Day in the Life on the Cardiovascular Operating Room (CVOR) Rotation One month of CVOR at THI outperformed all combined months of cardiac in residency in terms of case quality and volume. I feel well prepared for any practice environment. It is a well-balanced system that I believe is a great mix of independent time at home to study, spend time with friends/family while being occupied at work with high octane CV anesthesiology cases. Since we have 10 fellows, we have adequate coverage to share the call responsibility. This can vary slightly but is certainly manageable. While on CVOR, I probably am on home call 3-4 days out of the month and one weekend day. We have a peel off system of dismissal throughout the day. Some days you proceed with another case and some days you are dismissed. Once we return we are usually going onto cardiopulmonary bypass by 9-10 a.m.
One of the workflow benefits of the fellow's schedule is we are given a breakfast break after timeout with complimentary food/coffee provided in the physician's lounge. You then perform a comprehensive echo and communicate salient findings to the surgeon as they are prepping the chest. The strength of the program is that you are sitting your own cases the entire year to work on your efficiency to become excellent CV anesthesiologists. Our fellows consistently become expedient at arterial line placement, induction and central line with TEE placement independently of any assistance. Anesthesia ready time is aimed to be 15 minutes and by the end of the year. The anesthesia techs will assist in all the other components necessary to start the case (transducer prep, echo in the room, EKG set up). You will not supervise residents and you will perform all the components of the case. You are rolling in the room at 730 sharp or earlier if nurses are ready. Since you are sitting your own cases you will draw up your own medications, check the machine, and prepare airway equipment. depending on the length of setup required for the case. There is robust effort from leadership that our time in the OR is preserved for high quality cases.Īrrival to the OR is approximately 6 - 6:15 a.m.
We spend seven months of CVOR time during the 12 months on this service. Fellows are primarily in a cardiopulmonary bypass case, mechanical support case (VA & VV ECMO, Impella, LVAD), structural heart case (TAVR, MitraClip, LAA occlusion devices), or a high-risk cardiac patient undergoing non-cardiac surgery. Scheduling information is sent out by the overnight resident the night before to read in some capacity about the patient or case as you desire. If there is echo didactics (Wednesday), MM (Thursday once a month), or additional echo conference (Friday) I will arrive earlier to attend those at 6:30 a.m. A day in the life of the main Operating Room
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