ROTATION: Neuroanesthesia (N);  Neuroanesthesia VA Medical Center (VAN)
TYPE:  Elective
DURATION: 1 month - 6 months
FACULTY:  N:  Michael E. Mahla, MD;   VAN: Cheri A. Sulek, MD
PREREQUISITES: CA-3 level in good standing

CA-3 Advanced Clinical Track Neuroanesthesia Rotation

Goals: In addition to those outlined for the basic rotation in Neuroanesthesiology:

• Expand the knowledge base with regards to CNS physiology and pharmacology and pathophysiology developed during CA-1 and CA-2 years. 
• Develop clinical judgment to provide anesthetic care for more complex neurosurgical procedures. 
• Develop technical skills necessary to conduct more complex neurosurgical cases. 

Patient Care Skills and Medical Knowledge: In addition to those outlined for the basic rotation in Neuroanesthesiology:

• Be able to complete a thorough preoperative evaluation for all neurosurgical patients, 
  recognizing impact of neurologic disease state on perioperative management. For routine neurosurgical procedures, accomplish preoperative preparation and anesthetic planning independently.  For complex procedures, preoperative preparation and planning will occur with assistance from the attending neuroanesthesiologist as needed and as appropriate.
• Plan and carry out anesthetics for routine neurosurgical procedures with minimal assistance from the neuroanesthesia attending physician. 
• Perform anesthetics for complex neurosurgical procedures with as needed assistance from the attending neuroanesthesiologist. 
• Perform all invasive monitoring techniques and interpret information obtained reliably with minimal assistance from the attending anesthesiologist. 
• Develop beyond a basic understanding of neurophysiologic monitoring and be aware of the most common uses of neurologic monitoring during neurosurgical procedures.  Be aware of and able to discuss documented advantages and disadvantages of the use of neurologic monitoring during neurosurgical procedures. 

Evaluation:  As described in the primary neuroanesthesia rotation.  However, in addition, your ability to practice neuroanesthesia as an independent consultant anesthesiologist will be assessed.

Resources: As described in basic Neuroanesthesiology Rotation