• Clinical Base (Intern) Year Rotations

     

    Methodist Internal Medicine
    Our interns complete 4 months of medicine wards at Methodist Hospital. A foundation in managing common medical pathology is crucial in becoming a strong perioperative physician. As an intern on medicine wards, residents learn the work up and management of acute coronary syndrome, congestive heart failure, COPD, cirrhosis, acute CVA, renal failure, pneumonia and much more. They admit patients from the ER and coordinate their care for the duration of their hospital stay. They round with a medicine attending, an upper level resident, and will also have the opportunity to teach medical students.

    Methodist Medicine Intensive Care Unit
    Managing critically ill patients is a fundamental part of our specialty. Our interns spend one month rotating through the medicine ICU at Methodist Hospital. While rotating here, residents see common critical disease processes such as sepsis, cardiogenic shock, hemorrhagic stroke, diabetic ketoacidosis, liver and renal failure. They also gain experience doing procedures such as intubations, central and arterial lines, bronchoscopies, lumbar punctures, thoracentesis, and paracentesis. They learn to make decisions about mechanical ventilation and inotropic/vasopressor support. They round with excellent critical care faculty who provide guidance by using current evidence-based practice data. Each team consists of an anesthesia intern, two senior level residents and one internal medicine intern. This is one of the most high yield rotations we do as interns.

    Baylor Coronary Care Unit
    On this rotation, residents work closely with a team of cardiologists and internal medicine residents to care for patients with complicated cardiac physiology. Residents see patients both on the floor and in the CCU, as well as having the opportunity to spend time in the angio suite observing percutaneous interventions. They become proficient in the management of patients after acute MI and with chronic congestive heart failure due to any number of disease processes. This rotation is a change to become well-versed in cardiac physiology, understanding electrocardiography and choosing vasoactive agents. This rotation has in house call.

    Children’s Medical Center Pulmonary Service
    Our interns spend one month rotating on the pulmonary service at Children’s Medical Center (CMC). The pulmonary service takes care of some of the sickest patients at Children’s Medical Center in Dallas: cystic fibrosis, severe asthmatics, chromosomal and syndromic disorders, and children dependent on mechanical ventilation with tracheostomies. This unique group of patients often requires very specialized management. The pediatric pulmonologists working closely with our residents are some of the most respected in the country. Anesthesia interns work on a team with a senior pediatric resident and two other pediatric interns. They learn to manage the patient's hospital and home ventilators. They become familiar with all the different pharmacology available to treat pulmonary pathology. This rotation is especially helpful for those with an interest in pediatric anesthesiology, as early exposure is crucial.

    Parkland Hospital Emergency Medicine
    Rotating one month through Parkland Hospital’s Emergency Room is an exciting and fast paced rotation. Residents learn to rapidly assess, triage, and stabilize patients as they walk through the door of one of the busiest ER’s in the country. As a Level One Trauma Center, Parkland is a high-volume trauma and burn center. A normal shift has the potential for patients with injuries related to gunshot wounds, motor vehicle accidents, knife wounds, and drug overdoses. Our residents are often the first physician to diagnose a STEMI or an acute CVA. They may also be called upon to intubate an unstable patient, or perform an I&D of an abscess. This rotation trains residents to promptly make a decision on a critical patient, which is a skill that will serve well in the operating room.

    Parkland Hospital or Baylor Pulmonary Service
    One month is spent rotating on the pulmonary consult service at Parkland Hospital or Baylor Hospital. Residents see and assess patients with a wide range of pulmonary pathology such as tuberculosis, pulmonary fibrosis, pulmonary malignancies, etc. They observe and participate in bronchoscopies in the pulmonary lab. Understanding pulmonary mechanics is an imperative part of our specialty, and our residents certainly master the basics on this rotation. They cover consults on the floor, the ICU and see patients in clinic once a week. The team usually consists of an anesthesia intern, a medicine resident, a pulmonary fellow and a pulmonary critical care attending. The schedule of this rotation is generally amenable to studying for and taking Step 3 exam.

    Baylor Transplant Intensive Care Unit
    Rotating at Baylor Hospital is a favorite rotation among our residents. The Liver and Kidney Transplant program at Baylor is one of the busiest in the country. Residents have the opportunity to accompany the surgeons on “harvest runs” which could be a drive across town or a plane flight to a neighboring state. They assess potential transplant recipients preoperatively, scrub and assist on the transplant operation, and directly manage the transplants in the post-op period. They work as part of a team that includes a surgical intern, a transplant surgery fellow and the transplant attending. As the anesthesia intern, our residents are responsible for covering the pre and post op patients in the Intensive Care Unit.

     

    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.

    Vapor Camp
    All of our interns will attend Vapor Camp in June of their intern year. This rotation is an invaluable “intro to Anesthesia” month. Interns are paired with upper level anesthesia residents. Residents learn how to perform thorough pre-ops, set up the operating room for cases and practice induction and emergence techniques and skills such as intubation, arterial and central line placement. This rotation was created five years ago to improve our interns’ anesthesia experience, and the difference in the abilities and knowledge base of our new CA-1s in July has been noticed by the faculty. This rotation gives residents the confidence they need to start CA-1 year in the OR.