CLINICAL ANESTHSIA CURRICULUM

UTMB ANESTHESIOLOGY RESIDENCY

OVERVIEW OF GOALS & CURRICULUM

 

PROGRAM EDUCATIONAL GOALS:

 

The educational mission of the UTMB Department of Anesthesiology is to train highly qualified and competent anesthesiology consultants as defined by the American Board of Anesthesiology: "A physician who:

  • Possesses knowledge, judgment, adaptability, clinical skills, technical facility and personal characteristics to carry out the entire scope of anesthesiology practice;
  • Is able to communicate effectively with peers, patients and their families, and others in the medical community;
  • Can serve as an expert in matters related to anesthesiology, deliberate with others, provide advice and defend opinions in all aspects of the specialty of anesthesiology; and
  • Is able to function as the leader of the anesthesiology care team."

 

OVERVIEW:

Our Residency Training Program has an intense and well developed educational program with competency based curriculum, goals and objectives, and evaluation systems. The six core competencies as mandated by the Accreditation Council for Graduate Medical Education are:

  • Patient care
  • Medical knowledge
  • Practice-based learning and improvement
  • Interpersonal and communication skills
  • Professionalism
  • Systems-based practice

Didactics embrace daily sessions with formal lectures (blocks based on ABA content outline), key word concepts, advanced anesthesia conferences, surgical intensive care unit conferences, Quality Improvement/ Morbidity and Mortality conferences, departmental grand rounds, Problem Based Learning & Improvement/ Quality Improvement meetings, journal club, mock oral examinations, simulation training and a visiting professor program.  Learning activities are planned to promote self-reflection and individualized study plans and encourage residents to realize that knowledge acquisition and maintenance is a life-long pursuit.

The 48-month continuum in anesthesiology provides Clinical Base (CB) and Clinical Anesthesia (CA) rotations that are structured to provide the basic and advanced skills required for the practice of anesthesiology and perioperative medicine.  Residents may enter the 48-month continuum in anesthesiology directly from medical school with the 36-months of CA integrated with 12 months of CB.  As an alternative, residents may enter the 36-month CA after satisfactory completion of 12 months of post-graduate training (internship), with the CB performed in a primary care specialty, such as medicine, surgery, pediatrics, obstetrics and gynecology, neurology, or any combination of these specialties. Our program primarily matches for PGY-1 positions (14) for the 48-month categorical program and also offers 4 PGY-2 positions beginning with the CA-1 year.

 

The Clinical Base curriculum is intended to prepare the physician for the practice of medicine. By developing and overseeing the CB curriculum, the program assures quality control and uniformity of CB education. The UTMB curriculum offers two tracks for Clinical Base. One track offers a Clinical Base in a traditional transitional year format primarily based at St. Joseph’s Hospital, Houston, with all CB requirements met by end of PGY-1 year. The second track, which has been a long-standing tradition unique to UTMB, is the integrated Clinical Base. Incorporating the CB into the 48-month continuum allows the resident to apply anesthesiology to each of these separate medical disciplines while simultaneously learning how each of these disciplines applies to anesthesiology. The CB rotations offer experience in medical assessments and management of adults, children, and parturients, in diverse medical settings – clinic, ward, consult, operating room, ICU, and emergency room. Residents in the integrated Clinical Base track complete all CB and CA-1 requirements by end of PGY-2. Clinical Base residents are evaluated at the end of each rotation (monthly) by attending faculty. Residents use the New Innovations systems to complete faculty, peer and rotation evaluations and report duty hours. The Program Director reviews evaluations quarterly to track CB residents’ progress.

 

The CA curriculum offers a well-rounded clinical and didactic experience in all aspects of anesthesiology including pediatric, obstetrical, cardiothoracic, neurosurgical, critical care medicine, pain management, and OR/ Resource management. Additionally, the CA curriculum provides training in respiratory therapy and cardiopulmonary resuscitation.  Because a resident may enter the 48-month continuum as either a PGY-1 or PGY-2, use of the term “CA-1” year is confusing. The more descriptive terms “PGY-1” and “PGY-2” are used to describe rotation schedules in accompanying table. The terms PGY-3 and PGY-4 are used to describe the CA-2 and CA-3 years, respectively.  All residents entering the program have access to and participate in the same clinical anesthesia (CA) rotations and experiences, regardless of level of entry (PGY-1 or PGY-2).  The CA curriculum is divided into three (3) sections: (I) Basic Anesthesia-the PGY-1 and/or PGY-2 years; (II) Subspecialty Anesthesia-the PGY-3 (CA-2) year; and (III) Advanced Clinical Track (ACT)-the PGY-4 (CA-3) year of refinement and increased autonomy. 

