We offer 17 positions in our 4-year Categorical Program. The year typically consists of 1-month rotations in anesthesiology, anesthesia pre-op clinic, anesthesia-directed SICU, emergency medicine, and CT and vascular surgery. There are three to four months of medicine wards and a medicine consult month.
July begins with an Introductory Lecture Series that addresses essential topics in anesthesiology. The first month of the two-month Lecture Series is devoted to practice management topics, including sleep deprivation, substance abuse, professionalism, ethics, and malpractice issues. There is a drug/equipment practicum to familiarize residents with medication dilution and labeling, infusions, IV tubing, handling of blood transfusions, and running infusion pumps. There is a two-part simulator experience with Part 1 focused on anesthesia induction, maintenance and emergence, and tracheal intubation. The focus of Part 2 is "call readiness." As the year progresses, lectures on core topics such as anesthetic pharmacology, neuromuscular blockade, monitoring, the autonomic nervous system, and pre-op and post-op management are presented. The Anesthesia Knowledge Test (AKT) is given on day 1 of residency training and again after one month of training to assess the areas of greatest deficiency. These topics are then incorporated into the didactic program from September through June of the CA-1 year.
NEW FOR THE 2013-2014 ACADEMIC YEAR is a fully revamped CA-1 lecture series focused entirely on teaching the knowledge essential to passing the new ABA Part 1 Basic examination that occurs at the end of the CA-1 year. Podcasting, a program that began last year, continues to grow. Each resident is provided with an iPad education. Topics such as the basic machine check, induction drugs, airway devices, aortic stenosis, sleep apnea, morbid obesity, and fluid therapy are available in the Dropbox on the iPad. Finally, we conduct a number of workshops specifically for the new resident, including a central line workshop, residents as teachers of the medical students and interns, and perioperative management of the morbidly obese patient.
The CA-2 year rotations are primarily in the subspecialty areas of Pain, Obstetric, Pediatric, Regional, Neuro, Ambulatory, Trauma, Airway, and Critical Care Anesthesia. We find learning is best achieved with rotation-specific lectures presented during the resident's time in that subspecialty. Thus, at Children's Hospital of Wisconsin (typically CA-2 and CA-3 residents), lectures specific to pediatric care are presented three mornings per week prior to the OR start. While on the pediatric anesthesia rotation, residents are invited to attend a bimonthly, multidisciplinary case or topic-based conference with pediatric surgery and pediatric critical care. Conferences during the OB anesthesia rotation are held weekly at St. Joseph's Regional Medical Center. In addition to the lectures, the OB service has a web-based platform that presents an OB grand rounds case each month for resident evaluation and commentary. Neuro anesthesia residents have weekly problem-based learning sessions and Pain, Regional, and Critical Care all have rotation specific weekly lectures. We offer two workshops for our CA-2 residents. One covers conflict resolution and the other, transition to practice. The latter workshop teaches residents job interviewing skills and CV preparation, compares and contrasts a private vs. academic practice, presents information on money management, and malpractice, disability, and life insurance.
Finally, CA-3s have a mix of general OR and subspecialty rotations, along with some rotations in private practice settings. As stated above (CA-2 year), the subspecialty rotations offer their own focused lectures. In addition, residents have weekly problem-based learning discussions from September through March, followed by three months of Board review lectures.
We aim to provide many opportunities to help our residents prepare for board exams by offering keyword reviews, mock oral exams, Journal Club, workshops, a Board review course, and a Visiting Professor Lecture Series. As part of the scholarship and discovery experience and to encourage collegiality, we have a Friday Conference series and faculty, residents, and medical students are encouraged to attend. This rotating conference series consists of Morbidity and Mortality Conferences, Grand Rounds, case conferences, Anesthesia Board Jeopardy, and quality improvement topics.
In addition to the didactic program, residents who express interest will find ample opportunity to conduct research and complete scholarly projects in their area of interest. We also provide support to present scholarly work at scientific meetings.
It is our desire to graduate well-balanced residents who enjoy a happy personal and professional life. To that end, we aim to foster close working relationships between the resident and his/her colleagues, and we encourage professional networking by matching the resident and a mentor with shared interests. The mentoring relationship is designed to provide the resident with personal and professional support throughout the residency.
