2021 Resident Fact Sheet

October 2021 Department of Anesthesiology Welcome to The University of Tennessee! Introduction Welcome to The University of Tennessee! During your virtual interview, several questions will arise about our residency. This brochure will serve as a guide and information source for some of the ‘facts and figures’ about our training program. Please feel free to ask any questions that you may have. Some of these topics will be discussed at length with both the Chairman of the Department of Anesthesiology, Dr. Robert M. Craft, MD, and the Program Director, Dr. Patrick O. McConville. Educational Philosophy One of the outstanding areas of our residency has been the excellent didactic and clinical teaching our trainees receive (see page 2). However, our didactic efforts are predicated on the assumption that postgraduate medical education is ultimately the responsibility of each individual resident. To be successful in the anesthesiology residency at the University of Tennessee, our average resident must commit to read about one hour per day and actively participate in our educational activities. Measures of Academic Performance Anesthesiology Residency Review Committee/ACGME Review Cycle: 12 years between site visits 5-Year American Board of Anesthesiology Board Certification Rate:95% 1

ANESTHESIOLOGY RESIDENCY Didactic Program For over twenty years, our program has customized the educational programs for our residents to fit the needs for each year of training. For example, our lecture series is specific for the year of training. With the “splitting” of Part I of the American Board of Anesthesiologists Certification Examination into Basic and Advanced sections starting with the physicians who matched into anesthesiology residencies in 2013, our educational program is ideally situated to assist our residents in achieving successful passage of this new milestone. The following schedule demonstrates the expected educational opportunities: Monday (0600 - 0645)  CA-1 Lecture Series Based Upon ABA Basic Content Outline (June – September)  CA-2 Lecture Series Based Upon ABA Advanced Content Outline (July – September)  CA-1–CA-3 Lecture Series Based Upon ABA Basic and Advanced Content (October through April) Tuesday (0600 – O645)  Mock Oral Examinations (three times per month)  Problem-Based Learning Discussions (one time per month) Wednesday (0615 – 0645)  Resident Wellness Break Thursday (0600 – 0645)  CA-1 Introductory Reading Program (June – September)  CA-2 Lecture Series Based upon ABA Advanced Content Outline (July – September)  CA-1–CA-3 Lecture Series Based upon ABA Basic and Advanced Content (October through April)  Morning Report - Case discussion to develop the oral presentation skills needed for the oral portion of the Applied ABA Certification Examination Friday (0630 – 0730)  Grand Rounds  Case Conference  Morbidity and Mortality Conference  Root Cause Analysis *Independent study days and designated protected time around exams are also incorporated into the didactic schedule throughout the year. Clinical Base Year SRNA-Resident Interactions The Anesthesiology residency training An area of concern of resident applicants has been the program is a 4 year, categorical program, possibility of competition for cases between our beginning with a Clinical Base Year. residents and the student nurse anesthetists who train at the University of Tennessee Medical Center. The Clinical Base Year emphasizes direct Assignment of cases is simple at our institution. patient care responsibility and development Residents are assigned first, then SRNAS second and the of basic clinical skills necessary for success remainder of cases assigned to CRNAS. Residents are for virtually any clinical pathway. the primary providers for @ 25% of our cases. As a result, resident assignments are based upon the best This year is structured with rotations in the educational experience and not service requirements following specialties: which are provided by nurse anesthetists. Camaraderie in the department between the *Internal Medicine residents, faculty, student nurse anesthetists and *Medicine Critical Care certified nurse anesthetists is superb and makes for an *Pulmonary Medicine excellent working environment. *Cardiology *Surgery 2 *Surgical Critical Care *Emergency Medicine *Anesthesiology *Neonatal Critical Care

