Residency Programs Strong in Regional Anesthesia?

[TrojanGopher]

MS4 here, definitely going into anesthesia (despite the doom & gloom). I recently did an away rotation and fell in love with regional anesthesia. Since the ERAS can be submitted today, I'd really appreciate people's opinion on which residency programs are strong in regional.

Thanks in advance

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[Mista Suprane]

MS4 here, definitely going into anesthesia (despite the doom & gloom). I recently did an away rotation and fell in love with regional anesthesia. Since the ERAS can be submitted today, I'd really appreciate people's opinion on which residency programs are strong in regional.

Thanks in advance

SLR
VM
Cornell
Iowa

to name a few.

 

[Gardner]

I was really impressed with Iowa when I interviewed there. Very strong for regional.

 

[boggy]

There is no better residency in the country than Saint Luke's Roosevelt in Manhattan for regional anesthesia. The chair, Dr. Santos, is a great resident supporter and the program director, Dr. Wasnick, is very forgiving of residents. Dr. Admir Hadzic himself is director of regional anesthesia and it is the home NYSORA. You cannot do better if you want regional.. On the other hand if you want to do heart transplants go to Columbia. It is all a matter of choice as different programs highlight different things. Y

 

[CrazyJake]

NY and Iowa are the big 2 that come to mind.

goodluck,
CJ

 

[stimmed]

Any way to find out for these regional-heavy programs the average types and number of blocks performed during residency?

 

[okayplayer]

New Mexico is outstanding for regional experience as well.

 

[Mman]

Any way to find out for these regional-heavy programs the average types and number of blocks performed during residency?

Not sure, but if they aren't getting several hundred between interscalene, supraclav, LP, classic sciatic, femoral, pop sciatic, paravertebrals, etc, then they aren't close to the best around.

Be very wary of any program that counts epidurals in their regional numbers.

 

[Dejavu]

I am not the PD for our residency, but our residents tell us that, never mind the rest of the blocks they get in the rest of their residency, when they do their two month rotation with our ortho-anesthesia division (here in SE Minnesota), they get over 200 blocks of various kinds (USGRA, fem, sciatic, paravert, psoas, etc.) in just that two month period.

Please put our program on the list of those very strong on regional experience. Top notch instruction by well known people. Friendly people as well.

Small town atmosphere sometimes turns people off and we don't live near either coast, but if you want hands on needle experience, come here.

 

[pmichaelmd]

Am not sure how the flavor of our residency program has changed since I graduated, but we had a very strong regional experience. As a smaller program, we got a lot of individualized attention, which can be good or bad, depending. The strength of the regional program was in 2 of our Professors, Drs. Greengrass and Clendenen. I did 3 dedicated months of regional and, not including epidurals and SABs, finished with over 750 blocks, at least half of them with catheters.

Again, I can't comment on how much things have changed in the past 4 years or so, but I felt very well-trained in regional upon graduating and have used that experience extensively in my current practice.

PMMD

 

[bigdan]

Upmc

 

[midazme]

on the West Coast, VM, UW and OHSU.

VM is regarded as the highest of the three, but not all attendings use ultrasound.

UW is building their program up pretty quickly, and have the latest equipment.

OHSU has a healthy number of blocks, but most of these are neuraxial blocks.

i'm pretty sure all three also have regional fellowships, which means that your block numbers may decrease (if the fellow poaches all of them) OR increase (if the fellow is the 'supervising attending').

 

[amyl]

CCF is very strong in regional.... there are so many blocks to go around even the interns do a month of regional anesthesia. our regional dept head is a great guy and is expanding the program everyday.

from the interview trail i remember dartmouth also seemed strong.

 

[geogil]

Mayo Rochester also claims strong regional experiences. Residents can finish with 350-450 blocks under their belts.

 

[seamonkey]

From what I recall from the interview trail, Duke was pretty big on regional as well...

 

[proman]

From what I recall from the interview trail, Duke was pretty big on regional as well...

Yes the schedule is filled with ortho cases every day.

 

[shaz8901]

I am really interested in regional also so I was wondering that now that people have gone on some interviews what places did you find or were told had a good regional experience?

For me, wayne state said that regional is very strong and one of their strongest points of their program?

 

[lvspro]

I am really interested in regional also so I was wondering that now that people have gone on some interviews what places did you find or were told had a good regional experience?

For me, wayne state said that regional is very strong and one of their strongest points of their program?

