The members of the Department of Anesthesiology at The University of Tennessee Graduate School of Medicine (UTGSM) work together for a single purpose: to provide the best possible perioperative care for all patients. The anesthesia care teams provide services for approximately 45,000 procedures in the operating rooms and satellite anesthetizing locations such as the obstetrical suites, the gastroenterology outpatient center, radiology department, cardiovascular laboratory and the University of Tennessee Ambulatory Surgical Center. For over five decades, our core training philosophy combines progressive clinical responsibility with careful supervision to maintain patient safety and resident support. The caseload of our Level 1 trauma center provides a broad-based clinical experience and upon completion of the residency, our graduates easily achieve board certification.
The mission of the Department of Anesthesiology is to practice, teach and study perioperative medicine. Toward this end, our department has sole responsibility for 1/3 of the ICU beds at UTMC and for the institution’s only Comprehensive Pain Management Clinic. Furthermore, our department provides sole medical direction for the Pre-Anesthesia Clinic. While this degree of departmental involvement in perioperative care is not unique, our residents train in these areas much more extensively than the minimum required by the ACGME Anesthesiology RRC. Specifically, over the 4-year continuum, our residents complete 6 weeks each of Pre-Anesthesia Evaluation and Post-Anesthesia Care (RRC minimum is 2 weeks each), as well as 5 months of Critical Care experience (RRC minimum is 4 months). Our residents also complete a 2-week rotation in Palliative medicine. Even with this significant commitment to teaching perioperative medicine, our residents meet or exceed the national averages for intraoperative experience as defined by subspecialty and anesthesia technique.
The innovative aspect of our education in perioperative medicine hinges on our belief that the future of anesthesiology leadership will be defined by both clinical and management abilities. Thus our curriculum incorporates teaching from the University of Tennessee, Knoxville Physician Executive MBA (PEMBA) program faculty, including education in LEAN processes, financial reporting and management skills. Furthermore, we have begun a Perioperative Medicine Fellowship which involves clinical experience through the medical direction of anesthesia care at UTMC while obtaining the PEMBA degree. The College of Business has consistently been ranked for its top-tier MBA programs by U.S. News & World Report, Financial Times, The Wall Street Journal and other prestigious publications. The PEMBA program at the University of Tennessee is a preeminent, nationally ranked degree program exclusively for physicians seeking leadership, management, and business skills.
As part of its role to provide peri-operative medical care, the Department of Anesthesiology directs the Anesthesia Pre-Op Clinic. A staff anesthesiologist and resident work with registered nurses to obtain a detailed electronic record of patients' past medical history, a directed physical examination, and appropriate laboratory and evaluative studies for approximately 800 patients per month.
The ultimate goal of the anesthesia pre-op clinic is to minimize surgical and anesthetic risk by assuring that patients are in a state of "best possible condition" in regard to their co-existing disease. By performing this assessment in the pre-op clinic, the additional goal of cost containment can be achieved by avoidance of unnecessary "blanket" pre-op testing, as well as minimizing delays and/or alteration of the Operating Room schedule. Thus, the Department of Anesthesiology strives to provide optimal peri-op patient care, cost containment, and optimization of OR scheduling and personnel utilization.
The University of Tennessee Medical Center, Knoxville, performs about 22,000 operative procedures in 26 different operating rooms. Separate critical care areas include Cardiovascular, Coronary Care, Trauma, Neurological Intensive Care, Medical Intensive Care, Surgical Intensive Care, Pediatric Intensive Care and Neonatal Intensive Care. Almost 3000 deliveries were performed in 12 labor rooms and 3 Obstetrical Operating Rooms. Epidural analgesia is provided for about 70% of deliveries.
About 3,000 operative procedures per year are performed in the four operating rooms at the University of Tennessee Day Surgery Center located adjacent to the main hospital. This is a separate facility from the ambulatory surgery unit found within the main hospital.
The University Center for Pain Management includes both our comprehensive pain management clinic as well as the Anesthesia Interventional Pain Clinic (AIPC) located in the University of Tennessee Day Surgery Center. It is led by physicians trained in acute, chronic, and cancer-related pain management. Consultative services are available for those who are hospitalized as well those referred for evaluation in the ambulatory setting. The pain management team members develop an individualized and comprehensive plan for optimal pain treatment that will allow each person to return to an optimal level of function in his or her work and personal life. More than 2,400 pain procedures are performed each year and include procedures such as: spinal cord stimulation trials, intrathecal pain pump trials, superior and inferior hypogastric nerve blocks, radiofrequency ablations, celiac plexus blocks, cervical, thoracic and lumbar medial branch blocks, lateral femoral cutaneous nerve blocks, sacro-iliac joint injections, epidural steroid injections, and lumbar discography. Referrals to the Pain Clinic can be made by calling 865-305-8684.
The Department of Anesthesiology facilities consists of the Powell Memorial Electronic Library, department conference rooms, and the Advanced Center for Medical Simulation. Seven call rooms are assigned as follows: one for faculty, one for CRNAs, three for residents, and two for SRNAs. Separate lounges are available for both the residents and certified and student nurse anesthetists. A medical administrative specialist and four clerical staff members provide administrative support for the faculty, residents, CRNAs, and SRNAs. Clinical support in the operating rooms consists of three anesthesia technicians. The four divisions of Anesthesia Research aim to advance basic and clinical research to enhance understanding of anesthetic mechanisms and improve clinical care.
Robert M. Craft, MD, Professor
Dr. Craft joined the Department in 1994 as assistant professor following a fellowship in Neuroanesthesia at Mayo Clinic. Since that time, he has been promoted to professor and has served as departmental vice chair since 2006. He is also section chief for Neuroanesthesiology and Pre-Operative Evaluation.
During his tenure, Dr. Craft has been deeply involved in resident education institutionally and nationally, including serving as residency program director from 2008-2017. As chair of the Department’s Education Committee for the past 12 years, Dr. Craft has helped move the residency from a 3-year program of 21 residents to a 4-year program of 32 residents. The program has also maintained a maximum ACGME review cycle for the past decade. Nationally, Dr. Craft has served the American Board of Anesthesiology as a Written Exam Editor. He is the Anesthesiology representative to the Organization of Program Directors Associations, and he is a council member of the Association of Anesthesiology Core Program Directors.
Dr. McFarland met with the Senators on "Tennessee Tuesday" at the Senate Building in D.C. during the ASA Legislative Conference. They briefly discussed the ongoing opioid epidemic with the need for efficient and sustainable solutions. Senators Corker and Alexander were appreciative for Dr. McFarland's input.
At the University of Tennessee Center for Advanced Medical Simulation (UTCAMS), physicians, students, and other members of the healthcare team attain not only improvement in individual skills, but also learn and practice team skills that are essential for patient safety. This type of multi-faceted, orchestrated training improves critical thinking, decision making, and clinical techniques - all without imparting risk to a real patient. Discover how the UTCAMS is enhancing the learning of our anesthesiology residents and nurse anesthetists:
The University of Tennessee Graduate School of Medicine
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