Resident Performance on ANESTHESIOLOGY RESIDENCY Standardized Tests Other Residency Facts As a result of the quality of our residents and the efforts of our training program, resident performance on standardized tests has  Most residents obtain the ABA/ACGME been superb. The accompanying chart is just one example of the minimums in all categories by the end of consistent performance of our trainees. the CA-2 year American Board of Anesthesiology 2021  Case logs approach or exceed the Growth in Knowledge of CA-2 Residents national averages in all categories by graduation  The only mandatory “away” rotation is two months of pediatric anesthesia at Monroe Carell Jr. Children’s Hospital at Vanderbilt University. A furnished apartment close to Vanderbilt University Hospital is provided  The geographic area for resident recruitment is from across the USA with a predominance in the Southeast but increasing representation from the Midwest  25-50% of residents per year pursue fellowship training upon graduation  An optional educational opportunity that is paid is available to residents on the weekends Faculty Specialization & Composition ABA Board Examiners As our medical center has grown Longevity over the past twenty-five years, Our faculty currently has four American A unique aspect of the residency the expansion of our department Board of Anestheisology (ABA) Board program at the University of has increased from eleven to 37 Examiners. Chairman, Dr. Craft is an ABA Tennessee is the lack of clinical faculty members. written board examiner while Drs. Buehler, “turnover” in faculty at an Due to the lure of our McConville, and Messenger serve as academic medical center. For the practice advantages, many of ABA applied examiners for both the past twenty-five years, only four our faculty completed their structured oral and OSCE exams. faculty members have left to residency at the University of practice anesthesiology at another Tennessee. Chairman Emeritus institution. The reasons for this After serving as consistency are myriad. The The vast majority of our faculty Chairman of the unique aspect of the combination are fellowship-trained and bring the department for 12 of private practice and academia expertise from other institutions to years, Jerry Epps, in the Department of ensure an immense breadth of MD, Chairman Anesthesiology is common techniques and approaches to Emeritus, occupied throughout the medical center. anesthetic management. Sub-speacialty the role of Chief The beautiful scenery of east training of our faculty encompass all Medical Officer at Tennessee coupled with the love aspects of anesthesia care including UTMC from July of outdoor activities and college Neuroanesthesia, Cardiac Anesthesia to 2015 to April 2019. athletics are temptations that include advanced TEE, Obstetrical During that time he some individuals cannot resist. Anesthesia, Acute and Chronic Pain, was instrumental in Regional Anesthesia, Critical Care, Palliative Medicine, Pediatric Anesthesia implementing the IV drug use associated and Neurocricial Care. infection plan of care at UTMC. Dr. Epps was a long-standing ABA structured oral board 3 examiner and remains active in department activities including oral board preparation.

ADVOCACY ANESTHESIOLOGY RESIDENCY One of the goals of our training program is to produce well-rounded anesthesiologists who understand not only the clinical practice of anesthesiology but the need to raise the profile of anesthesiology within the highly competitive environment of congressional politics. Each year residents and faculty attend the American Society of Anesthesiologists Legislative Conference in Washington, D.C. as well as serve as delegates to the American Society of Anesthesiologists House of Delegates at the Annual Meeting. Pictured (L to R): Senator Lamar Alexander, Patrick Pictured (L to R): Joshua Ragan, MD, Eric Cox, MD and McFarland, MD and Senator Bob Corker Patrick McFarland, MD The Department of Anesthesiology at the University of Tennessee was the first department to have 100% contribution to the ASA Political Action Committee by both faculty and residents, and continues this advocacy every year. Since our department achieved this feat, only two other departments have ever met this milestone. Patrick McConville, MD is President- elect for the Tennessee Society of Anesthesiologists (TSA). In addition, the past president of the (TSA) is Daniel Bustamante, MD, Assistant Professor of Anesthesiology, and he currently serves as Secretary and on the Board of Trustees for the Knoxville Academy of Medicine as well as delegate to the Tennessee Medical Association. Faculty member, W. Eric Cox, MD, is also a past president of the Tennessee Society of Anesthesiologists and currently serves as the Treasurer of the TSA and the Tennessee Alternate Director to the ASA Board of Directors. The TSA District 4 Director is Adam Roth, MD and Brigítte Messenger, MD previously served in that role. The American Society of Anesthesiologists (ASA) sponsors a prestigious Policy Research Rotation in Political Affairs and our own Dr. Patrick McFarland was selected to participate during the 2017-2018 academic year. During his four week rotation, he achieved a comprehensive understanding of health care politics and policy, gained first-hand experience of a political environment, assisted in day-to-day activities in the ASA's Advocacy Division, attended lobby events sponsored by ASA, created a research project and explored and reported on new law and policy changes affecting the profession of anesthesiology. 4

