Anesthesiologist assistants (AAs) work as integral members of the Anesthesia Care Team within the hospital setting. AAs help to formulate and implement the anesthesia care plan under the direct supervision of a licensed anesthesiologist. Duties include but are not limited to the following:

• Collecting preoperative data and performing physical examinations
• Inserting venous, arterial, and other invasive catheters
• Delivering drugs for induction and maintenance of anesthesia
• Placing, delivering, and managing regional anesthesia
• Securing and managing the airway
• Managing supportive therapy such as intravenous fluids and blood products
• Administering cardiovascular drugs as supportive therapy
• Making anesthetic adjustments using intraoperative monitoring modalities
• Providing a safe transition from the operating room to the recovery area
• Performing functions in the intensive care unit and pain clinic as directed by an anesthesiologist
• Participating in administrative affairs, research, and clinical instruction
  

The first year experience begins with learning the fundamentals of anesthesia and ends with the student having a strong knowledge base and proficient clinical skills needed to finish study in the second year.

First two weeks provide an introduction to anesthesia in the classroom and OR.

• 8:30 am-3:00 pm, Monday-Friday
• Small class size, intimate learning environment
• Instructors are AA-Cs or MDs
• Set up hospital e-mail account and get pager, thereby gaining access to communicate with all students and staff
• Receive instructions on use of the clinical database
• Become oriented to operating rooms, anesthesia machines, and monitors
• Meet second year students
• Gain a basic understanding of the practice of anesthesiology, learn basic concepts and skills, and gain some comfort in the hospital environment

• 6:00 am-2:00 pm, Monday-Friday, in the OR with AA-C
• Class is split between University Hospitals and MetroHealth Medical Center
• Initially students shadow instructors before gradually participating in patient care under close supervision of instructors
• Students are expected to be in the operating room by 6:00 am to set up for the day's cases
• Room set up
• Set up and calibrate anesthesia machine and monitors
• Draw up medications for the day
• Prepare anesthesia equipment
• Students remain in assigned room all day and manage cases
• Students are expected to get the next day's assignment before leaving in order to study and prepare for those surgeries
• Begin to develop clinical skills: IV placement, airway management, intubation, drug administration
• Instructors facilitate learning by answering questions and guiding clinical experience

In the OR 6:00 am-4:00 pm, Monday-Tuesday

• UH and Metro
• Clinical expectations are gradually increased
• Arrive in OR by 6:00 am to set up room. Practice a full day of work with morning, lunch, and afternoon breaks (time permitting). Get the next day's OR assignment in order to study and prepare
• Clinical skills
• IV placement, intubation, airway management
• Drug administration and fluid management
• Formulation and implementation of anesthetic plan
• Case management
• Preoperative interview, induction, maintenance, emergence, and safe transition to recovery room

• Study the basic science and clinical aspects of anesthesiology
• Study pharmacology and clinical decision making as it relates to anesthesiology
• Practice skills and management in the Anesthesia Simulation Laboratory
• Attend weekly lectures by second year AA students and Anesthesiology faculty

In the OR 6:00 am-4:00 pm, Monday-Wednesday

• UH and Metro
• Clinical expectations are further increased
• Students expected to apply classroom learning to clinical practice
• Improve clinical skills and case management

• Continuation of class work
• Practice in the Anesthesia Simulation Laboratory
• Attend weekly lectures by second year AA students and Anesthesiology faculty
• Give one lecture to AA student and faculty audience

The second year focuses on clinical practice and independent study as the students perfect their clinical skills, knowledge base, and clinical decision-making. By the end of the year students are ready to take the national board examination and begin professional work.

Clinical Time

• Students are expected to work full clinical days Monday- Friday. They are assigned a room and are expected to begin and finish all the cases assigned to them for the day.
• Students are closely supervised and urged to become more independent as they begin to master their skills and become competent anesthesia providers.
• Students take night and 24 on-call responsibilities at least one to two times per month and have the following clinical day off.
• Students complete month-long rotations in subspecialties of anesthesia including pediatrics, obstetrics, neurosurgery, ambulatory surgery, trauma, cardiac, and critical care.
• Clinical rotations are completed in Cleveland area hospitals as well as in Springfield and Cincinnati, Ohio. Students may arrange a clinical rotation outside of the standard rotations as long as certain criteria are met.

• Second-year students attend clinical lectures at University Hospitals Case Medical Center.
• Students are required to give one lecture in the Fall and one in the Spring.

• Once a month second-year students attend a Journal Club meeting to review and analyze current anesthesia scientific literature. Second years also meet once a month to review chapters in one of our main text books with an anesthesiologist as a means of preparing for the board exam.