Clinical Rotations

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. 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 faculty includes multiple anesthesiologists with subspeciality training in pediatric anesthesia. 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 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. We continue to utilize infant spinal anesthesia when appropriate for patient care.

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 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.