day each in the DSU, Pain Clinic, OB, Shriners Hospital and the OR Holding area to obtain a well-rounded view of the Anesthesia program. Students actively participate with the resident or faculty in perioperative management of surgical patients. Typically students arrive at the hospital at 0615-0630 for OR preparation prior to attendance at daily departmental Grand Rounds at 0645 hours held in the Harvey C. Slocum Memorial Conference Room, Suite 2A, John Sealy Annex. Students also participate in simulator exercises for airway management. No night or weekend call.

Type of students who would benefit from the course
This rotation is not designed solely for those interested in an anesthesiology residency. Nearly all physicians will care for patients who will need to undergo anesthesia for surgical procedures. It is important for these physicians to understand the perioperative stresses involved and what is needed to prepare patients in order to reduce their risk of complication. In addition, knowledge and skills gained are valuable in diagnosis and treatment of patients in need of emergent resuscitation (airway, breathing, and circulation).

Obstetrical Anesthesiology
ANEU-4002
4 Weeks(Duration)

Prerequisites: Successful completion of Year 3

Responsible Faculty Director:
Rakesh Vadhera, M.D.

Location to Report on First Day

Periods Offered
1-11 NOT including Period 12 (June), NOT including the holiday vacation Period 13 (Dec)

Maximum Enrollment
2

Goals
See objectives

Objectives

1. To prepare the medical student for the practice of medicine, regardless of specialty, by instruction in the preparation of the parturient for anesthesia.
2. To learn the basic principles and components of obstetrical anesthesia in order to provide the parturient with insensibility to pain and relief of the stress of labor and delivery.
3. To learn the basic physiology of pregnancy, labor and delivery, and to learn perinatal pharmacology of analgesia during labor and delivery.
4. To familiarize medical students with methodology, techniques, indications, and limitations of both invasive and noninvasive monitoring for interpretation and anesthetic intervention during labor and delivery for both simple and high risk parturients.
5. To recognize life threatening medical emergencies resulting in alterations in airway,breathing and circulation, for both simple and high risk parturients, during labor and delivery, obstetrical emergencies during labor and delivery, and the anesthetic management of both regional and general anesthesia for parturients so affected.
6. To learn basic principles of the resuscitation of the newborn.
7. To personally administer (optional) regional anesthesia, beginning with the preanesthetic assessment, placement of either subarachnoid and/or epidural neural blockade, for analgesia during labor and delivery and through recovery of the patient's protective reflexes.

Description of course activities
Student participation is under the direct supervision of residents and faculty. Students do not do rapid sequence general anesthesia inductions and tracheal intubations since this requires expertise and speed not usually obtainable from students. However, students will, under direct supervision of anesthesia residents and faculty, learn to do spinals and epidurals for vaginal delivery. After students have demonstrated reasonable skill, they may perform regional anesthesia for C-section patients. No night or weekend call.

Type of students who would benefit from the course
The design of this elective is to be of value to all students interested in Anesthesiology, Obstetrics and Gynecology, and Primary Care Medicine.

Critical Care Medicine - Surgical and Neurosurgical Intensive Care Units
ANEU-4003

Responsible Faculty Director:
William Whitehead, M.D., Ph.D.

Location to Report on First Day

SICU Anesthesia Students should report directly to the Senior Anesthesia Resident in the SICU on 4A, 4th Floor, John Sealy Hospital at 7:00 a.m.

Periods Offered
1-11 NOT including Period 12 (June), including the holiday vacation Period 13 (Dec)

Maximum Enrollment
4, 2 Period 13

Goals
See Objectives

Objectives

1. To prepare the medical student for the practice of critical care medicine, by instruction in the diagnosis and management of the critically ill patient.
2. To evaluate the severity of diseases in critically ill patients and to recognize, prioritize, and treat life threatening derangements.
3. To learn basic and advanced principles of airway management, oxygen transport, respiratory therapy and institution, management and weaning of mechanical ventilation; nutritional support and antimicrobial therapy and management of sepsis and multiple system organ failure, and techniques for invasive and non-invasive hemodynamic monitoring.

