• Clinical Anesthesia Years
  • Junior Level (CA-1) Rotations

  • Parkland Hospital General Anesthesia 

     As a CA-1, residents will spend 2-3 months rotating on general anesthesia at Parkland Hospital. This is where our CA-1s learn the bread and butter of anesthesia. They are involved in a wide variety of cases: general surgery, urology, ENT, gynecology, surgical oncology, ophthalmology, ortho, and plastics. Residents will take call with a senior level resident and an attending. Call on this rotation is every four days w/16 hour calls during the week days and 24 hour calls on the weekends. Because Parkland is a busy trauma center, call nights are full of ex-laps for gunshot wounds, motor vehicle accidents, neck explorations for stab wounds, open orthopedic fractures, ruptured globes, and the endless supply of lap appys and I&Ds. Overnight call at Parkland is a great opportunity to learn from upper level anesthesia residents and develop some autonomy of your own.

     

    Parkland Hospital Burn Anesthesia

    Parkland Hospital is a national burn center (ever heard of the "Parkland Burn Formula"?) and, as a CA-1, residents spend one month providing anesthesia in the Burn OR. Burn patients are a unique patient subset and often present many anesthetic challenges: difficult airways requiring awake fiberoptic intubations, challenging IV access, difficulty with temperature and fluid regulation, and surgical procedures with great potential for blood loss. This rotation also allows for experience with pediatric burn patients, as they are often transferred to Parkland for burn care. This rotation has in house call, with an experience similar to that described above under Parkland General.

     

    Parkland Hospital Obstetric Anesthesia

    As a CA-1, residents spend two months on Labor and Delivery, learning to place spinals, epidurals, and combined spinal/epidurals for both scheduled and emergent C-sections. They also assist with epidurals for laboring patients. Many of the patients at Parkland are considered high-risk OB, meaning their pregnancy has been complicated by pathology such as pre-eclampsia, HELLP syndrome, placenta previa, diabetes, HIV/AIDS, etc. Residents see the full complement of OB emergencies, including STAT C-sections for fetal distress, placental abruption, amniotic fluid embolism, post-partum hemorrhage and shoulder dystocia. Because of our proximity to Children's Medical Center of Dallas, it is also common to be part of the delivery of infants with congenital anomalies (e.g. EXIT procedures). This rotation has in house call.

     

    Clements Hospital Cardiovascular Intensive Care Unit

    Clements Hospital is a quaternary referral center for high intensity cardiac surgery on sick patients and thus we have a robust CVICU in order to take care of these patients in the perioperative period. As a resident (can rotate here as a CA-1 through CA-3) you will be caring for CABG's, Valve replacements, ECMO, LVAD, Transplants under the supervision of Our Anesthesia Critical Care Trained Faculty. This is an amazing learning experience and although it is rigorous, our residents usually really love this month!

  • Dallas VA Medical Center General Anesthesia

    As as CA-1, residents spend 1-2 months rotating on general anesthesia at the VA Hospital. Many of the patients at the VA have complex pathophysiology- coronary artery disease, COPD, chronic pain, PTSD, cirrhosis, etc. At the VA, residents get experience in orthopedic surgery cases (including regional blocks), ENT, general, urology, and plastics. Because the VA has their own full time faculty, residents are exposed to many different methods of delivering anesthesia. This rotation has home call. 

     

    Clements University Hospital General Anesthesia

    The University Hospital System (William P. Clements, Jr. Hospital and Zale Lipshy Hospital). These are busy ORs that handle cases ranging from general surgery, ENT, ortho, vascular, surgical oncology, gynecology/gyn-onc, plastics and liver and kidney transplants. Many of our CA-1s find themselves in cases such as pheochromocytomas, large abdominal tumor debulkings, radical neck dissections for laryngeal cancer, cosmetic procedures and kidney transplants. Call on this rotation is home call.

     

    Dallas VA Medical Center Intensive Care Unit

    We have a unique opportunity to take care of some of our nation’s veterans as they recover in the peri- and postoperative period. Our interns spend a month in the VA ICU managing both SICU and CVICU patients after major abdominal, thoracic and cardiac surgeries. Our ICU is a closed anesthesia-run unit with surgical services following their patients on a daily basis in a consultant capacity. Call for this rotation is in house.

     

    Parkland Hospital Pre-Operative Anesthesia Clinic

    Parkland Hospital has a pre-operative anesthesia clinic where patients come prior to surgery to be assessed and optimized by an anesthesiologist. Two CA-1s each month rotate through this clinic. This is an excellent opportunity for residents to refine their pre-op assessment skills, learning to decide who is medically optimized for surgery and when surgery needs to be delayed for further work-up. The clinic-type schedule of this rotation makes for a comparatively light load. There is no call on this rotation.

  • Senior Level (CA-2/CA-3) Rotations
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    Dallas VA Medical Center Intensive Care Unit

    Similar to the CA-1 rotation, residents may spend a month in the VA ICU managing both SICU and CVICU patients after major abdominal, thoracic and cardiac surgeries. Our ICU is a closed anesthesia-run unit with surgical services following their patients on a daily basis in a consultant capacity. This rotation has in-house call.

     

    Clements University Hospital Cardiovascular Intensive Care Unit

    Residents may spend a month in the Clements Hospital cardiovascular intensive care unit taking care of critically ill patients. These patients include post cardiac and thoracic surgery patients including, but not limited to: CABG, valve replacements, heart transplants, liver transplants, ECMO, and heart failure patients. Residents will gain experience in the post operative care including weaning of inotropic agents, weaning from the ventilator, and placement of lines and catheters. There is no call on this rotation.