 

EVALUATION:

Each resident’s performance, during all CA rotations, is evaluated as either satisfactory of unsatisfactory on a 9 point scale by his/her supervising faculty anesthesiologist on a daily, weekly, or monthly basis. The resident will receive a monthly summative evaluation via the on-line New Innovations evaluation system. These data are reviewed, discussed, and acted upon by the Clinical Competency Committee (CCC) semiannually. Unsatisfactory overall performance on a rotation requires successful repetition of the rotation; ongoing or egregious unsatisfactory performance in any competency may result in recommendations for improvement plans and/or administrative sanctions by the CCC. The program (including rotations and didactics) and clinical faculty are evaluated by all residents at a minimum of every twelve months. The New Innovations evaluation system requires monthly evaluation of faculty and is linked to a departmental evaluation system that gives the residents the opportunity to do daily or weekly anonymous faculty evaluations. Each rotation is evaluated for educational content and effectiveness. A detailed description of the evaluations is found in the “Anesthesiology Evaluation Policy” in the Residents Handbook.

 

DESCRIPTION CLINICAL CURRICULUM:

The CB and CA clinical curriculum consist of the rotations as outlined in the following table.  Rotations are structured to provide gradually increasing difficulty and autonomy with progressive challenges to the resident’s intellectual and technical skills. Competency based goals and objectives for each CA and CB rotation specific to educational level are available on the departmental intranet in the Resident Handbook and CA Goals and Objectives are additionally distributed to residents prior to assignment via New Innovations on-line system.

 

 

 

CLINICAL ANESTHESIOLOGY (CA) Curriculum GRID

 residents enter 48-month continuum as a PGY-1, 36-MONTH AS CA-1/pGY-2

 

TYPICAL ROTATIONS 2012-2013

PGY-1 SJ Transitional

PGY-2

CA-1 PGY-2

PGY-3

PGY-4

MEDICINE

OR

OR-ORIENTATION

NEURO (1)-METH

AMB

MEDICINE

OR

OR

NEURO (2)-JSH

OR-REMOTE

MEDICINE

OR

OR

CT (1)-UTMB,METH

PEDI-DCH

MEDICINE

OR

OR

CT (2)-UTMB,METH

CT UTMB or METH

MEDICINE

OR

ECHO-DIAG

VASCULAR

SICU (4)

SURG WARD

ECHO-DIAG

OR-ENT

PEDI (1)

JSH ELEC

NEONATAL UNIT

OR-ENT

OR-AW

BLOCK (PAIN 3)

JSH ELEC

UTMB SICU(1)

OR-AW

SICU (1)

OR (CA-1 PAIN #2)

OR/ACT

PAIN-CB (1)

OB (1)

SICU (2)

PACU

OR/ACT

ER

SICU (2)

PRE-OP CLINIC

PEDI-SBI (2)

NON-JSH ELEC

ELECTIVE CB

PRE-OP CLINIC

OB (2)

SICU (3)

NON-JSH ELEC

UTMB OR-ORIENTATION

PAIN (2)

PAIN (1)

OB

NON-JSH ELEC

KEY

CB=CLINICAL BASE (SJ or UTMB)

JSH= John Sealy Hospital, UTMB

CB INPATIENT

OR (UTMB OR)

SBI=Shrine Burn Institute

DCH=Driscoll Children's Hospital

METH=The Methodist Hospital

AMB=Ambulatory Surgery, Victory Lakes

SJ= St. Joseph’s Hospital

JSH ELECTIVES- Pedi, ENT, Neuro, Vascular, OR-Airway, Remote, OR/ACT

Non-JSH electives-SBI, BLOCKS (UTMB or Victory Lakes), PAIN, OB, SICU, Meth CT, Meth Neuro, UTMB CT

CB electives- UTMB: Oral Surgery, ENT Surgery, Medicine Consult

ACT=ADVANCED CLINICAL TRACK

UTMB INTEGRATED CLINICAL BASE OPTION

CB must have 6 mos inpt,1 ER, 1 ICU (other: elective, PAIN, Card Consult, Echo/diag)

PGY-1

PGY-2

#

CB

CA-1

OR-ORIENTATION

Cardiology Consult

1

MEDICINE

OR-ORIENTATION

MEDICINE

ECHO-DIAG

2

MEDICINE

OR

MEDICINE

ER

3

MEDICINE

OR

MEDICINE

NEONATAL UNIT

4

MEDICINE-Card

OR

MEDICINE-Card

ELECTIVE CB

5

SURG WARD

OR

SURG WARD

OR-ENT

6

NEONATAL UNIT

OR-ENT

PAIN-CB (1)

OR-AW

7

MICU

OR-AW

MICU

OB (1)

8

ECHO-DIAG

OR

OR

SICU (2)

9

CARD CONSULT

OB

OR

PRE-OP CLINIC

10

ER

SICU

OR

PAIN (2)

11

ELECTIVE

PRE-OP

OR

OR

12

PAIN (CB)

PAIN

PGY1

PGY2

CB=7

CB=5

CA=5 (5 OR)

CA=7 (3 OR, OB)

 

 

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