Medical students are a critical component of our teaching mission. We are involved with teaching in the medical school throughout all four years of the curriculum and offer both required and elective courses. Students serve an important function for our residents and faculty: Residents and attendings need to constantly develop and improve their teaching skills, and students provide “feedback” to all of us. In medicine, it is our responsibility to mentor and teach, reproducing knowledge and techniques for the next generation. Through one-on-one teaching in the operating rooms to small-group teaching on rotation, students offer themselves as eager learners and astute evaluators of our teaching program.
Various members of the department participate in teaching throughout the four years and in all areas of the curriculum (in the anatomy course, for example, we offer "in vivo" ultrasound teaching demonstrations to correlate with cadaver anatomy instruction). This runs the gamut from lectures to advising students interested in careers in anesthesiology. Additionally, research is constantly going on in the department, and students have the opportunity to work with an investigator over the summer or throughout the school years, as time permits. Much of the work is done in conjunction with basic science departments, allowing students to see and participate in both bench and clinical research.
Medical students interested in anesthesiology may consider joining the Anesthesiology Interest Group (ASIG) through the P&S Club. ASIG runs multiple events throughout the year, including an anesthesiology skills fair in the Margaret Wood Center for Simulation and Education, and weekend shadowing opportunities in the Milstein operating rooms. As students hone their interests in these years, they may consider reaching out to our Vice Chair for Research, Dr. Charles Emala, who can assist in finding research projects and mentors that align with the student’s interests.
Major Clinical Year Clerkship
The Department of Anesthesiology's major clinical year (MCY) clerkship is a five-day rotation that allows students, under direct supervision, to obtain clinical experience in perioperative medicine. Schedules, expectations, and educational videos for pre-rotation viewing will be emailed out in the weeks leading up to the rotation, and room assignments will be emailed on the evening before the first day of the rotation.
Students jump right into perioperative patient care with a resident mentor on day one. That afternoon, they will participate in a hands-on didactic session including an airway workshop, practice-based learning discussion, and PACU simulation in the Margaret Wood Center for Simulation and Education. Over the week they will continue to participate in direct patient care in the acute setting of the operating room and recovery room. Students will gain insight into the anesthesiologist’s management of pre-, intra-, and post-operative patient care. Students will conclude their rotation with case presentations precepted by one of our faculty members.
Goals of the Rotation:
Learn how to perform a preoperative assessment and appreciate its value
Generate simple anesthetic plans tailored to the patient’s co-morbidities and intended surgery
Apply basic cardiopulmonary physiology and pathophysiology
Understand the pharmacology of commonly used anesthetic agents and vasoactive medications
Comprehend how to use the ventilator and manipulate its settings
Hone procedural skills including peripheral IV access and basic airway management
Differentiation and Integration: 4th year electives
The Department of Anesthesiology offers four electives, as described below. Application deadlines and estimated decision dates for visiting students will be updated as soon as they are available through the medical school. Instructions for visiting student applications may be found here.
AS01P - Pain Medicine
One month with the pain team working in the outpatient clinic on chronic pain issues and the inpatient acute setting. The month includes observing and participating in block procedures as well as rounds and conferences. The rotating medical student meets with the division/program director to establish goals and expectations of the rotation. During the rotation the student is encouraged to be an integral part of the team with the residents and fellows and to obtain exposure to all aspects of clinical pain medicine. The student will also have directed meetings with core faculty to discuss their learning and address any concerns. At the end of the clerkship, the student will present a brief lecture on a pain-management-related clinical or research topic of their choosing.
