August 7, 2000

Cardiac surgery is performed all the time at the MGH and at hospitals across the country. Every winter, special guests come to the MGH to observe first-hand how cardiac surgical patients are cared for by a team of anesthesiologists, nurses and surgeons. These guests are first-year medical students at Harvard Medical School (HMS), and they come as part of a cardiac anesthesia rotation included in the HMS physiology course.

Lisa Swartz came to the MGH this January to observe a triple bypass surgery. "The visit to the operating room was one of the highlights of my first year," she says. "The entire staff was wonderful and allowed the medical students to really get a close view of all aspects of the surgery. Everyone was helpful and patient. They spent time explaining the surgery and anesthesia process to us."

Until recently, the HMS physiology course focused on animal studies to teach students the basics of physiology — in fact, the course was called Mammalian Physiology. In the 1990s, the course was changed to Human Physiology and focused more on teaching students the basics of physiology using human medical exams and procedures. At that time, Bruce Zetter, PhD, director of the HMS Physiology course and a researcher at Children's Hospital, solicited the help of Michael D'Ambra, MD, director of MGH Cardiac Anesthesia, to help strengthen the students' physiology education by giving them a solid hospital experience.

With that in mind, D'Ambra and Scott Streckenbach, MD, head of the MGH Cardiac Anesthesia Education program, created the cardiac anesthesia rotation. The rotation starts with a lecture given by Streckenbach to approximately 160 students. The students then visit the operating rooms of the MGH, BWH or Beth Israel Deaconess Medical Center in groups of two or three for a one-day visit during January and February.

According to D'Ambra, because the cardiac operating room is a good model for applied physiology with sophisticated monitors and imaging devices attached to the patient, it is an ideal place to build upon the students' knowledge of human physiology. According to Zetter, the rotation has been getting high praise from the medical students since it started in 1996. "Medical students normally wouldn't get to experience a hospital setting until their third year, so there is nothing more exciting to a first-year student than stepping into an operating room to see first-hand what is being learned in class.

Streckenbach credits the success of the rotation to the staff and surgeons - including David Torchiana, MD, chief of Cardiac Surgery; Thomas Macgillivray, MD; Joren Madsen, MD; Gus Vlahakes, MD; and Alan Hilgenberg, MD — and their willingness to interact with the students. "I'm really proud of the fact that everyone participates in this learning opportunity for the students," he says. "It is a major team effort that requires everyone's help."

D'Ambra praises Streckenbach for helping the rotation run as smoothly as it has. According to D'Ambra, the work Streckenbach does with the first-year students is additional to his teaching duties with the cardiac anesthesia residents and fellows. "Scott has single-handedly made this happen," he says. "It is because of Scott that more than half of the students come to the MGH for the rotation. He has done a fantastic job of orchestrating the program. The dedication of professionals like Scott is a major reason that the MGH has its reputation as a world-class teaching institution."