Education/Call Schedule
The Department of Anesthesiology provides the four-year curriculum required by the American Board of Anesthesiology for certification as a consultant anesthesiologist.
The program is structured in a manner, which ensures residents acquire sufficient levels of knowledge, clinical/technical skills and judgment to allow them to be competent in all areas of the specialty, meeting the criteria to become certified as consultants in anesthesiology.
Anesthesiology Rotation Schedule Structure
The preliminary year consists of:
blocks
| Rotation | |
|---|---|
| 5 | Internal Medicine (Renal, University of Cincinnati Medical Center Wards, Cardiology, VA Wards) |
| 1 | ENT |
| 1 | CCAT – Multispecialty Critical Care Unit |
| .50 | CPC – Center for Perioperative Care |
| .25 | Blood Bank |
| 1 | NSICU |
| 1 | Emergency Medicine |
| 1 | Anesthesia |
| 1 | Vacation |
| .50 | POCUS -Point-of-care ultrasound |
| .50 | Chronic Pain |
| .25 | FLEX - In-house pre-op/optimization service |
Rotations during this preliminary year of training are done at University of Cincinnati Medical Center and the VA Medical Center.
CA-1 Year
The first year of anesthesia training introduces the resident to the fundamentals of general and regional anesthesia. Supervision and teaching by faculty is often 1:1 in the first month of training, and never exceeds 1:2 throughout the anesthesia portion of the residency. This allows close personal attention to operating room teaching.
| Rotation | |
|---|---|
| 6 | General Adult Anesthesia |
| 1 | CCAT - Multispecialty Critical Care Unit |
| .5 | Flex - In-house pre-optimization service |
| 1 | OB Anesthesia |
| .5 | PACU |
| .5 | CPC (Pre-op clinic) |
| .5 | Inpatient Pain Service |
| .5 | Chronic Pain |
| .5 | NORA |
| 1 | Neurosurgical Anesthesia |
| 1 | Cardiac Anesthesia |
Residents are assigned progressively more challenging cases commensurate with their developing skills and experience. Each resident will anesthetize approximately 400-500 patients per year.
The CA-2 year provides the resident with anesthesia subspecialty rotations in the following areas:
| 4 week blocks | Rotation |
|---|---|
| 1 | Cardiac Anesthesia |
| 1 | Neurosurgical Anesthesia |
| 2 | Pediatric Anesthesia (consecutive months) |
| 1 | Surgical Intensive Care Unit |
| 1 | Inpatient Pain Service |
| 1 | Regional Anesthesia |
| .5 | Chronic Pain |
| .25 | CPC |
| .25 | Flex - In-house pre-op/optimization service |
| 1 | OB Anesthesia |
| 1 | Vascular Anesthesia |
| 3 | General Adult Anesthesia (including one month of night float) |
During this year, patients requiring more complex anesthetic management comprise an increasing proportion of the resident’s clinical caseload.
The CA-3 year is constructed, in consultation with the program directors, to meet the needs of the resident. The 13 four week blocks consist of:
| Required 4 week blocks |
|
| 4 | Advanced general Anesthesia - difficult cases |
| 1 | Ambulatory private practice experience - West Chester Hospital |
| 1 | Center for Perioperative Care/FLEX - In-house pre-op/optimization service |
| 1 | Critical Care Medicine |
| 1 | Inpatient Pain Service |
| 1 | Obstetrical anesthesia |
| 1 | Pediatric Anesthesia |
| Elective 4 week blocks |
Choices - Pick 3 |
| AOD-Operating room management | |
| Ambulatory anesthesia | |
| Cardiovascular anesthesia | |
| Chronic Pain | |
| Obstetric Anesthesia | |
| Pediatric Anesthesia | |
| Point-of-care ultrasound | |
| Regional Anesthesia | |
| TEE |
Each resident will spend at least 6 blocks on General and/or Pediatric Anesthesia rotations to fulfill the ABA requirement.
Education
CA-1 Bootcamp
This one day comprehensive training session is designed for residents beginning their training in anesthesiology to give them a strong knowledge base focused on the fundamentals of anesthesia.
Tuesday Lecture Series
On Tuesday afternoons between 4 PM and 6 PM, the residency program has protected educational time in the form of our lecture series. The topics that are covered follow the content outline of the ABA certification exams, and are split into both basic and advanced topics. The material is presented in a variety of formats. These include classic lecture-based presentations, PBLDs, hands-on practicals, simulation sessions, question and answer sessions, and board review. Our goal is to present the information in an engaging and interactive way. The lecture series is constantly re-evaluated by both the faculty and the residents via the work of a curriculum committee. We strive to make modifications quickly and efficiently such that we are presenting the correct material in a manner that best matches the learning styles of our residents.
Another component of the Tuesday lecture series is an embedded curriculum on the business of medicine that takes place after the in-training examination. Utilizing various financial, legal, and administrative professionals from the community, our goal is to teach our residents some of the complex financial and legal topics that will arise within their careers, such as contract negotiation, practice pattern, retirement and investment vehicles, etc.
