Question: What is the trauma experience like at Stanford and what is the role of the anesthesia resident?
Answer: For the most recent graduating class data from the ACGME reports shows an average of 34 trauma cases were done by each resident by the end of training. The required minimum by the ACGME is 20. Trauma is also a point of emphasis for some of the simulation sessions. A formal trauma experience exists at Stanford Hospital through our ortho trauma rotation, which includes blunt trauma from motor vehicle and cycling accidents for example. At the Santa Clara Valley County Hospital, many emergent trauma cases come in including penetrating trauma. Anesthesia residents are intimately involved with the care of trauma patients from the moment they arrive in the OR to the time they are dropped off in the ICU.
Question: Is there a difficulty airway team or is their an airway pager that the resident carries and what exactly does that mean?
Answer: Our department is the cornerstone of Code Teams at all of our training hospitals. At all sites, the anesthesia resident who carries the emergency airway pager is primarily responsible for securing the airway. Once the airway is secured, we contribute to patient management by placing lines and getting access. “Running the code” is a role usually reserved for ICU fellows and attendings.
Question: Does the program provide money for food at the hospital or provide meals to the residents?
Answer: The hospital-wide graduate medical education office provides a small stipend ($10) to any resident who works more than 12 hrs/day (based on duty hours reports). In addition, our department provides breakfast on weekdays and there are a number of afternoon and evening lectures that provide food to attendees.
Question: This question was for Jorge Caballero one of our Chief Residents. Why did you choose to do you residency at Stanford?
Answer: By Jorge–“Having trained at Stanford from undergrad through residency, I’m often asked why I’ve opted to stay on the Farm for so many years. There are plenty of reasons but they all boil down to one thing: the people. From the time I stepped foot on campus in 2002, I’ve met one remarkable individual after another. Interacting with students, faculty, and staff who are committed to making a difference is inspiring and invigorating. What’s more, the culture at Stanford encourages collaboration rather than competition, which makes it easy to explore novel ideas and discover new interests. As a resident, I’ve enjoyed the camaraderie of my co-residents, many of whom I consider among my closest friends. Given how much support I’ve received from Stanford Anesthesia, it should be no surprise that I’m looking forward to contributing to our department as a member of our research and clinical faculty.”
Question: What training do Stanford residents get as anesthesia “managers” and with supervision?
Answer: The issue of supervision is an important one and wrt to the manager function several rotations come to mind:
1) VA Chief Resident where resident runs the board, helps start cases, does blocks, teaches junior residents etc
2) ASC periop rotation which is similar but is in the ambulatory surgery center here on stanford campus
3) Byers practice management a new rotation in a freestanding surgery center with 2-3 CRNAS
4) VA ICU which has interns on the team
5) EVOLVE, a multi- year simulation-based curriculum for anesthesia residents transitioning into supervising anesthesiologists.
6) The Stanford Anesthesia interns do 1 month of anesthesia and are paired with a resident for a week at a time. The resident supervises the intern delivering anesthesia care in the OR.
Question: Does the Stanford training program have CRNAs?
Answer: There are CRNAs at the County Hospital and at the VA hospital where the residents rotate. At Stanford Hopsital there are CRNAs in the cardiac cath lab, IR lab, and endoscopy suite.