Curriculum

Clinical Base Year:

The Clinical Base Year (CBY) is a PGY-1 experience designed to offer the intern a foundation in medical and surgical specialties, and an introduction to anesthesiology. The current composition of the year is divided into four-week block rotations including:

• 12 weeks Surgery (Colorectal, Trauma, Vascular Surgery)
• 8 weeks Internal Medicine (Ward Medicine)
• 4 weeks Emergency Medicine
• 4 weeks Cardiology Consult
• 4 weeks Pulmonology Consult
• 4 weeks Critical Care (Medical Intensive Care Unit)
• 4 weeks Acute Pain Service
• 2 weeks Otolaryngology 
• 2 weeks Transfusion Medicine
• 4 weeks Anesthesiology
• 4 weeks Perioperative Fudamentals QI and Patient Safety Rotation

The PGY-1 is expected to attend all didactics as included within the curriculum of the specialty upon which they are rotating. In addition, if time allows, they are also invited to attend Anesthesiology Grand Rounds on Wednesday mornings at 7 a.m. and the resident sessions immediately following Grand Rounds from 8 a.m. –noon.

As a PGY-1, certification in Basic Life Support, Advanced Cardiac Life Support, Acute Trauma Life Support is expected. These classes are offered through the school at no cost to the resident.

CA-1 Year

During the first 12 months of training the emphasis is on the fundamental aspects of anesthesia, including basic physiology and pharmacology, as well as the skills involved in the administration of anesthesia and associated invasive and noninvasive monitoring. Rotations during the CA-1 year include:

• Completion of the 8 weeks OR orientation period - University/Memorial/Hahnemann
• 5 months General OR - University/Memorial
• 1 month OB - Memorial
• 1 month Acute Pain - University
• 1 month Surgical ICU - Memorial
• 1 month Ambulatory - Hahnemann
• 2 weeks Advanced Clinical - University
• 2 weeks Non-OR Anesthesia - University
• 2 weeks Pre-Surgical Evaluation 

This experience begins with an orientation from July into early August during which each resident will work under 1:1 supervision of either a senior resident, attending faculty member or CRNA. Didactic conference schedules and clinical teaching is coordinated to facilitate timely achievement of the basic skill and knowledge sets. CA-1 residents do not extend to independent case management and enter the call pool until a holistic review in mid-August identifies a trainee who is prepared to take this next step. 

CA-2 Year

The CA-2 year concentrates almost exclusively on subspecialty rotations. Residents will be introduced to the unique anesthetic issues associated with the following anesthesia specialty areas (all rotations at University Campus unless otherwise specified):

• 2 months Cardiothoracic– University/Memorial
• 1 month Pediatrics - University/Hahnemann General Pediatrics and Memorial for NICU cases
• 1 month Vascular - University
• 1 month Neuroanesthesia - University
• 1 month Surgical Critical Care (Surgical/Trauma/Transplant ICU) - University
• 1 month OB - Memorial
• 1 month Chronic Pain – Memorial
• 2 weeks Ambulatory - Hahnemann
• 2 weeks Regional Anesthesia - Ambulatory Surgery Center Shrewsbury
• 1 month Total Joint - Memorial
• 1.5 months General OR
• 2 weeks Post-Anesthesia Care Unit - University

Incorporated into the above rotations is experience in special techniques such as fiberoptic bronchoscopy and intubation, and placement of double lumen tubes and bronchial blockers. Residents also become more familiar with techniques and physics of monitoring, i.e., transducer set-up and use, and cardiac output determination and interpretation of arterial blood gases. CA-2 residents will manage patients requiring liver and kidney transplantation, cardiopulmonary bypass, deep hypothermic circulatory arrest, intra-aortic balloon pumps and other forms of mechanical circulatory support.

CA-3 Year

The CA-3 year is designed to allow the resident to gain experience in advanced and complex clinical anesthesia assignments while also meeting the requirements of the ACGME Residency Review Committee. 

CA-3 rotations include:

• 1 month Pediatrics - University/Hahnemann General Pediatrics and Memorial for NICU cases
• 1 month Neuroanesthesia – University
• 2 weeks Post-Anesthesia Care Unit - University
• 2 weeks AIC (Anesthesiologist in charge)/OR Management - University
• 1 month Critical Care (2 weeks Neuro/Trauma Intensive Care Unit and 2 weeks junior fellow experience)
• 5 months elective General OR – University/Memorial/Hahnemann/Marlboro/OB
• 2 months away electives (may increase to 3 under certain circumstances)
• Oppurtunity for free standing endoscopy center experience

Residents may elect to pursue specific rotations in the resident’s areas of interest including various opportunities at the UMass Memorial Health Care campuses (critical care, cardiovascular, pain management, transplant, ambulatory, etc.) as well as additional elective rotations outside the UMass Memorial system. Outside electives are limited to two months and are often used to “audition” for fellowship positions or employment positions.

The residency program currently has the following electives through affiliation agreements:

• Pediatric Anesthesia at Boston Children’s Hospital, Boston (two month requirement)
• Pain Management at Brigham and Women’s Hospital, Boston
• Pain Management at Baystate Medical Center, Springfield

Other clinical interests at different sites may also be pursued with the approval of the program director. Rotation selection is made in the latter half of the CA-2 year, at which time residents are asked to provide their elective selection in rank order. Residency and Clinical leadership then creates the final rotation schedule, taking into account the requirements and choices of other residents in the class.

Residents will be considered for a 2-4 week research elective during their CA-3 year to aid in completion of their Capstone project. A six-month Clinical Scientist track is available for trainees with a strong academic and clinical portfolio.  Applicants must submit a research proposal to the department chair and program director before their formal presentation to the department research committee. Katherine Vlahcevic, the department research coordinator, is available to offer information about ongoing departmental and institutional research projects, as well as suggestions or advice. The Clinical Competence Committee will make the final decision, with input from the program director, as to the resident’s suitability for the Clinical Scientist track.

CA-3 residents may also take the PALS course.