Resident Curriculum
Following the post-graduate year, the Department of Anesthesiology Residency
Program consists of a three year training:
- CA-1: The first year of clinical anesthesia training targets
technical skills necessary for clinical practice. Residents begin with a two-month
orientation program which includes a period of close faculty supervision.
This provides new residents a safe and comfortable environment in order to
learn during this important introductory phase to clinical anesthesiology
training. CA-1 residents take junior call during the latter part of the orientation
program and become familiar with the on-call routine. The trainees will gain
proficiency in the area of basic anesthesia training in the operating room
and ambulatory suites, critical care medicine and emergency airway management
and resuscitation. The CA-1 residents are gradually given greater responsibility
in case management and are the primary physician in the ICU. Their responsibilities
include pre-operative evaluation, intraoperative management, and post-operative
management and follow-up. By the end of CA-1 year each resident will be prepared to take and pass their BASIC ABA exam.
- CA-2: Comprehensive clinical training continues during
the CA-2 year. Emphasis is placed on subspecialty training as well as more
independent roles in the management of routine cases. CA-2 residents are introduced
to more complex cases and increasing responsibility. One-month rotations in
the CA-2 year include cardiac, neuroanesthesia, obstetrics, and pediatrics.
CA-2 residents are first responders to emergency call and answer consultation
in cooperation with the attending staff. Second year residents will become
proficient in fiber optic intubations and invasive monitoring in the operating
room by the end of the year.
- CA-3: Residents are expected to demonstrate independence
in the OR, confidence managing the most complex cases, academic skills important
for a professional career, and clinical acumen in their CA-3 year. The final
year of training is structured to meet the needs and interests of each resident. Towards the end of the CA-2 year and begining of the CA-3 residents are encouraged to interview for fellowships. At the conclusion of the residency each resident will be adequately prepared to sit for the remainder of the ABA Staged Examinations.
The Didactic Program
Each year the program begins with an intense 1-month overview of basic anesthesiology and perioperative medicine topics. This introduces CA-1 residents to the fundamentals of anesthesiology not only through didactics but also through intense clinical training with a one-on-one attending. After the month is over CA-1 residents, along with the CA-2 and -3’s begin a year long didactic program based on the premise of self-guided education with lectures serving as review. Additionally, the curriculum includes written and oral board review, journal club, grand round presentations, case conference, PBLD, as well as medical student lectures which are given by residents to encourage academic development and learn various lecturing methods.
In addition to didactics, the Anesthesiology Resident Program exposes students to interesting and complex cases and other experts in the field through the following teaching methods listed in detail below:
Anesthesiology Grand Rounds is a weekly
formal presentation that features a renowned visiting professor, a faculty
member of New Jersey Medical School, or senior resident case presentations.
Third year residents may select to present a Grand Rounds at the conclusion
of their research project to partially satisfy the scholarly activity requirement
of program requirements for residency education in anesthesiology.
Case Conference is a weekly meeting,
which provides Anesthesiology staff and residents with a venue to discuss
interesting and complex cases, morbidities and mortalities. Complementing
the didactic program, these:
- Emphasize patient management options
- Develop clinical judgment skills
- Identify areas of controversy in context of real cases
- Provide a lively exchange of ideas
- Insure a regular quality improvement program
Journal Club is presented monthly
and is an opportunity for residents to master critical reading skills that
are so necessary to keep up-to-date with the rapidly changing field of anesthesiology.
Journal Club is designed to demonstrate critical analysis of scientific literature
and focus on an interactive critique that highlights clinical relevance of
the medical literature.
Pediatric Conference Clinical opportunities
for the practice of pediatric anesthesia abound in pediatric surgical subspecialties
at University Hospital and Hackensack University Medical Center. The following
pediatric subspecialties are represented: Ear, Nose, and Throat, Plastics,
Orthopedics, General, Ophthalmologic, Neurologic and Trauma Surgery. Additionally,
Pediatric Anesthesia services are available to practitioners in the Divisions
of Pediatric Dentistry, Pediatric Oncology, and Pediatric Radiology. Cases
are distributed along a spectrum of illness severity. A clinical case conference
is conducted once or twice every month, which covers the ABA content outline
fully over a two-year time period. Conferences are presented by residents
with faculty support and guidance. See Pediatric
Anesthesia for more information.
Written Board Review is scheduled weekly
and designed to assist residents in obtaining a passing grade on the In-Training
Examination (ITE) as well as surpassing the national mean on the AKT (Anesthesia
Knowledge Test).
A faculty member moderates each session and reviews a
chapter from Barash's "Clinical Anesthesia" utilizing key words
from the ITE. Questions and answers from the chapter are discussed.
Oral Board Review is a monthly session
in which all CA levels meet with a senior faculty member to practice for the
oral boards. One resident is chosen to be examined simulating the actual environment
of the oral board examination. This educational exercise benefits all by reviewing:
- Questions
- Resident responses
- Nuances of the examination process
PBL (Problem Based Learning) is a monthly
discussion providing residents with an opportunity to address and solve authentic
clinical problems. Residents drive the discussion and actively learn by researching
and seeking answers to issues and problems presented.
Research Conference is a monthly
research conference held for faculty and residents to develop and critique
research projects within the Department of Anesthesiology.
Guest Lectures exposes residents to specialized topics
such as Practice Management and Contract Negotiations presented by leaders in various fields of health and medicine.
Throughout their training, residents are encouraged to actively participate in research projects. Physician-investigators and scientists present a monthly research conference that provides an opportunity for residents to discuss research design, cutting edge subject matter and critique current basic science and clinical research activities.Residents are provided with basic textbooks upon entering the program aswell as membership into professional organizations.
An institutional as well as departmental educational allowance is provided to each resident annually. This allowance may be used for books or to help defray costs to a conference of their choice. Residents are also given palm pilots to assist them in tracking their cases and with time management issues.
Simulation Training
To
help residents train with real-life situations they are likely to encounter
in the operating room, the Department of Anesthesiology began using SimMan®
as a medical learning tool. This fully instrumented simulated patient allows
residents and students to become acclimated with real-life situations and reenact
stressful scenarios like a difficult
intubation, cardiac arrest,and other kinds of life threatening events.
Just
as other industries use simulators to train and learn how to avoid errors, our
Residents have a distinct advantage by being able to go through exact situations
and dilemmas that they can expect in the future. By practicing with the simulator,
if a stressful scenario does occur in the OR, our Residents will be well prepared.Using
the simulator, students are given the same pre-op assessments, equipment, medicine,
and monitors to recreate
the exact environment they will face.
Simulator
theory comes out of the space industry. Anesthesiology is the leader in medicine
for using a simulator to train students for actual patient crisis. SimMan®
grew out of the Resusci Anne Simulator® , the first generation resuscitation
model made by Laerdal. The Department acquired SimMan® in the fall of 2004.
Eventually the program will be expanded for training of other departments within
the University such as Emergency Medicine.
Residents
enjoy using SimMan® and understand the importance of taking advantage of
this exercise. It allows students to explore scenarios without the time constraints
of being in the OR. They can take their time to really learn each step of a
procedure. This immersion helps them commit to a plan of action.
Research
projects are also included in the simulation suite. Holter monitors can measure
the heart rhythm of Residents to see the effect of stress during the life-like
simulated crises. The simulator can also measure how Residents respond or score
when they are in peak condition vs. fatigued from being on-call for an extended
period of time.
Patient
safety is the foremost concern. The specialized training afforded by simulation
offers a great deal of interacting and learning. A Resident can have the best
plan in the world, but if the patient has a problem, you need to be able to
react to meet their needs quickly, efficiently, and safely.