Education / Graduate Medical Education / Prospective Residents / Anesthesiology Residency Program / Curriculum

Curriculum

Probably the single greatest recent innovation in our residency program was the introduction of an Integrated (Categorical) Residency Program in Anesthesiology and Perioperative Medicine in 2011. Despite what programs will tell you, few offer the truly integrated experience that we initiated. Our residents join the department as PGY1s (Clinical Base Year, CBY), orient to clinical anesthesia in either September or January of CBY, a Operating Room nd complete deliberately scheduled and appropriately juxtaposed “floor” rotations during their CA1 and 2 years. For example, residents complete two weeks of cardiology before the cardiac anesthesia rotation. Similar rotations are paired with the neurologic, obstetric, and pediatric anesthesia subspecialties. This schedule is specifically designed to train perioperative physicians; instead of “getting through” your intern year, “intern” rotations are woven into your experience learning anesthesiology. All the rotations you do are through the lens of becoming a consultant anesthesiologist.

Sample Schedule

CBY	CA-1	CA-2	CA-3
Chronic Pain (4 weeks)	Neurology/ EEG (4 weeks)	Cardiology (2 weeks)	Cardiac Anesthesia (4 weeks)
Perioperative Medicine (2 weeks)	Neuro Anesthesia (4 weeks)	Cardiac Anesthesia (4 weeks)	Vascular Anesthesia (2 weeks)
Emergency Medicine (4 weeks)	Obstetric Anesthesia (4 weeks)	Vascular Anesthesia (2 weeks)	Thoracic Anesthesia (2 weeks)
Surgery floors (4 weeks)	Acute Pain Service (2 weeks)	Pulmonology (2 weeks)	Transplant Anesthesia (2 weeks)
Surgical ICU (4 weeks)	Regional Anesthesia (2 weeks)	Thoracic Anesthesia (2 weeks)	Pediatric Anesthesia (4 weeks)
Improvement Sciences (2 weeks)	Surgical ICU (4 weeks)	Obstetric Anesthesia (4 weeks)	Pediatric Cardiac Anesthesia (2 weeks)
Medicine (4 weeks)	Pediatric Surgery (2 weeks)	Anesthesia (10 weeks)	Neuro Anesthesia (4 weeks)
Medical ICU (2 weeks)	Pediatric Anesthesia (4 weeks)	Highland Anesthesia (2 weeks)	Neuro ICU (4 weeks)
Nephrology (2 weeks)	Ambulatory (4 weeks)	Burn/ Trauma ICU (4 weeks)	PACU (2 weeks)
ENT (2 weeks)	Anesthesia (10 weeks)	Chronic pain (2 weeks)	Anesthesia (6 weeks)
Transfusion/ Sleep (1 week)	Highland Anesthesia (2 weeks)	Acute Pain Service (2 weeks)	Anesthesia Electives (8 weeks)
Anesthesia (16 weeks)	Palliative Care (2 weeks)	Regional Anesthesia (2 weeks)	Night float (4 weeks)
Late float (1 week)	Night float (2 weeks)	Non-OR Anesthesia (2 weeks)	Late float (4 weeks)
Vacation (4 weeks)	Late float (2 weeks)	Night float (4 weeks)	Vacation (4 weeks)
	Vacation (4 weeks)	Late float (4 weeks)
		Vacation (4 weeks)

In addition to the integrated program, several rotations have been created to further foster the development of perioperative physicians. A few recent additions include:

The ‘Improvement’ Science rotation, a 2 week required CBY rotation which introduces residents to and educates them on quality improvement terms and topics, makes key physician and administrative leaders in the hospital accessible, and offers hands on experience in departmental and institutional root cause analyses and quality improvement projects. This rotation was nominated for the Society of Education in Anesthesia’s Philip Liu Award for Innovations in Anesthesia Education in 2018.
Anesthesiologists transfuse more blood products than any other medical specialty, so it makes sense that residents should receive education dedicated to delivery of blood products, right? During Transfusion Medicine, a one week required CBY rotation, residents work with national and international leaders in URMC’s very own Blood Bank and Transfusion Medicine Department.

CBY Anesthesia Orientation

In their clinical base year (CBY) our residents complete at least 4 months of clinical anesthesia, which is amazing! Our orientation is 7 weeks long and is jam packed with a combination of: resident lectures, attending lectures, fundamentals of ultrasound, ultrasound scanning sessions, reading time, simulations, and PBLDs. Oh yeah, and lots of hands on experience in the OR! The first and last OR weeks are spent with a senior resident who guides the intraoperative learning while gradually transitioning the intern to general supervision. The middle 4 weeks are spent in learning pods that rotate weekly. These pods consist of one attending and 2 interns. The residents and attendings will provide daily feedback to promote continued growth throughout these 7 weeks. Credentialing is performed in the final week of orientation with a standardized case in our high fidelity simulator.

The curriculum is designed to be progressive and repetitive to help with skill building and knowledge consolidation. After the 7 weeks, our interns are able to provide maintenance of anesthesia under general supervision. Operating Room orientation is a steep learning curve; with support and individualized attention, our interns are able to build a great learning foundation during orientation. Our interns are so well prepared after orientation that they can even be scheduled on rotations such as nights and lates during their CBY year (towards the end, of course!). The orientation rotation is being tweaked constantly based on resident feedback. This continued adaptation and updating is one of the best parts about the UofR anesthesiology residency as a whole which we highlight with the orientation curriculum.

Sample Anesthesia Orientation Schedule

Orientation Schedule

Clinical Training

The clinical training at the University of Rochester is outstanding. The University of Rochester Medical Center is the only Level 1 Trauma Center within 70 miles and one of Dr. Wyrobek Teaching only 65 accredited burn centers in the country. The Golisano Children’s Hospital is the only pediatric hospital with a congenital heart program in New York State west of Albany. We anesthetize patients in over 60 locations a day at URMC; the majority of our patients have complex pathology or are critically ill. You will learn to manage high-risk obstetrics, advanced neurosurgical procedures, a wide range of thoracic cases, complicated pediatric and adult congenital heart cases, complex traumas and burns, and much more, all on one medical campus. You will rotate through our affiliated community hospital, Highland Hospital, as well as our ambulatory surgical center to experience private practice models and become extremely comfortable with nerve blocks – it's not unusual for residents to graduate having completed over 200 peripheral nerve blocks!

The future of anesthesiology is changing. We equip our graduates at the University of Rochester to lead that change from the front lines. We have wholeheartedly bought into the Perioperative Surgical Home model and are leading the wave. You'll get experience at our cutting-edge Center for Perioperative Medicine and see why Rochester has a reputation of innovation in the perioperative surgical home initiative.