The Department of Anesthesia, at University of Iowa Hospitals & Clinics is pleased to offer a Fellowship in Regional Anesthesia and Acute Pain Medicine, and accepts applications from anesthesiologists who desire to focus on this relatively new and rapidly growing subspecialty. Over a 12-month period, two fellows will rotate through a broad range of clinical areas including outpatient, inpatient, and pediatric regional and acute pain management within UI Hospitals & Clinics and Ambulatory Surgery Center.

The Acute Pain and Regional Anesthesia Service at the University of Iowa aims to provide excellence in acute and regional anesthesia for postoperative pain relief, to educate residents and fellows in the management of acute pain, and to further clinical research in the fields of pain management and regional anesthesia.

We consult on the management of patients with postoperative, post-traumatic, or any acute pain condition requiring:

• Specialized interventions such as epidural analgesia
• Continuous peripheral nerve blockade
• Complex pharmacological management, such as opioid tolerant patients

We also offer a full range of interventional procedures, such as blood patches, difficult lumbar punctures, fluoroscopy-guided epidural placement and ultrasound-guided regional blocks. The service is staffed for 24-hour coverage seven days a week. Please take this opportunity to explore the possibilities you will find at the University of Iowa by visiting our departmental website as well as this website for specific curriculum and types of procedures performed.

Didactic Lecture Series

The acute pain lectures are presented Monday's at 3 p.m. The fellows are expected to present between two or three PBLD (Problem Based Learning Discussion) type lectures during the academic year.

Anesthesia Clinical Case Conference

Clinical Case Conference (M and M) and visiting professor presentations are on Tuesday mornings from 0700 - 0745.  Fellows are invited and encouraged to attend these weekly conferences. Pain and Regional interesting cases are presented by Pain Medicine Faculty three to four times per year.

The clinical program will serve as the cornerstone of the fellowship training in regional anesthesia. In order to achieve the necessary level of expertise, fellows should be familiar with the indications, contraindications, techniques, and complications of the techniques listed below:

Basic Techniques

• Superficial cervical plexus block
• Axillary brachial plexus block
• Intravenous regional anesthesia (Bier block)
• Intercostobrachial nerve block
• Saphenous nerve block
• Ankle block
• Spinal anesthesia
• Lumbar epidural anesthesia
• Combined spinal-epidural anesthesia
• Femoral nerve block
• TAP (transverse abdominis plane) block
• Lateral femoral cutaneous nerve block

Intermediate Techniques

• Deep cervical plexus block
• Interscalene block
• Supraclavicular block
• Infraclavicular block
• Sciatic nerve block: posterior approach
• Popliteal block: all approaches
• Suprascapular nerve block
• Thoracic epidural anesthesia

Advanced Techniques

• Continuous interscalene block
• Continuous infraclavicular block
• Continuous supraclavicular block
• Continuous axillary block
• Thoracolumbar paravertebral block: single injection or continuous
• Lumbar plexus/Psoas block: single injection or continuous
• Combined lumbar plexus/sciatic block: single injection or continuous
• Continuous femoral nerve block
• Obturator nerve block
• Sciatic nerve block: anterior approach and parafemoral technique
• Continuous sciatic nerve block: all approaches
• Continuous popliteal block: all approaches

Exposure to regional and acute pain techniques involving pediatric and ambulatory surgery patients is strongly encouraged. Physiologic and pharmacologic consequences of regional and acute pain anesthesia will be stressed. Particular attention should be focused on the potential respiratory and hemodynamic perturbations, which accompany performance of neuraxial and peripheral nerve blocks.

The regional anesthesia fellows are assigned to cover acute pain call on the weekends, beeper call from home.

Weekdays - the regional fellows as well as the residents rotating on the acute pain service rotate acute pain consults. When assigned to acute pain consults, they are expected to stay in-house until the OB resident can take over the beeper call for the evening.

How are the applicants chosen for interviews?