AS02P - Anesthesiology Preceptorship
4-week Operating Room Elective: The Department of Anesthesiology offers a one-month 4th-year elective in the operating rooms to all students throughout the United States. The primary objective is to acquaint students with the broad scope of operating-room anesthesia as it is practiced here at Columbia. Because of our large service, students can see a wide variety of clinical cases. Generally students spend two weeks in the general operating rooms honing IV placement and airway management skills. The rest of the month is spent in the subspecialty areas, such as cardiac, neuro, pediatrics, etc. This can be tailored to the particular student's interest or be very generalized. Neither weekend nor night call is required. There are didactic sessions once per week, where students are expected to present short topics in anesthesia that they have researched through the literature. At the end of the rotation, students are asked to do a longer presentation on a topic in anesthesia of particular interest to them. The rotation is offered August through June of the following year.
AS03P - Cardiothoracic and Surgical Intensive Care Unit Sub-Internship
The department offers one-month subinternships in Cardiothoracic and Surgical Intensive Care. This sub-I elective has been consistently the most popular elective in the curriculum, as students get the chance to follow critically ill patients throughout the month and have critical input into their care. The rotation is offered throughout the year (July through June) for up to six students per month. Students spend half of the month in the cardiothoracic intensive care unit (CTICU) and the other half in the surgical intensive care unit (SICU). In the CTICU, students care for patients recovering from major cardiothoracic surgery, including heart and lung transplantation, coronary revascularization, ventricular assist device (VAD) placement, and extracorporeal membrane oxyenation (ECMO). In the SICU, the patient mix consists of thoracic, liver transplant, vascular, abdominal, orthopedic, ENT, urologic, and gynecologic patients requiring postoperative critical care. Under the supervision of the ICU attendings and fellows from the Department of Anesthesiology, students participate in day-to-day patient care.
Rounds are held twice daily with ICU attendings, during which patients and their laboratory and x-ray findings are carefully analyzed and plans are made to clarify and resolve management problems. Each Thursday, students attend Critical Care Grand Rounds, a conference attended by all staff involved in critical care at Columbia University Medical Center. Consultants in infectious disease, cardiology, renal disease, neurology, and pulmonary medicine make daily rounds within the unit and review problems relevant to their special fields with the house staff and subinterns. Students are required to take twenty-four hour call and late call during the week, and there is no call on weekends or holidays.
Students will develop a working understanding of: resuscitation and endotracheal intubation; mechanical ventilation; hemodynamic monitoring using arterial, central venous pressure, and pulmonary artery catheters; nutritional support, including total parenteral nutrition; interpretation of blood gas and other monitoring data; management of major postoperative problems, such as bleeding and sepsis; and an understanding of organ-system failure and shock. Students will have an opportunity to develop the skills of analysis and judgment important in the optimal management of complex critically ill patients.
AS90P - Anesthesiology Research Elective
The department conducts research across the broad spectra of basic and clinical research. We maintain modern research laboratories that support NIH- funded research from molecular to whole animal models addressing topics in physiology and pharmacology across many organ systems. Clinical research includes direct interventional research/clinical trials as well as large data outcome studies using sophisticated statistical approaches. Examples of basic research topics include organ ischemia reperfusion injury, purinergic receptor signaling in sepsis, anesthetic effects on the electroencephalogram and post-anesthesia outcomes, inflammatory and fibrotic lung diseases, elucidation of protein structure/function via cryo electron microscopy techniques, mitochondrial bioenergetics, mechanisms of anesthetic neurotoxicity and mechanisms of acute and chronic pain. Clinical studies include investigations into biomarkers of kidney and liver injury in the perioperative/lCU environment, delirium and cognition changes in the perioperative period, protective strategies against ventilator induced lung injury, perioperative pain and opioid management, complications in the pediatric patient after surgery/anesthesia, and the impact of palliative care in cancer patients. Large data studies address research topics related to pediatric anesthetic neurotoxicity, intraoperative predictors and interventions for kidney injury, anesthetic complications in obstetrical anesthesia, and risks for cognitive decline and delirium after anesthesia and ICU care. Students are paired with mentor(s) experienced in clinical, basic and epidemiological research and identify appropriate contributions to ongoing research projects during this elective.