Ultrasound is the doctor’s new stethoscope.  At UI COM, residents are exposed to point of care ultrasound (POCUS) throughout their training, starting in Intern year.

Intern Year:

Ultrasound is a critical tool that is used in the intensive care units, emergency department, surgical elective, and in patient resuscitation efforts on the medical services.  Additionally, interns are exposed to transthoracic echocardiography during the cardiology elective at the Jesse Brown VA.  At the end of intern year, trainees spend the last two months of their internship within our department and participate in a two-month orientation.  This is optimal in preparing interns to transition smoothly into CA-1 year.  Point of care ultrasound is introduced during orientations so that residents can use this instrument in caring for patients.  The curriculum includes a general overview of ultrasonography including ultrasound physics, probe selection, ergonomics and view optimization.  During anesthesia months interns can expect to interact with ultrasonography during placement of central lines or arterial lines and transthoracic echocardiography in the operating room. Our goal is to introduce the basics of ultrasound early in training so that the residents can utilize this valuable tool throughout the training period.

CA1 Year:

Residents apply the basic concepts of ultrasounds throughout the CA1 year. OR, ICU and PACU patients may decompensate and require immediate evaluation using ultrasound.  With direct supervision and guided technique residents may utilize point-of – care ultrasound (POCUS) to evaluate for pneumothorax, pleural effusions and identify global cardiac dysfunction and initiate a targeted treatment until definitive diagnostics are pursued. While on the obstetric anesthesia rotation lumbar ultrasound is routinely used to identify and evaluate spinal anatomy for challenging neuraxial techniques on high risk parturients.

CA2/3 Years:

The regional anesthesia rotation prioritizes ultrasonography for all upper extremity, lower extremity and truncal perioperative blocks. Ultrasound guided regional blocks are also utilized at off-campus rotations such as Jesse Brown VA hospital and Northshore. Graduating CA-3 residents’ regional ultrasound skills are tested via OSCE board preparation workshops held by regional anesthesia faculty.  Prior to the cardiac and liver transplant rotation experience, each resident is assigned to a two-week rotation in trans-esophageal echocardiography (TEE).  In addition to didactics and hands-on TEE, residents also use our TEE simulator and an online curriculum with dedicated modules.

Our senior residents are quick to use ultrasound in placing challenging PIV, arterial lines, or to evaluate the heart and lungs during intra-operative instability.  Ultrasound skills are routinely used by senior residents during OR crisis and challenging cases off-hours and while on-call. Senior residents at this level will also participate in teaching and facilitating basics of ultrasonography for medical students and junior residents.

The ultrasound curriculum is rapidly evolving to meet our broadening scope of practice.  Graduating residents will graduate with competency in ultrasonography skills to meet the growing needs of peri-operative patient care.

The great majority of our graduating residents pass the written board exam on their first attempt. We promote our residents learning from day one through a comprehensive lecture program, and by making it as easy as possible for all residents to attend these conferences. We also enroll all CA1-CA3 residents in the Stanford STARTprep program.

Each morning before the start of surgery, when everybody is awake and available, we have our daily conferences. We get together and discuss an anesthesia topic. Our conferences include:

