The Division of General Anesthesia
encompasses not only general
sugery, trauma surgery and surgical oncology but also oversees
perioperative services and critical care. Faculty members within the
division include:
Anesthesia residents will be exposed to the general division at
numerous times throughout their residency training. After the
initial period of intense didactic and one on one dedicated faculty,
CA-1 residents enter a four week rotation with close faculty
supervision. The focus is on general patient management and
problem solving in the operating room. The clinical experience is
supplemented with medical simulation of routine cases and critical
events. Each resident will “fly solo” in the simulator
approximately once per month with additional time being used to
solidify particular teaching points.
Additional CA-1 exposures involve a dedicated PACU rotation in which
residents are involved in everything from the routine evaluation and
discharge of patients to the management of critically ill patients
prior to their transfer to the ICU. Residents are supervised by
two faculty members trained in Critical Care Medicine. The PACU
rotation also encompasses the advanced airway rotation in which
residents complete at least twenty advanced intubations under faculty
with specific interest in advanced airway management.
During their CA-2 year, residents spend four weeks in Pre-operative
Services clinic. It is expected that residents will become fluent
in current practice guidelines from the American Society of Anesthesia
and American Heart Association. Residents are expected to become
proficient in the identification and optimization of medical
conditions, make appropriate selection of residents for the ambulatory
setting and provide patients with the necessary information for making
informed choices in their anesthetic care.
CA-2 residents also rotate through Vascular Anesthesia for four
weeks. Although the focus is on minimally invasive endovascular
procedures, there is exposure to major vascular procedures and the
physiologic changes associated with surgical procedures involving
aortic cross clamping. There is a focus on invasive monitoring
and transesophogeal echocardiography for the diagnosis of ischemia and
monitoring of volume status.
CA-3 residents are involved in an Advanced Clinical rotation for major
general and radical oncologic procedures. There is a focus on
increasing complex patients with multiple co-morbid conditions.
Senior residents are given increasing independence as they gain
additional experience in the management of these patients. Senior
residents are also given additional responsibilities as team leader on
call and assist in the triage and management of patients involved in
emergent surgical procedures.
Experience with trauma will occur at all levels of training.
Stony Brook serves as the only Level 1 Trauma center for Suffolk County
with a population of almost 1.5 million people. Residents will
gain significant experience in dealing with complex multi-trauma
including closed head injury, intra-abdominal injury and major
orthopedic injury simultaneously. Although uncommon in this
geographic area, penetrating trauma is managed by our trauma services
as well. Trauma/Critical Care experience is also augmented by a
four week rotation in the 20 bed Surgical Intensive Care Unit which is
run by both surgical and anesthesia faculty. Additional Critical
Care experience can be done on an elective basis in our Coronary Care
Unit, Medical Intensive Care, Pediatric Intensive Care and Neonatal
Intensive Care Units.
Research opportunities within the general team involve both basic and
clinical research. In Dr. Liu’s research lab on aging
animal hearts, Dr. Long Nguyen (2006) received second place in the
American Society of Anesthesiologists Residents Research Essay
Contest. For clinical projects, residents will be involved in the
actual studies as well as encouraged to initiate projects of their own.
For an interdisciplinary approach to patient care, joint anesthesia and
surgical grand rounds are held several times a year. Faculty and
residents from both services present controversial topics or specific
challenging cases. The goals are resident and faculty education
as well as to promote better communication between services.
The division of general anesthesiology provides a diverse, well rounded
experience for both residents and attendings, from the most basic
aspects of the practice of anesthesiology up to the most demanding and
complex.
