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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.
The Department of Anesthesiology offers a preliminary year internship as part of a 4 year categorical program. We offer rotations in medicine, surgery, otolaryngology, critical care, emergency medicine, as well as 3 rotations in anesthesia related areas such as pain medicine, OR anesthesia, and pre-admission testing for ambulatory surgery.
PGY-1 residents will train at University Hospital of Brooklyn, Kings County Hospital Center, and Long Island College Hospital. The clinical experience at these combined hospitals is incomparable, and the residents are given comprehensive responsibility for patient care.
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 & Performance Improvement Conference
Grand Rounds consists of cases covering topics or problems in anesthesiology. The cases are presented by residents every Friday at 7:15 a.m. Each case presentation is followed by questions and discussions by faculty and residents. Grand Rounds are open to all practicing anesthesiologists in the Brooklyn, Queens and Staten Island areas. The Chairman of the Department or designee moderates all Grand Rounds sessions.
At least six times a year, a Visiting Professor of Anesthesiology visits the residency program. The professor participates in operating room teaching of the residents, mock oral examinations, luncheon discussions, meets with residents for a case discussion, and delivers a one-hour lecture during Grand Rounds.
The case-based discussions are CA-1 study groups. Four (4) residents are assigned each Friday to attend from 8:00 am-11:00 am. To accommodate a class of 20 residents, 5 weeks are scheduled for each module. Residents, in groups, will sequentially review Miller’s 6th Edition, using the Content Outline as a guide for their notes and group presentations. At the end of the session, residents will be able to interpret and discuss, using physiologic concepts, the pathophysiology presented in clinical cases.
Anesthesiology subspecialty directors conduct discussion groups focusing on current research articles reported in the subspecialty journals. These clubs are directed by faculty members in the subspecialty to promote continuous research in the field as well as assist the resident in developing proficiency in research methods and techniques. The journal clubs meet at a time selected by the faculty member.
I.T.E. Board Reviews
January and February colloquia time is dedicated to ITE Reviews presented by departmental faculty. Textbook or ABA/I.T.E. Content Outline reviews are intended to assist residents in learning key concepts essential to passing the In-Training Examination (ITE) and the Anesthesiology Board Examination.
Morning rounds are conducted from 6:40 a.m. to 7:15 a.m. Mondays – Thursdays at UHB, KCHC, LICH, and LMC. The Chief Resident generates the monthly resident assignments. All residents will participate in preparing these reviews. The reviews are presented by the assigned resident during morning rounds at each hospital.
The subspecialty Conferences occur in lieu of morning conferences at the designated hospitals. At SUNY, cardiac conferences take place on the second and fourth Wednesdays of the month. At LICH, Pediatric Anesthesia – Core readings for CA-2 and CA-3 residents, take place at 6:15 a.m. – 7:00 a.m., once a month. Also at LICH, Neurosurgical Anesthesia Chapter review and tests are scheduled and moderated by Dr. Gina Matei.
Mock Oral Board Examination
Residents, usually CA-3 residents, will participate in practice mock oral board examinations. Selected faculty members will serve as examiners and ask oral board practice questions. Residents are expected to respond based on their clinical experience and academic knowledge.
Workshops and Competency lectures
Specialty workshops, such as, Airway Management, TEE, Regional, and Neuromonitoring, are held throughout the academic year to enhance faculty and resident education and clinical skills. In addition, special competency-based educational lectures or workshops are scheduled each academic year to educate faculty and residents on topics, such as, Professionalism and Cultural Diversity, Ethics, Resident Fatigue (identification and management), substance-abuse, practice management and other important topics.
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.
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.