Curriculum
Clinical Base Year
The resident in anesthesiology must complete 12 months of accredited preliminary training in a clinical discipline other than anesthesiology. Acceptable training includes a transitional year, internal or emergency medicine, pediatrics, surgery or any of the surgical specialties, obstetrics and gynecology, neurology, family medicine, or any combination of these as approved for the individual resident by the program director.
The Clinical Base Year must be spent in residency programs in the United States which are accredited by the Accreditation Council for Graduate Medical Education (ACGME) or approved by the American Osteopathic Association. It also may be spent in Canadian institutions that are approved by the Royal College of Physicians and Surgeons of Canada and are affiliated with medical schools approved by the Liaison Committee on Medical Education.
UPMC Mercy offers a transitional year program and a preliminary year in surgery, which are both acceptable to this department for fulfilling the Clinical Base Year requirement.
It is a requirement of the Commonwealth of Pennsylvania that, prior to beginning the CA-1 year, the resident must complete a qualifying examination (NBME/USMLE or FLEX) that would serve as a basis for securing an unrestricted license to practice medicine in the Commonwealth of Pennsylvania.
Clinical Anesthesia
Each new CA-1 resident is paired with a higher level resident who serves as their mentor during the first month of training.
The first three months of the CA-1 year emphasize basic concepts and are devoted to fundamental aspects of anesthetic management. In July of each year the department conducts a series of intraoperative tutorial sessions for residents beginning their first year of clinical anesthesia.
During the remainder of the CA-1 and CA-2 years, the program provides rotations in anesthesia for general surgery, pediatric surgery, obstetrics and gynecologic surgery, neurosurgery, cardiovascular and thoracic surgery, orthopedic surgery, and surgery of the ear, nose, and throat. Experience in caring for Level I trauma patients undergoing emergency surgery or airway management occurs on an ongoing basis. A dedicated obstetrical anesthesia rotation takes place at Magee-Womens Hospital of UPMC, and dedicated pediatric anesthesia training occurs at Children’s Hospital of Pittsburgh of UPMC. In addition, residents enhance their experience and care of both obstetric and pediatric patients at UPMC Mercy. The CA-1 and CA-2 years also include training in the management of acute and chronic pain, anesthesia for ambulatory surgery, and postanesthesia care. A regional anesthesia experience at Jefferson Regional Medical Center in Pittsburgh provides a dedicated rotation to regional anesthetic techniques. Residents perform three to five blocks per day during this rotation, more than adequately fulfilling this residency requirement.
The American Board of Anesthesiology requires a two month experience in critical care medicine. The Trauma and Life Support Center at UPMC Mercy is a mixed medical-surgical unit where attending physicians with Critical Care Certification from the Departments of Anesthesiology, Medicine and Surgery direct residents from those three departments in providing total management of patients in the unit.
Advanced Anesthesia Training
The CA-3 year consists of one of three tracks which may be selected by the resident in collaboration with the director or associate director of the program.
Advanced Clinical Track: Residents who select this track will complete a minimum of six months of assignments in advanced and complex anesthetic management. The remaining six months may be spent in one to three selected subspecialty rotations or an additional period of time caring for patients with complex medical-surgical problems that require anesthesia care.
Subspecialty Clinical Track: Residents may elect to complete six months in a single subspecialty rotation along with advanced experience in complex clinical anesthesia assignments. Alternatively, the resident may select six months of experience in each of two subspecialty rotations. The subspecialty experiences at UPMC Mercy include cardiovascular and thoracic anesthesia, neuro-anesthesia, pain management, and critical care medicine.
Clinical Scientist Track: Residents who elect this option must devote six months to clinical or laboratory investigation. The remaining six months must be in advanced or subspecialty clinical training. During the six months of clinical or laboratory investigation the resident will receive instruction in research methodology and statistics and will participate in protocol development. Departmental investigations in the use of ultrasound, clinical pharmacology, blood conservation, echocardiography, and novel drug therapy have been ongoing.
Specific departmental research has concentrated on outcome parameters in cardiac anesthesia, postcardiopulmonary bypass coagulopathy, clinical applications of ultrasound (transesophageal echocardiography and facilitation of vascular access), pharmacologic studies of critically ill patients, blood pressure control during cardiopulmonary bypass, and value-based anesthesia care. The department uses computer generated anesthesia records that provide opportunities for automated prospective data acquisition.