Wake Forest

Study Guides for Each Rotation:

Our study guide system is unique to Wake Forest. We call them "Things to Remember" and we have introductory and advanced versions for each rotation. Each study guide has a dozen or so open-ended questions that residents answer during the first two weeks of each rotation. These serve as ice-breakers for one-on-one discussion with faculty and they cover all of the key concepts to be learned from each rotation. Everything that matters most is best remembered through repetitive drill: seeing, writing, speaking, even drawing. Our Things to Remember Guides are a thorough application of fundamental learning theory.

Chaperoned Reading Program:

Our faculty has created a system to help first year residents get the most out of the introductory texts of our field. It consists of web-based quizzes that can be done from home in five chapter intervals. It is optional, low key, and not graded. It covers more than 500 key words and provides instant answers with explanations for each question. It can be used and re-used a variety of ways. Two introductory texts are covered with 19 quizzes under this format to help prepare our junior residents for the Basic Examination.

Distinguished Graduate Program:

Residents at Wake Forest can choose to pursue Academic Distinction in three different ways: Research, Quality Improvement, or Exam Performance. A few exceptional residents each year earn the Academic Distinction notation on their diploma along with a monetary award. The time and commitment required is above and beyond the expectations to finish the program, but it is a tangible lofty goal for the motivated learner.

Obstetrics in Ghana, Africa:

We have two or three rotations per academic year in Ghana for those with interest in Global Health and working in austere environments. It is a longstanding relationship with our Obstetric Anesthesia Section and it includes both clinical work and instruction.

Carey Commendation Awards:

We incentivize performance on the national in-training exam by presenting awards to those who perform particularly well. We have named it after one of our graduates who got the highest score in the nation when he was a CA-3. The award includes a certificate and a monetary bonus that is added to their Books and Travel account.

Peri-Op Medicine:

Peri-Op is an elective rotation spent in our Perioperative Surgical Home, predominantly helping to prepare challenging patients for surgery. Anemia, pulmonary dysfunction, congestive heart failure, whatever the concern, we are taking an early and pro-active approach to optimizing the care of our most at-risk patients. This rotation includes instruction by internists, hospitalists and anesthesiologists interested in perioperative care.

Supervisory Ambulatory Anesthesia:

One of our most popular elective rotations, our Advanced Ambulatory rotation allows our CA-3 resident to help run our 8 operating room ambulatory suite as its Board Runner. Thus, there are numerous pre-operative nerve blocks and the determination of home readiness in the PACU. It is an opportunity to supervise younger residents, CRNAs and SRNAs during the normal workday, much like they might be doing ever after beginning the following year.

Safari:

We have more than a dozen exciting Out-of-OR sites that allow this rotator to feel like they are truly on safari. Day in, day out, for an entire month, the resident gets to explore distant locations far from the safety and comfort of the operating room: each day determining the most fundamental concerns required to anesthetize remote patients safely. Cases are tracked daily to make sure each resident gets ample opportunities in interventional radiology, gastroenterology, burns, cardiology, brachytherapy, and half a dozen other unique locations that would never have been considered anesthetizing locations a decade ago.

Embedded Simulation:

Throughout the continuum of residency training, our simulation center is used repeatedly to enhance preparation for both the rare and routine. It provides initial orientation, a Boot Camp experience during the intern rotation, and numerous opportunities to practice Crisis Management scenarios. Simulation is completely embedded into the curriculum with advanced case complexity simulations for our senior residents every Tuesday, and Crisis Management scenarios for our CA-1s every Monday.

Ancillary Airway Training:

Ours is an "Airway First" profession, so we make sure all of our graduates can comfortably follow each branch of the Difficult Airway Algorithm, awake and anesthetized. We have more than a dozen fiberoptic bronchoscopes in constant circulation and our residents average more than 50 fiberoptic intubations during their training. We particularly embrace the awake intubation because of its unique complexity and importance. All of our residents perform at least 20 awake intubations and learn to use both topical and nerve block approaches to anesthetizing the airway.

The Lightwand:

The lightwand is an old, simple, inexpensive, remarkably "low-tech" rescue device. Great in a helicopter or the woods, it is now rarely taught outside the military-perhaps it works too well or remains too inexpensive. Nonetheless, it is sublime in that it very rarely fails because it actually places the endotracheal tube in the trachea. Please use any search engine to watch our lightwand tutorial or click on the following link to learn just how this tool is at its best when circumstances are at their worst: blood in the mouth, fused neck, failed DL, remote locations, vomit in pharynx, patient on ground, no electricity, etc… http://www.wakehealth.edu/School/Anesthesiology/Tutorials/Lightwand-Intubation-Tutorial.htm

Merit Badge:

Most of our final training year is spent in preparation for supervision as a consultant. We have more than 20 electives from which to choose, with all of our residents getting 6-8. Merit Badge is a senior elective rotation whereby we support the resident in the acquisition of as many training certificates as they can acquire. The record is eight (8) in a single month, but most who choose this rotation get three or four. Certificates obtained include ACLS, BLS, PALS, NRP, ATLS, AWLS (wilderness), ABLS (burns), ALSO (obstetric), and ECMO to name a few. They have been earned in nearly as many states to include California, Arizona, New Mexico, Colorado, Montana and all of the southeastern states. Many people choose not to pursue such things due to lack of time or money, but here is a rotation that provides both of these-right at the culmination of residency.