Anesthesiology is a medical specialty encompassing a broad range of medical and scientific activities. The clinical practice of anesthesiology includes the following:

  1. Assessment of, consultation for and preparation of patients for anesthesia and surgery;
  2. Provision of insensibility to pain during surgical, obstetric, therapeutic and diagnostic procedures;
  3. Monitoring and restoration of physiologic homeostasis during the perioperative period as well as homeostasis in the critically ill or seriously injured patient;
  4. Diagnosis and treatment of painful syndromes; and
  5. Clinical management and teaching of cardiopulmonary resuscitation.

The realm of scientific investigation in anesthesiology also spans a broad range. Scientific efforts at the cellular and molecular levels are directed toward understanding the molecular mechanisms of anesthesia and analgesia. Clinical research in anesthesia includes broad epidemiological approaches to identifying indicators of outcome as well as prospective clinical studies examining new technologies, anesthetic agents and methods.

The Department of Anesthesiology presents the student with the opportunity to do the following:

  1. Acquire and apply pharmacologic knowledge related to anesthetic agents, opioids, paralytic and sedative drugs, and drugs affecting the autonomic nervous system;
  2. Understand and apply the basic principles of airway management and mechanical ventilation;
  3. Understand and apply the principles of cardiopulmonary resuscitation;
  4. Understand and apply the technical skills and anatomic and pharmacologic knowledge used in performing regional nerve blocks;
  5. Learn and apply the fundamental principles of acute and chronic pain management; and
  6. Learn and apply the basic principles of critical care medicine.

Anesthesiology bridges the gap between basic science and clinical medicine. It provides experience with the clinical evaluation and management of patients as well as with applied physiology and pharmacology. The Department of Anesthesiology offers student experiences in the operating room, the intensive care unit, the pain management clinic and the laboratory.

Contact Info

Contact:Maureen Arends
Email:arendsm@wustl.edu
Website:http://anest.wustl.edu

Anesthesiology Research Electives

During the fourth year, opportunities exist for many varieties of advanced clinical or research experiences.

Special electives in basic science research as it applies to anesthesiology can be arranged with the principal investigators in the Department of Anesthesiology; in the Division of Basic Research under the direction of Jose Moron-Concepcion, PhD; in the Washington University Pain Center under the direction of Rob Gereau, PhD; and in the Division of Clinical and Translational Research under the direction of Simon Haroutounian, PhD.

The basic science laboratories focus on various topics related to ion channel structure and function, molecular mechanisms of anesthetic action, sepsis, cellular and molecular mechanisms of reward and addiction, and the cellular and genetic basis of acute and chronic pain. Arrangements for these special electives are made through the specific investigators: Meaghan Creed, PhD; Alex S. Evers, MD; Robert W. Gereau, PhD;  Richard S. Hotchkiss, MD; Christopher J. Lingle, PhD; Qin Liu, PhD; Jose Moron-Concepcion, PhD; or Arvind Palanisamy, MD. In addition, opportunities exist for clinical research under the direction of Joanna Abraham, PhD; Michael Avidan, MBBCh; Anne Drewry, MD; Brian Fuller, MD; Simon Haroutounian, PhD; Thomas Kannamapallil, PhD; or Ben Palanca, MD, PhD.


ANESTH 8000 General Anesthesiology (Clinical Elective)

This clinical elective is designed to familiarize the student with basic aspects of anesthesiology practice. The primary teaching method is patient care in a clinical setting. The student will learn the basics of preoperative evaluation of surgical patients, the use of intraoperative monitoring inpatient management and postoperative care. In addition to perioperative care, the student will be exposed to other clinical areas which include our pain management clinic, regional anesthesia / acute pain management, cardiothoracic intensive care unit, labor and delivery, pediatric anesthesia, and the Center for Preoperative Assessment and Planning.
   
During the four-week rotation, the student will learn airway management skills, basic IV skills, practical perioperative fluid and electrolyte therapy, along with general and regional anesthetic techniques. As an integral part of the anesthesia care team, the student will participate actively in the anesthetic management of surgical patients.
   