ANESTHESIOLOGY RESIDENCY Unique Learning Opportunities The Department of Anesthesiology has collaborated with The University of Tennessee's Haslam College of Business to offer two unique experiences, both clinically and educationally. Daniel R. Bustamante, MD Resident Leadership Series This series was designed based on The University of Tennessee's Physician Leadership Academy, which provides physicians who aspire to be part of the leadership team with the skills needed for advancement. The curriculum consists of 12 seminars delivered quarterly over the course of three years and covers topics such as healthcare policy, finance, leadership style and skills, conflict and communication, influencing and negotiating skills, and leading change. In an effort to foster interdepartmental collaboration, residents from the departments of Surgery, OB/GYN and Radiology also participate. Perioperative Medicine Fellowship In addition to advancing their clinical practice related to the non-surgical care of patients from the time surgery is considered through full recovery, the fellow completes the Physician Executive MBA (PEMBA) program through The University of Tennessee's Haslam College of Business. The PEMBA program is a pre-eminent, nationally ranked MBA program exclusively for physicians seeking leadership, management and business skills. With regard to advancing their clinical practice, fellows can enrich any aspect of clinical practice via a customized curriculum, including advanced regional anesthesia and echocardiography. Pain Medicine Fellowship The Department of Anesthesiology at the University of Tennessee Graduate School of Medicine (UTGSM) now offers a Pain Medicine Fellowship. The new training program is ACGME-accredited and designed to qualify anesthesiologists for specialty certification in pain medicine by the American Board of Anesthesiology. Transition to Practice Rotation The Transition to Practice (TTP) rotation was created in 2016 and provides residents experience in medically directing mid-level anesthesia providers in a rapid-paced, environment. This one-month rotation occurs during the final six months of training and takes place primarily in UT Day Surgery. The TTP resident functions as the acting attending in all aspects for the care of patients scheduled in up to 6 ORs and procedure rooms with faculty anesthesiologist oversight. Goals of this rotation are for the resident to: 1. Gain experience in personally providing complete anesthetic care management in the outpatient setting from patient arrival to discharge 2. Gain first-hand experience working in an (ambulatory surgery center, with a different pace and more limited resource availability 3. Learn to plan ahead and prepare for events that could occur when the resident is \"alone on the island\" 4. Gain experience interacting with surgeons as a consultant in anesthesiology 5

ANESTHESIOLOGY RESIDENCY Research and Scholarly Activity Professor Allen has joined the department having had a long career as a successful highly published clinician-scientist at Brigham and Women’s Hospital/Harvard Medical School. The focus of his basic and translational science has been on the studying and defining the mechanisms controlling excitation contraction (EC) coupling in skeletal muscle, specifically structure - function relationships of the ryanodine receptor and the interactions of the ryanodine receptor with other proteins in the triad. Much of this basic research has examined and defined the mechanisms causing susceptibility to Malignant Hyperthermia, a disease caused by mutations in EC coupling machinery which is triggered by exposure to volatile anesthetic agents. In addition to his basic and translational lab research, a significant portion of his research career also focused on clinical research. In this regard, he worked with other anesthesiologists, fostered collaborations with many of his surgical colleagues, and served as a bridge between the clinic and basic science. He served on the IRB in Boston for 30 years and is currently an alternate member of the IRB at the UTGSM. His current role in the Department of Anesthesiology research effort is primarily mentorship of both faculty and residents toward achievement of a higher level in their academic pursuits. This role specifically includes: helping with design and carrying out clinical research projects; preparation of grant applications; establishing relationships with foundations and pharma for grant support; and preparation of abstracts, presentations, and full length papers for presentation and/or publication regionally and nationally. Scholarly Activity 2020-2021 Resident Scholarly Activity Presentations made at: Posters/Abstracts at National Meetings - 6 American Society of Anesthesiology Annual Meeting Faculty Scholarly Activity Society for Obstetric Anesthesia and Perinatology Book Chapters - 10 Tennessee Society of Anesthesiologists Journal Articles – 12 Presentations - 19 International Anesthesia Research Society Annual Meeting Invited Lectures - 3 Society of Critical Care Anesthesiologists Annual Meeting Number of Grants with Faculty in Leadership Role - 21 Society of Critical Care Medicine Targeted Pain Treatment Conference Publications made in: American College of Cardiology National Conference Journal of Biological Chemistry The 24th Annual Louis Cancellaro Primary Care Conference North American Neuromodulation Society Annual Meeting Anesthesiology Frontiers in Aging Neuroscience 23rd Fall Psychiatric Symposium Tennessee Pain Society Frontiers in Physiology Journal of Palliative Medicine Pain Society of the Carolinas Annual Meeting Journal of the International Neuromodulation Society Pacific Spine and Pain Society Pain Medicine 6

