Welcome to the
Yale Anesthesia Rotation
If you have questions please contact us
This page has basic infomation about your anesthesia rotation. If you have questions, please reach the Resident Medical Student coordinators at anytime on our Mobile Heart Beat (MHB) phones or at this email: [email protected]
Welcome
We are excited to have you rotate on the anesthesia service at the York Street Campus, and hope you have a great experience in a variety of operating rooms (OR) and with our various clinical teams. Most days you will be assigned to a resident and attending team in an OR's, although you may also rotate with our obstetrics team, acute pain team, ICU team or regional anesthesia teams. If you have a specific interest in working in a particular clinical area, please let us know and we will do our best to accommodate. The resident coordinators are always available to help you with these request (see "contact information" button below.) At the bottom of this page, note the various lecture series that you are required and/or invited to attend.
Lastly, we appreciate our student rotators. Click this link for our gallery of YSM and other visitors.
Dr. Chris Szabo, Clerkship Director
[email protected]
Phone: MHB 203-500-8839
Rotation organization
The clinical service consists of attending anesthesiologists, Fellows, Residents, Yale and visiting Sub-Is. The anesthesia coordinators canvas the next-day's schedule to identify cases susible or your education. You are allowed to request subspecialty cases or rotations during your weeks with us. Below on this page you will learn how to find your assignment.
Get ready for your cases: It is your responsibility to in preparation for the procedure and anesthetic management. At a minimum you should know the following:
1. Name and basic demographics (gender, age, etc) of the patient
2. History of present illness (presenting diagnosis) and pertinent medical history
3. Procedure to be performed
4. General anesthetic plan
Most of this information can all be obtained from Epic. Remember, “You are the master of your own education”. How much you learn from a case depends directly on how well you prepare for it. If you are not sure what to read, ask us!
Didactics: (complete list below)
Tuesday afternoon is the scheduled didactic in the North Pavilion Anesthesia Workroom. There is lunch provided every other week. This is an in-person lecture (no hybrid option) and you are excused from any clinical duties for the lecture.
Research:
There is a tremendous amount of clinical research being carried out in the Department of Anesthesiology. Our faculty, residents, fellows, and students are continually developing new research endeavors in a broad range of topics. If interested in reading about them or possibly participating on a project, please inquiry to any of the faculty.
Reading: There are 31 reading topics - one for each day of the month. This link will take you to the daily learning topic that can guide your discussion with the resident, fellow or attending you are working with. Click on the appropriate day of the month for an in-depth discussion.
How is my clinical assignment made?
Your OR or team (e.g. Pain, regional, etc) assignment will be made the day before when the anesthesiologist in charge ("South Pavilion Floor Runner" or SPFR) has finalized the scheduling of the attending and resident physicians for the next day. For example, your schedule for Tuesday will be posted Monday, typically by 6pm. If you do not see an assignment by 8pm, please reach to the resident coordinators (See contact phone numbers).
How do I find my assignment when I'm at the hospital?
You should be able to find your assignment at any one of the monitors in the Anesthesia Workrooms displaying the "Status Board"
How do I find my assignment from home (or a non-OR location)?
If you are in an anesthesia area, you should be able to access the Status Board at any Epic workstation or with any access to Epic (e.g., at home):
Log onto EPIC and change your context to YNH Anesthesia - This may lead you to another screen, with a large menu on the left side, please scroll to YNH Charge SP and double click - Click on the icon in the upper left hand corner “Status Board” - Below that tiny icon you will see a few icons including “Charge NP” and “Charge SP”. Depending on your assignment, you will find your room under one of these icons (for example, SP1 stands for South Pavilion OR 1)
Coming soon! Screen shot of the mysterious Epic Context board
Looking at the Epic Status Board? What now?
When you are assigned to the OR's, you can find your assignment posted to the EPIC "Status Board". You will need to reference your "extern" number to find your assignment. Use the below link for an example of where to find your assignment on the EPIC status board.
What should I do each day?
You should plan to arrive 45 mins prior to the start of your first case. You can meet up with your resident or attending in the OR, or in the preoperative holding area. Do not go meet with your patient before talking with your resident or attending.. It is always a good idea to reach out to the resident you are working with the day prior (usually easy to find them on MHB or email).
What if I have a particular interest?
Our goal is for you to be an active participant in the care of your assigned patient - if you have a particular interest in a certain surgery, procedure or clinical care area, let us know! If you want to learn about a certain procedure, please ask your resident and/or attending if they would be willing to teach you or find a colleague who is involved in that particular care.
