"Pre-ttending" as CA3 with CRNA medical direction in your program

[whodenie]

Looking for some quick info about how various programs handle introducing supervision in their curriculum.

Does your program or one you know of have situation/rotations where CA3's are paired with an attending to do medical direction of CRNA's?

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[btbam]

Our peds fellows do this towards the end of their fellowship...they also supervise the CA-2s that come through.

 

[Wiscoblue]

Mayo?

 

[jthedestroyr]

Wake forest does I believe. Nicman I'm sure could tell us.

 

[Ronin786]

At my program CA-3s will do it for a couple weeks. They will run two CRNA rooms in coordination with the attending.

 

[HalO'Thane]

We did not have a formal rotation in residency for this but our CA-3 calls are basically set up for you to function as a junior attending. We usually fielded the consults and add-ons and ran the OR's. The attendings, of course, were readily available but some more hands off than others. There was usually a CRNA who worked weekends and nights in one room and a junior resident in another room. I actually learned quite a bit during these calls; more than I would have sitting in a room and doing a craniotomy or SICU ex-lap for the 100th time.

 

[whodenie]

Thanks for the replies.

@Ronin786 -which program are you referring to?...you can PM as well if you prefer

I am trying to put together a list of places where CA3s function in a supervision role with CRNA's.

 

[McPoyle]

We do this at my program. It's a few weeks of running the board, making the schedule, and supervising two mid level rooms (we use nurses and AAs-with our hiring predominately AAs in the last few years). Most people really like this rotation, we don't do much supervising outside of this, except for on call when you'll supervise a junior resident if the opportunity presents.


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[Ronin786]

Thanks for the replies.

@Ronin786 -which program are you referring to?...you can PM as well if you prefer

I am trying to put together a list of places where CA3s function in a supervision role with CRNA's.

Loyola University in Chicago.

 

[floridaboy18]

Wake forest does I believe. Nicman I'm sure could tell us.

Wake does do this. While on CA-3 call, we never sit cases from the time we show up to the time we finish. Instead we are responsible for running the PACU (after 2:30pm once day resident/staff leave), helping to run the OR after the same time (pre-op assessment in holding, induction, maintenance, emergence, etc) with CRNA's and residents, running the board if we want, handling emergency/urgent airways with the airway bag on the floor/ICU (this trumps OR work when it comes up), attending level 1 traumas for airway help, etc.

We practice with a lot of autonomy with an attending always available, but allowing us to get our feet wet, make decisions, and generally act like the "attending" at night. I think this is one of the greatest (and toughest) experiences at Wake. Really shows the CA-3 how much they've learned and how well trained that we are. We have approximately 6 CA-3 call months each year taking ~ 6 to 7 calls per month on those months. These CA-3 calls can be general OR months (though most do not do this) or electives (out of OR safari month, research, advanced neuro month, advanced peds months, etc).

 

[R-35]

I hope all programs integrate this in their curriculum. We do it at U. of Miami with CRNA medical direction during CA-3 year in our transition to practice and VA rotations. Medical direction of junior residents in Trauma and OB.

 

[WholeLottaGame7]

I assumed most places do this in some form or another? We supervised junior residents and CRNAs while on call (nights and weekends). Only sitting in a room if something crazy going down or there's an interesting case. Also did some junior resident supervision during elective general OR months as a CA3.