The student's specific requests to be assigned to certain types of cases will be honored as time and availability dictate. The rotation will include at least one clinical simulator session using a simulator mannequin for practical management of airway problems. NOTE: Presence and participation in Presentation on the last day of the rotation are required to receive a grade.

Credit 4 units.

Typical periods offered: Medicine Year


ANESTH 8010 Cardiothoracic Anesthesiology (Clinical Elective)

This clinical elective offers practical experience in the perioperative assessment and management of surgical patients undergoing cardiothoracic procedures. The student, as an integral part of the cardiothoracic anesthesia team that is composed of faculty members, fellows and residents, will learn basic principles of airway management and lung ventilation, essential aspects of pharmacologic treatment of hemodynamic abnormalities and cardiac dysrhythmias, and management of intraoperative coagulation disturbances. Emphasis will be placed on the interpretation of intraoperative hemodynamic data, echocardiographic finding (TEE), and laboratory results. During this rotation, the student will also gain practical experience in endotracheal intubation as well as the placement of intravenous lines and invasive monitoring lines, including radial artery and pulmonary artery catheters. Students will learn how to use these parameters in clinical decision making during anesthesia. At the conclusion of the rotation, the student will have a better understanding of invasive monitoring and data interpretation, as well as a more systematic approach to the management of intra- and post-operative hemodynamic, pulmonary and coagulation abnormalities. The students are expected to attend the didactic sessions of CTA and the Department of Anesthesiology.

Credit 4 units.

Typical periods offered: Medicine Year


ANESTH 8015 Pediatric Anesthesiology (Clinical Elective)

The primary goal of this rotation is to gain exposure to the field of anesthesiology within the pediatric patient population. This elective provides the opportunity to take part in anesthetics across the range of surgeries and procedures, patient age, and acuity. With the entire elective taking place at St. Louis Children's Hospital, learners are able to observe the differences in physiology, medical/surgical problems, and patient care considerations in pediatric patients.

Credit 2 units.

Typical periods offered: Medicine Year


ANESTH 8020 CTICU: Cardiothoracic Intensive Care Unit (Clinical Elective)

This clinical elective offers practical experience in the postoperative management of cardiothoracic patients. The student will be fully integrated into one of the intensive care teams and have the opportunity to contribute to the management of critically ill patients. Students will have the opportunity to follow specific patients over the course of their stay in the ICU, during which time they will gain insight into holistic management of patients with multi-organ dysfunction.
   
The CTICU environment is both challenging and exciting. Students will gain unique insight into cardiorespiratory physiology and pharmacology which will be demonstrated at the patients' bedside, an invaluable and unforgettable learning experience. Students will have opportunities to learn and sometimes assist with procedures, such as central lines, chest tubes, bronchoscopy and pulmonary artery catheter insertion as well as bedside ultrasound including TTE and TEE. Principles of management and resuscitation of hemodynamically unstable patients following surgery will be emphasized as well as ventilator management. Students will also see and help manage patients with unique physiology such as those patients on ventricular assist devices, and on ECMO. We also have a very busy and heart and lung transplantation program at the hospital - all of these patients are cared for in the CTICU.
   
At the conclusion of the rotation, the student will have a better understanding of shock, sepsis, multi-organ failure, organ system support and compassionate withdrawal of life support. In addition to bedside teaching, there will be informal teaching sessions on a wide variety of topics as well as teaching on interpreting hemodynamic data and waveforms, and cardiac echo exams. Students will be encouraged to present on their patient at morning rounds, during which constructive feedback and interactive teaching will occur. Medical students will be asked to present a short discussion on a topic of their choice. This should be a short 20 - 30 minute presentation followed by a discussion on the topic which will be moderated by the attending. Discuss the time and topic of choice with the attending of service.

Credit 4 units.

Typical periods offered: Medicine Year


ANESTH 8030 Pain Management (Clinical Elective)

Acute pain is the most common symptom of medical illness and is ubiquitous after major surgery. Chronic pain is the leading cause of worker disability. Severe pain afflicts most people with advanced cancer. Learning the fundamentals of pharmacologic, interventional, and multidisciplinary pain management is important for all areas of clinical medicine.

