Cardiothoracic Fellowship

The UCLA Department of Anesthesiology is inviting applications for a one year clinical fellowship in cardiac anesthesiology.  Click here to print out the Cardiac Fellowship Application.

The cardiac program at UCLA is unique in the clinical mix of patients and includes surgery for neonates, infants and adults with complex congenital heart disease, adults with acquired heart disease, heart and lung transplants and an active assist device program. The ratio of pediatric to adult patients is 40%:60%. Moreover 50% of the pediatric cases are less than one year of age. 

The clinical fellowship will include 6 months in the cardiothoracic operating rooms, two months in the echocardiography lab (adult and pediatric) , extensive intra-operative TEE experience, one month in the cardiac intensive unit, two months of optional time, one month vacation. There will also be an opportunity to participate in one of several ongoing clinical research projects with nitric oxide, echocardiography etc.. 

If interested, please submit your CV to Donna Harless, Cardiac Fellowship Coordinator, Department of Anesthesiology, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 3325, Los Angeles, CA 90095-7403, or contact Donna Harless by telephone at (310) 267-8680 or by e-mail at dharless@mednet.ucla.edu.

Pain Fellowship

The UCLA Pain Management Fellowship Program consists of a comprehensive outpatient pain practice, along with an inpatient consult service.  We offer four CA-4 (PGY-5) positions each year.  The assignments for clinic, procedures, and inpatient coverage are not confined to specific “blocks”.  Thus, a balanced, real-world experience can be provided to the fellows.

The UCLA Pain Management Center offers clinical services to our patients Monday through Friday, divided between 4 attending physicians.  A variety of cases such as low back and neck pain, myofascial pain, RSD, neuropathic pain, cancer pain, post-herpetic neuralgia etc., are evaluated and treated.  Our multidisciplinary approach utilizes the many resources at our disposal, including pain psychology, physical and occupational therapy, neurology and neurosurgery, psychiatry and addiction medicine.  The interventional treatments range from basic diagnostic nerve blocks such as epidurals, facet medial branch nerve blocks and sacroiliac joint injections, to sympathetic blocks, chemical neurolysis, cryoanalgesia, radiofrequency lesioning and implantable devices.  A weekly lecture series includes didactic lectures, journal clubs and industry in-services.

Beginning in July 2007, ACGME requirements for pain fellowship programs have changed to include formal rotations for other specialties important to the practice of pain management.  The purpose is to provide a more well rounded experience which will prepare our fellows for the pain medicine board exam, and more importantly, future practice.  Our training program will now include rotations in neurology and psychiatry.  There is also a possibility of a palliative care rotation, and an elective rotation in neurosurgery.  These rotations will be spread throughout the year.

The application deadline is September 30th.  Selected applicants will be invited for an interview and the final selection is made by the first week of December.  Click here to print out application letter and here to print out the Pain Fellowship Application.

If interested, please contact the Fellowship Coordinator, Evangelina Rodriguez, at (310) 319-2241 or email at evrodriguez@mednet.ucla.edu, for further information.

Introduction
Medicine has always undergone technological changes, but in recent years the rate of change has accelerated dramatically.  In virtually every field of medicine new devices and drugs emerge to improve diagnosis and treatment.  For example, in anesthesiology technological advances in the last 15 years include frequent insertion of pulmonary artery catheters, sometimes with oximetric capabilities, for measurements of cardiac pressures, and interpretation of cardiac function; use of transesophageal echocardiography to evaluate cardiac function; fiberoptic laryngoscopy for placement endotracheal tubes, evaluation of endobronchial position, or tracheal toilet; new techniques for management of the difficult airway; and administration of potent narcotic and/or sedative hypnotics by continuous infusion to establish and maintain an anesthetic state primarily through the use of intravenous drugs.  These are just a few of the many examples that might be cited. 

Anesthesiologists who trained more than 15 years ago may not have been taught some of the procedures noted above, or for that matter use of many other drugs or techniques that constitute modern anesthesia practice.  How are these anesthesiologists in practice to learn and keep abreast of the new advances?  There is not an easy way available to them.  Many attend postgraduate educational programs, but none of them offers closely-monitored supervision while they are gaining hands-on experience in administering new drugs or attempting new technological procedures in patients.  Sometimes experienced anesthesiologists can learn new technology from watching and being supervised by recent anesthesiology graduates who join their group.  Some learn new techniques by trial and error on patients without benefit of supervision.  Finally, some anesthesiologists never learn new technologies, thereby depriving their patients of the advances in the specialty. 

To meet these deficiencies in continuing medical education in anesthesiology, we have developed a unique and innovative educational program.  The principle objective of this program is to provide a supervised, hands-on educational experience for anesthesiologists who desire to evaluate and/or upgrade their skills and knowledge to assure that they are providing safe, modern anesthesia care to patients. 