Description of course activities
Each student gathers and organizes data on one or more critically ill patients, and this data is presented during rounds and discusses in detail with the Faculty. The student will be asked to answer questions, which arise on rounds, and to participate in formulation of care plans. After rounds, students are expected to aid SICU residents in evaluation and management of critically ill patients and implementation of the daily plan, including instituting and/or withdrawing invasive monitors (catheters), ventilatory, cardiovascular, nutritional support, and laboratory evaluation. Medical students are expected to attend morning and afternoon rounds and SICU lectures. No weekend responsibility or overnight call.

Type of students who would benefit from the course
Students planning a career in Anesthesiology, Surgery, Emergency Medicine, Internal Medicine.

Anesthesiology - Pain Clinic
ANEU-4004
4 Weeks (Duration)

Prerequisites: Successful completion of Year 3

Additional Requirements: n/a

Responsible Faculty Director:
Courtney Williams, MD

Other Faculty:
Gulshan Doulatram MD
Daneshvari Solanki FRCA
Jeff Baker PhD
Scott Lin, MD
Rene Przkora, MD, PhD
Govindaj Ranganathan MD

Location to Report on First Day

Pain Clinic Students should report to the Pain Clinic 2600 Gulf Freeway South, Town Center Shopping Center, right off I-45 at exit 20 between Hobby Lobby and Sports Authority at 8:00 a.m.

Periods Offered
4-11 including Period 12 (June), including the holiday vacation Period 13 (Dec)

Maximum Enrollment
1

Goals
Enhance knowledge of pain and pain management.

Objectives

1. To develop and learn skills in the basic principles of chronic and acute pain management and learn to evaluate, consult and manage pain syndromes, both chronic and acute.
2. To learn the indications , limitations, and complications of neural blockade in pain management and begin to develop procedure skills to perform neural blockade.
3. To learn indications, limitations, and contraindications for the use of non-opiod, opioid and adjunctive pharmacologic and non-pharmacologic therapy, including psychologic and support therapy, in management of pain syndromes, both chronic and acute.

Description of course activities
The student will be assigned directly to the faculty member covering the Pain Clinic each day and will work in partnership with the anesthesiology resident(s) and/or fellow. Attendance at Anesthesiology Morning Conference (0645 - 0715 hours) is expected. After conference the resident(s) and student will conduct morning rounds on Acute Pain Service inpatients and consult patients. Clinic begins at 8:00 a.m.(except on Wednesdays at 9:00 am)and generally finishes by 2:00 p.m. Afternoon inpatient rounds are done after completion of clinic. Approximately 15 patients are evaluated each clinic day. Night and weekend call is not required. When multi-disciplinary pain conferences are scheduled, students participate in the presentation of a case or protocol. Special projects are encouraged but must be arranged well in advance.

Type of students who would benefit from the course
Students interested in psychiatry or rehabilitation medicine may benefit from this early exposure to chronic pain management. Students pursuing surgery, anesthesiology, and oncology may also benefit from their exposure to both acute and chronic pain problems. Students with a strong interest in neurosciences may also find the rotation enlightening. Primary care physicians may especially benefit from the ability to deal with patients in pain; a difficult and poorly understood patient population.

ing Internship in Anesthesiology
ANEU-4005
4 Weeks (Duration)

Prerequisites: Successful completion of Year 3

Additional Requirements: Clinical Anesthesiology or Cardiothoracic Anesthesiology Elective

Responsible Faculty Director:
S. Lynn Knox, MD

Other Faculty:
n/a

Location to Report on First Day
John Sealy Annex 9:00am, Slocum Conference Room, Suite 2A, Cherie Barker, Administrative Coordinator

Periods Offered
3-11 NOT including Period 12 (June), NOT including the holiday vacation Period 13 (Dec) Maximum Enrollment
1

Goals

1. The student will gain skills and knowledge required to function at the level of a beginning anesthesiology intern.
2. The student will understand the principles of preoperative patient evaluation; including decisions regarding laboratory investigation and consultation, implications of chronic medical disease, & elements of a directed H&P.
3. The student will personally administer perioperative anesthesia care with close supervision, beginning with preoperative assessment, equipment preparation, intraoperative management and postoperative stabilization and pain control.
4. The student will become familiar with the management of acute circulatory and respiratory adverse events.

