CBY Rotations

PREMIER ROTATION:

• Anesthesiology Professional Practice (1 block): This unique and innovative non-clinical didactic-based rotation is designed to deeply educate CBY residents on many important aspects of professional practice.  Though specifically focused on future careers in within anesthesiology and perioperative medicine, this curriculum spans many topics such as research, professional development, leadership, wellness, patient safety, education, and quality that are broadly applicable to future leaders in modern healthcare. All CBY residents complete this rotation together in a four-week block that includes the opportunity to attend the ASA annual meeting with travels funds provided by the department. More information about this innovative rotation can be found at the dedicated APP webpage.

CLINICAL ROTATIONS:

• Acute Pain Medicine (1 block): This rotation is an introduction to acute pain medicine for CBY residents. They spend one block working with the Acute Interventional Perioperative Pain Service at either UPMC Presbyterian or UPMC Mercy. The CBYs learn safe opioid prescribing, the principles of multimodal pain management, the indications and contraindications for regional anesthesia, and management of in-dwelling peripheral nerve block catheters. While it is not the emphasis of this rotation, the CBYs often exceed the ACGME’s required minimum for peripheral nerve blocks during this introductory rotation.
• Anesthesiology (1 block): During their PGY1 Anesthesiology rotation, CBYs are paired with senior anesthesiology residents for a mentored immersive experience caring for surgical patients in the operating rooms at UPMC Presbyterian/Montefiore. Most days CBYs perform hands-on perioperative care alongside their senior resident. In this mentored context, CBYs get the opportunity to participate in advanced cases and subspecialty care as well. Readings focus on fundamentals of anesthesiology practice, and this is augmented by directed teaching from residents and supervising faculty. The rotation also includes the opportunity to take two overnight shifts with the call team, including two upper-level residents and an attending. Through all these experiences, the CBY Anesthesiology rotation fosters camaraderie among the residents and introduces the CBY residents to many of our department’s core educational faculty.
• Cardiology (1 block): CBYs join the cardiology consult service at UPMC Presbyterian/Montefiore for this rotation. They field requests for consultations ranging from chest pain to perioperative optimization. This active and academic service provides important teaching regarding cardiovascular medicine in an acute care setting directly applicable to the practice of anesthesiology.
• Critical Care Medicine (CCM) (1 block): CBY residents work in one of two different medical intensive care units (ICUs) during their CCM rotation, at either UPMC Presbyterian or UPMC Shadyside. CBY residents enjoy close supervision by upper-level residents and critical care fellows, in addition to formal teaching from attending physicians. The CCM rotation serves to provide the necessary foundation in care of the critically ill medical patient required for successful practice in anesthesiology.
• Emergency Medicine (1 block): The CBYs work in the busy UPMC Presbyterian Emergency Department (ED) during this rotation. This ED sees a wide spectrum of illness ranging from exacerbations of chronic illnesses to early complications arising from organ transplantation. UPMC Presbyterian is also a Level I trauma referral center.
• Hemostasis & Hemotherapy (1 block): This unique rotation serves to address the very important issues of transfusion medicine and coagulation, which are integral to the practice of anesthesiology, but sometimes not adequately addressed in anesthesiology training. The CBYs attend transfusion rounds and review complications from transfusions with UPMC’s transfusion medicine experts. The rotation also includes coagulation rounds, during which the residents learn clinical coagulation management.
• Internal Medicine (2 blocks): CBY residents spend two months working on Internal Medicine inpatient teams at UPMC Presbyterian. These important rotations serve to hone the residents’ history-taking, physical examination, and diagnostic skills in a highly supportive but acute environment. Skills furthered here serve to bolster the important medical decision-making often required of anesthesiologists.
• Otolaryngology (1 block): This is the primary surgical rotation of the CBY curriculum and was chosen because of the high level of collaboration necessary between anesthesiologists and surgeons in caring for otolaryngology patients. The CBY residents spend one month on the UPMC Presbyterian/Montefiore Head and Neck Cancer service. This very active service provides advanced care for patients with malignancies of the head and neck, often including the airway. The CBY residents work alongside otolaryngology residents to learn important basic surgical patient management principles. Importantly, our residents gain important experience in the surgical creation of tracheostomies, as well as exchange and management of tracheostomy tubes.
• Surgical Critical Care (1 block): This experience involves caring for post-operative patients in the Medical-Surgical ICU at UPMC Mercy. This provides the opportunity to care for patients across the acute care, general, neurological, thoracic, and trauma surgery services. As an open unit, close collaboration with surgical teams provides opportunities for learning and observing bedside surgical procedures. CBY residents work on a small team with direct teaching from Critical Care attending physicians. CBY residents benefit from closely working with these faculty, many of whom are dually-trained as anesthesiologists.