On Monday and Wednesday through Friday, patients are expected to be in the OR at 7:30am. On Tuesdays, the in-room time is 8:30am to allow time for morning meetings and conferences beforehand. Residents typically arrive between 6 and 6:30am to set up their rooms and to perform regional blocks, etc. before moving their patients into the OR.

Residents typically get breaks in the morning and afternoon, and a longer break for lunch. Our ORs usually begin to wind down between 4 and 6pm. For any residents still in the OR at 6pm, relief is generally provided by the night-call team, late-day CRNAs, and evening shift (3-11pm) residents.

Although we follow ACGME duty hour rules, residents are expected to remain with critically ill patients or major cases as long as necessary (for patient safety or educational value). The ORs are particularly busy during the summer, but we do our best to relieve non-call providers. If residents need to leave (for personal reasons) at some earlier time, they notify the OR Clinical Director and we do our best to get them relieved.

Our strongest subspecialties are probably acute pain, regional anesthesia (approximately 3,700 peripheral nerve blocks/year), and intensive care (3,000 admissions/year). We also have strong pediatric, obstetric, and cardiac anesthesia experiences as well. We have the privilege of working with some especially strong surgical services, including otolaryngology, neurosurgery, orthopedic surgery, and general surgery (including transplant and trauma).

I've heard that you have a very strong regional anesthesia program. Is this true?

Absolutely true! We perform thousands of peripheral nerve blocks each year. Many of our faculty have expertise in regional anesthesia–including ultrasound guidance for blocks. Given these numbers, it shouldn't be surprising that our surgeons enthusiastically accept regional anesthesia as a beneficial part of patient care—something that cannot be said for every institution.

Residents rotate through the regional anesthesia service from CA-1 to CA-3 year and can request additional electives in regional anesthesia as well. Our graduates perform approximately 150 peripheral nerve blocks during their training.

Our residents have no difficulties meeting their ACGME requirements in any area, so we really have no "weak" rotations. Like many other institutions, our cardiac surgical load (cases on bypass) is somewhat limited, but all residents are still able to meet their required case numbers and are more than prepared to go on to perform standard cardiac cases or pursue cardiac anesthesia fellowship. However, we do have a very popular senior cardiothoracic elective rotation in Des Moines for residents who would appreciate additional cardiothoracic experience.

Because Iowa City is such a pleasant and safe place to live, we do also see fewer penetrating trauma (gunshots, stab wounds, etc.) cases than some large city programs might see. However, we do have some cases come in from nearby communities, and we certainly see our fair share of blunt/penetrating trauma related to automobile accidents, farming equipment, and other unintentional traumas. As an institution that regularly performs high acuity cases and all types of transplants, we are more than equipped with the knowledge needed to provide care to acutely, critically ill patients. We truly appreciate the trauma experiences we are able to learn from while simultaneously living in such a safe, healthy community.

Away electives for seniors include:

Cardiothoracic anesthesia in Des Moines
International pediatric anesthesia in underserved foreign countries

Local anesthesia electives include:

All surgical subspecialties
Simulation
ECHO
Ambulatory surgery anesthesia
Regional anesthesia
Advanced clinical anesthesia
Chronic pain
Research
Point-of-Care Ultrasound (POCUS)

Yes, our CA3 residents have opportunities to participate, with our faculty, in mission trips to Guatemala and Colombia.  We offer this opportunity to four to six of our CA3 residents and continue to explore opportunities for more residents to participate in these valuable international mission trips.

Interns and CA-2 residents rotate on the chronic pain service. During this experience, they work largely with chronic pain patients in the outpatient pain clinic setting. Residents evaluate patients, make treatment recommendations, and participate in diagnostic and therapeutic procedures (depending on level of training). Interns and residents do not take call on the chronic pain rotation.

CA-1, CA-2, and CA-3 residents rotate on the Acute Pain Service (APS). During this experience, they work in the inpatient setting, evaluating patients and participating in performing perioperative peripheral nerve blocks and epidurals. They also round on inpatients on the APS for management of acute postoperative pain. Acute pain call is shared with the regional anesthesia fellows. This is home call. However, the resident taking in-house OB night call generally handles simple issues such as changing the epidural infusion rate or replacing a pump battery. 

This is true. Our department has managed the Surgical and Neurosciences Intensive Care Unit (SNICU) and Cardiovascular ICU (CVICU) at the University of Iowa Health Care for decades. The goal of the department is to train outstanding physicians, not technicians.

One factor that defines the excellent anesthesiologist is his/her ability to care for the critically ill, both in and out of the OR. We feel strongly that critical care experience is crucial to meeting our goals. Our interns spend two months in the SNICU and CVICU; clinical anesthesia residents spend three months in the SNICU and CVICU.

We take 15 interns each year. Their rotations include:

• 2 blocks in the SNICU/CVICU
• 1 block each in:
  • Emergency medicine
  • General medicine ward
  • Renal medicine consult service
  • Trauma surgery
  • Pediatric surgery
  • PICU (Pediatric ICU)
  • EKG course
  • Palliative care medicine
  • Safety and quality
  • Advanced clinical medicine
  • Anesthesia

Interns spend 2 weeks each on the inpatient cardiology service and an elective (chest radiology or chronic pain).

Interns are also invited and encouraged to attend Anesthesia Grand Rounds.

Absolutely true! We performed more than 3,700 peripheral nerve blocks last year. Many of our faculty have expertise in regional anesthesia–including ultrasound guidance for blocks. Given these numbers, it shouldn't be surprising that our surgeons enthusiastically accept regional anesthesia as a beneficial part of patient care.

CA1 and CA2 residents rotate through the regional anesthesia service. Senior residents can elect a regional anesthesia rotation. Residents also participate in a formal training course in regional anesthesia. Our graduates perform approximately 150 peripheral nerve blocks during their training.