Tips & Tricks for the rotation
Getting to know you: Always introduce yourself to the team - The operating room or procedure area is a secure environment. Any person (staff, student, visitor, vendor) has access to patient Protected Health Information. It is vital that we know who you are. Introduce yourself to the resident (or sometimes a CRNA) and the attending on your team. Feel free to introduce yourself to anyone in the room. Fortunately every case or procedure is preceded by a formal "sign-in" where all personnel introduce themselves while at the patient's bedside. This includes you. state your name and position (e.g., 3rd year medical student)
General OR: Find your way to the operating room to which you are assigned, or wherever you and your resident agreed to meet.
OB team: Arrive at 7 AM in the OB anesthesia workroom located on WP 4th floor.
Acute pain / IPM: Arrive at 7:30 AM in the acute pain workroom across from the SPOR workroom. Attire: professional and white coat.
Regional team: Arrive at 6:15 AM in the south pavilion PACU near bays 16-20 in scrubs. Please ask Elisa if you can place PIVs.
Pediatric / WPOR: Do NOT meet the family without your anesthesia team.
Code resident: Meet in SPOR workroom at 7:00am.
Pedi cath lab: West pavilion 2nd floor. Make sure you get lead prior to the case start.
The MRI Operating Rooms: NP9 and NP10 are MRI Operating Rooms. As you may know, the MRI environment can be dangerous for the patient and personnel. Everyone entering the MRI-OR must be credentialed to do so. Fortunately this is an easy process. Go to the MRI credentialing page and use the QR codes found there.
Notes on Professionalism
The operating room, or procedural are is a serious and professional environment. You are expected to act accordingly.
Attire: In any area including patients you should be dressed appropriately. You will find that both patients and staff will respond to you differently depending on your attire. Though you may have personal preference in behavior and dress, please remember we are there for the patients. Luckily, hospital "scrubs" are appropriate in almost all situations, though there are times you will be expected to wear a white coat or "scrub jacket" - simply take the lead of your resident or attending.
Illness: If you are sick and cannot come in to work, be sure to contact your resident and/or attending so they know.
End of day: When you leave for the day, let your attending know in case they were intending to set some time aside for teaching.
Quiet on the set! A lot happens in the OR and the procedure room. Clinician are concentrating on the patient and should not have external distractions. Your voice should be modulated as such. For example, during the sign-in procedure, be sure everyone can hear you. When you are having a discussion with your resident or attending in the OR, hush tones are more appropriate.
Lectures
We have a mandatory weekly lecture on Tuesdays from 12:00-12:30 by a different resident or attending each week that is designed specially for our rotators! This is a new initiative based on rotator feedback! The specific location may vary, but you can always come to the "Calllway" or ask your resident to guide you there and ask for the "POCUS" resident who will be giving the lecture.
We have many other optional lectures happening in the department that we would love for you to join during your rotation. The zoom links for these lectures can change from week to week, and lectures vary during holidays and the summer months, so please ask your resident the night before for the link and they can get it for you from our weekly departmental listserve.
- Monday and Tuesday morning lectures (6:30am) are by the pediatric anesthesia division.
- Tuesday 12:00-12:30 mandatory lecture (see above)
- Wednesday morning lectures (6:30am) are a rotating series of quick topics by attendings. Wednesday afternoon sessions (4:30pm) for CA-1s are lectures or flipped classrooms and for CA-2s are problem based case discussions.
- Some Thursday mornings (6:30am) include a board review of high yield anesthesia topics.
- Friday at 7:00am is grandrounds, which can be attending in person at Harkness Auditorium or via zoom.
Click here to edit your subtitle
Feedback
Want feedback from your resident and/or attending? Give them this QR code
(Resident / Attending password available from clerkship director or resident coordinators)
Grading Criteria
Sub-I: You will receive one of the following grades: Honors, High Pass, Pass, Fail, or Incomplete. The following are criteria for obtaining each grade:
• Honors (similar to high pass however has exceptional feedback on evaluations or of own initiative has taken on a project or presentation on own initiative during the 4 weeks). In other words, finding a way to be memorable to the residents or attendings
• High Pass- professional, shows up and does work in timely fashion. Great feedback. Curious, engaged during rotation.
• Pass- Minimum work done to complete learning objectives
• Fail- exhibits unprofessional behavior, truant, not showing as assigned
• Incomplete- missed significant time. This would be reported back to the Director of Electives and Associate Dean of Student Affairs for further discussion
Clerkship or Advanced two week elective: You will receive one of three grades: Pass, Fail or Incomplete.
As we do not have complete objective criteria for grades in Anesthesia, there is a degree of subjectivity to all evaluations. For any student looking for feedback or discussion about their evaluation during the rotation, please contact [email protected].