IAA currently accepts 4 fellows per year. The training program is 12 months long equally divided into into 3 rotations:
- Regional Anesthesia / Acute Pain Management Service
- Pediatric / Research / Intra-op / Outpatient (PRIO)
- Attending Anesthesiologist
Regional Anesthesia & Acute Pain Management Rotation
While on the regional anesthesia & acute pain service, the fellow will gain vast experience in regional anesthesia techniques by performing peripheral nerve blocks and thoracic epidurals.
Fellows will become proficient in basic and advanced blocks of the upper extremity, lower extremity, thorax, abdomen, and head and neck.
This rotation allows the fellows to hone their skills by providing high volumes of blocks and provides the opportunities to explore new and different procedures. Additionally, fellows develop their organizational and leadership skills as they oversee the daily operations of the acute pain service.
These responsibilities include involvement in block selection, division of labor, performance and/or supervision of blocks, acute pain service rounds & consultations, orientation of new team members, and maintenance of the quality improvement research database.
This database will be an instrument for quality improvement, chronicling the fellows’ experiences, and for clinical outcomes research.
Pediatric / Research / Intra-op / Outpatient (PRIO) Rotation
The PRIO rotation is a valuable experience for our fellows that expands the fellows’ education. This flexible rotation will provide the fellow with some of the less common experiences in regional anesthesia training that are crucial to an overall advanced level of education. Fellows participate in the following 4 sub rotations:
- Pediatric – Fellows gain experience in pediatric regional anesthetics at Connecticut Children’s Medical Center and their affiliated outpatient surgery center. Under the training of our board certified pediatric anesthesiologists, fellows will learn numerous types of blocks and learn the techniques unique to the pediatric population.
- Research – Fellows will have dedicated, protected time to pursue new research projects and continue on the several ongoing studies and quality improvement initiatives already in progress. They will work closely with our Clinical Research Coordinator, Dr. Aseel Walker, along with our robust research team consisting of staticians, residents, fellows, medical students, volunteers. We have over 19 exciting ongoing research projects, mostly at our institution, as well as some multicenter trials. Click here to learn more about some of our research projects in our Department Research Section.
- Intra-op – This rotation is a unique training opportunity in which the fellows perform a pre-op nerve block and then also provide the intraoperative anesthetic. Fellows get additional practice performing peripheral nerve blocks and get the added benefit of seeing how the blocks affect the intraoperative anesthetic. As the fellows are mostly in the orthopedic rooms for this subrotation, they will become proficient in performing spinals as well.
- Outpatient – Fellows work at different outpatient surgery centers gaining experience in ambulatory anesthesia. They become proficient in running a busy, fast-paced outpatient surgery center, while learning peripheral nerve block techniques unique to these types of centers.
Regardless of rotation, fellows will be relieved to attend protected didactic time every Tuesday afternoon from 4-5 pm during which a variety of regional anesthesia topics will be discussed.
This lecture series also incorporates journal clubs, guest speakers, as well as practical topics for the developing anesthesiologist such as “Building a Successful Personal Financial Portfolio” and “Elements of Creating and Maintaining an Acute Pain Service.”
Attending Rotation and Responsibilities
Making the transition from resident to an attending can be daunting, and this rotation helps make that shift a little smoother. Fellows on the attending rotation will get guidance from our staff of board-certified, fellowship-trained anesthesiologists who are experienced in orienting new attending anesthesiologists.
IAA physicians provide an immersive and appropriate orientation to familiarize fellows to the roles and responsibilities of a new junior attending. There are plenty of people available for guidance and help as questions arise on this new journey.
We look forward to aiding with that transition.
On this rotation, fellows function as an attending anesthesiologist, focusing on orthopedic and non-orthopedic surgeries in which a regional anesthetic plays a significant role at Hartford Hospital, The Bone & Joint Institute, and the Eye Surgery Center.
Fellows perform cases by themselves and also supervise residents and CRNAs. Working in the different locations as an attending physician provides the fellows with a unique opportunity to become familiar with various surgical procedures and management of patients with regional anesthetics in an intra-operative setting.
By working in efficiently run private hospitals and surgery centers, our fellows gain experience that few fellows obtain, making them highly desired by any group with a high caseload.
- The Bone & Joint Institute – A state of the art orthopedic hospital attached to Hartford Hospital that opened in 2017. This new facility is the primary location for all types of orthopedic surgeries, including total joint replacements, trauma, minimally invasive surgeries, spine, and ambulatory procedures. This facility increases our already high volume in orthopedic surgeries. It is the only free standing orthopedic hospital in New England and it integrates advanced technologies, providing a unique learning experience for the fellows.
- Hartford Hospital – An 868 bed regional referral center hospital with one of the highest surgical volumes in the country, performing over 36,000 surgeries a year. It is one of the largest teaching hospitals and tertiary care centers in New England with one of the region’s busiest surgery practices.
- The Hospital of Central Connecticut – A 414 bed, acute care, tertiary, community hospital in New Britain, CT that serves Connecticut’s central region. Fellows get a unique education with a different pace than the trauma centers of Hartford Hospital and the Bone & Joint Institute as they learn blocks and work as an attending in this quaint community hospital.
- Hartford Hospital Eye Surgery Center – A busy outpatient surgery center that performs 8,000 ophthalmic surgeries per year. This four operating room facility has between 50-70 surgeries per day, mostly before 3 pm. Many of the surgeries are performed under retrobulbar block, placed by the anesthesiologist. Fellows periodically rotate to this facility to become proficient in regional anesthetics for ophthalmic surgery and the management of a busy outpatient practice. Training of this skill is rarely found in regional fellowships.
- Connecticut Children’s – A pediatric hospital and surgery center where fellows get experience in pediatric regional anesthesia. Fellows get direct training by the team of pediatric fellowship trained, board certified anesthesiologists.
Benefits & Conditions
Fellows will take NO CALL or work weekends or holidays during the entire year of fellowship. This helps to ensure patient continuity on the regional anesthesia & acute pain service. Fellows are welcome to moonlight by doing additional shifts for compensation, provided they do not interfere with the usual daily schedule. However, these shifts are neither mandatory nor expected.
In addition to the competitive salary, fellows have 4 weeks of vacation, 1 week for academic activities that can be used to attend a conference or to take board exams. They also receive $3750 for CME, fully paid CT medical license, DEA, controlled substance license, and society dues.
Fellows can participate in oral board review sessions with our faculty members who are official ABA Oral Board examiners, including Dr. Finkel who is an ABA board examiner.
Fellows will have other academic opportunities such as presenting a department grand rounds lecture, performing a research project, or attending national anesthesia conferences.
In summary, our fellowship offers an exciting opportunity to master regional and orthopedi