The goal of the Residency Program of the Department of Anesthesiology is to train physicians to become both consultants in anesthesiology as well as diplomats of the American Board of Anesthesiology. It is a four-year categorical program organized in accordance with the American Board of Anesthesiology and the RRC of the ACGME. The current structure is:
- PGY 1 Clinical Base Year (CBY)
- PGY 2 Clinical Anesthesia (CA-1) - Basic Anesthesia
- PGY 3 Clinical Anesthesia (CA-2) - Subspecialties
- PGY 4 Clinical Anesthesia (CA-3) - Advanced Anesthesia
Throughout their training, residents are fully supervised by anesthesiology faculty and staff members. The faculty is comprised of about 30 full- and part-time anesthesiologists whose subspecialty training includes fellowships or expertise in cardiovascular anesthesia, pediatric anesthesia, neuro-anesthesia, pain management, and critical care medicine. During their training, residents continually reflect on their performance, seek feedback and guidance from faculty, and work towards improvement and eventual mastery. This cycle is the key to life-long learning and mastery of the skills necessary to become an independent, competent anesthesiologist.
Residents are assigned an individual clinical advisor to act as a mentor throughout the 3 years of Clinical Anesthesia training. Residency training is a team effort by the resident and the faculty, with an emphasis on progressive independence, constantly improving knowledge, and development of a professional and ethical attitude that defines the best physicians. Each training year and each individual clinical rotation has its own educational “Goals and Objectives.” Meeting the “Goals and Objectives” of the training years and rotations is the pathway of the educational process.
At any given time, there are typically 8 residents per class for a total of 32 residents. The Department participates in the National Resident Matching Program for all positions at the PGY1 level. The Department may also recruit other residents for open positions at any level.
The primary teaching hospital for the residency program is MedStar Georgetown University Hospital, a 609-bed acute care teaching and research hospital affiliated with the Georgetown University School of Medicine. Founded in 1898, GUH is the national capital area’s oldest and most recognized academic teaching hospital. In 2000, the hospital became part of MedStar Health, the largest health care network in the D.C.-Baltimore region. Centers of excellence include cancer, neurosciences, gastroenterology, transplant and vascular diseases. Each year, approximately 14,000 surgical procedures and 1,000 obstetric cases are performed. Residents will rotate through anesthetizing sites in the main operating rooms (16 rooms), Same Day Surgery (7 rooms), Labor and Delivery, and off-site locations (GI endoscopy, interventional radiology, CT/MRI, Cyberknife, bronchoscopy suite, and cath lab). Required rotations in critical care are completed in the Surgical Intensive Care Unit (SICU), located within the Concentrated Care Center.
In the CA-2 and CA-3 year, residents will complete rotations at MedStar Washington Hospital Center, a 926-bed sister institution located in the city several miles east. Founded in 1958 and part of MedStar Health since 1999, it is the largest non-profit hospital in the metropolitan region. PGY-1 residents may also rotate at Washington Hospital Center as well in other specialties. At WHC, CA-2 and CA-3 residents enjoy a robust clinical experience in Cardiac Anesthesia at one of the five largest cardiovascular surgery programs in the nation (over 1700 cases per year). WHC also operates the area’s only regional adult burn center and the region’s premier Level I trauma center. All residents complete a rotation in Trauma/Burns during the CA-2 year. The Labor & Delivery unit is quite busy with high-risk patients, and residents have an opportunity to spend time here during the final year. CA-3 residents may also chooose to be involved in the busy regional anesthesia service as well.
Rotations in advanced pediatric anesthesia for CA-2 and CA-3 residents are completed at Children’s National Medical Center, Washington, D.C.’s exclusive provider of pediatric care. Founded in 1870, CNMC moved to its current 303 bed facility in Northwest D.C. near Washington Hospital Center in 1977. CNMC also serves as the regional referral center for pediatric emergency, trauma, cancer, cardiac and critical care as well as neonatology, orthopaedic surgery, neurology, and neurosurgery. The Department of Anesthesiology provides care for nearly 15,000 surgeries per year.
For experience in chronic pain management, residents will rotate with Dr. Netsere Tesfayohannes ("Dr. Net") at his pain management clinics in Chevy Chase, MD and Greenbelt, MD. Dr. Net completed residency training at the University of Pennsylvania and a Chronic Pain Fellowship at the Cleveland Clinic. The practice encompasses medical management for chronic intractable pain, nerve blocks, neurolytic blocks, radiofrequency ablation, spinal cord simulators and intrathecal morphine pumps, vertebroplasty, percutaneous discectomy. The average resident (assuming no vacation) can expect to see 100 to 120 (approximately 25 new) patients and be involved in 40 to 60 procedures per month. The numbers can increase significantly if the resident expresses special interest in a pain management fellowship.
The Anesthesiology Residency Training Program is fully accredited by the Accreditation Council of Graduate Medical Education (ACGME). The most recent accreditation survey of the residency program was conducted in March 2009 by the ACGME, and unconditional 4-year approval was granted. The next RRC site visit review of our program will be Fall 2013.
The ACGME is now rolling out the “Next Accreditation System” (NAS), an outcomes-based evaluation system. Phased implementation begins July 2013 for seven specialties. Anesthesiology will enter this system starting July 2014. Residency program accreditation will shift from a “biopsy”-like model (every 4-5 year site visits) to annual data collection and self-study visits every 10 years. The Anesthesiology RRC will participate in annual data surveillance of our program’s composite milestone data, board pass rates, resident and faculty surveys, and case logs (among others). Educational milestones, an extension of the Core Competencies, are key components of the NAS. Additional information can be found at www.acgme-nas.org and will be provided as this system rolls out.