Medical Student Education

Anesthesiology is a large specialty and encompasses operating room anesthesia services, perioperative medicine, critical care, and pain medicine. Duke Anesthesiology provides care for more than 40,000 patients each year across a wide range of disciplines, providing students with extensive experience and challenging them to consider the management of patients in the perioperative period. In 2022, US News & World Report (USNWR) ranked our department within Duke University #3 “Best Medical Schools for Anesthesiology.” This marks our highest ranking since USNWR began including anesthesiology in its specialty rankings in 2018. And, USNWR once again ranked Duke University School of Medicine among the top in the nation, specifically the #6 “Best Medical Schools: Research.” Forbes magazine recently ranked Duke University the #1 Best Southern School and USA Today ranked it the #3 Best Private College in the United States.

Students can experience a range of general as well as regional anesthesia cases, discuss the preparation and planning for cases, better understand the perioperative pain management options, review the perioperative medications, calculate the correct dosing and choice of intravenous fluids (including blood transfusion therapy) and also plan postoperative care. Additionally, our students have the opportunity to learn airway management skills in the Duke Human Simulation and Patient Safety Center, in which they can apply in the operating room. They can also participate in vascular access techniques and a spectrum of point of care ultrasound skills during the care of patients.

Medical students in training For students, a mixture of practical skills, basic science knowledge, and clinical problem solving unfold in a fast-paced environment that touches on many topics covered in preclinical classes.

Anesthesiologists interact with students in all four years of the medical student curriculum, providing education in a wide variety of formats, including traditional didactics, problem based learning, small groups, tutorials, and utilizing the simulation center.

For visiting medical students interested in rotations, please visit Duke University School of Medicine Visiting Medical Student website, where all visiting student requirements are explained. After reviewing the School of Medicine Visiting Medical Students website, questions can be directed to Scott Campbell, scott.campbell@duke.edu, for more information about the application process. Acceptance to a visiting student rotation in the Department of Anesthesiology does not guarantee a residency interview.

Underrepresented in Medicine students can learn more about our Fourth Year Visiting Scholars Program. Please complete this survey if you are interested in this program.

To learn more about our courses, please click through the information below for specimen curricula and objectives. Actual course content can vary depending the time of year and current education initiatives.

Second Year Courses

205c Sub Rotation in Anesthesia. During the second year surgery rotation, all Duke medical students begin with a perioperative medicine experience. Class didactics, simulation center teaching on airway skills, and hands-on experience of intravenous cannulation are supplemented with exposure to operating rooms anesthesia. The pharmacology and physiology behind the safe care of the patient in the operating room are supplemented with skills on fluid resuscitation, blood transfusion, and monitoring sedation that are applicable to all interns. Emphasis is placed on the correct use of opioid analgesics and practical acute pain management. The course director is Dr. Elizabeth Malinzak.

ANESTH-220c Anesthesia. The two-week selective permits students with an interest in perioperative medicine to rotate through multiple anesthesia subspecialties. The clinical opportunity is supplemented by teaching in the simulation center and didactic opportunities in the department. The course director is Dr. Elizabeth Malinzak.

ANESTH-221C Chronic Pain. In addition to the selective in anesthesiology, there is a selective in pain management. This selective provides exposure to outpatient interventional pain management. Students will see patients in the Duke Pain Medicine clinic, fluoroscopy suite, and procedural operating room. The course director is Dr. Lance Roy.

Third Year Courses

ASEP Program. While the university offers a range of opportunities from biochemistry to organ physiology, anesthesiology, surgery and critical care integrate these multiple systems into a larger perspective of human pathophysiology and pharmacology. Students have opportunities for research in cardiovascular and respiratory physiology, molecular pharmacology, neurobiology, and environmental science. Regardless of ultimate career choice, investigation in anesthesiology, surgery, critical care medicine and environmental physiology provides strong basic science grounding and application of research principles. There are opportunities for continuity clinics. Please contact Dr. Elizabeth Malinzak.

