As interns, residents, and fellows are preparing to begin their new positions next month, another group of trainees is also gearing up for an important transition. Entering their fourth year of medical school, MS4 students at the Albert Einstein College of Medicine are getting ready to apply for residency this year. But first, they need to solidify their specialty of choice, which is often explored through clinical rotations at Montefiore Medical Center.

The Montefiore Einstein Department of Anesthesiology hosts one of the most robust four-week rotations for medical students looking to explore the field of anesthesiology. During the spring and summer months, the department hosts rising fourth-year students who have decided to pursue anesthesiology and who are looking to expand their knowledge of the specialty in anticipation of applying for residency.

Attending Anesthesiologist and Residency Program Associate Director Dr. Michael Rufino oversees the medical student rotations within the department together with Dr. Erik Romanelli, Anesthesiology Residency Program Director, and Dr. Jay Im, Assistant Residency Program Director. With about 10 students for each four-week rotation, Dr. Romanelli said that for fourth-year students participating in their anesthesiology sub-internship, it’s a crucial time for them to get exposure to various subspecialties and prepare for their Anesthesiology Residency applications.

“The rotation gives students a breadth of exposure, and if they express interest in a specific subspecialty, we coordinate having them rotate with that division,” Dr. Romanelli explained. “The students also go to different clinical sites so they get a sense of the adaptability and flexibility that is important for any anesthesiologist.”

As part of their sub-internship, students are paired with a resident each day and spend time doing preoperative assessments, assisting with the operating room set up, and participate in hands-on learning throughout the intraoperative period. Dr. Rufino also organizes didactics for the students to complement their education in the OR.

“Most fourth-year students come in with certain goals, and I try to tailor the rotation so they can achieve these goals,” Dr. Rufino said. “For those who are trying to decide if anesthesiology is the field they want to go into, I try to expose them to as much as I can. For those who plan on applying to anesthesiology, I try to help them so they learn as much as possible and succeed in the application process.”

Dr. Rufino has been managing the medical student rotations in the Department of Anesthesiology for more than a decade and noted that students interested in learning more about obstetric anesthesiology go to Weiler Hospital, while those interested in regional anesthesiology and acute pain medicine go to the Hutchinson Campus.

Mukhlisa Zakirova is a rising fourth-year medical student at the Albert Einstein College of Medicine who completed her Anesthesiology elective rotation at Montefiore in the spring and planning to apply to Anesthesiology residency programs this year. Ms. Zakirova’s first exposure to anesthesiology was during one week of her surgery rotation as a third-year student; she then decided to complete the four-week Anesthesiology elective to see if the specialty was the right fit. Ms. Zakirova said the elective solidified her decision to pursue anesthesiology, as she was exposed to a wide variety of cases and had many opportunities to learn in a hands-on manner from the department’s residents and attendings. In addition to observing numerous cases utilizing laryngeal mask airways, she had the opportunity to do direct laryngoscopies and work with the glidescope.

“Working with Dr. Rufino, I felt very mentored,” Ms. Zakirova said. “He showed me how to do blind IVs, walked me through the steps, and held lectures on different types of intubations. For me, getting involved in a hands-on way was really cool and allowed me to retain more of that information to use in the future.”

Attending Anesthesiologist and Non-Operating Room Anesthesia Director Dr. Irene Osborn also taught Ms. Zakirova and her classmates during a lecture on intubation and simulation. She also had the students shadow her during an awake craniotomy, which Ms. Zakirova described as a once-in-a-lifetime experience.

As Ms. Zakirova begins her applications for Anesthesiology residencies, she plans to apply to Montefiore Einstein after having such a positive experience during her rotations. She is also planning a second sub-internship with Montefiore during her fourth year of medical school to learn more about cardiothoracic anesthesiology. Having grown up in New York City, Ms. Zakirova had initially thought about applying for residencies in other states for a change of pace; but since being exposed to the Montefiore Einstein Department of Anesthesiology, she said it is clear she would get the best training here in the Bronx.

“I want to have the proper tools in my back pocket to be able to treat the sickest patients, which you get through exposure,” Ms. Zakirova said. “I know I would definitely get that kind of exposure at Montefiore and be prepared for when I’m on my own as an anesthesiologist in the future.”

Dr. Rufino said Montefiore’s challenging case variety and hands-on nature sets it apart from other clinical rotations for medical students and sets them up for success in residency.

“It’s very hands-on, and we challenge our students because we have a lot of sick patients,” he said. “So they get to see pretty advanced stuff. We challenge them to participate, and most of them rise to the challenge.”

Department of Anesthesiology Chair Dr. Matthias Eikermann said the department’s goal is to identify residency candidates who are interested in serving Montefiore’s patient population in the long-term.

"While we have more than 1,500 applicants for residency every year, it is important for us to train our young colleagues who are dedicated to serving the Bronx community as anesthesiology experts,” he said.