Subinternship in Anesthesiology

Course Number: AN450.01

We offer a three-week Subinternship in Anesthesiology to fourth-year medical students throughout the year (July through June), for up to eight medical students per rotation. During this rotation, medical students work primarily in the operating rooms at the Ronald Reagan UCLA Medical Center alongside attending physicians, residents, and fellows. One week of the rotation is spent at the Ambulatory Surgery Center, Santa Monica UCLA Surgery Center, or the Santa Monica UCLA Medical Center and Orthopaedic Hospital. Students participate in the preoperative, intraoperative, and postoperative evaluation and anesthetic management of a full range of cases: general surgery, cardiac, head and neck, interventional radiology, invasive medical procedures, organ transplant surgery, neurosurgery, obstetrics and gynecology, ophthalmology, orthopedic, pediatric, thoracic, urologic, and vascular surgery.

Medical students enrolled in this course receive orientation from the Medical Student Education Coordinator and Course Director on the first day of the rotation. Subinternship students attain basic intubation and IV catheter training, and participate in structured didactic lectures, case conferences, and workshops designed to enhance skills and knowledge. They attend the Department's weekly Grand Rounds, with lectures by UCLA faculty anesthesiologists as well as visiting professors from other institutions.  They also have the opportunity to work on the Human Patient Simulator at the UCLA Simulation Center., encountering clinical scenarios for airway management, surgery complications, and complex medical problems such as sepsis and high-output cardiac failure. Students also take evening calls to gain further experience in anesthesia for emergency surgery, trauma, and obstetrics.

Learning Objectives

Our Subinternship in Anesthesiology emphasizes the introduction of basic concepts in anesthesiology in the inpatient and outpatient settings. Specific learning objectives include: 

• Clinical physiology and pathophysiology 
• Principles of clinical pharmacology
• Preparation of patients for anesthesia and surgery
• Introduction to subspecialty anesthesiology
• Airway management by mask ventilation, endotrachael intubation, and other airway devices
• Introduction to the principles and techniques of general and regional anesthesia
• Introduction to the practical pharmacalogy of sedatives, narcotics, inhalation anesthetics, and local anesthetics
• Introduction to monitoring (EKG, BP, pulse oximetry and invasive monitors)
• Experience with IV, CVP, arterial, and Swan-Ganz catheters
• Introduction to pain medicine, multimodal analgesia, and appropriate opioid management
• Introduction to critical care and PACU management (resuscitation, IV fluid management, mechanical ventilation, reversal of anesthetics)

Expectations and Checklist Card

A list of expectations is distributed during orientation, and students receive a checklist card highlighting procedures to be performed and topics to be discussed with residents and attendings throughout the rotation. The resident or attending initials the checklist card for each item completed, and the card is submitted to the Medical Student Education Coordinator on the last day of the rotation.

Reading Material

Suggested reading includes chapters from an introductory anesthesiology text which may be checked out from the Medical Student Education Coordinator. A reading syllabus is provided during orientation.

Schedule

Typical Weekly Schedule

Medical students are expected to stay at least until 3:00 pm every weekday. If the medical student is involved in an interesting learning case, he or she is encouraged to stay longer to see the case to completion. As our subinternship in asnesthesiology is an excellent opportunity to gain knowledge and clinical training in the discipline, it is very important to be in attendance every day as scheduled. Medical students are encouraged to plan their rotation around this expectation. Any anticipated absences must be approved by the Medical Student Education Coordinator and Clerkship Director prior to the start of the rotation.

Examination

A written post-rotation exam will be administered on the last day of the rotation to evaluate the quality of the educational experience for the medical student. Medical students may use the reading syllabus as a general outline of the types of topics that will be covered on the exam.

Oral Presentation

Medical students are expected to present an anesthesia case or topic of their choice. The presentation will be limited to 10 minutes, and may include slides or handouts. Students must obtain approval for their topics from the course director, who is available for assistance in selecting a case or topic and developing the presentation.

Literature Review

Medical students submit a written review of the recent literature at the end of the rotation. They select three to five articles on a topic of their choice, and perform critical analysis of the papers based on guidelines distributed at the start of the rotation. The course director is available for assistance and guidance throughout the rotation.

Evaluations

Residents and attendings evaluate medical student performance formally, and provide immediate verbal feedback during cases. Evaluations are compiled into a summary evaluation and reflected in the Medical Student Performance Evaluation. For confidentiality purposes, residents and attendings will submit these evaluations directly to the Medical Student Education Coordinator.

Medical students are encouraged to complete evaluations on residents and fellows in order to provide confidential and anonymous feedback. Residents and fellows receive these evaluations in redacted form on a quarterly basis, and utilize them to assess and improve their practice and teaching performance. These evaluations should be submitted to the Medical Student Education Coordinator on the last day of the rotation.

Medical students are encouraged to complete an evaluation on the overall rotation to provide feedback to the Medical Student Education Coordinator and Course Director about the quality of the educational experience. We constantly look for opportunities to improve our educational programs in order to provide the best possible learning environment for all of our trainees, and we appreciate your feedback.

Visiting Medical Students

Visiting medical students who are interested in pursuing a subinternship may apply through VSLO. To obtain information about the David Geffen School of Medicine's supplemental document requirements, application deadlines, and fees, or to view detailed elective course descriptions, please visit http://medschool.ucla.edu/current-visiting-students.

If you have any questions, please contact the Course Director, Dr. John Shin, via email at [email protected].