Residents participate in two 2-week rotations in the Preoperative Anesthesia Unit, the PAU. The residents evaluate patients who are scheduled for elective surgery, with an attending readily available for consultation and discussion. The resident on the PAU rotation has the opportunity to evaluate a large range of patients for diverse operations. These range from healthy patients having a minor procedure to severely ill patients scheduled to undergo complex, major surgery. In the PAU the resident obtains a medical history and conducts a focused physical exam including the airway, cardiac and respiratory systems and vital signs. In addition, the resident will assess anesthetic risk, determine the necessity of any non-routine laboratory testing or if any further consultations and medical information is necessary prior to undergoing surgery and anesthesia. The resident is also responsible for discussing the anesthetic risks and options with the patient and to give preoperative instructions as appropriate.
The goal of the rotation, which is mandated for all residents by the ACGME, is to gain experience in the important areas of preoperative assessment. This includes the determination of which preoperative tests and consultations are necessary as well as discussing anesthetic plans and risks with patients and their families. It is a great introduction to an appreciation of the full role of the anesthesiologist as a “perioperative consultant.”