Department of Anesthesiology

Training in Anesthesiology requires four years of intensive clinical work and study. This includes 12 months of Clinical Base, followed by 36 months in Anesthesiology, divided into Basic Anesthesia Training, Subspecialty Anesthesia Training and Advanced Anesthesia Training.

Clinical Base year must be devoted to clinical training other than Clinical Anesthesia. Acceptable training for the 12 months of Clinical Base may include training in a transitional year, internal medicine, pediatrics, surgery, or any of the surgical specialties, obstetrics and gynecology, neurology, family practice or any combination as approved for the individual resident by the Director of the training program in Anesthesiology. The Clinical Base year must be spent in programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) or the American Osteopathic Association.

Medical training may be taken at SUNY Downstate at Brooklyn. The approved Medical Program encompasses Kings County Hospital, and University Hospital at Brooklyn. The clinical experience at these combined hospitals is incomparable, and the residents are given comprehensive responsibility for patient care.

The Long Island College Hospital in Brooklyn Heights, a primary affiliate of SUNY Downstate, offers preliminary year positions in internal medicine with specific electives and preparatory courses for graduates planning residencies in Anesthesiology. This program is under the direction of J. Vieira, M.D., Associate Program Director of the Department of Medicine.

At each of these institutions, the resident receives training in general medicine and its subspecialties. Each of the institutions has its own personality, patient mix, and ambience. However, all the institutions will expose the resident to the variety of pathology, learning experiences and instruction necessary for an optimal learning experience. At the end of the 12 months of training, the resident has a solid base of medical knowledge and experience upon which to build a superstructure of anesthesia knowledge and experience.

The first year of Clinical Anesthesia (CA-1) begins with a one-month orientation during which the resident spends the morning in the operating room at one of the affiliate hospitals, and the afternoon in a two-hour seminar designed to introduce the trainee to Anesthesiology. Basic aspects of the specialty are covered broadly in order to make the resident feel at home in this new environment.

Beginning with the second month, the resident is assigned on a monthly basis to a general specialty area, e.g., Long Island College Hospital/Orthopedics, or University Hospital/Gynecology, etc. These assignments ensure that in the course of training each resident will meet every form of pathology and a wide variety of anesthetic problems.

During the second year of Clinical Anesthesia (CA-2), subspecialty anesthesia rotations are structured to emphasize the theoretical background subject material and practice of subdisciplines in anesthesiology. These subdisciplines include ambulatory, cardiothoracic, pain medicine, pediatrics, obstetrical, neurosurgical and regional anesthesia. In addition, each resident receives two months of training in critical care medicine and two weeks to one month of training in the post-anesthesia care unit (recovery room).

Advanced Anesthesia Training occurs in the third year of Clinical Anesthesia Residents who meet the educational criteria, may elect to do up to six months of subspecialty training in one area or a combination of ambulatory, cardiac, pain medicine, pediatric, obstetrical, neurosurgical or regional anesthesia. An advanced clinical tract is also available. Fellowships are available in all the sub disciplines of anesthesiology.

For general and subspecialty anesthesia training, residents rotate to University Hospital (UH), Long Island College Hospital (LICH), and Kings County Hospital Center (KCHC). Team Captain Call at Kings County Hospital Center serves as one of the high points of the residency training pro-gram. Residents are designated as assistant attendings and participate in the entire team management approach in their third anesthesia year. This appointment is based upon outstanding performance as decided by the Clinical Competence Committee.

The Didactic Program

The didactic program is a major component of resident education. The program is structured to develop and enhance resident participation in Grand Rounds, Colloquia, Board Review Groups and Journal Clubs. The didactic program provides opportunity for residents and faculty to interact, learn and teach.

Grand Rounds

Grand Rounds are held on Friday mornings from 7:00-8:00 AM and are teleconferenced among our teaching hospitals. Grand Rounds is devoted to a case presentation by a senior resident, followed by a scholarly presentation on a topic related to that case. The scholarly presentation discusses specific aspects of anesthetic management, the pathophysiology of disease states and/or an unusual anesthetic complication. A brief review of recently published articles from anesthesia literature is presented and all presenters incorporate the core competencies in their discussion.

Colloquia

The Colloquia are organized as a three-year curriculum covering both general and subspecialty topics in anesthe-sia. Topics are chosen by the subspecialty directors and departmental attendings and guest lecturers present topics in a seminar format. Residents are expected to actively participate in the style of Problem Based Learning Discussions. The Colloquium is designed to ensure that residents are exposed to an extremely inclusive and broad range of topics during the course of their residency.

Board Review

At each institution, during morning conference, a resident reviews an assigned topic. The objective of this activity is to prepare residents for the in-training and board examina-tions. Residents prepare and present assigned topics cov-ering the basic anesthesia curriculum and an attending moderates the discussion.

The educational rewards earned by our anesthesia residents are evidenced by the numerous opportunities open to them upon graduation. The clinical and educational experiences gained in this program serve them well, as they confront anesthesia problems with their hands on experience and solid knowledge base. We assist our graduating residents by providing them with information on job opportu-nities, and training in how to write a resume, contract negotiations, and financial planning. These programs are systematically reviewed, assessed, and amended to meet the needs of our residents.