The Critical Care Component
Lin says that “one thing that has really drawn residents into this program is the critical care component. The ICU is really the intersection of medicine and anesthesia. You’re encountering critically ill patients with severe pathologies, so you need skills in acute resuscitation and advanced medical support that anesthesiologists are accustomed to providing in the OR, but you also need to treat the underlying pathology that landed them there in the first place, which is more aligned with the work of internal medicine physicians.”

Michael Lin, MD’s daily schedule mirrors that of a normal, busy anesthesia resident: early call times, long hours in the operating room and a flurry of patients and cases.

Once a month, however, Lin’s schedule deviates from the norm.

On these days, Lin will start early — around 6 a.m. — when he arrives at Stanford Hospital to begin preparations for his first anesthesia case of the day. By the time he gets himself prepped and situated it’s about 7 a.m. — the typical time when cases begin. He’ll spend the next five hours standing in the operating room anesthetizing patients.

At noon, he’ll leave his fellow anesthesiology residents behind in the OR, change out of his scrubs and walk over to the Stanford Internal Medicine clinic, where he’ll spend the rest of his day treating outpatients as a medicine resident.

Lin’s hybridized schedule is a hallmark of Stanford’s combined Internal Medicine-Anesthesia Residency, a unique five-year training program for residents interested in both specialties. Medicine-anesthesia graduates are board certified in both fields, and are poised to pursue careers focused in critical care, but they might choose another field where combined training would make sense, such as pain management or cardiac anesthesia.

The Critical Care Component
Lin says that “one thing that has really drawn residents into this program is the critical care component. The ICU is really the intersection of medicine and anesthesia. You’re encountering critically ill patients with severe pathologies, so you need skills in acute resuscitation and advanced medical support that anesthesiologists are accustomed to providing in the OR, but you also need to treat the underlying pathology that landed them there in the first place, which is more aligned with the work of internal medicine physicians.”

The Internal Medicine-Anesthesia Residency is structured as a five-year combined program, which basically saves a year for the person who wants training in both specialties. Residents spend their first postgraduate year in internal medicine, their second year in anesthesia and years three to five split equally between the two disciplines. Because of the parallel skills that are being acquired from both departments, the resident can cut out about six months of training in each discipline.

A Natural Fit for Stanford
“For us, this combined program makes perfect sense,” says Ron Witteles, MD, director of the Internal Medicine Residency Training Program. “We have very strong departments in both internal medicine and anesthesia at Stanford. Those two departments have historically been close. In fact, we’re one of the relatively few academic institutions whose ICUs are run jointly by the departments of medicine and anesthesia.”

With 10 residents currently participating in the combined program, Stanford is the largest of only four such programs in the United States. “Not only are we the largest, but more than half of all the U.S. medical graduates who are training in med-anesthesia in the nation are currently in our training program,” Witteles adds.

Lin, who will be the first person to complete the combined residency program — in June 2017 — sees many benefits of incorporating into his practice his training as an anesthesiologist and his training as an internist.

“It does give me a little bit more perspective that I think is helpful in counseling patients and in my own management of those patients both on the medicine side and on the anesthesia side.”

The Internal Medicine-Anesthesia Residency is structured as a five-year combined program, which basically saves a year for the person who wants training in both specialties. Residents spend their first postgraduate year in internal medicine, their second year in anesthesia and years three to five split equally between the two disciplines. Because of the parallel skills that are being acquired from both departments, the resident can cut out about six months of training in each discipline.

A Natural Fit for Stanford
“For us, this combined program makes perfect sense,” says Ron Witteles, MD, director of the Internal Medicine Residency Training Program. “We have very strong departments in both internal medicine and anesthesia at Stanford. Those two departments have historically been close. In fact, we’re one of the relatively few academic institutions whose ICUs are run jointly by the departments of medicine and anesthesia.”

With 10 residents currently participating in the combined program, Stanford is the largest of only four such programs in the United States. “Not only are we the largest, but more than half of all the U.S. medical graduates who are training in med-anesthesia in the nation are currently in our training program,” Witteles adds.

Lin, who will be the first person to complete the combined residency program — in June 2017 — sees many benefits of incorporating into his practice his training as an anesthesiologist and his training as an internist.

“It does give me a little bit more perspective that I think is helpful in counseling patients and in my own management of those patients both on the medicine side and on the anesthesia side.”