"The VA presents a wonderful working environment in meeting its mission to provide excellent care for our country's veterans. Our patients are very grateful for the care we provide, and the interactions between our surgeons, nurses, staff, and residents are excellent. Having a small but dedicated group of individuals allows us to build strong relationships between services and with our patients. This results in an idea working environment for our staff and training environment for our trainees. Additionally, as leaders in the administration of the operating rooms and SICU, we have a major role in running an efficient, safe, and successful facility." -- Dr. Minhaj, Chief of Anesthesiology Service
The patient population of this ~300-bed hospital is distinctive and challenging. Most of our patients present with advanced pulmonary, cardiovascular, and metabolic diseases. Residents receive an intense exposure to critical care anesthesiology for the geriatric patient, with an emphasis upon invasive as well as non-invasive monitoring. A wide range of surgical procedures is performed, including cardiac surgery, a busy orthopedic surgical program, and both open vascular/endovascular procedures.
The Veterans Affairs Puget Sound Health Care System is a two-division health care system providing comprehensive medical care to the veterans of Washington state; a substantial number of referrals for tertiary care also come from Alaska, Montana, and Idaho. At present, residents rotate through the Seattle division, although the Department also provides service at an attending level for an ambulatory surgery facility at the American Lake division in Tacoma.
The VA experience provides the resident with exposure to the care of a high-risk, high-intensity patient population, with a heavy emphasis on orthopedic, vascular, and cardiac surgical procedures. The cardiac surgical load is approximately 120 cases per year, including many complicated patients with problems far beyond the routine. Peripheral vascular surgery cases are performed nearly every day, again providing an opportunity to take care of complex patients.
The VA pain service is currently staffed by attendings and fellows, and includes patients with both acute and chronic pain problems. Most of the attending staff at the VA have advanced training beyond residency. Specialty interests include pain, cardiac, pharmacology, respiratory, critical care medicine, and critical event simulation.
Piotr Michalowski, MD, PhD