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.