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Program Pathways

Overview

The anesthesiology residency is a minimum of four postgraduate years:

  • One Clinical Base Year (CBY). Before starting our three-year program, the resident must successfully complete at least one clinical base year accredited by the American College of Graduate Medical Education (ACGME) or the American Osteopathic Association (AOA). This experience may be in internal medicine, surgery, emergency medicine, family practice, neurology, obstetrics and gynecology, pediatrics, or in an accredited transitional internship program.
  • Three years of Clinical Anesthesiology training (CA-1 through CA-3). These years are designed to teach and assess residents in the ACGME's six core competencies: patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and system-based practice.
  • Optional Subspecialty or Research Fellowship Education (CA-4). We offer fellowships in pediatric anesthesia, critical care, pain management, cardiac anesthesia, and OB anesthesia.

The Clinical Base Year (CBY)

Through the National Resident Matching Program (NRMP), we offer both four-year (Categorical) and three-year (Advanced) positions.

Students who enter our four-year categorical program spend the first year (PGY-1) in the Department of Anesthesiology’s rotating internship, under the direction of the Anesthesiology Residency Program Director. Clinical experience comes through residency programs of the University of Rochester. PGY-1 is designed to prepare the resident for subsequent anesthesiology training. Rotations include internal medicine, general surgery, trauma surgery, critical care medicine, emergency medicine, pediatrics, cardiology consultation service, pulmonology consultation service, nephrology consultation service, neurology consultation service and anesthesiology. Beginning in March, we integrate our PGY-1 year with our CA-1 year to give our 4-year residents an early start in learning anesthesology skills.

Students who enter the three-year advanced program arrange for their own PGY-1 training. Preliminary programs in internal medicine are offered at Rochester General Hospital (585-922-4440) and at the Rochester-based Unity Health System (585-723-7775).

imageClinical Anesthesiology (CA-1 through CA-3)

The first months of anesthesia training are spent learning and mastering basic anesthetic techniques, including airway management and regional anesthesia. After that, residents are immersed in subspecialties of anesthesia through structured rotations. As residents gain experience, they manage increasingly difficult and complex cases. They also get more responsibility and freedom to plan and conduct anesthetics. Residents eventually get even greater independence (and supervisory roles) as senior residents on call. The CA-3 year is designed for each individual resident, based on American Board of Anesthesiology (ABA) guidelines. The Department remains as flexible as possible in a resident's CA-3 year. Senior residents choose advanced clinical experiences or pursue interests in clinical or basic research.

CA-1 Summer Orientation Program

The first months of residency training in anesthesiology are the foundation of the three years of growth to follow, and the foundation of your career. Our Summer Orientation Program eases the anxiety of the unknown and the new. It enables the CA-1 resident to gain confidence and competence in basic pre-anesthetic evaluation and intraoperative anesthetic management.

New students meet residents and faculty during a two-day orientation that includes a welcome reception, resident happy hour, and picnic.

Every day in July and August, the faculty holds afternoon conferences from 12:30 p.m. to 1:30 p.m. This CA-1 Introductory Didactic Program covers basic anesthetic practice principles.

During the first six weeks, each CA-1 resident is paired with another CA-1 resident and a single faculty preceptor for the Introductory Clinical Experience. During intensive one-week periods, the three work together on the basic skills of planning and conducting safe anesthetics during daily care of surgical patients. It brings a beginning anesthesiology trainee up to speed in a supervised, comprehensive, and intense manner. It also provides a way to get to know fellow residents and faculty members early in the program. Goals and Objectives for CA-1 orientation.

One-on-one sessions with faculty members and chief residents in the Department’s state-of-the-art Simulation Center build the trainee’s confidence in performing the basic steps of providing general anesthesia. This"basic choreography" of general anesthesia is mastered at a very early stage. The remainder of residency training is spent exploring variations on the theme and the complexities and subtleties of the specialty.

There are no overnight on-call duties during the first two months. There are no late-call duties during the first six weeks. The entire focus is on building the foundation for the trainee’s career in anesthesiology.

Surgical Caseload (CA-1 through CA-3)

Clinical cases are the cornerstone of resident training. Our program offers clinical cases in all surgical subspecialties. The Department provides over 30,000 anesthetics each year for every type of surgical procedure. We have a very large surgical caseload, making it possible to match a resident's level of training and subspecialty rotation. We accept a limited number of postgraduate fellows, so residents don't have to vie for complex senior-level cases.