Training Program
Training is provided at UCLA Hospital, a 600 bed acute care hospital located in West Los Angeles.  All medical and surgical services that constitute a modern hospital are available at UCLA Hospital, and hence, are available to anesthesiologists in training.  Those appointed to the program are designated Fellows in Anesthesiology at UCLA.  The training period may vary from three months to one year depending upon the specific needs and progress of the Fellow.  Generally, a final decision regarding the length of the Fellowship is revised after a period of time in the program, and an opportunity to evaluate the skills of the Fellow.  Under special circumstances, we may be willing accept a Fellow for less than three months.  If appropriate and approved by the Fellowship Director, Fellows may take up to one month of training at one of the UCLA-affiliated hospitals (ie: Cedars-Sinai Hospital for obstetrical anesthesia or Harbor-UCLA Hospital for acute trauma).  Fellows will not take night call unless specifically arranged and deemed necessary to maximize the experience on a particular clinical service. 

The clinical training program is tailored to the specific needs of each Fellow.  In some cases, the need is to gain expertise in a particular type of specialty practice (ie: cardiac anesthesia, pediatric anesthesia, intensive care medicine, acute and chronic pain management, etc.) and in other cases needed to improve and upgrade general clinical skills.  The exact program is planned in advance by the Fellowship Director and the Fellow.  Generally, at least a month is spent on a general surgical anesthesia service to evaluate the Fellow’s knowledge and skill base before assigning the Fellow to specific subspecialty services. 

Fellows are supervised by faculty during the provision of all anesthesia services, usually on a one-to-one basis.  Fellows will work with one faculty member for a sustained period, but over the course of their training they will be exposed to multiple faculty, and hence multiple ideas and techniques.  Teaching will be conducted in the operating room and the conference room.  In the operating room, teaching will be direct, hands-on supervision of all patient management, as well as informal discussion of anesthetic care.  Use of the latest techniques in anesthetic management, including use of new drugs and devices will be emphasized.  The Fellows will be expected to attend the weekly resident seminar, the weekly Grand Rounds, and specialty conferences when assigned to specialty services.  Finally, Fellows will be given training time on our simulator model specifically focusing on critical incident diagnosis and management in Anesthesiology. 

Evaluation of Performance
Fellows will be evaluated on the basis of: 
1.  Daily performance in the operating room 
2.  Performance at rounds and conferences 
3.  Performance on monthly written and/or oral examinations 
4.  Performance on external examinations (ABA In-Training exam, etc.) when 
     available 
5.  Performance on our critical incident human simulator 

Computerized records of anesthetic cases performed, anesthetic techniques used, complications encountered, and patient outcome will be kept.  The Fellows must achieve a satisfactory clinical competence evaluation from the faculty and the Director at the completion of the training program to qualify for certification as a graduate of the Fellowship in Advanced Clinical Training in Anesthesiology at UCLA. 

Due Process
If a fellow is found unsatisfactory at the end of the training period, he/she will be informed in writing with specific citation of deficiencies.  At that time the Fellow may petition the program for an additional period of training.  Final decision on a re-application rests with the faculty and the Fellowship Director. 

Fees
There will be a one-time, non-refundable, Medical Staff Office (MSO) fee of $525, check made payable to the UC Regents to accompany your ASTP application. The fee for this program is $1000/month per Fellow. The first month ASTP fee will be $475 and $1,000/month thereafter for Fellowship training, checks made payable to the UCLA Department of Anesthesiology. The Department of Anesthesiology Business Office will follow up with a billing invoice and return envelope to the Fellow at the beginning of each month.

The Fellow is expected to provide for his own living quarters, incidental expenses, and health and malpractice insurance costs. Modest rentals are available in the UCLA area, and help in this regard can be obtained through the UCLA Housing Office, (310) 825-4271.

Application Process
Any anesthesiologist may apply for the program.  The applicant must provide documentation of: 
1. M.D. or D.O. certificate from an ACGME-accredited institution
2. Completion of training in anesthesiology in an RRC-approved program
3. Completion of an AST application
4. Copy of your California medical license
5. Copy of a valid DEA
6. Documentation of health and malpractice insurance
7. A recent copy of the resume/CV (if available)
8. Application fee of $525 which is non-refundable. Please make check payable to the UC Regents

Prior to appointment as a Fellow, the applicant must be appointed to the Medical Staff of the UCLA Hospital. Therefore, upon receipt of an approved initial candidate application package, the Department's Academic Personnel Office (APO) will notify the MSO to send the candidate a medical staff application. (Processing of application usually takes 3 - 4 months.) The Department's APO can assist the candidate on how to complete the application and review it for accuracy and completeness.

Click here for copy of application to be printed and filled out:

Application or inquiries should be directed to:

Daisy P. Valdez
Department of Anesthesiology
Ronald Reagan UCLA Medical Center
757 Westwood Plaza, Suite 3325
Los Angeles, CA 90095-7403
Tel. No.: 310-267-8695
E-mail: dvaldez@mednet.ucla.edu