Focus: Cardiothoracic Anesthesia
About 400 cardiopulmonary bypass cases are performed annually, providing an outstanding clinical experience for our residents. Cardiac cases include coronary artery bypass grafting, valvular repair and replacement, as well as complex aortic reconstructive surgery. Thoracic cases include video assisted thoracoscopic procedures, open thoracotomy for lung resection, as well as open and endoscopic esophageal surgeries. Intraoperative transesophageal echocardiography (TEE) is used in the majority of cardiac procedures and this hands-on TEE experience is supplemented with education from our TEE certified faculty. During this rotation, residents also become proficient in placement and interpretation of arterial and central venous catheters and become expert in management of perioperative cardiac dysfunction. We also offer a TEE elective for CA-3 residents.
Focus: Critical Care
The primary goal of the Critical Care experience is to provide physicians with an opportunity to acquire the knowledge, skills, experience, judgment and for optimal care of severely injured and critically ill patients. Residents are supervised by Critical Care Medicine faculty from the Departments of Anesthesiology and Surgery. Daily teaching from ICU faculty complements patient care in the SICU. We view familiarity with critically ill patients as being instrumental in the care anesthesiologists provide in the operating room and essential for creating a foundation of clinical practice in becoming a perioperative physician. Anesthesiology trainees rotate for 1 month in the PGY1/intern year, 2 months in the SICU during the CA-1 and CA-2 years, and 1 month in the CA-3 year acting as a fellow-like consultant.
Focus: Obstetric Anesthesia
UVM Medical Center serves as the regional referral center for high-risk perinatal patients as well as the community birthing center for low-risk deliveries. Currently, there are 2300 deliveries and we provide approximately 1900 neuraxial anesthetics per year. Anesthetic care is individualized for patients with a wide range of medical and obstetric co-morbidities. Through the provision of cutting-edge Enhanced Recovery After Cesarean Delivery (ERAC), we provide cesarean delivery patients current, best evidence-based perioperative care, anesthesia and post-cesarean analgesia. Our faculty includes 3 anesthesiologists with subspecialty training in obstetrical anesthesia. Residents typically spend one month on the obstetrical anesthesia service in each of their CA-1 and CA-2 years and receive continued exposure to obstetrics throughout their training.
Focus: Pain Medicine
The multidisciplinary Pain Management Center has six full-time anesthesiologist with subspecialty certification in pain medicine, as well as a physical medicine and rehabilitation specialist, a psychologist, and a full support staff. The pain service offers a full range of inpatient and outpatient consultation services, including care of patients with postoperative pain, chronic non-cancer pain, and cancer-related pain. Rotating residents participate in all aspects of the pain service while on this subspecialty rotation. The CA-2 rotation is designed to give residents a firm foundation in the assessment and treatment of a variety acute and chronic pain conditions. An advanced elective rotation including opportunities for participating in ongoing or investigator initiated clinical research is available for interested CA-3 residents.
Focus: Pediatric Anesthesia
Our institution has three general pediatric surgeons as well as pediatric sub-specialists in each of the major surgical and medical procedural specialties. This rotation provides our residents with knowledge and experience in providing general and regional anesthesia for a broad spectrum of pediatric surgeries. We also perform a significant number of anesthetics for patients undergoing procedures outside of the operating room. Our faculty includes ten anesthesiologists with subspecialty training in pediatric anesthesia. As in adults, our emphasis in pediatrics is on the successful use of regional anesthesia whenever feasible. Dr. Chris Abajian pioneered spinal anesthesia for infants at the University of Vermont, and maintains the largest database in the world on outcomes associated with the use of this technique.
Focus: Regional Anesthesia and Acute Pain Medicine
The use of regional anesthesia for surgery and postoperative analgesia is emphasized throughout training at the UVM Medical Center/University of Vermont. A large percentage of lower[1]extremity surgery is performed under regional anesthesia, including spinal, epidural, and peripheral neural blockade. Regional anesthesia is utilized in a significant portion of anesthetics for upper extremity surgeries as well. Trainees gain exposure to a variety of techniques including continuous catheter techniques for both regional and neuraxial analgesia. Ultrasound is an integral part of the experience. Unique to our institution is the extensive use of spinal anesthesia for neonatal abdominal and lower extremity surgery in infants.