The Resident in Anesthesiology must complete 12 months of accredited preliminary training prior to beginning Clinical Anesthesia (CA) training. This FCS training is embedded in the Categorical program. For the Advanced program, acceptable FCS training includes a transitional year, internal or emergency medicine, pediatrics, surgery, obstetrics and gynecology, neurology, family practice, or any combination of these as approved by the program director.
Allegheny Health Network provides opportunities for prospective residents to do their FCS (PGY-1) year in the same institutions as their anesthesiology residency through preliminary years in medicine or surgery. Each fulfills the department’s FCS requirement.
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. 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 (CA-1). New CA-1 residents are paired with higher level residents who serve as mentors during the first month of training.
The first 3 months of the CA-1 year emphasize basic concepts and are devoted to fundamental aspects of anesthetic management. Subsequently, 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:
The CA-2 curriculum 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:
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 Trauma Center at Allegheny General Hospital cares for patients in the region who experience penetrating and blunt force trauma.
The Burn Center at West Penn Hospital is one of the region’s largest and busiest burn centers, caring for patients referred to West Penn from the tristate area of Pennsylvania, Ohio and West Virginia.
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 2-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 AHN's West Penn Hospital and Forbes 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 units.
A modular approach to the Advanced Clinical Track (CA-3) 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. Research time is optionally available.
A comprehensive core curriculum has been implemented for the didactic education of residents at all levels. The formal didactic program begins in August of each year and runs through May. The format of these conferences includes basic science lectures, problem-based learning discussions, key-word review, written board questions and mock oral board 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 3-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 presence of Examiners for the American Board of Anesthesiology on the faculty. These faculty members and others conduct practice oral examinations in group and individual settings throughout the continuum of training.
An annual educational allowance is provided, and may be used to purchase reading or computer educational material, or to attend educational conferences. Each resident may attend one major educational meeting during each year of the residency. If a resident is presenting at a meeting, there is additional funding available.
AHN has its own sophisticated simulation facility at the Simulation, Teaching, and Academic Research (STAR) Center located next to West Penn Hospital. From their first days through the completion of residency, our residents attend regularly scheduled simulation sessions to gain experience with clinical scenarios, decision management, and resource management. Residents receive detailed structured feedback with each session.
Intraoperative Transesophageal Echocardiography
The faculty anesthesiologists at Allegheny General Hospital and West Penn Hospital have a strong focus on 2-D and 3-D intraoperative transesophageal echocardiography (TEE). Faculty who perform TEE and teach anesthesiology residents are testamurs of the Perioperative Transesophageal Echocardiography Examination or are board-certified by the National Board of Echocardiography.
Residents have ample opportunity to learn TEE from faculty members during their cardiac and dedicated Ultrasound rotations. Several recent graduates have achieved board certification in Basic TEE.