Faculty in the General Surgical Anesthesiology Division are a diverse group with many different clinical and research interests.
The Columbia University Department of Surgery is active in many subspecialties including breast, colorectal, esophagus, endocrine, gallbladder, kidney, liver, obesity, pancreatic, plastic and reconstructive, spleen, small and large intestine, oncology, transplant, and minimal access surgery.
Anesthesiology residents benefit from this diversity and learn to employ a variety of state-of-the-art anesthetic techniques including general anesthesia, regional anesthesia, peripheral nerve blocks, and monitored anesthetic care. By the end of their experience on this service residents are expected to be competent, efficient team leaders who can manage complex cases independently.
The resident experience in the General Surgical Anesthesiology Division is separated into 3 distinct levels of experience:
(Note – the name of the rotations reflects the name of the Milstein Hospital Building which is the site of our adult operating rooms)
1. Milstein Initial Rotation
The focus is on the CA-1 resident to acquire the knowledge and skills in order to deliver anesthetic care in a more independent manner to the adult general surgical patient, albeit always under close attending supervision. The resident will gain clinical experience on the ENT, General Surgical, Gynecologic, Urologic (including Cystoscopy suite), and Vascular/Endovascular Anesthesiology services. This experience will include both outpatient and inpatient procedures.
The resident will manage the recovery room under supervision of an attending anesthesiologist. During this rotation previously gained experience in echocardiography, thoracic and abdominal ultrasonography will be applied to facilitate diagnosis and therapy of patients in the acute setting of immediate post operative care.
2. Milstein Junior Rotation
Residents will manage introductory anesthetic cases competently with the supervision of an attending anesthesiologist. The resident will gain additional clinical experience on the ENT, General Surgical, Gynecologic, Urologic (including Cystoscopy suite), and Vascular Anesthesiology services. The assigned cases will be increasingly more complex and the resident will be expected to develop more independence in managing these cases.
3. Milstein Senior Rotation
The Senior Milstein Resident will be able to plan and manage complex anesthetic cases independently and competently. The Milstein Senior should have knowledge of Hospital and Departmental Practice Guidelines, how to access them, and be a role model and resource for junior Residents. The Milstein Senior will be able to manage Hospital and Departmental resources in an efficient and competent manner. The Milstein Senior will be able to discuss perioperative issues with patients, family members and surgical staff in a clear, competent, and compassionate manner.
The Resident will learn the skills of being a competent and efficient team leader, particularly when they act as Team Captain. The Team Captain will be introduced to managing the operating rooms under supervision of the on-call anesthesiologist. This includes scheduling of cases, prioritizing emergency cases and if necessary delaying operations in cases of emergency. The Team Captain will assign the anesthesia residents for the cases, plan with the residents and assist in executing the plans for the patient, supervise junior residents in performing emergency intubations on the general hospital floors in cases of respiratory failure or cardiopulmonary arrests, manage the patients in the post-anesthesia care unit, and respond to all emergencies and consultation requests in the hospital requiring anesthesia assistance. This experience will develop skills to be a team leader, to know when to delegate responsibilities, and to be able to multitask efficiently.