ANESTHESIOLOGY RESIDENCY Simulation at The University of Tennessee Our department is committed to preparing residents for American Board of Anesthesiology (ABA) certification. We provide numerous educational experiences in the simulation center, both in preparation for the ABA applied Objective Structured Clinical Exam (OSCE) exam and for clinical education. The OSCE began March 2018, and all residents completing residency from October 2016 forward will be required to complete this exam in addition to the Structured Oral Exam as the final stage of ABA board certification. Our current simulation experiences include: • Peripheral IV insertion • Anesthesia Monitors and Induction Sequence • Sterile Procedure and Central Venous Catheter Insertion • Difficult Intubation • Airway simulation with all available airway devices • Cricothyroidotomy simulation on pig cadavers • Total Spinal • Aspiration • Epidural and Spinal anesthetic placement • Laryngospasm • Multidisciplinary Obstetric Emergency Scenarios • Surface Ultrasound including: EFAST exam • Amniotic Fluid Embolism (Ultrasound exam of pericardial, pleural, hepatorenal, • Medication Errors and rectovesicular spaces). • Malignant Hyperthermia • Transthoracic Echocardiography (TTE) Case Simulation Anesthesia Olympics • Transesophageal Echocardiography (TEE) In addition to these simulation experiences, The University of Tennessee Department of Anesthesiology participates in the Anesthesia Olympics. Anesthesia Olympics is a simulation experience focused on skills specific to anesthesia. Anesthesia Olympics evaluates residents as they move through a series of six work stations where they are asked to demonstrate a skill that is appropriate for their expected level of training. Each station has a simulator patient or a human patient played by an actor, and a faculty mentor who evaluates performance using both quantitative and qualitative methodologies to determine strengths as well as areas that need to be further developed. Six stations including: 1) IV access/ intubation ABA APPLIED Exam Simulation 2) arterial line placement 3 Hand off report to PACU The University of Tennessee Department of Anesthesiology is participating in 4) Preoperative interview APPLIED Exam Simulation. CA3s participate in OSCE and SOE exams that simulate the 5) Machine Check actual day of the APPLIED exam. 6) High fidelity simulation of Intra operative Hypoxemia This includes a seven-station circuit that evaluates their proficiency in seven of the nine skills listed in the OSCE Content Outline, followed by two SOE encounters as one would Anesthesia Hub experience on exam day. The residents participate in this exercise on a second day as well, reversing the order. This simulation experience helps prepare residents for what to expect on exam day as well as practice their skills in both areas tested – OSCE skills and oral examinations. \"Anesthesia Hub\", a mobile app that brings numerous resources like schedules, important numbers, clinical protocols and much more together into a single, secure place right at your fingertips. Select 'Contacts' Look up vacation, to find call and conference information for schedules from everyone in the anywhere by tapping Anesthesia Schedules department. Tap on 'Facility Our Landing Page Find important Resources' to find The Hub is all you need! information such as useful numbers in the rotation goals and 7 hospital. objectives under 'Residency Resources'

