Critical Care Service

The Critical Care Service, a joint activity of the Departments of Anesthesiology and Surgery, provides a comprehensive critical care medicine experience. Residents participate in the management of a broad range of surgical and trauma patients under the supervision of critical care medicine trained anesthesiologists and surgeons. Residents become familiar with cardiopulmonary support, ventilatory management, nutritional therapy, metabolic therapy, and management of infectious diseases. A didactic program of lectures, tutorials, and journal clubs provided by the anesthesiologists, surgeons, internists, pharmacotherapists, and dieticians supplement the clinical experience. Residents on the Critical Care Service also have an active role in acute trauma management, which includes the initial assessment in the ER, intraoperative and postoperative care. Advanced subspecialty training in Critical Care Medicine with both a research and a clinical component is available.

Neuroanesthesiology

During the neuroanesthesiology rotation, residents participate in a wide variety of surgical procedures involving the brain and spinal cord. At Tampa General Hospital, more than 250 major craniotomies and more than 500 major spinal cases are performed each year. Since Tampa General Hospital is a Level I Trauma Center, residents learn to manage acute problems, which include head trauma, spinal cord injury, and neurovascular emergencies. Residents also become experienced in the airway management of patients with cervical spine injuries. The clinical experience is reinforced with informal didactic sessions in the operating room and structured lectures on neuroanesthesiology. Research opportunities in the area of motor evoked potential monitoring is anticipated. Additional neuroanesthesiology training is provided at H. Lee Moffitt Cancer Center and Research Institute and at James A. Haley Veterans' Hospital.

Cardio-Thoracic Anesthesiology

During the Cardiac Anesthesia rotation, residents have the opportunity to learn about the perioperative anesthetic management of patients who require cardiac, vascular, and thoracic operations. These include coronary artery bypass surgery, heart transplantation, valve replacement and repair, aortic aneurysm/dissection repair, and thoracotomy for lung cancer and emphysema. The cardiac program is divided into three different locations: Tampa General Hospital, James A. Haley Veteran's Hospital, and Mount Sinai Medical Center in Miami. Between the three locations, approximately 1500 cases requiring cardiopulmonary bypass are performed. Eighty percent of these operations are for coronary artery disease and 20 percent for valvular abnormalities. Experience with congenital hearts is also possible at All Children's Hospital in St. Petersburg. Although a minimum of two months training in cardiac anesthesia is provided, additional experience is available and frequently requested. Education is provided through clinical experience and didactic teaching. In addition to regularly scheduled lectures in cardiothoracic anesthesia, teaching on an individual basis by faculty with specialty training in cardiac anesthesia and critical care, is emphasized. Much of the training is spent on a one-to-one basis with faculty. Experience with transesophageal echocardiography also is available.

Ambulatory Anesthesiology

Although each institution offers ambulatory surgery cases, senior residents have the opportunity to experience a free-standing outpatient surgery center. At the surgery center, total involvement in perioperative patient care and treatment is emphasized. Resident physicians evaluate a wide range of patients, obtain consultations, prepare patients for anesthesia, administer regional and general anesthetics, direct recovery and discharge, and provide follow-up. In addition, residents learn to manage a cost-efficient anesthesia service, develop policies and procedures, and handle special surgeon and patient requests, while perfecting their anesthesia skills and techniques. This rotation allows residents to "put it all together" before going out into clinical practice. Experienced faculty ensure that each resident gains valuable knowledge and abilities during this two-month rotation.

Pain Management Program

Residents rotate for 1 or 2 months in the pain program during the residency. Daily pain clinics are offered at Tampa General Hospital, where more than 400 new outpatients are seen and approximately 1000 pain procedures are performed annually. In 1995, the Department founded CAMP - The Center for the Ambulatory Management of Pain, which is a comprehensive approach to the community-based patient. Residents have the opportunity to participate in this unique program. Also, residents are offered the opportunity to rotate through H. Lee Moffitt Cancer Center and Research Institute and discover a new dimension to cancer pain management. Senior residents who are interested in invasive pain procedures have the opportunity to rotate through the Pain Clinic in Ocala. A didactic program, composed of faculty and outside experts, is conducted to cover an array of pain topics.

Obstetrical Anesthesiology

The obstetric anesthesiology service provides the anesthetic coverage for approximately 3,000 deliveries/year at Tampa General Hospital. This population includes the private practice of the University Obstetricians as well as being the referral center for high risk obstetrical patients. Residents rotating through this service gain experience in managing analgesia/anesthesia for a wide range of patients, from the normal laboring patient to the critically ill patient.

The core rotation is a two-month block in the second year. The faculty assigned to the L&D suite during the week are those with advanced training and/or experience in obstetric anesthesiology. There is a two-week initial daily didactic schedule designed to cover the basics of obstetric anesthesiology. This is then expanded upon during the remainder of the rotation. By the end of the core rotation the resident should have gained a thorough understanding of the physiology and pharmacology of pregnancy and be comfortable with having mastered a variety of techniques for managing the patient in labor, as well as anesthesia for cesarean section and the critically ill parturient.

In addition, residents on the obstetric anesthesiology rotation will gain experience in providing anesthesia for patients undergoing pregnancy-related surgeries - cerclage of the cervix, postpartum tubal ligation, and other procedures. Gynecological surgeries are performed in the L&D operating rooms on a daily basis and this provides the residents with experience in covering a complete OB/GYN surgical services, as well as fostering greater cooperation among the obstetricians and anesthesiologists.

Residents who wish to spend time on the rotation during their third year will gain advanced experience in managing patients in labor as well as the critically ill. There also is opportunity for participation in clinical research.

Pediatric Anesthesiology

Residents will gain experience in all forms of pediatric anesthesia techniques during the pediatric anesthesiology rotation. Tampa General Hospital has active neonatal and pediatric intensive care units. The Children's Medical Center is a self-contained pediatric hospital with a pediatric emergency room and trauma center. Residents also will rotate through All Children's Hospital in St. Petersburg