ABA minimum case numbers
Started by militarymd
My computer is being slow, so didn't cut and paste. Go to: http://www.acgme.org/acWebsite/RRC_040/040_prIndex.asp
Look on Pages 18-21 of the anesthesiology PDF file. These are the latest requirements.
Look on Pages 18-21 of the anesthesiology PDF file. These are the latest requirements.
thanks
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My guesses -
1) Most people come out well trained, at least well enough to polish the rough edges with their partners' help. The person who goes into solo practice on Gitmo the day after residency is pretty rare.
2) The individual category numbers are low because a substantial number of programs have a hole - be it cardiac or neuro or regional. If you made the categories such that every program had to provide a robust experience in every discipline, it would require painful changes/closures in many places
3) They trust that between the graduate, their employer and the hospital privileging committee, at least one of the three will have the good sense to practice within the scope of experience.
It's in prepartion for the rumored 56 hour/wk residency.
dc
dc
The focus isnt C/S. its to ensure residents are getting some minimum number of epidurals and spinals for any scenario including C/S
40 patients undergoing vaginal delivery.
20 patients undergoing cesarean sections
40 patients undergoing surgical procedures,
including cesarean sections, in whom are
used as part of the anesthetic epidural
anesthetics technique or epidural catheters
are placed for perioperative analgesia. Use
of a combined spinal/epidural technique may
be counted as both a spinal and an epidural
procedure
40 patients undergoing surgical procedures,
including cesarean sections, with spinal
anesthetics. Use of a combined spinal/epidural
technique may be counted as both a spinal and
an epidural procedure
I've barely done 40 spinal anesthetics. Barely. I've done a ton of c-sections, most of which already had an epidural. No one seems to like spinals anymore, including the patients.
-copro
-copro
You are kidding aren't you?
If you read the regs closely, you don't ahve to do the blocks yourself. You just have to care for patients who have them.
What do you do for elective sections? Try this, next time you get the 'failure to progress' section that has an epidural, don't bolus it. Pull the bugger out and do a spinal. They work better anyhow.
No, we just don't do that many elective c-sections at our place. And, our Uro guys hate spinals. For them, it's propofol, LMA, wake-up, go home. I think this speaks more to their inability to do even basic Uro procedures in under an hour-and-a-half.
-copro
Uro hated spinals where I trained as well. But ortho did too. Probably because a total hip in academics can outlast even a tetracaine with epi spinal. My biggest surprise when I started my new job was the amount of spinals that get done. I can't say it's really surgeon preference as I don't think they really care, but it's like a group culture. Cysto room is all spinals. Total joints all spinals. Butt cases are all spinal. About half of the knee scopes are spinals. I was also surprised by the amount of lidocaine that is being used out in the real world. We never really did it in residency.
We rotate at a very small outside hospital, all by yourself, no other anesthesia person for miles. Not uncommon to get a 350 lb dude for a simple knee scope. If you think about the difficult airway algorithm "call for help" is on there. But what about when there IS no help? You have an ortho surgeon, that's it. That's where the chloroprocaine spinal will save you. Don't have to even mess with the airway. I know, be prepared for high spinal and being ready to intubate...but 9.999 times out of 10 you'll be just fine.
We rotate at a very small outside hospital, all by yourself, no other anesthesia person for miles. Not uncommon to get a 350 lb dude for a simple knee scope. If you think about the difficult airway algorithm "call for help" is on there. But what about when there IS no help? You have an ortho surgeon, that's it. That's where the chloroprocaine spinal will save you. Don't have to even mess with the airway. I know, be prepared for high spinal and being ready to intubate...but 9.999 times out of 10 you'll be just fine.