PGY-1 year: Rotations at three primary hospitals - Froedtert Hospital, Clement J. Zablocki VA Medical Center and Aurora Sinai Hospital
CA-1 through CA-3 years: Froedtert Hospital, Clement J. Zablocki VA Medical Center, Children's Hospital of Wisconsin, and St. Joseph's Regional Medical Center
The primary goal of the Medical College of Wisconsin, and resources to graduate adept and trusted anesthesiologists who are consultants in their specialty. This is achieved by offering a manageable volume and variety of cases, research opportunities, and a teaching faculty of outstanding clinicians and clinician scientists. The end result is that our residents have the opportunities to develop their skills to the highest level.
Our Residency Training Program has four ABA certified training tracks. The first is a four-year continuous program that includes the clinical base year. The four-year program is a great choice because it allows interns to take full advantage of the many opportunities available to them at the College and to attend anesthesiology core program seminars, workshops, and social events with the anesthesiology residents. Residents applying to the four-year Anesthesiology Residency Program will need to apply on ERAS for the Medical College of Wisconsin Program number 1784040C0. First year rotations are described above. All scheduling for the clinical base year is through the Anesthesiology Department. The Surgical Intensive Care Unit (SICU) is under the direction of the Anesthesiology Department and is located at the VA Medical Center. The rotations for the CA-1 through CA-3 years are described in the Advanced Program.
The Three-Year Advanced Program is listed on ERAS as the Medical College of Wisconsin Program number 1784040A0. The Clinical Anesthesia (CA) Program allows residents to gain experience in areas of basic, subspecialty, and advanced anesthesiology. The rotations for the CA-1 through CA-3 years are listed above. At the start of the first clinical anesthesia year (CA-1), the resident will have three to four months of general anesthesia training. Additional general anesthesia rotations will then be included in a mix of rotations including 1-month rotations in the Acute Regional Pain Service, Obstetric Anesthesiology, and Pain Medicine. Overnight call does not occur in the first several months of training and is instituted thereafter on an individual basis, based upon the resident's competency in Patient Care and Medical Knowledge as determined by an evaluation committee. Classroom work in the CA-1 year consists of a dedicated Introductory Lecture Series that covers all core topics in the specialty. There are multiple simulation sessions to review core skills, code and call readiness, and to assess basic skills in managing cardiac, respiratory events, and malignant hyperthermia.
In the second clinical anesthesia year (CA-2), residents are primarily focused on subspecialty rotations in Airway, Cardiac, Obstetric, Neuro, Pediatric, and Acute Pain Service (Regional Anesthesia elective), as well as Critical Care and Pain Clinic. Lectures are provided weekly in each of the subspecialty rotations.
In the third clinical anesthesia year (CA-3), residents may request electives in advanced anesthesia, any of the anesthesia subspecialties, or the clinical scientist tract. The clinical scientist tract is a six-month rotation in which a resident can chose to work with any one of the many anesthesiology faculty who have ongoing clinical or laboratory investigations. The resident experience is primarily tutorial in nature; (s)he is assigned a specific project that is closely supervised by a faculty mentor. The resident is expected to complete experiments, analyze data, and present results in oral and written formats.
In an average three-year program, each resident will have had the opportunity to perform 450-500 general anesthesia or monitored anesthesia cases, 100 spinal/epidurals, 120 other regional nerve blocks, 50 PA catheterizations, and 75 difficult airway cases. Because of the large number of severely ill patients at our academic hospitals, there are numerous opportunities for placing regional anesthetics, inserting central and peripheral catheters, and honing skills in ASA class IV patients.
Two new programs will soon be listed in ERAS. These are the combined internal medicine-anesthesia and combined pediatrics-anesthesia 5-year programs. Both programs received their respective Board approval in the Spring of 2013. We currently have one person enrolled in the peds-anesthesia program. The basic structure of these programs consists of a PGY-1 year in peds or medicine and a PGY-2 year in anesthesia. PGY-3 through 5 years are a mix of peds and anesthesia or medicine and anesthesia rotations that follow a very precise structure to make residents board eligible in each specialty within a 5-year period. More information on the two combined programs can be found in detail on the American Board of Anesthesiology website.
Residents receive $2000 ($500 Department/$1,500 MCWAH) per year to be used for educational purposes. The Department funds are for license fees, dues, PDA, etc. The Department provides extra funds to cover registration, travel, lodging, and meals to residents who have presentations based on their research efforts. The MCWAH funds are designated as a Working Conditions/Fitness Benefit, and the money will appear on the last paycheck of each academic year.
Medical information is readily accessible through internet-accessible Department and hospital computers linked to the Medical College of Wisconsin Libraries. The Department also uses the New Innovations and D2L websites accessed via username and password that provide monthly call schedules, notices and memos, contact information for residents and faculty, lectures, keyword reviews, and practice management guidelines.