The Anesthesiology Residency Training Program begins in PGY-2, following a Clinical Base Year (PGY-1).
Before entering CA-1, the resident in Anesthesiology must have completed 12 months of accredited preliminary training in a clinical discipline other than anesthesiology. Acceptable training includes a transitional year, internal or emergency medicine, pediatrics, surgery, obstetrics and gynecology, neurology, family practice, or any combination of these as approved for the individual resident by the program director.
Both West Penn Hospital and Allegheny General Hospital provide opportunities for prospective residents to do their Clinical Base Year (PGY-1) in the same institutions as their anesthesia residency, through a transitional year program, as well as through preliminary years in medicine and surgery, which are highly acceptable to this department for fulfilling the Clinical Base Year requirement. West Penn Hospital offers an Osteopathic Rotating Internship for graduates of osteopathic medical schools.
Residents may also spend their PGY-1 at another accredited healthcare institution. The Clinical Base Year must be spent in residency programs in the United States that are accredited by the Accreditation Council for Graduate Medical Education (ACGME) or approved by the American Osteopathic Association. The PGY-1 also may be spent in Canadian institutions that are approved by the Royal College of Physicians and Surgeons of Canada and are affiliated with medical schools approved by the Liaison Committee on Medical Education.
It is a requirement of the Commonwealth of Pennsylvania that prior to beginning the CA-1 year, the resident must complete a qualifying examination (NBME/USMLE or COMLEX) that would serve as a basis for securing an unrestricted license to practice medicine in the Commonwealth of Pennsylvania.
Residents in anesthesiology have a reasonable on-call schedule and time-off policy that allows them to balance educational and service needs with personal and family needs. They begin taking night and weekend call with a more senior resident during their second month of clinical anesthesia and assume additional clinical responsibility commensurate with their experience and progress.
A member of the faculty attends all night, weekend and holiday emergency procedures.
When they are scheduled for trauma call at Allegheny General Hospital, residents begin their call day at 2:30 p.m. and are off the day after night call.
Residents scheduled for night call at West Penn Hospital begin their day at 7 a.m. by participating in the preoperative evaluation clinic. They assume responsibility for obstetrical emergencies at 3 p.m.
The frequency of night call averages one night in seven. The program is easily compliant with the ACGME limits on work-duty hours.
In July of each year, the Department of Anesthesiology conducts a series of tutorial sessions for residents beginning their first year of Clinical Anesthesia. Each new CA-1 resident is paired with a higher level resident who serves as the new resident's mentor during the first month of training.
The first three months of the CA-1 year emphasize basic concepts and are devoted to fundamental aspects of anesthetic management. Each CA-1 resident is selectively assigned to cases designed to provide graded experiences of increasing difficulty that progressively challenge the resident's clinical performance in the provision of anesthesia for:
Major vascular surgery
Recovery room management
This level emphasizes the theoretical background, subject material and clinical practice of the subspecialties of anesthesiology. Each resident is assigned to a series of rotations that guarantees adequate exposure at the consultant level of practice within the subspecialties of:
Pediatric anesthesia (Children's Hospital of Pittsburgh)
Critical care medicine
While a dedicated obstetrical anesthesia rotation takes place at West Penn Hospital, and a dedicated pediatric anesthesia rotation occurs at the Children’s Hospital of Pittsburgh, residents enhance their experience and care of both obstetric and pediatric patients as an on-going experience at both West Penn and Allegheny General Hospitals. A dedicated regional anesthesia rotation at Allegheny General Hospital provides experience in regional anesthetic techniques, in addition to on-going experience in regional anesthesia at both West Penn and Allegheny General hospitals.
Experience in caring for Level I trauma patients undergoing emergency surgery and/or airway management occurs on an ongoing basis. The Burn Center at West Penn Hospital is the region’s largest and busiest burn center, caring for patients referred to West Penn from the tri-state area of Pennsylvania, Ohio and West Virginia. Similarly, the Trauma Center at Allegheny General Hospital cares for patients in the region who experience penetrating and blunt force trauma.
Anesthesiology residents also gain experience at Allegheny General Hospital with the specific anesthetic techniques used to manage the care of patients undergoing major organ transplantation, including heart, liver and kidney.
The American Board of Anesthesiology requires a two-month experience in critical care medicine. During their dedicated critical care medicine rotation, residents care for a mix of medical and surgical patients at both Allegheny General Hospital and Forbes Regional Hospital. Attending physicians from a variety of clinical backgrounds, including anesthesiology and internal medicine, direct residents as they provide comprehensive critical care management of patients in the unit.
Advanced Clinical Track
A modular approach to the Advanced Clinical Track has been developed with specific curricular objectives for advanced topics in clinical management or perioperative consultative practice. Residents may choose to focus on areas of interest and continue to develop their expertise in such areas as regional anesthesia, 3-D transesophageal echocardiography, pediatrics and obstetric anesthesia.
A comprehensive core curriculum has been implemented for the didactic education of residents at all levels. Teaching conferences are conducted daily and the departmental computer center was recently upgraded to support clinical and didactic education.
The formal didactic program begins in September of each year and runs through the first part of June. Scheduled conferences are held every weekday morning at West Penn Hospital and in the afternoons at Allegheny General Hospital. The format of these conferences includes basic science lectures, problem-based learning discussions, key-word review, and written board question and mock oral board question reviews. Monthly Journal Clubs, a guest lecture series, resident research projects, and attendance at local and national conferences all complement the daily conference program. Specialty didactic sessions complement the Obstetrics, Cardiac, Transesophageal Echocardiography, and Post Anesthesia Care Unit rotations.
Our Didactic Lecture Series is based on the Current Content Outline of the In-Training Council of the American Board of Anesthesiology (ABA) and the American Society of Anesthesiologists (ASA). It is structured to provide a systematic approach to the basic sciences and clinical anesthetic management, so that all aspects of the ABA written exam are covered over a three-year period. The lecture series runs in parallel at West Penn Hospital and Allegheny General Hospital.
Anesthesiology Grand Rounds is a weekly conference provided by Distinguished Visiting Professors from other anesthesiology departments, as well as by residents and attending faculty members on an assigned basis. Problem-Based Learning Discussions are patterned after the successful format from recent meetings of the American Society of Anesthesiologists, emphasizing participation of the entire group. The sessions provide in-depth reviews of factors surrounding common and uncommon clinical problems; the format reinforces communication skills vital to a consultant in anesthesiology.
An important feature of this program is the inclusion of Associate Examiners for the American Board of Anesthesiology on the faculty, who in addition to being current oral board examiners participate in the preparation of the two major certification exams.
Christopher Troianos, MD, is on the ABA’s Oral Exam Writing Committee and Richard Stypula, MD, is an editor for the ABA’s written exam. These faculty members and others conduct practice oral examinations in group and individual settings throughout the continuum of training.