University of Iowa Anesthesia > Programs > Residencies

Dr. Todd

Thank you for taking time to learn more about the Department of Anesthesia at The University of Iowa. This is one of the oldest and, in our clearly biased opinion, one of the best clinical training programs in the country.�

The University of Iowa Carver College of Medicine accepted its first students in 1870 and was one of the first medical schools in the nation to admit women alongside men. We graduated our first anesthesia resident (Mary Ross, MD) in 1920. Anesthesia became a recognized academic division within the College in 1939 with the arrival of Stuart Cullen, MD. Since that time, over 500 physicians have received a superb education in anesthesiology.

Our program is accredited for 13 positions per year. We receive several hundred applications each fall, interview ≈80 candidates, and accept 10 PGY-1 residents through the match, with three more residents joining as CA-1s. They come from every state in the Union and from many countries around the world to receive their training in our state-of-the-art medical center located in one of the most livable, family-focused, university communities in the United States. They are prepared to care for any kind of patient in any kind of environment, from the smallest rural practice to the largest multispecialty hospital. Some go directly into practice after residency. A growing number are seeking fellowship training, and our recent graduates have each been accepted into the fellowships of their choice. Our residents' success, over the last 10 years, in passing their boards is ≈98%. You can find out a lot about Iowa, Iowa City, the University of Iowa, the Hospital and the Department on this web site; please look around. However, I'd like to briefly tell you a few of the reasons that you should seriously consider joining us.�

1. Airway experience: Anesthesiologists are the preeminent medical experts in the management of both the normal and the most difficult airway. Our department has focused on insuring that our trainees excel in this area. All of our residents become skilled with flexible fiberoptic techniques, GlidescopesÒ, intubating LMAs, lightwands, and devices. The huge numbers of neurosurgical, orthopedic and otolaryngology patients provides our residents an unparalleled opportunity to refine their skills with these techniques.

2. Regional anesthesia: In many programs, regional anesthetics (other than spinals and epidurals) are uncommon. Not at Iowa. Over 5,000 patients per year (about 25% of our total surgical load) receive some kind of regional anesthetic, and this doesn't include obstetrics. All of our residents become facile in thoracic epidurals and cervical, thoracic, and lumbar paravertebral blocks, as well as both upper and lower extremity blocks (for example, interscalene, infraclavicular, axillary, femoral, sciatic, and popliteal blocks). Ultrasound guidance is now in routine use. We have a detailed program for training residents in anatomy related to regional anesthesia. Our residents typically complete their training with regional caseloads several times greater than that required by the Residency Review Committee (RRC).

3. Pain management: Under the direction of Dr. Richard Rosenquist, Iowa has developed one of the most active and sophisticated pain medicine programs in the Midwest. Our Acute Pain Service typically cares for 10-15 patients per day (most of whom have continuous catheter regional anesthetics) and our Pain Clinic deals with all aspects of chronic pain, including interventional procedures. Residents participate fully in both the acute and chronic pain services.

4. Pediatrics: Over 20% of our cases involve children and the University of Iowa Children's Hospital performs almost 75% of the complex pediatric surgery in the state of Iowa. These range from preemies to teenagers, and involve every kind of major and minor surgical procedure. The University has now embarked on the planning and construction of a new Children's Hospital.

5. Critical care medicine: In many departments, anesthesiologists are consultants in the ICU. Not at Iowa. The Department has managed the Surgical Intensive Care Unit for 40 years. The Medical Director of the SICU is Dr. Steven Hata (who is board certified in both medicine and anesthesia). Ten of our faculty members are critical care trained and certified. We manage over 3,000 patients per year, and our residents spend a full six months in the ICU during their training, obtaining some of the best critical care training in the country.

6. Trauma, transplants and robotics: The University of Iowa Hospitals and Clinics (UIHC) is the only Level 1 trauma center in the state and cares for the most severely injured patients imaginable, ranging from motor vehicle accidents to farm-related injuries. In addition, we are the only Iowa hospital performing kidney, liver, lung, and heart transplants. Finally, we have been in the forefront of robotics surgery in multiple areas including cardiac surgery, pediatric surgery, urology, and gynecology.

7. Ambulatory care: In the spring of 2007, the UIHC opened a new, state-of-the-art Ambulatory Surgical Center (ASC), under the direction of Dr. Doug Merrill. All of our residents have dedicated ASC rotations where they learn all aspects of modern ambulatory patient care, with a heavy focus on regional anesthesia.

8. Patient Simulator Center: The Department of Anesthesia opened the first simulator center at the University and one of the earliest simulator centers among anesthesia departments in the Midwest. Recently, our simulator center underwent a major renovation, with new faculty directors, a newly purchased pediatric simulator, and several airway and specialty mannequins. In January 2008, we replaced our old adult simulator with a new, state-of-the-art, high-fidelity unit. Simulator-based activities are now an integral part of our clinical rotations (including critical care) and all of our residents participate in simulator-based training on a regular basis.

9. Faculty teaching: We take our teaching responsibilities seriously. Our residents routinely evaluate all faculty and the department has worked hard to enhance our teaching abilities; faculty teaching scores (given by the residents) have risen progressively over the last four years. Our didactic program has been revised and is now based on a mixture of lectures, PBLDs, small group sessions, visiting professors, and web-based reference materials. We have a special yearlong introductory series for our interns to insure that they are well prepared to enter their CA-1 clinical activities. Specialized sessions to prepare our trainees for their oral examinations are also presented on a regular basis.

10. Other activities: The department believes in activities outside of the hospital. Our chief residents have a substantial budget that allows them to organize a variety of "fun" activities, ranging from our post-graduation golf tournament, the yearly paint-ball outing, and many others. We enjoy department-wide get-togethers, including our graduation, our resident welcome party, a fall picnic (great for kids), the winter party, and a culinary extravaganza hosted by Dr. Tyrone Whitter and several of our gourmet faculty.�

In many programs even today, residents are viewed predominantly as "manpower" to get the clinical work done. There is no question that extensive, focused, rotation-based clinical work is required for good training, and anyone who tells you that residency isn't hard work is not being honest. This is NOT a "7 to 3" job. But a good residency must involve more than just doing a lot of cases; residents are here first to learn, not just to provide clinical service. We have a large, dedicated group of CRNAs who help us insure that case assignments for residents are of maximum educational benefit. We also carefully track assignments to insure that everyone will meet (and exceed) their RRC-mandated requirements. We provide residents with a $3,000 education fund which can be used for a wide range of educational activities. In addition, we happily fund resident research presentations at the Midwest Anesthesia Residents Conference (now the 4th largest anesthesia meeting in the US) or at other major meetings.�

11. Community: Finally, I would be remiss if I didn't say something about our community. Iowa City is one of the best-kept secrets in North America. It is small (about 80,000 including the adjoining community of Coralville), inexpensive, safe, and cosmopolitan (many good restaurants, four live theater companies, a huge performing arts center, Big 10 athletics, and much more). The public school system is consistently rated as one of the best in the country, and we repeatedly appear on various "top 10" lists of the best places to work and live in the country. Our cost of living in low, and many of our residents own their own homes.

Our goal is to provide the best, well-balanced residency experience possible, in terms of both clinical training and the extensive medical knowledge you will need to succeed, and to do so in an intense yet pleasant working environment. You will not find a department with a better focus on clinical training and education or on team spirit, quality of life, family values, and community.

Michael M. Todd, MD
Professor and Head
July 2008