Current Anesthesiology Reports

, Volume 6, Issue 1, pp 59–64 | Cite as

The Anesthesiology/Emergency Medicine Combined Residency: Defining a New Future for Trauma Resuscitation

Anesthesia for Trauma (JW Simmons, Section Editor)
First Online:
Part of the following topical collections:
  1. Anesthesia for Trauma

Abstract

As management of patients in extremis becomes increasingly complex, the need for a resuscitation consultant is apparent. This physician must be able to provide and/or coordinate care for the acutely ill and injured patient across the continuum of care; from presentation to definitive care to disposition. The resuscitation consultant produced by a residency in anesthesiology and emergency medicine will capitalize on the complementary strengths of both programs; a 60-month residency will offer board eligibility in both specialties. The first (PGY-1) year will be spent as an intern on the emergency medicine service and the second (PGY-2) year will be spent on the anesthesiology service as a clinical anesthesiology-1 resident. The remaining 3 years will be split into 18 months each of anesthesiology and emergency medicine. Approval of the program in anesthesiology and emergency medicine by appropriate governing bodies is a pre-requisite for program establishment. While medical students will determine the success of the program in anesthesiology and emergency medicine (for it is they who are the prospective applicants to the program), it is the patient who will be the beneficiary of a uniquely trained resuscitation consultant. A physician who is at ease diagnosing undifferentiated disease, managing resuscitation in the operating room or interventional radiology suite and managing the critically ill patient throughout the care continuum will define the future specialty.

Keywords

Trauma Resuscitation Residency Simulation Anesthesiology Emergency medicine 
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Notes