Clinical anesthetic caseload during training includes:

General Surgeryimage

  • Intraabdominal
  • Endocrine
  • Breast
  • Laparoscopic

Pediatric Surgery

  • General
  • Urology
  • Oral maxillofacial
  • Craniofacial
  • Orthopedic
  • Neonatal (Rochester's Strong Memorial Hospital has the only Neonatal Intensive Care Unit in the region)

Orthopaedic

  • Extremities (peripheral nerve blocks)
  • Spine
  • Joint replacement
  • Arthroscopic
  • Sports medicine

Gynecology/Oncology Obstetric

  • More than 3,200 deliveries per year
  • Healthy parturients (two large private practice groups)
  • High-risk (university-based maternal fetal medicine faculty)

Cardiac

  • Coronary Artery Bypass Graft (CABG), with and without cardiopulmonary bypass
  • Transespohageal echocardiography
  • "Beating heart" coronary
  • Circulatory arrest/aortic arch
  • Valve replacement
  • Pediatric cardiac

Neurosurgery

  • Spine
  • Intracranial tumor
  • Intracranial vascular
  • Pediatric
  • Epilepsy

Thoracic

  • Open thoracic
  • Video-assisted thoracoscopic surgery (VATS)
  • Esophageal
  • Tracheal
  • Laser bronchoscopy

Major Vascular

  • Carotid (general and regional techniques)
  • Thoracic and abdominal aortic aneurysms
  • Endovascular aortic aneurysm repair
  • Peripheral vascular

Organ Transplantation

  • Liver (adult and pediatric; cadaveric and living donor)
  • Kidney
  • Pancreas
  • Heart

Ambulatoryimage

  • Lattimore Community Surgicenter (a free-standing, high-volume, outpatient surgery center)

Plastic Surgery

  • Breast
  • Facial
  • Pediatric craniofacial
  • Post-traumatic reconstructive

Trauma

  • Level I Trauma Center for the region
  • Blunt trauma
  • Penetrating trauma
  • Burn injuries and surgery

"Out of OR" Anesthesia (two to three sites daily)

  • Pediatric MRI
  • Pediatric cardiac catheterization
  • Interventional radiology
  • Pediatric radiation oncology
  • Pediatric hematology/oncology clinic (bone marrow biopsies, intrathecal chemotherapy)
  • Pediatric endoscopy clinic
  • Electroconvulsive therapy
  • Infertility clinic
  • Extracorporeal shock wave lithotripsy

Clinical Anesthesiology: Faculty

Daily clinical supervision and instruction is provided in a faculty-to-resident ratio of 1:2 or 1:1, depending on each resident’s level of experience and the particular subspecialty rotation. Individualized clinical instruction happens in a variety of settings: the operating room, during discussions of the next day's cases, at bedside in the pre-anesthesia area, and at the end of the day while reviewing the day’s cases. It also takes place in the intensive care units, a Pain Management Clinic, and the Pre-Admission Evaluation Center. Most of the full-time teaching faculty are subspecialty trained and most have research interests. Faculty training and experience are highly diverse, providing the benefits of heterogeneity in clinical approach and techniques. View Faculty Information.

Clinical Anesthesiology: Subspecialty Rotations

After mastering basic anesthetic principles and techniques, residents begin the first of many subspecialty rotations. Some structured subspecialty rotations are required by the Anesthesiology Residency Review Committee (RRC). During each subspecialty rotation, the resident focuses exclusively on that subspecialty. Formal subspecialty rotations include:

  • Ambulatory anesthesia (four weeks in outpatient Surgicenter)
  • Cardiac anesthesia (eight weeks)
  • Critical care medicine (eight weeks)
  • Neuroanesthesia (four weeks)
  • Obstetric anesthesia (four weeks)
  • Pain management (four weeks in acute; four weeks in chronic)
  • Pediatric anesthesia (four weeks)
  • Postanesthesia care (two weeks)
  • Preadmission Evaluation Center (four weeks)
  • Regional anesthesia (five weeks)
  • Thoracic anesthesia (two weeks)
  • Vascular anesthesia (two weeks)
  • Liver transplant anesthesia (four weeks)

For more details, see Subspecialty Rotations.