Credit 4 units.

Typical periods offered: Medicine Year


ANESTH 8040 Anesthesiology for Neurosurgery (Clinical Elective)

This clinical elective is designed to familiarize the student with basic aspects of anesthesiology practice. The primary teaching method is patient care in a clinical setting. The student will learn the basics of preoperative evaluation of surgical patients, the use of intraoperative monitoring inpatient management and postoperative care. In addition to perioperative care, the student will be exposed to other clinical areas which include our pain management clinic, regional anesthesia / acute pain management, cardiothoracic intensive care unit, labor and delivery, pediatric anesthesia, and the Center for Preoperative Assessment and Planning. During the four-week rotation, the student will learn airway management skills, basic IV skills, practical perioperative fluid and electrolyte therapy, along with general and regional anesthetic techniques. As an integral part of the anesthesia care team, the student will participate actively in the anesthetic management of surgical patients. The student's specific requests to be assigned to certain types of cases will be honored as time and availability dictate. The rotation will include at least one clinical simulator session using a simulator mannequin for practical management of airway problems.

Credit 4 units.

Typical periods offered: Medicine Year


ANESTH 8050 Obstetrical Anesthesiology (Clinical Elective)

The medical students will learn the different analgesia/anesthetic options for the labor patient. They will also learn how the physiological adaptations of pregnancy influence anesthetic management. They will be actively involved in the parturient's management, i.e., starting an IV, placement of spinal, epidural or CSE (combined spinal epidural) anesthetics. They will also attend the OB anesthesia conferences and interview patients in labor (with an OB anesthesia attending).

Credit 2 units.

Typical periods offered: Medicine Year


ANESTH 9100 Anesthesiology Advanced Clinical Rotation (ACR)

This Advanced Clinical Rotation is similar to the General Anesthesiology elective in exposure to anesthesiology, but the level of participation and assessment is enhanced. The expectation is that the students act at the level of a Clinical Anesthesia Year 1 resident. Though a prior elective in anesthesia is not required, it is encouraged, if possible. Students will learn the basics of preoperative evaluation of surgical patients, the use of intraoperative monitoring in patient management, and postoperative care. In addition to perioperative care, they will be exposed to other clinical areas which include labor and delivery, pediatric anesthesia, and the Center for Preoperative Assessment and Planning. The students will interact with patients across all age ranges and demographics. During the four-week rotation, the student will learn airway management skills, practical perioperative fluid and electrolyte therapy, along with general and regional anesthetic techniques. As an integral part of the anesthesia care team, the student will participate actively in the anesthetic management of surgical patients. Grading will be based on competency of anesthesia skills such as preoperative evaluation, bag mask ventilation, intubation, vascular access, handoffs, postoperative pain orders, etc. The student's specific requests to be assigned to certain types of cases will be honored as time and availability dictate. The rotation will include clinical simulator sessions using a simulator mannequin for practical management of airway problems, resuscitation, and trauma emergencies as well as supplemental educational sessions covering relevant topics in anesthesiology.

Credit 4 units.

Typical periods offered: Medicine Year


ANESTH 9150 Surgical Critical Care Advanced Clinical Rotation (ACR)

The 4400 Surgical ICU provides an exciting and challenging opportunity to care for some of the sickest patients in the hospital and offers incredible teaching and education about a variety of medical topics and conditions. The ACR SICU rotation integrates medical students into one of the two SICU teams, and each medical student, in conjunction with a resident or Advanced Practice Provider, will care for 3-5 patients on the service. Working with the resident, medical students will develop a problem list, as well as an organized plan for their patients. They will then need to follow up on the execution of all determined labs/interventions/consults, closely communicating with the rest of the ICU team throughout the shift, as well as presence for sign-outs each morning/evening at shift change. This rotation takes place at the Barnes-Jewish Hospital 4400 ICU Surgical and Burn/Trauma Intensive Care Unit. This ICU takes care of patients from a variety of backgrounds, including general surgery, trauma/acute care surgery, transplant surgery, vascular surgery, urology, as well as medical ICU overflow patients.

Credit 4 units.

Typical periods offered: Medicine Year