The clinical base year in anesthesia at the University of Iowa is structured to prepare you for clinical training in anesthesiology and peri-operative medicine. The goal is to give you a wide exposure to the clinical specialties that will help you take care of your patients while you learn the system at University of Iowa Hospitals & Clinics. This will help you develop collegial relationships with faculty and house staff members on teams you will work with later as an anesthesia resident.

During this year, you rotate through:

• Surgical Neuroscience Intensive Care Unit/Cardiovascular Intensive Care Unit (SNICU/CVICU)
• Pediatric Intensive Care Unit (PICU)
• Emergency Medicine
• Surgery, including:
  • Trauma Surgery
  • Pediatric Surgery
• Internal Medicine, including:
  • Renal consults
  • Cardiology
  • General medicine
• Palliative Care Medicine
• Either Radiology or Pain Medicine
• Advanced Clinical Medicine
• Safety and Quality
• Anesthesia
  • All our interns do their block of anesthesia in June so that the transition to the anesthesia residency is smoother.

The Safety and Quality (SAQ) Rotation is unique at the University of Iowa. It is a required 4-week rotation that was integrated into the internship in 2014-2015.

The goals of the SAQ rotation are:

• Orient trainees to UI Hospitals & Clinics quality, safety, and performance improvement programs
• Teach system thinking through shadowing
• Teach patient safety through relationship building
• Enable empowerment by being agents of change.

Interns participate in activities such as:

• Shadowing:
  • SNICU nurses
  • MRI technicians
  • Emergency Department
  • Main OR Pharmacy
  • Perioperative Units
• Meeting with hospital safety and quality officers and legal counsel
• Attending meetings of the Safety Oversight Team
• Council on Quality and Safety
• M and M conferences in the Department of Anesthesia and Internal Medicine
• Root Cause Analysis (RCA) and Failure Mode Effect Analysis (FMEA) processes
• Completing the 16 on-line learning modules for the basic certificate of the Institute for Healthcare Improvement.
  • This required rotation is novel for anesthesia training programs and provides trainees with uncommon access to hospital leadership concerned with safety and performance improvement.

The Palliative Care Medicine rotation is another relatively unique rotation for anesthesia trainees.

The goals of the Pallivative Care Medicine rotation include:

• Understand the principles of palliative/hospice medicine
• Define and apply effective strategies and techniques for communicating with patients and families (especially when the communication is related to "bad news")
• Identify and apply effective management strategies for non-pain symptoms (for example, nausea, dyspnea, anorexia, delirium and terminal restlessness) in patients at the end of life
• Appropriately prescribe opioid and non-opioid drugs for treatment of pain
• Explore the emotional and psychosocial aspects of the illness experience and physician grief
• Work with patients regarding goals of care.

On this rotation residents develop a close working relationship with the faculty physicians. Residents participate actively in-patient evaluation, management, and education.

During May and June, interns participate in the Advanced Clinical Medicine (ACM) rotation and have their first rotation in Anesthesia. During these two blocks, residents have an orientation to the department, workshops, simulations, and basic lectures on anatomy, physiology, pharmacology, machines/monitors, communications, leadership, and the basics of anesthesia. Faculty from the Department of Anesthesiology and other UI Hospitals & Clinics departments and CA3 residents provide the educational content. Residents also conduct anesthesia in the OR.