Medical Student Elective

The Anesthesiology Department offers a four-week rotation to fourth year medical students from Tufts and other medical schools approved by the American Association of Medical Colleges (AAMC) and the American Association of Colleges of Osteopathic Medicine (AACOM). We allow two medical students per month with preference given to Tufts Medical School students.

Maine Medical Center is a busy, 30-room OR that conducts 50 to 90 surgeries a day. Medical students are paired with a senior resident and attending anesthesiologist each day to experience a variety of surgical and anesthetic cases.

Goals & Objectives

Goal

With the help of the Anesthesia staff and residents, medical students will become familiar and participate in the care of patients through all phases of anesthetic care from pre-operative patient evaluation and preparation for surgery to OR management, procedures and planning for post-operative analgesia.

Objectives

  1. Demonstrate airway management skills, including:
    1. Safe sedation technique
    2. Bag- mask technique
    3. Endotracheal intubation
    4. Use of alternate airway devices (LMA, videolaryngoscope, flexible fiberoptic scope, etc)
    5. Comprehension of the difficult airway algorithm
  2. Learn predictors of difficult endotracheal intubations
  3. Learn the pharmacokinetics and side effects of medications used in anesthesia and critical care, including:
    1. Induction medications
    2. Volatile anesthetics
    3. Muscle relaxants
    4. Vasopressors and “rescue” medications
  4. Learn to perform a basic anesthesia history and physical exam
  5. Learn about the alterations in physiology due to anesthesia, most importantly:
    1. Pulmonary
    2. Cardiovascular
    3. Neurologic
  6. Demonstrate professional OR interaction

Curriculum

During the 4 week rotation, medical students are expected to take part in the following “Core anesthesia experiences:” Students will observe or participate, under the supervision of a faculty member:

  1. Delivery of a general anesthetic to an adult patient
  2. Delivery of a general anesthetic to a pediatric patient
  3. Use of regional anesthesia as a primary surgical anesthetic
  4. Use of regional anesthesia as a primary labor analgesic
  5. Perform a preoperative evaluation of a patient and classify their ASA status

Furthermore, rotators should attempt the following during their month in the operating room under direct supervision:

  1. IV placement with a goal of at least five IV placements
  2. Demonstration of adequate mask ventilation with both 1, and 2 hand technique.
  3. Endotracheal intubation with a goal of intubating five patients utilizing a variety of techniques including: Direct laryngoscopy with Miller blades, direct laryngoscopy with Macintosh blades, use of McGrath video laryngoscope, use of Glidescope video laryngoscope.
  4. Insertion of a laryngeal mask airway

Each day, medical students will engage in a discussion with the resident and attending covering a variety of topics including: 

  • The pharmacology and clinical use of local anesthetics, pressors, inotropes, muscle relaxants, sedatives, and analgesics
  • The physiology and delivery of general anesthesia, mechanical ventilation, and regional anesthesia
  • Methods of patient monitoring
  • Fluid and transfusion therapy
  • The intra-operative management of co-existing diseases such as hypertension, cardiac disease, asthma, diabetes, and renal insufficiency
  • Aspects of anesthesia for surgical subspecialties such as vascular, neurosurgery, thoracic cardiac, regional block service, pediatrics and obstetrics

A text book will be provided for the rotation. For additional texts and current journals, students have access to the department library. Students are expected to attend the Anesthesiology Grand Rounds each Thursday morning at 7:00 AM as well as the anesthesiology residents’ lectures series that takes place each Thursday morning at 8:00 AM. Students may also participate in Simulation sessions during their month if scheduled for further hands-on experience.

Expectations & Evaluations

Students' clinical responsibilities are from Monday through Friday from 6:30 AM to 4:00 PM, unless arranged differently with the attending and/or resident anesthesiologist. No overnight call or weekend hours are expected.

Professionalism is paramount in the operating environment. Students are expected to exhibit professional behavior with all staff.

Students are expected to give a brief presentation at the end of their rotation demonstrating knowledge of an anesthetic topic of their choosing.

Performance during the rotation will consist of a weighted average of your daily performance, preparation, professionalism and an end of rotation oral presentation.

  • Cumulative evaluations - 70%
  • Presentation - 20%
  • Professionalism - 10%

Apply

Students who are interested in this clerkship should apply electronically through the VSAS System.

For specific questions about the rotation, contact Jonathan Meserve MD FAAP, Director of Medical Student Education in the Department of Anesthesiology at (207) 662-2526 or Kristin Johnson, Program Manager, Anesthesia Residency, at (207) 662-4594.