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Department of Anesthesiology and Pain Medicine

Department of Anesthesiology and Pain Medicine

Message from the chair

http://teamsite/anesthesiology/images/body/Moore_msg.jpgWelcome to the Department of Anesthesiology at the University of California, Davis. Our department is an integral part of the UC Davis Medical Center and School of Medicine located in Sacramento, California. Together, these entities along with the UC Davis Medical Group form the UC Davis Health System that encompasses a network of primary care and specialty care providers and regional hospitals throughout northern California.

The UC Davis advantage

We live in challenging times and fueled by the success of the UC Davis Health System we have welcomed the opportunity to build and expand our academic programs in research, education, and clinical practice. The foundations of our growth have come from our commitment to the communities of Northern California with particular efforts to reach the underserved rural communities. The adoption of new technologies and the development of widespread telehealth network have ensured that every citizen of Northern California can be reached and served by the specialists in our system.

The importance of learning

The residency and fellowship training programs are critically important to our growth and development. We want our residents to fulfill their potential as professionals and astute clinicians as they will be the champions of our specialty for the foreseeable future. The residency program in anesthesiology and the fellowships in pain medicine and pediatric anesthesiology are both fully accredited by the Residency Review Committee for Anesthesiology of the Accreditation Council for Graduate Medical Education. We also offer a fellowship in cardiac anesthesiology.

The department has designed an educational program emphasizing problem-based learning. We have utilized new developments in information technology and virtual reality to establish a rich learning environment to further knowledge, concepts and clinical decision-making.

We gain our momentum for all our activities from clinical teaching programs. We place emphasis on subspecialty training and a balanced clinical experience in the CA-1 and CA-2 years. The residency program features CA-3 years in the advanced clinical track, the clinical scientist track and clinical subspecialty tracks in cardiac anesthesia, critical care anesthesia, neuroanesthesia, obstetric anesthesia, and pediatric anesthesia.

Innovations in education

We are committed to interactive learning through medical informatics, on-line clinical resource support and the heavy utilization of the Center for Virtual Care which provides a state of the art learning center wherein residents and medical students can hone their skills and judgment in case-based management over a wide variety of clinical problems and scenarios. The center includes adult human patient simulators, pediatric simulators, emergency patient care simulators, and number of clinical skills simulators including a whole body intravascular simulator for anesthesia use in the placement of invasive hemodynamic monitors and airway mannequins with appropriate equipment including fiberoptic bronchoscopes and other airway devices. Much of the educational material is presented in a multimedia format and can be further utilized for personal study at a pace appropriate to the individual resident.

Striking a balance

The department is committed to place the educational and learning needs of the residents as its paramount concern thereby ensuring sufficient time for self-paced learning and study. We closely monitor and manage the clinical commitments and assignments of our residents to ensure we strike the appropriate balance between direct clinical experience and time for study as we recognize it is important for our residents to reflect on their experiences and develop a study routine that ensures they are well prepared for clinical practice in the future.

Stress and fatigue are factors in clinical anesthesiology that can result in errors and lapses in judgment. Our clinical schedules recognize these factors and limit on-duty time by providing appropriate pre and post call time for recovery and adequate sleep; an on-duty shift never exceeds 13 hours.

The war on pain

We are proud of the efforts of our Division of Pain Medicine under the leadership of its chief, Scott M. Fishman, M.D. as they have distinguished themselves as the finest academic pain medicine program in the nation. The commitment to learning for all physicians and a commitment to fellowship training in pain medicine for those wishing to pursue a full-time career in pain medicine is a driving factor for the excellence that they group has achieved.

Both the department and the division are committed to the development of pain medicine as a specialty in its own right through a commitment to multidisciplinary and multimodal management of acute and chronic pain patients. The division accepts resident applicants from Anesthesiology, Physical Medicine and Rehabilitation, and Psychiatry and Neurology into its fellowship programs. In addition, residents in Anesthesiology, Physical Medicine and Rehabilitation, Psychiatry and Neurology, Orthopaedic Surgery, and students in Behavioral Psychology all rotate through the division for clinical experience in advanced pain management. The Pain Management Center including the Invasive Pain Management Procedures Suite presently cares for more than 6,000 patients per year. The Pain Center works closely with UC Davis Medical Group and telemedicine to further develop outreach services to rural communities in the region.

The growth in clinical anesthesiology

Clinical anesthesiology falls under the direction of Jeffrey Uppington, M.D., Vice Chair for Clinical Affairs for the department. Dr. Uppington leads a large cohort of attending staff with specialty expertise in all branches of clinical anesthesiology.

Clinical care is a major priority of the department as faculty, residents, and nurse anesthetists administer over 20,000 anesthetics to patients at UC Davis. The phenomenal success of the UC Davis Health System has resulted in a growth in surgical and obstetric services of over 60% in the last seven years. We have pioneered the development of a unique hospital management structure to integrate the clinical activities of the surgical departments, clinical anesthesiology and hospital services to efficiently mange the patients that require surgical services from both the clinics and the emergency room. As the leading level one trauma and pediatric trauma center in Northern California and one of the busiest trauma and burns centers in the country, it was a key element to develop an integrated information management system and leadership to maximize access for patients requiring surgery.


Perioperative care begins in the Surgery Admissions Center, continues in the 24 operating rooms and other locations such as the University Birthing Unit, interventional radiology, MRI Suite, Cancer Center, gastroenterology laboratory, cardiac catheterization laboratory, and lithotripter, and is completed in the Post-Anesthesia Care Units or Surgical Intensive Care Units where patients are closely followed by the department and the in-patient pain service to ensure quick recovery and optimum outcomes for our patients. A total quality management program for surgical patients has been in place since 1995 and the adoption of evidence-based medicine protocols improves outcome and the efficiency of care for patients.

There is great excitement with the recent opening of the Surgery and Emergency Services Pavilion with 24 operating rooms that brings our O.R. capacity to over 40 rooms. We are also excited by the short and long term plans for pediatric surgical services in the UC Davis Children's Hospital Surgery Center, slated to open in the current year, which will provide a warm and supportive environment for children requiring surgery and for their families.

Breakthroughs in research

Major funded research activities include the membrane biology of cellular integrity and injury (ischemic and reperfusion injury), gene therapy in spinal cord injury, the role of agrin in the regulation of the synaptic localization of the nicotinic receptors at the developing neuromuscular junction, and clinical studies of emerging therapies for the management of chronic pain.

Concluding thoughts

We are committed to excellence in clinical practice, education, and research and with our abiding commitment to the community are invigorated by the opportunities offered by the growth and stature of the UC Davis Health System. The Health System campus in Sacramento and its proximity to the government and legislature provides us with unique and exciting prospects for shaping the direction of health care and medical education in the state.

For those interested in joining us as residents or faculty,  we welcome you to contact us to explore the various options available to you to join us at UC Davis.

Sincerely,

Peter G. Moore, M.D., Ph.D.
Professor and Chair