All potential residents are encouraged to obtain a clinical base year in an accredited program approved by the American board of Anesthesia.
The CA-1 year consists of administering anesthetics at Robert Wood Johnson University Hospital while learning the fundamentals of the specialty. During the first eight weeks, residents are assigned daily to the operating suite where they are involved in relatively simple anesthetic problems. The fundamentals of the specialty are discussed in formal daily seminars. The ratio of faculty members to residents varies between 1 to 1 and 1 to 2 depending on the competence of each resident and the complexity of the clinical cases involved. Early in their training, residents discuss and get approval for all major clinical decisions by the appropriate faculty member. Trainees are assigned increased responsibility as their instruction continues until they are capable of managing complex anesthetic problems and are competent in the use of all anesthetic agents and "state of the art" techniques. General clinical training occupies 10 months of postgraduate year two. In addition, CA-1 residents spend two weeks in the post anesthesia care unit (PACU) and one month learning the basics of cardiac anesthesia on the Cardiac Service.
During clinical year 2, residents rotate into the following anesthesia subspecialties: cardiothoracic anesthesia, neuroanesthesia, pain management, pediatric anesthesia, ambulatory, obstetric anesthesia and intensive care. Faculty members, who are section heads of a subspecialty and who have extensive subspecialty training, provide instruction and clinical direction in the various training specialty assignments. Cardiothoracic anesthesia, neuroanesthesia, and ambulatory anesthesia training all occur in the operating rooms of Robert Wood Johnson University Hospital or in the CORE building. CA-2 residents also spend one month at the New Jersey Pain Institute where they become indoctrinated in the fundamentals of the specialty of pain management. In addition, trainees complete a two month rotation in the Trauma and Surgical Intensive Care Unit (SICU) at Robert Wood Johnson University Hospital. The SICU is a 17 bed unit designated for the care of all critically ill, trauma, and postoperative major surgical patients. Overall, during this year, residents achieve a higher level of clinical responsibility and gain more independence in performing their anesthesia duties. Weekly lectures and seminars which focus on teaching the scientific basics of the specialty as well as reviewing clinical problems are held regularly throughout the post graduate training years. A Visiting Professor Program provides residents with personal contact with leading figures in anesthesia and related fields.
Residents are offered three advanced anesthesia tracks - the ADVANCED CLINICAL TRACK, the SUBSPECIALTY CLINICAL TRACK and the CLINICAL SCIENTIST TRACK - in order to complete their continuum of education. This elective format offers the flexibility necessary to provide for each resident's educational objectives and personal needs.
Trainees who choose the ADVANCED CLINICAL TRACK spend a minimum of four months at Robert Wood Johnson University Hospital administering anesthesia to a select group of complex general surgical patients with multiple system disease requiring intricate anesthetic management. The remaining eight months of the CA-3 year can be spent at RWJUH handling the most difficult and complex neurosurgical, vascular, or cardiothoracic anesthesia assignments and participating in their postoperative management. These remaining eight months can be divided into 1, 2, or 3 month blocks. Individuals who choose the SUBSPECIALTY CLINICAL TRACK may spend from nine to twelve months, or two six month blocks in the following areas: pain management, ambulatory anesthesia, pediatric neuroanesthesia, obstetric anesthesia, neonatology, cardiothoracic anesthesia, or critical care medicine at Robert Wood Johnson University Hospital, or at another affiliated hospital. Residents who choose this track handle the most difficult subspecialty cases. For example, during cardiothoracic anesthesia subspecialty training, along with doing the more difficult surgical cases and acquiring skills in transesophageal echocardiography, residents rotate in the Cardiac Catheterization Laboratory in the cardiodynamics suite and in the Coronary Care Unit. Trainees who choose critical care medicine manage the more difficult cases in the Trauma Surgical Intensive Care Unit, Medical Intensive Care Unit, and in the Coronary Care Unit. Those who choose obstetric anesthesia or neonatology manage the most difficult obstetric cases and rotate in the Neonatal Intensive Care Unit and/or in the Pediatric Intensive Care Unit. Also, specialized year residents may choose the CLINICAL SCIENTIST TRACK which offers two options. They can participate for six months in one of the many clinical or laboratory studies being done by department researchers. The remaining six months is spent doing advanced or subspecialty clinical training. A second option of the CLINICAL SCIENTIST TRACK is offered to those who wish to consider becoming academic investigators. The clinical base year and 30 months of clinical anesthesia training with an additional 18 months of research experience under the direction of one of our investigators are required of those residents who choose this option.
Faculty members are responsible for evaluating the performance of the residents/fellows. Each resident/fellow is evaluated quarterly in writing by the faculty members with whom he/she has been working. Trainees are rated on the basis of standardized criteria. All resident evaluations are reviewed by the Clinical Competence Committee and the Education Committee. Each resident meets formally with the Director of the Anesthesia Residency Program to review his/her progress. Fellows meet formally with their Subspecialty Director to discuss their progress. Residents are required to take the ABA/ASA In-Training Examination each year as well as scheduled department exams. Analysis of the examination results is used to evaluate the progress of each individual resident.
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