Adult Cardiothoracic Anesthesiology

General Information

The CA-4 fellowship in Obstetrical Anesthesiology at Cedars-Sinai Medical Center is a 12 month program design to provide advanced experience and training in all aspects of Obstetric Anesthesiology including, research, administration, and clinical management of the complex obstetrical and gynecological patient. The fellow will become an experienced consultant in providing analgesia and anesthesia to the normal and high risk obstetric patient.

Cedars-Sinai Obstetric Anesthesia is a very strong ground with emphasis on future growth and development in obstetric anesthesiology. The obstetric anesthesia faculty is here to assist in any way they can to make your educational experience memorable.

Departmental Educational Goals, Objectives and Evaluations

The Obstetric Anesthesia Fellowship Program at the Cedars Sinai Medical Center has 3 approved positions. In addition to the requirements set forth by the Society of Obstetric Anesthesia and Perinatology, the Department has established its own goals and objectives to help guide its fellows through their training:

The fellow will be expected, under the supervision of one of the obstetric anesthesia attendings, to manage the labor and delivery suite. This will include direct patient care and supervision of the residents. The fellow will spend a total of 9 months working on the labor floor. Additionally, 2 month rotations are available in research, the neonatal intensive care unit and in the Division of Maternal-Fetal Medicine of the Department of Obstetrics, Gynecology and Reproductive Science.

Clinically, the fellow will be expected to be proficient beyond the level of the non-obstetric anesthesiologist in providing anesthesia care for women during labor and vaginal delivery and for women undergoing cesarean section, postpartum tubal ligation, dilation and curettage, and removal of the placenta. Training will also include experience with patients having anesthesia for non-obstetric surgery during pregnancy. During the labor floor rotation the fellow will also supervise and teach the anesthesia residents during the core rotation

Although, all fellows may not seek a career in academic obstetric anesthesia, the fellows are strongly encouraged to participate in ongoing research projects and to initiate their own. Fellows will be required to do a 1 month elective in research. The fellow will be exposed to all of our clinical and basic science research projects at the beginning of the year. The fellow will choose a project in his/her area of interest, to work on during the course of the fellowship. The faculty and Program Director will provide academic guidance. The guidance will be provided during weekly research meetings to discuss progress of the fellow's research projects. The goal is to complete at least one of the projects initiated during fellowship training. An appropriate mentor will be assigned. The fellow and mentor will develop a timeline which ensures the opportunity to present the results of the fellow's research at a national meeting. The project will likely lead to either an abstract presentation at a major meeting or a publication in a peer reviewed journal.

Goals- Obstetrical Anesthesia Fellowship

The Obstetrical Anesthesia Fellowship allows advanced obstetric anesthesia subspecialty training. The program's emphasis includes clinical sciences and scholarly activity to:

• promote expertise necessary to deliver comprehensive peripartum care to the obstetric patient
• become involved in the acquisition of new knowledge through clinical investigation and study
• develop educational skills by supervising residents and instructing them by means of both didactic and case-oriented teaching

Three broad goals of the fellowship program include:

1. Development of the required six core competencies needed to provide anesthesia services to pregnant patients undergoing obstetrics.[elucidate them here]
2. Development of the knowledge, skills and judgement necessary for the safe conduct of obstetric anesthesia. This includes preoperative patient evaluation, interpretation of diagnostic data; hemodynamic monitoring; and management of peripartum care.
3. Development of the art of obstetric anesthesia in a moral, ethical, and professional manner worthy of the Cedars Sinai's model of life-long professional excellence and learning.

The program achieves these goals through a "learner-centered" program. The integration of educational methods is based on: clinical learning; didactic staff lectures; problem based learning discussions; debates; learning projects, including research, journal presentations, and evidence based reviews, multidisciplinary conferences; and exposure to a high volume of obstetric cases

These goals support the department's mission of graduating fellows who are "experts" in providing obstetric anesthesia, life-long learners, and models of professional excellence with unique skill sets allowing them to make a significant contribution to the field of obstetric anesthesia.

Three fellow positions are offered

The Fellowship consists of twelve calendar months of clinical and didactic teaching. Year 1.

Clinical Responsibilities

• Clinical care:
  Clinical obligations include on-call responsibilities as determined by the needs of the department and the educational objectives of the fellowship. Typically, fellows spend a minimum of 24 days per annum functioning as junior attendings in areas outside the fellowship. Non-clinical time (research, etc.) must be approved prospectively and 150 days of activity is the minimum expected of all fellows.
  
• Clinical research
• Supervision of residents

Educational Responsibilities

These include, but are not limited to continuous self-education and participation in the obstetric anesthesia lecture series. Weekly attendance at Departmental Grand Rounds is required of all clinical fellows, and fellows are expected to participate in one yearly presentation at this forum under the guidance of the Director of Obstetrical Anesthesia.

Fellows are expected to attend weekly Departmental Research Conferences.

Academic Responsibilities

The fellow must participate in on-going, approved clinical research protocols or the development of a clinical research idea and pathway. Participation in either form of academic activity should lead to a presentation at a national specialty forum and to subsequent preparation of an interdepartmental scholarly review manuscript.

A mentoring program is available to guide fellows and to provide continual support from the faculty members.

Ample on-call facilities are provided, Fellows are on call no more than every 3rd night, with one additional weekend day off each week: Fellows receive a calendar month of vacation. The House Staff assistance program offers assignment, evaluations, and referrals for free psychiatric services.

There are computerized systems (Web-VS and Careview) which allow fellows to access patient medical information at all times, even from home.

Libraries

The Department of Anesthesiology Library, also known as our Learning Resource Center (LRC), is located on the 4th floor. It is supplied with current medical text books, journals, CD's, audio cassettes. There are computers with internet access. Our LRC always contains recent anesthesia texts and literature to keep our fellows, residents and faculty abreast of the current literature.

Also located within the Medical Center is the Medical Library. This is filled with a collection of books emphasizing clinical medicine and is searchable via the Library's electronic catalog. Also available are popular magazines, newspapers, and computers with internet access to health and medical resources.

Mission Statement

The mission of the Department of Anesthesiology, subsection of obstetric anesthesiology at Cedars- Sinai Medical Center is to provide the highest quality anesthesia care to the patients of this institution and to advance the science of the specialty through research and teaching. We are committed to providing our services to the patients of Cedars-Sinai Medical Center in a comprehensive and compassionate manner that maintains human dignity and is in conformance with the mission of the Cedar-Sinai Medical Center.

Vision Statement

An academic medical center must provide excellent care that is compassionate and competent, focusing on the needs of the community as well as striving to continuously improve its services.

Department of Anesthesiology

• Co-Chairman, Julian A. Gold, MD
• Co-Chairman, Ronald H. Wender, MD

Anesthesiology Residency Program

• Academic Chair, Ronald H Wender, MD

Core Program Director

• Roya Yumul, MD, PhD

Obstetric Anesthesia Program Director

• Mark Zakowski, MD

Obstetric Anesthesia Associate Program Director

• Sivam Ramanathan, MD

Faculty Listing

If you have further questions, please contact: