From the Chief Resident...
Welcome from all of us here with the Department of Anesthesiology and Perioperative Medicine in glorious Portland, Oregon. First of all, let me take a second to thank you for your interest in this exciting field and this exceptional training program. I hope that after learning about all this great program and city have to offer you will consider furthering your development as a perioperative physician with us out here in the beautiful Northwest.
OHSU is uniquely situated in downtown Portland on Marquam Hill, just above the South Waterfront. During our training we regularly rotate between OHSU, the Portland Veteran’s Medical Center, Doernbecher’s Children’s Hospital, and our outpatient ambulatory surgical center, the Center for Health and Healing (CHH). Of great benefit is the close proximity of these clinical facilities to the main OHSU campus. All but CHH are located on Marquam Hill and are directly connected making transportation and parking very convenient. Access to CHH is by our aerial tram, the second commuter aerial tram in the US, traveling approximately 3,300 feet between Marquam Hill and the South Waterfront.
Notwithstanding all the incredible benefits of life here in Portland, the greatest advantage of our training program lies in its clinical experience. With exemplary clinical and research faculty, as well as inspiring departmental leadership, you can be assured that your training will be both comprehensive and progressive. The continuously evolving nature of anesthesiology is mirrored in our training program, with regular changes to the curriculum to reflect the goals and desires of the individual residents. This continued growth is seen greatly in our Clinical Base Year for our Categorical Program. This program was instituted two years ago and has since grown from four positions primarily at the VA to now ten, rotating at all the facilities on Marquam Hill. At the request of residents, changes have quickly come about to optimize our clinical experience including diverse ICU, Surgical, Cardiology, and Anesthesiology rotations to name a few. The benefit of this year cannot be overstated, as, in addition to developing critical diagnostic knowledge and treatment skills, much benefit is attained from becoming familiar with your future facilities and staff. By the time your CA-1 year comes along you will feel comfortable and will be well known in the department.
Beginning your CA-1 year is often a stressful time for residents but the structure of our program makes this unique time much more manageable. During the first four weeks you will be paired with one of our highly rated attendings or senior residents helping to both acquaint you with the surgical suite and flow, as well as helping you to develop your clinical independence at your own pace. You will attend daily didactic lectures centering on chapters from the "Baby Miller" text ensuring that by the end of this "Anesthesia Boot Camp" you will have a firm grasp of the basics of many anesthetic techniques. This year we are developing a staggered roll out process for the new CA-1 residents allowing freedom from call for approximately 6 weeks, then working groups into the call process in a more seamless manner making for an easier transition. The first half of your CA-1 year will be spent performing "general" OR cases with subspecialties, beginning in the second half. That being said, the nature of our patient base ensures that you will have performed anesthetics for many craniotomies, vascular, thoracic, transplant, and large abdominal cases even before starting your subspecialties allowing these specialized rotations to be focused on refining your techniques. Subspecialty rotations in the CA-1 year often include obstetrics, pediatrics, cardiothoracic, neurosurgery, pain, and regional. Our fantastic transplant team will ensure your exposure to a broad range of cases including liver, kidney, small bowel, pancreas, and heart transplants. Patient acuity and surgical/anesthetic complexity increases as you progress through the program so that, by your CA-3 year, you will be taking care of very challenging patients for a variety of procedures with great autonomy.
Didactics are a well established aspect of our training curriculum and are highly rated by the residents. After "Anesthesia Boot Camp" you will continue to attend weekly midday lectures on various topics which progress throughout your three years. In addition, our fantastic chair Dr. Jeffrey Kirsch holds Monday "Kirsch Rounds" where we go through mock oral board preparation with participation from residents of all years at a level commensurate with their training. Monday mornings also include Grand Rounds, M&Ms, and often distinguished guest lecturers. Journal club is held once a month and is attended by many of our clinical and research faculty. Biannual mock oral board exams are held which held to minimize the stress of the real exam. The evolving nature of our training program has now seen the successful institution of a dedicated TEE option with three residents already having passed last year's exam. Simulation has become an integrated and popular part of our curriculum. Residents attend sessions at our state-of-the-art SIM Center two to three times per year with faculty to run through common and rare anesthetic issues and emergencies. This all describes only a fraction of all the didactic experiences available to our trainees.
Another great and unique aspect of the program is our leadership's willingness to allow residents to individualize their clinical experience. Many residents choose to rotate with the Kaiser Cardiac Anesthesia program located just off the hill for some very unique and educational private practice experience. Some residents with a desire for international mission trips are afforded time to broaden their exposure by administering anesthetics in regions such as Ethiopia, Kenya, Guatemala, and Peru to mention a few. Still others have done domestic rotations and fellowships in Public Policy and Legislative development in Washington D.C. Many of our residents choose to fill much of their training with research opportunities, for which there are many. While not required, research is highly encouraged and easily organized with many of our nationally renowned clinical and bench research faculty. Most of our residents have authored book chapters and articles in peer-reviewed journals. Others have presented posters at state and national conferences gaining great recognition and experience for their efforts.
The Department has remained at the forefront in the development of dedicated research and critical care tracks. Currently 3 of our residents per class choose to participate in the 48 month Oregon Scholars Program in either Critical Care or Research. During these four years, the participant will split rotations in their final two years between the research lab or ICU and their general and subspecialty anesthetic experiences.
The Portland Experience
As incredible as it is, I am only now getting to one of the greatest reasons to consider OHSU for your next step in training. Portland is a fantastically unique, youthful, and bustling city. It contains all the benefits of a large metropolitan city while remaining extremely family friendly. The very reasonable cost-of-living gives residents the ability to live comfortably, with many of us choosing to buy properties and start putting down roots. Portland is truly a livable city. Many residents and staff bike to work daily, making a car more of a luxury than a necessity. Dogs are welcomed in nearly every business in this city, so bring your pooch with when you go to the video store, markets, or pubs and you can be sure someone will have a treat waiting for them.
No matter your tastes I can assure you that Portland will have something for you. Well known for its food, Portland maintains its unique style with options ranging from nationally recognized food carts to more formal four and five star restaurants. We in the Northwest pride ourselves on a great selection of organic and "Farm Fresh" foods, with convenient Farmer's Markets open nearly year-round. Those with a passion for beer or wine will find comfort in our proximity to expansive wine country or enjoy living in the city with the most microbreweries per capita in the country. Make sure to get out and enjoy our amazing music festivals along the Willamette River waterfront right downtown. Outdoor activities are a key aspect of Portland lifestyle with many residents taking up unique and challenging hobbies during their time off. Come here and enjoy learning how to kite-surf, kayak, adventure race, or ski as there is something for everyone. Our great proximity to Mt. Hood, Timberline Lodge, and Mt. Bachelor allow quick day trips or weekends away for skiing. Travel 90 minutes to the west and experience the Pacific Coast like nowhere else. Sites like Haystack Rock, the Sea Lion Caves, and Cannon Beach litter the Oregon Coast. I could go on and on but you really must see for yourself. We all here at OHSU welcome you and thank you for your interest in our program and our great city. We hope to see you sometime soon and please feel free to contact me by email with any questions you may have. Have a great day and good luck!