To reiterate, this lecture series is protected educational time that aims to enrich your understanding of the important topics within the field of anesthesiology in an engaging way.
True Learn
Residents are provided a subscription to the True Learn question banks appropriate to their training level which helps them prepare for the in-training exam, and the ABA Basic and ABA Advanced exams.
Simulation & OSCEs
The fundamental tenet of the simulation program at the University of Cincinnati is experiential learning. Residents are encouraged to immerse themselves in the scenario and treat it as they would any encounter with a real patient. None of the simulations are graded or used in overall resident evaluations, they are simply a mechanism to promote reflection and deeper learning, in essence, “learning by doing”.
In an effort to make the scenarios as believable and immersive as possible, many of our manikin-based scenarios are run in the actual operating room, rather than a simulation center, so the environment and anesthetic equipment is exactly the same as you use in every day cases and it is more convenient to attend.
Simulation is presented in a wide range of modalities, with experienced, enthusiastic faculty and well-tested scenarios. Trained standardized patients (SP’s) are used for ultrasound training, in the fashion of the American Board of Anesthesiology’s Applied portion of the Board exam. SP’s are also involved in patient encounter scenarios, similar to those seen on the Board exam and can play the role of either a patient or another healthcare provider. We also provide routine high-fidelity manikin training with weekly sessions involving 3-5 residents. The manikin-based training is centered around scenarios classically seen as “high-risk, low-frequency” events. Also, select scenarios are focused on pieces of equipment in the OR that are not frequently used, yet require skill to utilize them safely, such as the flexible fiber optic bronchoscope and the defibrillator. We also provide a critical care skills lab once per year which includes manikin-based simulation for ECMO cannulation and cadaver-based training for surgical airway, among other things. Finally, we have a shared cardiac ultrasound simulator where both transesophageal and transthoracic ultrasound is learned and practiced. All simulation scenarios include debriefing after the scenario concludes.
Journal Clubs
Journal club is held every other month it order to critically appraise current literature. Two articles are selected for resident presentation.
Grand Rounds\M & M Case Presentations
Departmental Grand Rounds are held on Wednesday mornings from 7 to 8. Grand Rounds consists of presentations on various anesthesia topics given by residents, fellows and faculty. Visiting professors are also a regular part of our Grand Rounds. A Quality Assurance Case Presentation Session occurs once a month as well.
Subspecialty Lectures
Various subspecialty groups, including pediatric anesthesia, OB anesthesia, pain management and critical care, have their own didactic programs.
Mock Oral Exams
CA-2 and CA-3 residents participate in Mock Oral Exams patterned after those of the American Board of Anesthesiology. The Department has two ABA Oral Board Examiners.
Global Humanitarian Outreach Elective - Belize, C.A.
The residents may elect to spend 1 week during the CA-3 year providing anesthetic care for patients in a low-income, low-resource, country.
The resident is expected to provide the full spectrum of anesthetic care to patients of all ages and socio-economic backgrounds as part of the medical/surgical mission team.
UC Health Science Library/Clinical Key
Residents may take full advantage of the many resources available at the UC HSL including a multitude of textbooks for anesthesia, critical care, OB and may other topics. Subscriptions include Elsevier Clinical Key, Scopus and Pubmed.
Call Schedule
1st Call
One resident from either the CA-3 or CA-2 class will be assigned to night float each month. This resident works the night shift Monday through Friday 7 p.m. to 7 a.m. On weekends, second- and third-year residents take 1st call. 1st call begins at 7 a.m. and lasts until 7 a.m. the next day. Residents taking 1st call are off call the following day.
2nd Call
One resident will be assigned to 2nd call each day. All residents take 2nd call. CA-1 residents begin taking 2nd call in August of the CA-1 year. 2nd CALL is 24-hour in house call, 7 p.m. to 7 a.m. The resident is off call the following day.
OB Call
Residents on the OB service work 12-hour shifts from 6:45 a.m. to 6:45 p.m. or 6:45 p.m. to 6:45 a.m.
Pediatric Anesthesia Call
Residents are assigned to take one week of night shift per month 3 p.m.to 11 p.m. There are one or two weekend shifts per month from 7 a.m. to 7 p.m.
SICU
Residents on this service are assigned to take 24-hour in-house call every third or fourth night.
Inpatient Pain Service
The resident on their pain rotation will round on the inpatients on the pain service with the pain faculty on Saturday and Sunday mornings one to two days per month.
On Call Facilities
Residents are provided with private sleeping and bath facilities, vending and food, a lounge and 24-hour access to computer, library and study facilities.
Training Facilities
Residents train at the University of Cincinnati Medical Center, Cincinnati Children's Hospital Medical Center, West Chester Hospital, West Chester Hospital Surgical Center , UC Health Pain Medicine Center. CA-2 residents train in OB Anesthesia at the Good Samaritan Hospital and Cardiothoracic Anesthesia at Bethesda Hospital.