Curriculum

Clinical Base Year

Our PGY-1 year includes a diverse group of rotations:

• Internal medicine (3 months)
• Perioperative medicine (1 month)
• ENT surgery (1 month)
• Emergency medicine (1 month)
• Surgical ICU (1 month)
• Cardiothoracic ICU (1 month)
• Chronic Pain (1 month)
• Acute Pain/Regional Anesthesia (1 month)
• Intern Anesthesia (2 months)
• Research (1 month)

The two months of Intern Anesthesia serve as an introduction into the ORs with intense classroom instruction, simulation lab experience, and pairing 1:1 with either senior residents or teaching faculty in the operating rooms. The purpose of our boot camp is to fully prepare our interns for the role and responsibilities of their CA-1 year and ensure a smooth (and less anxiety-producing) transition.

Clinical Anesthesia Years

University Hospital Cleveland Medical Center is a tertiary care center, which includes UH Rainbow Babies and Children’s Hospital, UH Seidman Cancer Center, and UH MacDonald Women’s Hospital. All clinical rotations, with the exception of Community OR, are completed at main campus, which comprises 26 adult main ORs, 7 adult outpatient ORs, 9 pediatric ORs, 3 Obstetric ORs, several cath labs, and IR suites. Working at a Level 1 Trauma Center for Adult and Pediatric patients, residents are exposed to a high volume of cases with varying acuity.

During the three years of clinical anesthesia, residents assume increasing responsibility and autonomy in the selection and administration of anesthesia and the pre-and post-operative care of patients for all types of surgical and obstetrical procedures.

After rotating in the general ORs, CA-1s are exposed early to subspecialty rotations, including neurosurgery, obstetrics, cardiac surgery, and pediatrics. This early clinical exposure has aided residents in choosing their preferred fellowship or career path. While stepping into the Senior role, CA-2s gain experience in running services and mentoring junior residents in Acute Pain, Obstetrics, Surgical/Cardiothoracic ICUs. CA-2s rotate through more advanced rotations, including thoracic and vascular surgery, often requiring central access, invasive hemodynamic monitoring, and massive transfusion. Through two months of perioperative medicine, residents practice pre-operative patient optimization and clearances. The CA-3 year is designed to broaden the resident's experience and allows for customization of each resident's education, based on their interests. Residents may choose from a wide range of available electives or develop their own. By this time, residents are mostly independent, function at a consultant level, and are called upon to “pretend” on junior residents.

The department also offers ample opportunities in research, with research time available during the CA2 and CA3 years. The pain department in particular has published many articles in recent years in distinguished journals.

Curriculum Highlights

TEE

Our board-certified cardiac anesthesiologists instruct our residents on intraoperative TEE. Part of our advanced curriculum then reinforces teaching of TEE, reviews further TEE studies in a classroom setting (to ensure eligibility for NBE Basic Exam), and then prepares our residents to pass the NBE exam.

Introduction to Publication

Our residents are paired with a mentor with the goal of publishing a piece in a peer-reviewed journal. In addition, they participate in our EQUIPS program to learn about the importance of quality improvement in healthcare and how to carry it out.

Acute Pain Service

We have a dedicated acute pain team that provides regional anesthesia both in and out of the OR for all types of perioperative patients. Our residents perform a variety of ultrasound-guided peripheral nerve blocks and neuraxial blocks with dedicated fellowship-trained faculty. With annual cadaver workshops, the whole department may practice new regional techniques.

Global Health

We offer a limited number of spots to qualified residents (CA-3 in good standing) to participate in a global health initiative in collaboration with Dr. Chad Zender at the University of Cincinnati. Residents travel to Kampala, Uganda for surgical outreach and practice as independent anesthesia providers for relief work.

POCUS

One of the available electives to our residents focuses on point of care ultrasound. This elective is carried out in conjunction with our emergency medicine colleagues and their ultrasound fellowship. Our residents receive expert instruction in POCUS from world-renowned faculty on a multitude of patients as they pass through our ER and ICU.

Transition to Practice

An important part of the anesthesiology department at our hospital is in running the operations side of the ORs. The logistics of scheduling providers, cases, and triaging emergencies is an integral part of this curriculum along with learning about finance and the economics of anesthesia.

Example Schedule

Call Assignments

While residents are rotating in the operating rooms, they are eligible for in-house general OR or OB call.

• Weekday Call M-F 15:00-07:00
• Weekend Call Sat-Sun 07:00-07:00
• Post-call day off

Acute Pain and Chronic Pain: Residents on service divide pager call throughout the rotation, responding to consults and rounding on patients.

Transplant call: 4 weeks divided between the echo and PACU residents. Residents are relieved from their clinical duties to prepare for liver, lung, and heart transplants.

ICU: During CA-2 and CA-3 years, residents are expected to work 7 nights in their SICU and CTICU rotations