Wayne state regional is crazy good, I went there for residency, and now work at one of that groups divisions. We have 2 outpatient surgi-center that our seniors rotate through (ORH, and MIOSH), as well as DRH with Sam Perov, MD that u go thru your 1st yr, and both do wicked numbers. DRH you only get 5-6/day, but senior yr, at ORH/MIOSH you get 20-45 cases, of which 75-90% are blocks and catheters, so do the math, and you end up with bout 21d/mo of work at 15-35 blocks per day, you can see that you get pretty durned good at sticking needles around nerves with u/s, trans-art, and stim techniques are used. Also, you will do blocks at other sites like harper, hutzel, pain, SGH, SDSC etc... just npot quite as many as the sites I touched on... and that's the real deal folks.

 

[Mman]

I am really interested in regional also so I was wondering that now that people have gone on some interviews what places did you find or were told had a good regional experience?

For me, wayne state said that regional is very strong and one of their strongest points of their program?

The single most important thing you need to find in a residency is one that provides a great all around education preparing you for both academic/fellowships and private pratice. The particular details about finding one that is great in whatever little niche you enjoy as a med student is far less important. For one, you don't know what aspect of anesthesia you will enjoy most after finishing 4 years of residency. I mean as a student, your exposure to the field is fairly limited. And the best all around residencies tend to also be very strong in all areas.

 

[shaz8901]

Wayne state regional is crazy good, I went there for residency, and now work at one of that groups divisions. We have 2 outpatient surgi-center that our seniors rotate through (ORH, and MIOSH), as well as DRH with Sam Perov, MD that u go thru your 1st yr, and both do wicked numbers. DRH you only get 5-6/day, but senior yr, at ORH/MIOSH you get 20-45 cases, of which 75-90% are blocks and catheters, so do the math, and you end up with bout 21d/mo of work at 15-35 blocks per day, you can see that you get pretty durned good at sticking needles around nerves with u/s, trans-art, and stim techniques are used. Also, you will do blocks at other sites like harper, hutzel, pain, SGH, SDSC etc... just npot quite as many as the sites I touched on... and that's the real deal folks.

Ya, I was pretty surprised by wayne's regional experience. Alot of places embellish about their experience and say their strong but honestly the place was so candid and transparent during the interview that I got the sense that they were not exaggerating the regional experience at all.

Any other places besides wayne and the other places mentioned with a strong regional experience?

 

[Pooh & Annie]

on the West Coast, VM, UW and OHSU.

VM is regarded as the highest of the three, but not all attendings use ultrasound.

UW is building their program up pretty quickly, and have the latest equipment.

OHSU has a healthy number of blocks, but most of these are neuraxial blocks.

i'm pretty sure all three also have regional fellowships, which means that your block numbers may decrease (if the fellow poaches all of them) OR increase (if the fellow is the 'supervising attending').

All of the attendings at VM use ultrasound. Several are using it more for challenging neuraxial stuff. It's also being incorporated into a lot of pain cilinic procedures.

 

[Dejavu]

Mayo Rochester also claims strong regional experiences. Residents can finish with 350-450 blocks under their belts.

As seniors, our residents do a two month rotation as block residents over and above all the blocks they get as normal residents. I just asked one of them how many blocks he will get in that rotation and he estimated (the last month isn't over yet) about 260-270 in this rotation alone. They tend to do about 10-15 in a day. The day before he answered my Q, he had done 15.

The first part of the first month they focus on the non-USGuided approaches, then have a didactic on US. After that, most of their blocks are USGuided (axillary, interscalene (w/ or w/o catheters), supra-clavic, TAP, fascia iliaca, Popliteal (w/ or w/o cath), ankle, etc) plus the usual load of fem, psoas, sciatic, etc. Oh, and I forgot paravertebral blocks on a mostly daily basis, although our block fellow will sometimes steal them or guide the resident in doing them. This doesn't include spinals and epidurals that they get asked to do also.

All in a rather friendly teaching environment.
Yeah, we are quite proud of what we offer residents.

 

[shaz8901]

I guess I will do a tally so far and see if there are any other people feel a school should be added to this list:

Healthy Regional Programs:
St Luke's Roosevelt
Virginia Mason
University of Washington
Oregon Health & Science University
Mayo-Rochester
Wayne State University
Duke
Cleveland Clinic
University of Iowa

 

[Tuohy]

Wash U in St. Louis is up and coming-new division chief of regional anesthesia brought in from Duke...

 

[lushmd]

I guess I will do a tally so far and see if there are any other people feel a school should be added to this list:

Healthy Regional Programs:
St Luke's Roosevelt
Virginia Mason
University of Washington
Oregon Health & Science University
Mayo-Rochester
Wayne State University
Duke
Cleveland Clinic
University of Iowa

I would add UPMC. Our seniors typically graduate with 400-600 blocks.