Fourth Year Courses

ANESTH-440c Anesthesia. Fourth year students can participate in the perioperative anesthetic management of patients while assigned to an individual resident or attending anesthesiologist. The close interaction with faculty and residents is based around rotations of approximately two weeks in the general operating rooms – one in the cardiothoracic operating rooms, and a fourth week in subspecialty areas, including Duke’s hyperbaric facility, the Acute Pain Management Service, and others. Learning opportunities will include preoperative patient evaluation, anesthetic technique selection, airway management, pharmacology, physiology, and anatomy, as well as procedures such as ultrasound guided vascular access, including central venous and arterial line placement, and patient monitoring. These areas will be reinforced by lectures, Grand Rounds, and an innovative problem-based learning series that builds through the rotation. The course director is Dr. Elizabeth Malinzak.

ANESTH-401c Cardiothoracic Critical Care Elective and ANESTH-402c Cardiothoracic Critical Sub-I. The cardiothoracic intensive care sub-internship or elective will allow fourth year medical students to be exposed to and participate in the care of the postoperative and critically ill cardiac and thoracic surgery patient. This patient population has the highest rate of invasive monitoring, echocardiographic and hemodynamic assessment, and advanced circulatory support, including utilization of inotropes, vasopressors and mechanical circulatory support devices (LVAD, RVAD, IABP). A working knowledge of these concepts will be critical to a future career in anesthesiology, critical care medicine, or surgery.

Critical care medicine has evolved from a discipline where one or two organ systems are supported during critical illness to one where technological advances allow us to support virtually all organ systems. The CTICU (7W) utilizes the highest variety circulatory support and a wide variety of support of other organ systems. Physicians practicing in the 21st century will need a working knowledge of these devices, the opportunities they offer, and their shortcomings. The course director is Dr. Sharon McCartney.

ANESTH-441c. Critical Care Sub-I. The sub-internship in the Surgical Intensive Care Unit (SICU) is designed to broaden the student’s knowledge and experience in managing critically ill surgical patients. Under supervision, students function as sub-interns in the SICU. Students are assigned their own patients and actively participate in daily rounds as part of the SICU team. There is a daily lecture on aspects of critical care. Students take call one night in four and work on a one-on-one basis with SICU house staff in the supervised management of critically ill patients. Time may be spent in the SICU at Duke University Medical Center (trauma, vascular surgery, liver-kidney-pancreas transplantation, general surgery) and/or the SICU at the Durham VA Medical Center (cardiothoracic and vascular surgery, general surgery). There is emphasis on teaching of procedures and techniques necessary for the management of all critically ill patients, including hemodynamic assessment and monitoring, cardiovascular resuscitation and use of vasoactive drugs, ventilator management such as ARDS, prevention and management of nosocomial infections, and ethical decision making in the ICU. Students are formally evaluated by the SICU house staff and the attending physician. The course director is Dr. Chris Young.

ANESTH-446C Acute and Chronic Pain Management. This course is offered to fourth year medical students within Duke Anesthesiology. During this four-week elective, students will participate in both inpatient and outpatient pain management. Each student is assigned daily to an individual fellow or attending physician who supervises the student’s active involvement. This involvement emphasizes a multidisciplinary approach appropriate for the individual patient. Topics reviewed include opioid and non-opioid management, interventional procedures such as epidural and peripheral nerve catheter placement, nerve blocks, neurolytic procedures, as well as implantable devices. The benefits of physical and psychological therapy are stressed. Students will observe and/or participate in various interventional procedures. In addition to this clinical work, students attend a pain conference and weekly grand rounds. The course is offered during each elective period throughout the year. The course director is Dr. Lance Roy.

ANESTH-430C. Diving and Hyperbaric Medicine. Students participate actively in assigned patient care and clinical projects. Well-focused segments of ongoing clinical work provide intensive exposure to clinical physiology and pharmacology. Consultative services are provided for inpatients and outpatients from orthopedics, medicine, radiation oncology, intensive care units, and preoperative and postoperative care units. Specific indications for hyperbaric oxygen therapy are used in clinical care and in developing translational projects. Students are guided in producing concrete clinical presentations and reports related to the field. The course director is Dr. Bruce Derrick.

Anesthesia Interest Group

The Anesthesiology Interest Group is a student led organization whose purpose is to increase awareness of the spectrum of clinical practice in anesthesiology and encourage medical students to explore career opportunities within the field. The faculty mentors for this group are Dr. Abigail Melnick and Dr. Grace McCarthy.

Elizabeth B. Malinzak, MD