ANESTHESIOLOGY RESIDENCY Quality Reporting at The University of Tennessee The Centricity Perioperative Anesthesia information AlertWatch: OR was implemented in 2018. AlertWatch is management system was implemented in 2009. This a secondary monitoring system that runs simultaneously with system incorporates pre-anesthetic evaluation, intra- the Centricity Perioperative Anesthesia system to provide operative documentation with automated monitor entry, real-time information to both in-room and supervising clinical decision support through crisis checklists, providers. This data can also be extrapilated for analysis of professional billing module, post-operative evaluations and Quality Improvement measures such as blood pressure quality measure recording. management, temperature and glucose control. The Multicenter Perioperative Outcomes Group was formed in 2008 by six academic medical departments and lead by the University of Michigan to develop the necessary policies, procedures, and technical infrastructure required for multicenter perioperative outcomes research. Currently, MPOG is a consortium of 50 medical centers nationwide aggregating large volumes of electronic health record (EHR) data, patient reported outcomes, and long term administrative outcomes which is then available for data extraction. The Department of Anesthesiology at the University of Tennessee was the first academic department to join the founding members. By participating in MPOG, residents have the opportunity for research involving the MPOG data. The Anesthesiology Performance Improvement and Reporting Exchange (ASPIRE) is a quality improvement initiative based at the University of Michigan partially funded by Blue Cross Blue Shield of Michigan (BCBSM) and based upon the data infrastructure of the Multicenter Perioperative Outcomes Group (MPOG). ASPIRE uses EHR and administrative data to analyze the interplay between patient comorbidities, surgical procedure, intraoperative anesthesiology technique and interventions, and postoperative outcomes. As a member of ASPIRE, each provider receives a monthly email detailing their performance on the current 16 quality measures tracked by the department. ASPIRE not only allows for continued feedback on anesthetic management, but also creates opportunities for residents to take ownership of specific measures (i.e. Quality Improvement Projects). 8

ANESTHESIOLOGY RESIDENCY Camaraderie at the University of Tennessee The same reasons that attract residents to east Tennessee appeal greatly to other team members at The University of Tennessee. As a result, the ‘esprit de corps’ among all members is excellent and social interactions between our residents, faculty, SRNAS, CRNAS and surgeons are common place. A better working environment within our operating rooms is hard to envision. 9

ANESTHESIOLOGY RESIDENCY New and Exciting Resident Workspace Remodel The resident work spaces are undergoing remodeling with expected completion date of Spring 2022 Expansion of Residency Complement Beginning with the 2022 Match, our residency will increase the number of residents per class from 8 to 10. As the department and Medical Center have continued to expand, there are increasing opportunities both inside and outside the operating room environment for our residents. Maintaining physician-led care in the perioperative environment is a principal priority for our department and specialty. The department was compelled to expand our residency complement in order to extend these additional learning opportunities to our residents. We expect no impact to case numbers and case variety, and an increase in diversity of learning opportunities. 10

Contact Information ANESTHESIOLOGY RESIDENCY Chairman Associate Program Director Robert M. Craft, MD [email protected] Ashley Hambright, MD [email protected] Vice Chairman Associate Program Director Associate Program & & Clinical Base Year Director CBY Residents Director Program Director Elizabeth Driscoll, MD Brigitte Messenger, MD Mark Allen Patrick O. McConville, MD [email protected] [email protected] [email protected] [email protected] CA-2 Residents CA-1 Residents Dunsin Bakare [email protected] CA-3 Residents Brandon Alford Brett Barrilleaux [email protected] [email protected] Austin Bowyer Michael Donovan mbowyerutmck.edu [email protected] Philip Cato Jackson Harris [email protected] [email protected] Alex Brown Liliane Ernst [email protected] [email protected] Kamry Clark Tara Keil [email protected] [email protected] Stephanie DeFord Rob Gassert [email protected] [email protected] Ethan Guffey Bill Majors [email protected] [email protected] Tyler King Terry Nowell [email protected] [email protected] Katherine Huff Samuel Pettigrew [email protected] [email protected] John Madigan \"E\" Nwaneri [email protected] [email protected] Jim Loughridge Adam Seal [email protected] [email protected] Logan Patton Kylie Pearon [email protected] [email protected] Dustin Smith Paul Shanahan [email protected] [email protected] Alix Roaten [email protected] Kyle Snyder Corey Stack [email protected] [email protected] Adam Wilson [email protected] 11

The University of Tennessee Non-Profit Org. Graduate School of Medicine U. s. Postage Department of Anesthesiology 1924 Alcoa Highway, Box U-109 PAID Knoxville, TN 37920 University of Tennessee ADDRESS SERVICE REQUESTED Knoxville 12