Objectives
The student will:

1. Personally conduct in consultation with faculty the preoperative evaluation of their patients and assign ASA physical status.
2. Discuss basic principles and techniques of general and regional anesthesia, including risks and benefits of various techniques.
3. Identify specific agents used for induction and maintenance of anesthesia and discuss their advantages and disadvantages (IV agents, Inhalational agents, Neuromuscular blocking agents).
4. Demonstrate basic airway management techniques, including airway evaluation, mask ventilation & direct laryngoscopy.
5. Demonstrate skill at establishing venous access.
6. Discuss indications, techniques and limitations of noninvasive and invasive monitoring.
7. Calculate maintenance and replacement IV fluid requirments for the perioperative period.
8. Demonstrate knowledge of assessment and management of postop pain.

Description of course activities
Students will be given the manual prepared for interns entering the department of Anesthesiology, course syllabus, handouts and loaned textbooks: Basics of Anesthesia, by Stoelting and Miller; Anyone Can Intubate: a practical step-by-step guide for health professionals by Christine E. Whitten. Students will be responsible for doing the preoperative evaluation of the patients whom he or she will care for. He or she will discuss these evaluations with the appropriate faculty in advance and formulate the anesthetic plan. In most cases students will personally perform under supervision all airway interventions, placement of vascular access and regional anesthesia for the patients he or she is assigned. Students will typically arrive at 0600 to 0615 for OR preparation prior to attending the 0645 departmental morning conference each day, and have overnight call once a week in weeks 2,3,&4 of the elective with postcall day off.

Type of students who would benefit from the course
This course is a more comprehensive, intense follow-up experience in anesthesiology, building on skills and knowledge obtained in a 3rd or 4th year Clinical Anesthesiology Elective. The design and purpose of this elective is to be of value to the student who desires an intense, hands on experience in anesthetic management of patients. This should be of particular value to the student interested in anesthesiology or fields which involve interactions with anesthesiologists. The course will emphasize the evaluation and management of adult patients undergoing a variety of procedures, from simple to complex.

Cardiothoracic Anesthesiology
ANEU-4007
4 Weeks (Duration)

Prerequisites: Successful completion of Year 2

Additional Requirements: none

Responsible Faculty Director:
Christopher K. McQuitty, MD

Other Faculty:
Adam Wacher, MD
Michael Kinsky, MD
Alexis Lutschg, MD

Location to Report on First Day

CT Anesthesia Students should attend Grand Rounds in the Slocum Conference Room, Suite 2A, John Sealy Annex, Dept. of Anesthesiology at 6:45 a.m. and report to the Anesthesia Residents on CT following the lecture.

Periods Offered
1-11 including Period 12 (June), including the holiday vacation Period 13 (Dec)

Maximum Enrollment
1

Goals
To improve the student's understanding of advanced hemodynamic monitoring, cardiopulmonary physiology and anesthetic implications, perioperative risk assessment, management of hemodynamic derangement, and management of postoperative thoracic pain

Objectives
To gain skills and knowledge required to evaluate and manage the perioperative course of a patient with significant cardiac and/or pulmonary disease for high-risk procedures including cardiac, thoracic, and major vascular surgery. This will include:

1. Principles of preoperative evaluation of patients with severe cardiac and pulmonary disease and optimization to minimize perioperative risk.
2. Indications, techniques, and limitations of invasive hemodynamic monitoring including arterial, central venous, pulmonary artery, and transesophageal echocardiography.
3. Acute management of hemodynamic derangements by use of pharmacologic and mechanical devices.
4. Principles and techniques of airway management including lung separation.
5. Principles and techniques of general and regional anesthesia for thoracic procedures.

Description of course activities
The student (along with the assigned resident and faculty) will be responsible for the preoperative evaluation of the patients he/she is assigned to. The anesthetic plan will be discussed and formulated with the faculty and resident. The student will be performing airway, venous and arterial access procedures, central line placement, and regional anesthesia techniques for these cases. The student typically arrives at 6:00 am for initial line placement and conference attendance.

Type of students who would benefit from the course
This course is a focused, intense experience in cardiothoracic and vascular anesthesia. The purpose of the elective is to be of value to the student who desires intense experience in the management of patients with critical cardiac and pulmonary diseases, especially in the perioperative period. This should be of particular value to those students interested in anesthesiology, cardiology, cardiac surgery, critical care medicine, and pulmonary medicine. At the conclusion of this elective, the student should understand the principles of preoperative optimization of patients, the implications of chronic and acute cardiac and pulmonary disease processes in the perioperative period, the principles and utility of advanced hemodynamic monitoring, and the management of acute cardiac and respiratory derangements in adult patients.

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