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Butler FK Jr, Hagmann J, Butler EG. Tactical combat casualty care in special operations. Mil Med. 1996;161(Suppl):3–16.PubMedGoogle Scholar
  2. 2.
    Holcomb JB, Tilley BC, Baraniuk S, Fox EE, Wade CE, Podbielski JM, et al. Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial. JAMA. 2015;313(5):471–82. doi: 10.1001/jama.2015.12.PubMedCentralCrossRefPubMedGoogle Scholar
  3. 3.
    Borgman MA, Spinella PC, Perkins JG, Grathwohl KW, Repine T, Beekley AC, et al. The ratio of blood products transfused affects mortality in patients receiving massive transfusions at a combat support hospital. J Trauma. 2007;63(4):805–13. doi: 10.1097/TA.0b013e3181271ba3.CrossRefPubMedGoogle Scholar
  4. 4.
    Holcomb JB, Wade CE, Michalek JE, Chisholm GB, Zarzabal LA, Schreiber MA, et al. Increased plasma and platelet to red blood cell ratios improves outcome in 466 massively transfused civilian trauma patients. Ann Surg. 2008;248(3):447–58. doi: 10.1097/SLA.0b013e318185a9ad.PubMedGoogle Scholar
  5. 5.
    • American Board of Anesthesiology. Guidelines for combined training in internal medicine and anesthesiology. In: Combined training. 2015. http://www.theaba.org/PDFs/Internal-Medicine/CombinedTrainingRequirementsInternalMed. Accessed 15 Apr 2015. Defines specifications for combined program in anesthesiology and internal medicine.
  6. 6.
    • Accreditation Council for Graduate Medical Education. ACGME program requirements for graduate medical education in anesthesiology. 2014. http://www.acgme.org/acgmeweb/portals/0/pfassets/programrequirements/040_anesthesiology_07012014.pdf. Accessed 3 May 2015. Defines specifications for combined program in anesthesiology and internal medicine.
  7. 7.
    • American Board of Internal Medicine. Internal Medicine/Emergency Medicine Policies. In: Combined training in internal medicine. 2015. http://www.abim.org/certification/policies/combinedim/comem.aspx-guidelines. Accessed 15 Apr 2015. Defines specifications for combined program in internal medicine and emergency medicine.
  8. 8.
    •• Culley DCN, Hall S, Kuhn C, Lewis L, Mason L, Nestler SP, Patel RM, Schartel S, Waldschmidt B, Warner M. The anesthesiology milestone project. In: Accreditation council for graduate medical education and american board of anesthesiology. 2013. http://acgme.org/acgmeweb/Portals/0/PDFs/Milestones/AnesthesiologyMilestones.pdf. Accessed 4 May 2015. Describes innovative method to assess resident performance along continuum of learning from program entry to graduation.
  9. 9.
    Miller GE. The assessment of clinical skills/competence/performance. Acad Med. 1990;65(9 Suppl):S63–7.CrossRefPubMedGoogle Scholar
  10. 10.
    Fleming ND, Mills C. Not another inventory, rather a catalyst for reflection. Improve Acad. 1992;11:137–55.Google Scholar
  11. 11.
    Pashler HMM, Rohrer D, Bjork R. Learning styles: concepts and evidence. Psychol Sci Public Interest. 2009;9(3):105–19.Google Scholar
  12. 12.
    Rohrer D, Pashler H. Learning styles: where’s the evidence? Med Educ. 2012;46(7):634–5. doi: 10.1111/j.1365-2923.2012.04273.x.CrossRefPubMedGoogle Scholar
  13. 13.
    Vanderbilt AA, Feldman M, Wood IK. Assessment in undergraduate medical education: a review of course exams. Med Educ Online. 2013;18:1–5. doi: 10.3402/meo.v18i0.20438.Google Scholar
  14. 14.
    Masters JC, Hulsmeyer BS, Pike ME, Leichty K, Miller MT, Verst AL. Assessment of multiple-choice questions in selected test banks accompanying text books used in nursing education. J Nurs Educ. 2001;40(1):25–32.PubMedGoogle Scholar
  15. 15.
    Gaba DM, DeAnda A. A comprehensive anesthesia simulation environment: re-creating the operating room for research and training. Anesthesiology. 1988;69(3):387–94.CrossRefPubMedGoogle Scholar
  16. 16.
    Okuda Y, Bryson EO, DeMaria S Jr, Jacobson L, Quinones J, Shen B, et al. The utility of simulation in medical education: what is the evidence? Mt Sinai J Med. 2009;76(4):330–43. doi: 10.1002/msj.20127.CrossRefPubMedGoogle Scholar
  17. 17.
    Ziv A, Rubin O, Sidi A, Berkenstadt H. Credentialing and certifying with simulation. Anesthesiol Clin. 2007;25(2):261–9. doi: 10.1016/j.anclin.2007.03.002.CrossRefPubMedGoogle Scholar
  18. 18.
    Committee for Trauma and Emergnecy Preparedness (COTEP). Curriculum for CA-1 and CA-2 residents. 2013. http://www.asahq.org/For-Members/About-ASA/ASA-Committees/Committee-on-Trauma-and-Emergency-Preparedness.aspx. Accessed 19 July 2013.
  19. 19.
    Committee for Trauma and Emergnecy Preparedness (COTEP). Curriculum for CA-3 residents. 2013. http://www.asahq.org/For-Members/About-ASA/ASA-Committees/Committee-on-Trauma-and-Emergency-Preparedness.aspx. Accessed 19 July 2013.
  20. 20.
    •• Kehoe A, Jones A, Marcus S, Nordmann G, Pope C, Reavley P, et al. Current controversies in military pre-hospital critical care. J R Army Med Corps. 2011;157(3 Suppl 1):S305–9. Describes complimentary roles of anesthesiology and emergency medicine physicians in the combat environment. Google Scholar

Copyright information

© Springer Science + Business Media New York 2015

Authors and Affiliations

  1. 1.Trauma AnesthesiologyKeck School of Medicine of University of Southern CaliforniaLos AngelesUSA
  2. 2.Department of AnesthesiologyKeck School of Medicine of University of Southern CaliforniaLos AngelesUSA

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