     

    Children’s Pediatric Anesthesia

    Each resident will spend two consecutive months at Children’s Medical Center where he or she will gain exposure to pediatric anesthesia. Children of all ages with an array of different congenital and acquired illnesses travel to CMC for their care. In addition to their own large NICU, CMC also serves the surgical needs of the Parkland NICU next door. Residents spend time in both the main hospital operating rooms and the pediatric ambulatory surgical center. They gain experience with high case volume and rapid turn overs, complex physiology and the specialized skills required for airway management, peripheral IV access and regional anesthetic techniques in small children and infants. This rotation has in-house call.

     

    Clements University Hospital Hybrid Pain

    At Clements, two residents each month work closely with our pain and regional faculty learning to perform blocks both pre- and post-operatively. They also manage any in-hospital pain consults. Call on this service is from home.

     

    Dallas VA Medical Center Chronic Pain


    One resident each month rotates in the VA Chronic Pain Clinic. In addition to seeing patients and performing office-based interventions, residents spend one full day per week in the operating room learning a variety of chronic pain procedures such as intrathecal pain pump, ablations and injections. Call on this service is from home.

     

    Dallas VA Medical Center Cardiac

    Each month, one resident is assigned to the cardiac OR at the VA and will have the opportunity to provide anesthesia for many complex cardiac and thoracic cases. For each cardiac case, the resident will place all of the lines, intubate, and perform the majority of the medical management throughout the case using the knowledge that he or she has acquired on their prior cardiac rotations. In addition, the resident will work directly with the cardiac faculty to hone his or her basic TEE skills. This rotation has home call.

     

    Parkland Chiefing 

     As a an upper level resident, you will spend 2-3 months rotating on general anesthesia at Parkland Hospital. Similar to CA-1 year you will be exposed to a wide variety of cases with slight differences. First your cases will be tailored towards the fact that you are now an upper level and can handle more complex cases on very sick patients (potentially ASA 4/ASA 5 patients). Call on this rotation is every four days w/16 hour calls during the week days and 24 hour calls on the weekends. As the upper level you will take call overnight w/ a junior resident and your night is spent "Pre-Attending" for that junior Resident, while controlling the flow of emergent cases through the OR overnight, while preparing the next day's patients for surgery. Overnight call at Parkland is a great opportunity to improve on your level of autonomy while learning how to multitask in order to deal with the intricacies of running perioperative serves. 

  • Texas Scottish Rite Hospital for Children Pediatric Anesthesia 

    Each month, one CA3 will have the opportunity to rotate at Texas Scottish Rite Hospital for Children (TSRH). TSRH is a children’s hospital that provides a multitude of services to children from all over the region. Most of the operations performed are by orthopedic and plastic surgeons to correct congenital musculoskeletal abnormalities, and this creates a rather unique patient population. The resident will perfect his or her pediatric anesthesia skills with special focus on fluid therapy, difficult airways, and pain management. This resident does not take call or work any weekends/holidays.

     

    Baylor University Medical Center Transplant Medicine

    Two CA3 residents rotate at Baylor University Medical Center (BUMC) each month. The main purpose of this rotation is to gain experience in liver transplant anesthesia, but our residents may partake in any of the anesthetics that occur at BUMC. This allows the resident to experience anesthesia in a more private setting in addition to learning how to manage the complex physiological challenges presented during a liver transplant. One resident will take call for liver transplants each day.

     

    Dallas VA Medical Center Intensive Care Unit Chief

    One CA3 per month will be assigned as the VA ICU chief. This presents an opportunity to showcase the strong training that our residents have received throughout their years. The chief has the responsibility of overseeing the care of the service, coordinating care with the team’s surgical colleagues, and teaching lower level residents as well as medical students. This rotation has in house call.

     

    Clements University Hospital Advanced General

    This rotation allows senior residents to spend time focusing on the anesthetic management of complicated surgeries. They spend time dedicated to the busy hepatobiliary, surgical oncology and colorectal services, taking care of patients undergoing exploratory laparotomies for tumor resections, liver resections, pheochromocytomas and Whipple's. No change in Whipple procedures. This rotation does not currently have call.

     

    Zale Lipshy University Hospital Neuroanesthesia

    At Zale, four residents each month work closely with our neuroanesthesia faculty learning to perform anesthesia for a variety of neurosurgical procedures including:  craniotomy for neurovascular disease and tumors, complex spine surgery, endovascular neurosurgery, and functional neurosurgery. They also get exposure to anesthesia for ECT. Call on this service is from home.

     

    Parkland's Airway Rotation

    A general Anesthesia rotation at Parkland hospital that centers around difficult airways. There you'll work with Attendings who specialize in nasal/oral fiber optic intubations (awake and asleep), intubating through LMAs, cricothyrotomies, use of doublet lumen tubes, airway blockers etc and apply these techniques to different high intensity ENT/thoracic cases. The rotation also comes with an experience in practicing cricothyrotomies on porcine cadavers. 

     

    Post Anesthesia Care Unit Rotation

    Our residents spend time as the main Anesthesia Provider for the PACU at Parkland Hospital. You deal with the expected post operative issues including pain, nausea/vomiting, delayed arousalas well as the unexpected complications surrounding a procedure ACS, hemodynamic instability, severe bleeding, etc. Call on this rotation is every four days. On the days you're not on call, your schedule is essentially 8AM-3PM. When you are on call you join the general call pool of Parkland Chiefs w/ 16hour calls during the week days and 24 hour calls on the weekends.