North Carolina

Institution: Duke University
Position: Perioperative Medicine
Contact Name: Susan Morris
Contact Number: 919-681-6754
Contact Email: susan.morris@duke.edu

Duke Anesthesiology and its POET (Perioperative Enhancement Team) program at Duke University Medical Center, are leading efforts to advance the field of perioperative Risk Evaluation and Care Optimization (RECO) for issues including anemia management, diabetes management, nutrition management, complex chronic pain management, perioperative management of pacemakers and implanted defibrillators, anticoagulant management, and the special circumstance of extreme advanced age. In addition, Duke has pioneered Enhanced Recovery After Surgery (ERAS) implementation in the United States having a long-standing relationship with the leaders in the National Health Service and U.K. system from the University College London. Postoperative management and tracking, application of handheld ultrasound to enhance diagnostic skills, as well as business administrative skills are also included in the perioperative medicine curriculum.

Each fellow will have a faculty mentor and will be able to prioritize components of the fellowship to their individual clinical and research interest.

The fellowship curriculum will consist of several different components:

Clinical Training – fellows will work one to two days per week in the operating room as faculty fellows. Clinical practice will include supervising residents and CRNAs, and will predominately involve anesthesia for high-risk noncardiac surgery.

MSc in Perioperative Medicine – fellows will be enrolled in UCL’s master’s program in perioperative medicine.

Perioperative Research – fellows will assume a supervised personal research project, which will also form the basis of their MSc dissertation.

Clinical and Managerial Rotations – fellows will complete monthly core and elective rotations in different aspects of perioperative medicine.

A Typical Week Consists of…

One to two days of staffing the operating room
One day devoted to the MSc
One academic day to focus on research and quality improvement projects
One to two days on clinical rotations

Fellows will also attend weekly fellowship lectures, Grand Rounds lectures, and Duke Perioperative Enhancement Team (POET) weekly meetings.

Perioperative Medicine Fellows should develop an appreciation of all aspects of perioperative medical management. This includes an understanding of the physiologic processes, as well as the physical and psychological impact. This also implies an awareness of and ability to effectively utilize a broad range of therapies aimed at modifying those impacts.

Specific Expectations:

By the end of the fellowship, the fellow will be able to:

Describe the physiologic changes occurring in the perioperative period.
Describe the preoperative risk assessment of patients with regard to both preoperative patient risk factors and various surgical
procedures.
Perform preoperative patient assessments and develop management strategies with a view to risk stratification and
management and collaborative decision-making.
Understand the components of a comprehensive preoperative risk evaluation and optimization process, and learn how to
implement optimization processes into clinical practice. Preoperative optimization includes:
Prehabilitation
Optimization of modifiable risk factors
Optimization of pre-existing medical conditions (diabetes, anemia)
Manage high-risk surgical patients in the preoperative, intraoperative and immediate postoperative period.
Provide in-hospital anesthesia consultation for high-risk patients.
Describe the options available for postoperative analgesia, their advantages and disadvantages, including multimodal
analgesia and select appropriate therapies for individual patients.
Explain the concept of enhanced recovery and how it is implemented and sustained to improve outcomes.


Master’s of Science in Perioperative Medicine

Fellows will be enrolled in University College London’s (UCL) master’s program in perioperative medicine (MSc), which provides distance learning to earn a postgraduate degree in one-two years. This innovative, online course is taught by faculty from UCL, Duke University and abroad. Fellows will assume a supervised personal research project that will form the basis of their MSc dissertation.

Core Masters Modules Include the Following Topics:

Understanding the landscape of perioperative medicine and its new model of care
How to effectively use data
Safety and leadership in perioperative care
The evolving paradigm in perioperative pain, cancer, and cardiac disease
Better understanding of perioperative issues for an aging population


Study Abroad

Fellows will work alongside mentors and peers from other countries during a two-week exchange program with UCL. Fellows will live in London and interact with the perioperative medicine fellows from UCL. They will have the opportunity to see another healthcare system and develop collaborative projects with UCL as well as enjoy time in London. Fellows will also be able to attend a perioperative medicine conference in London and spend time with prominent international faculty.

Application Due Date: June 1, 2017

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Institution: University of North Carolina
Position: Obstetric Anesthesia Fellowship
Contact Name: Kathleen A. Smith MD
Contact Number: 919-966-5136
Contact Email: ksmith@aims.unc.edu

ACGME accredited fellowship in Obstetric Anesthesia. Our program offers excellent training, located in the beautiful area of Chapel Hill, North Carolina. UNC is a level 1 trauma center with advanced maternal and neonatal care units. We deliver 3700 babies/year, a large proportion of which have high risk maternal and/or fetal conditions. Come join our team!

Application Due Date: July 31, 2017