• Basics of Anesthesia Lecture Series Designed for CA-1 residents but open to all, this is an intense, eight- to ten-week series of daily lectures given each July and August, covering nearly every chapter from an introductory anesthesiology textbook
• Patient Management Conference A clinical case scenario in the format of the oral board exam. A case scenario is announced in advance, and a faculty member leads a discussion with the residents on anesthetic management
• Journal Club A review of the clinical and basic science literature, presented by a resident and faculty member
• Critical Thinking Workshop A monthly focused session in which several faculty members individually conduct small group discussions with residents on critical thinking and decision-making in various clinical scenarios. The individual groups are tailored to clinical experience, so that the discussions are training year-appropriate. Department fellows submit a case for discussion in advance, and the workshop takes place during our 90 minute Wednesday protected conference time.
• Survey of Anesthesia An in-depth, didactic lecture on an essential anesthesia topic
• Subspecialty Conferences A clinical review of pain, obstetric, pediatric, cardiac, and neuroanesthesiaCritical Skills Workshop An occasional session in which younger residents learn hands on skills as they prepare for call-taking responsibilities, including setting up rooms for various kinds of subspecialty emergencies, setup and use of advanced airway equipment, management and setup of rapid infusion devices and drug infusion systems, etc.
• ACE Questions An every-other-week conference discussing questions from the Anesthesiology Continuing Education component of the Maintenance of Certification in Anesthesiology (MOCA) program. This satisfies that program’s lifelong-learning and self-assessment requirements, and exposes residents to essential knowledge material that is likely to be seen on the annual In-Training Examination
• Morning Report An every-other-week Socratic method-type conference in which all aspects of one of that day’s cases is discussed. It’s lively and freewheeling, and encourages preparedness and thinking on your feet
• Practice Management Each fall, we present a brief series of conferences tailored to private practice anesthesia. A private practice anesthesiologist presents the facts of that practice style, whether in the OR or pain management environment, and an expert talks to the residents about contract negotiation and other aspects of securing post-residency employment.
• Consensus & Best Practices Periodic overview of specialty consensus and evidence-based best practices.
• Subspecialty Update Periodic overview by subspecialty faculty of new and emerging practices and concepts in their area of expertise.
• CA-3 residents rotate through a one week Systems-Based Practice Module to introduce them to the everyday management issues of a busy OR environment from several different points of view. On Monday, they shadow the OR Board Runner and then create the Tuesday schedule assignments. On Tuesday, they function as the Board Runner (under supervision). On Wednesday, they attend the OR Staff Meeting and then shadow the OR Director of Perioperative Services. That afternoon, they shadow the OR pharmacy staff to gain insight in the issues and logistics of meeting perioperative pharmacy needs. On Thursday, they learn the basics of anesthesiology and OR billing operations. And finally on Friday, they meet with the director of the OR to discuss their written summary of the OR processes, including suggestions on quality improvement.
• In addition, each month there is either a Grand Rounds visiting speaker or a Morbidity and Mortality (M&M) Conference held in the department. We feel that this combination of educational conferences and opportunities for social interaction provide our residents with exposure to academic topics, nationally known speakers, and the excitement of transferring book knowledge into clinical reality.
• Simulation Education

The Division of Pain Medicine is truly multidisciplinary and focuses on treating pain through interventional modalities when appropriate.  Resident learn pain medicine during a one month rotation at UIC and a month rotation at the Jesse Brown VA.  Residents manage acute and chronic pain needs for inpatients and outpatients settings.   All modalities and interventions are used to maximize pain relief while minimizing risks.  Residents are heavily involved in pain management plans which include prescribing medications, interventional pain procedures, and physical therapy.   We offer daily didactic lectures addressing topics ranging from basic pain principles to fellowship level didactics.  Additionally, residents are exposed to a multidisciplinary conference every Friday morning at the VA which includes physiatrists, psychologists, pain medicine doctors, and clinical pharmacologists.  At University of Illinois at Chicago, our service offers 3600 outpatient encounters, over 2200 procedures, 1200 outpatient consults, and 500 inpatient interactions.  At the VA, the numbers are approximately 3,600 outpatient encounters, 800 procedures, 900 consults, and 150 inpatient interactions per year.

Our residency program highly values and supports an environment of inquiry for the trainees. While traditional didactics and clinical care are cornerstones of residency training, some skill sets are best developed outside of the classroom or operating room. We believe a well-rounded consultant in anesthesia should showcase their skills and experience on a national level. Through our residents’ active participation in scholarly activity at numerous anesthesia meetings, they are provided an opportunity for personal and professional development.

Our residents are encouraged to identify a scholarly activity project from the very beginning of their training. Close collaboration with faculty mentors results not only in an enhanced fund of knowledge about the topic of choice, but invaluable skills such as professional development, public speaking, networking and leadership opportunities and communication style and delivery. Further, the residents who participate in scholarly activity experience comradery with, not only fellow anesthesia residents, but the anesthesia community at large.  We are proud of our residents and the scholarly activities they participate in.  These meetings also serve as an excellent opportunity to network with leaders in our field and various fellowship directors.  Midwest Anesthesia Resident Conference (MARC), American Society of Anesthesiologists (ASA), Society of Obstetric Anesthesia and Perinatology (SOAP), Society of Neuroscience (SNACC), Society of Pediatric Anesthesia (SPA), Society for Education in Anesthesia (SEA) are some of the venues that our residents frequently participate in.