Duke University Medical Center Department of Anesthesiology ...

Mission Statement:
Duke University Medical Center
Department of Anesthesiology
Fellowship in Ambulatory and Regional Anesthesia
The purpose of the Fellowship is to develop a set of standards for subspecialty in ambulatory and
regional anesthesia. This fellowship program will ensure the ongoing development of regional
anesthesia as a defined subspecialty. Research activities, education curricula and most importantly,
clinical care will be emphasized.
Clinical Educational Goals:
• Development of expertise in the practice and theory of regional anesthesia
• Assessment of anesthesia needs and options for patients having procedures in the ambulatory
setting: develop anesthesia plan with necessary interventions to minimize risk
• Medical evaluation of patients from history and physical examination to determine anesthesia
risks; establish benefits of regional anesthesia
• Understanding the medical benefits and advantages of regional anesthesia especially in high
risk patients and geriatric patients in the ambulatory setting
• Recommendations and consultation in postoperative pain management, evaluation of regional
anesthetic intervention in the management of acute postoperative pain
• Learn and hone the techniques of regional anesthesia understanding the specifics of anatomy
involved in the performance of paravertebral blockade
• Application and supervision of appropriate treatment protocols
• Assisting with clinical data collection
• Participate in research projects, presentations and teaching
In-Situ Images of the Paravertebral Space

Program Design:
The Fellowship in Ambulatory/Regional Anesthesia is designed to provide advanced training in
anesthesia in the ambulatory surgery setting. This program will be an extension to previous training
with an emphasis on a continued educational component to include research, clinical and teaching
responsibilities. The program will train participants in various regional anesthesia techniques that are
used to enhance the perioperative experience of one day surgery patients. These anesthesia
techniques are beneficial in their postoperative pain management and in the reduction of
postoperative nausea and vomiting. The anesthesiologists in the fellowship will also gain invaluable
experience with the use of continuous peripheral nerve catheters which control pain up to 2-4 days
after surgery. The fellows continue the use of general anesthesia during their fellowship, however, the
mission and objective of the fellowship is to teach the specialized advanced regional anesthesia
techniques. Mastering of the various techniques will prepare the fellowship participant to successfully
utilize these skills to provide anesthesia and analgesia options to the ambulatory surgery population.
Fellows will be encouraged to submit an abstract at the American Society of Anesthesiologists annual
meeting as well as conduct clinical investigations and clinical outcome studies for Regional
Anesthesia.
A further objective of the fellowship is for the participant to develop a working knowledge of the fast
pace of an ambulatory surgery center. It will be important to evaluate anesthesia risk and necessary
interventions to minimize risk as well as understand how to safely and successfully provide optimal
anesthesia care to patients in this setting.
A successful fellowship participant will soon be able to identify the best regional anesthesia technique
suited for the type of surgery to be performed. During the training, the ability to reach the proper
conclusion regarding the anesthesia techniques to be utilized for special procedures is evaluated.
The development of the skill and technique to administer the necessary regional anesthesia
techniques is the primary goal and objective of the fellowship. This learning process is monitored and
supervised closely by the attending anesthesiologists in the Division of Ambulatory Anesthesia.
The program curriculum is established by the attending anesthesiologists in the Division of
Ambulatory Anesthesia all of whom are Board Certified Anesthesiologists or equivalent and have
completed a fellowship in regional anesthesia and are practitioners in a division which demonstrates
expertise in regional anesthesia. The program is reviewed yearly by the teaching group of
anesthesiologists.
Program Requirements:
The work environment allows fellows to have a non-clinical day per week to dedicate to research and
project activities. Duty hours for the fellow are posted on the operative schedule and begin at 6 am
and end when the last patient is discharged from PACU or housed in the Recovery Care Center with
appropriate orders written. Duty call is monitored daily. Fellows are required to attend
Anesthesiology Grand Rounds and are encouraged to attend other Departmental educational
sessions. Fellows represent the Department at national meetings, conferences as well as prepare inservice
teaching on site departmentally. Fellows are expected to be involved in at least one
publication while participating in the fellowship.

Scholarly Activity:
Contribute to the science of regional and ambulatory anesthesia by participating in clinical
and/or laboratory research -given non-clinical time to fulfill these goals. Participate in the didactic
curriculum for resident education and other clinical teaching. Academic education objective which
assures skill development in: -the ability to formulate clinically relevant hypotheses in regional and
ambulatory anesthesia -execution of research projects -introduction to statistical analytical techniques
utilizing patient outcomes database -presentation of research at an educational meeting while
participating in the fellowship.
Fellows participate in research, outcomes, writing for journals and publications as well as in-service
training to nursing staff, etc. Fellows participate in journal clubs, roundtable discussions, grand rounds
and lectures. There are opportunities for the fellow to become involved in research already in
progress or to develop an original project. Activities considered as academic projects include a
research paper or case report submitted to a peer-review journal and presentation of a clinical chart
review or a review article submitted to and accepted by a peer-reviewed journal, a book chapter or
other endeavor.
Selection Process:
The selection process for fellows includes the completion of a Fellowship Application which is to be
substantiated by three letters of recommendation from experts in the field. In addition to the letters of
reference the application is to include a current CV and a letter of affirmation stating interest in the
program. Applications are closely reviewed by all the attending anesthesiologists of the Division of
Ambulatory Anesthesia. Potential candidates will have interviews scheduled at Duke Medical Center,
Department of Anesthesiology with members of the Division of Ambulatory Anesthesia participating in
the interview process.
Deadlines for receiving applications:
August 15 prior to Fellowship year (i.e. for Fellowship year 2010-2011 application due on or
before August 15 of 2009). Interviews will be completed by October 15 prior to Fellowship
year.
Contact Information: Stephen M. Klein, M.D.
Associate Professor of Anesthesiology
Chief, Division of Ambulatory Anesthesia
Medical Director of Ambulatory Surgery Center
Department of Anesthesiology, Box 3094 #4
Duke Medical Center
Durham, NC 27710
or
LuAnne Latta, Staff Assistant to Dr. Stephen M. Klein
latta005@mc.duke.edu or 919-681-9941