Completion of an Anesthesia residency program is a requirement. Applicants are chosen based on their educational background including scores, educational presentations, and research activities as well as their performance in the interview process and based on their references. The successful applicant will have an M.D. or equivalent and will have passed the Anesthesiology specialty exams or in the process of examinations by the American Board of Anesthesiology. Candidates must have completed a core residency program with at least one year of clinical training from an ACGME accredited program.
Interested applicants should submit the following: letter of intent, curriculum vitae, official record(s) of Board scores (NBME, FLEX, USMLE), letter of recommendation from anesthesiology residency program director, and two additional letters of recommendation from faculty members. Final selection will be made by a selection committee upon the recommendation of the director of the fellowship program.

Can you describe a typical clinic day for your fellows?

Typical clinic day starts around 6:30 am completing the regional blocks for the early start surgeries followed by morning acute pain rounds. During the day, the fellows perform regional procedures and attend acute pain consults. In the afternoon they check the OR schedules for regional procedures for the next day. If on call, the fellow would conduct/attend acute pain evening rounds.

Do you have an electronic record?

Yes, since November 2010 the University uses Epic for medical records, including documentation and orders.

Do fellows have an educational fund?

Yes. Fellows are allotted a fund of $2,400 to provide support for specific needs during the course of their training. An additional $600 is awarded to the fellow if they present a research project at a national meeting that is approved by the Director for Acute Pain Medicine.

What are your average duty hours?

The average duty hour week is 56 hours. Duty hours are recorded on Med Hub.

How are fellows performance evaluated?

Faculty evaluates fellows using MedHub monthly. The evaluations are based on the six ACGME core competencies.
The fellows also evaluate the faculty using the Department of Anesthesia Faculty Evaluation System (these evaluations are combined with resident evaluations and presented to the faculty quarterly to ensure confidentiality).

The Regional Anesthesiology and Acute Pain Medicine fellowship at the University of Iowa Hospitals & Clinics is a one-year fellowship which was accredited by the Accreditation Council for Graduate Medical Education (ACGME) effective April 17, 2018.

Information specific to program requirements for a regional anesthesiology and acute pain medicine training program may be found at the ACGME’s Anesthesiology Review Committee (RC).

Eligibility criteria for applicants:

1.  Graduate from one of the following:

• United States or Canadian medical school accredited by the Liaison Committee on Medical Education (LCME)
• United States college of osteopathic medicine accredited by the American Osteopathic Association (AOA)
• Medical school outside the United States or Canada with:
  • A valid certificate from the Educational Commission for Foreign Medical Graduates (ECFMG) and have a passing score for Step 1 and Step 2 of the USMLE
  • Be a U.S. citizen, a legal permanent resident, or hold a visa which provides eligibility to work in the U.S. Typical visas are J-1 (requires Steps 1 and 2 of USMLE and ECFMG certification) and H1-B (requires departmental approval, and Steps 1, 2 and 3 of USMLE, and an Iowa medical license)

2.  Meet Iowa Board of Medicine licensure requirements.

3.  All applicants must also meet program eligibility requirements as defined by the ACGME’s respective RRC.

Contact our Fellowship Coordinator if you have any eligibility questions.

The Department of Anesthesia at Roy J. and Lucille A. Carver College of Medicine and UI Health Care shares the University of Iowa’s commitment to equal access and, consistent with its academic mission and standards, strives to achieve excellence through the advancement of diversity, equity, and inclusion. In the Department of Anesthesia, we are mindful of all aspects of human difference and define diversity in the broadest sense to mean inclusion of all persons. This means we do a holistic review of applications, with particular interest in recruiting applicants who have shown grit and resilience in their path to medicine, as well as potential to lead anesthesiology in the future.

The Interview

To minimize health risks associated with travel, and in compliance with institutional, state, and national recommendations, we will conduct all interviews online only. We will not offer any in-person interviews or site visits during this cycle. The online-only interview requirement applies to all candidates, internal or external, so that we may provide an equitable experience to all applicants.

Invitations to interview

Interview invitations from our program will be extended via our Program Coordinator through SF Match. You will be able to see available times and dates and self-schedule your interview.

What should I expect on the interview day?

Your interview day will typically begin at 2 p.m. and end around 4:30 p.m. We plan to conduct interviews on the Zoom platform. The interview includes an overview of the program and interviews with the program director, current fellows, and Acute Pain Medicine faculty.

Nada Sadek, MD

Carla Hightower, MD

Cynthia Wong, MD

Department Chairman
Professor of Anesthesia