Integrated Anesthesia Associates Fellowship in Regional Anesthesia & Acute Pain Management
Our mission is to train anesthesiology fellows to become specialists in regional anesthesia, acute pain management, and orthopedic anesthesia. By having our fellows train in a busy, high volume clinical practice, we will ensure that they will not only be proficient in regional anesthetic techniques, but also learn to thrive in a busy private practice environment.
Integrated Anesthesia Associates
Integrated Anesthesia Associates (IAA) is private-practice / academic hybrid group of over 100 Anesthesiologists. The regional anesthesia & acute pain service in the Hartford division is led by fellowship-trained attending anesthesiologists from 7 different training programs. This diversity and concentration of expertise makes IAA’s regional and acute pain service poised to provide a unique training environment with a focus on efficient, quality clinical care. Our practice provides anesthetics for over 4,500 orthopedic surgeries per year at Hartford Hospital and thousands more at outpatient surgery centers, resulting in over 7,000 peripheral nerve blocks and catheters performed each year.
We currently accept 3 fellowship positions 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 team of research staff and other institutions participating in multicenter trials.
- 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 the outpatient orthopedic surgery center gaining experience in ambulatory orthopedic anesthesia. They become proficient in running a busy, fast-paced outpatient orthopedic surgery center, while learning peripheral nerve block techniques unique to this type of center.
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 a 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.
- 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, all 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.
- Litchfield Hills Orthopedic Surgery Center – A highly efficient, orthopedic surgery center where fellows gain experience in same day orthopedic anesthesia and unique peripheral nerve blocks.
- Connecticut Children’s Medical Center – 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.
- 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 manditory 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.
- 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 orthopedic anesthesia in a unique training environment. We have a long history of training successful experts in regional anesthesia and acute pain management who move on to fruitful careers in both private practice and academia. As the fellowship director, I look forward to the opportunity to work directly with the fellows to ensure a robust and enjoyable educational experience. If you are interested in applying for the fellowship, please visit our link on the ASRA Fellowship Directory.
Kevin Finkel, MD
IAA Regional Anesthesia and Acute Pain Management Fellowship
Apply for a fellowship with IAA
Contact: Kevin Finkel, MD
IAA Regional Anesthesia and Acute Pain Management Fellowship
Please visit our link on the ASRA Fellowship Directory
Meet our Core Faculty
- Kevin Finkel, MD
- Adam Fishler, MD
- Daniel Gianoli, MD
- Pranjali Kainkaryam, MD
- Benjamin Kong, MD
- Jennifer Sposito, MD
- Amir Tulchinsky, MD
2018 – 2019 Fellows
- Andrew Raisbeck, MD
- Carla Maffeo, MD
- Matthew Mitchell, MD
2017 – 2018 Fellows
- Daniel Tighe, DO
2016 – 2017 Fellows
- Kim Youngren, MD
- Pranjali Kainkaryam, MD
2015 – 2016 Fellows
- John DaSilva, MD
- Joseph Tyler McCruiz, MD