Clinical Base Year
The Clinical Base Year (CBY) is a PGY-1 experience designed to offer the intern a solid experience and foundation in medical and surgical specialties. The current composition of the year includes 12 weeks of Ward Medicine; 4 weeks of Critical Care Medicine; 4 weeks of Medicine subspecialties (Cardiology, Pulmonary and Renal); 12 weeks of Surgical specialties (Vascular, Colorectal and Trauma); 4 weeks of Emergency Medicine and 4 weeks of Anesthesiology, 2 weeks of Transfusion Medicine and 2 weeks of Adult and Pediatric Chest Radiology.
The PGY-1 is expected to attend all didactics as included within the curriculum of the specialty upon which they are rotating. In addition, if time allows, they are also invited to attend the Anesthesiology Grand Rounds on Wednesday morning and the resident sessions on Wednesday mornings.
During the first 12 months of training the emphasis is on the fundamental aspects of anesthesia, including basic physiology and pharmacology, as well as the skills involved in the administration of anesthesia and associated invasive and non-invasive monitoring. Rotations during the CA-1 year include:
- General OR - 2 months Memorial Campus. This rotation provides a significant amount of experience primarily in providing anesthesia for GU, GYN and Endocrine procedures
- Regional Anesthesia -1 month Hahnemann Campus
- Pre-Surgical Evaluation Clinic - 2 weeks
- Post-Anesthesia Care Unit (PACU) - 2 weeks University Campus
- Anesthesia Consult Service/Acute Pain Service - 1 month University Campus
- Surgical ICU - 1 month Memorial Campus
- General OR - 6 months University Campus. The resident will gain experience providing anesthesia for intra-abdominal, cardiac, basic vascular, basic neurosurgical, orthopedic, trauma, ENT and transplant procedures under close supervision
This experience begins with a two month Orientation through July and August, during which each resident will work under close 1:1 supervision of either a senior resident or attending faculty member. Didactic conference schedule and clinical teaching is coordinated to facilitate timely achievement of the basic skill and knowledge sets. Entry into the daily work and call schedule in September will be dependent upon positive evaluations of faculty and residents with whom the CA-1 resident works. Please see the Orientation Packet for specific details and expectations.
All residents are required to have an updated Basic Life Support certificate. CA-1 residents are also required to take the ACLS certification course, with subsequent recertification at the two year expiration point.
The CA-2 year concentrates almost exclusively in subspecialty rotations. Residents will be introduced to the unique anesthetic issues associated with the following anesthesia specialty areas (all rotations at University Campus unless otherwise specified):
- Cardiac Anesthesia - 1 month University Campus
- OB Anesthesia: Memorial Campus - 1 month Memorial Campus
- Neuroanesthesia -1 month University Campus
- Vascular Anesthesia -1 month University Campus
- Thoracic Anesthesia - 1 month shared between Memorial and University Campuses
- Surgical Intensive Care -1 month University Campus
- General OR - 2 months University Campus
- Chronic Pain Clinic - 1 month Memorial Campus
- General OR - 1 month Memorial Campus. This rotation has a focus on more complex colorectal and oncologic surgical procedures.
- Pediatric Anesthesia -1 month University Campus
- Ambulatory Anesthesia – 1 month Hahnemann Campus
Incorporated into the above rotations is experience in special techniques such as fiberoptic bronchoscopy and intubation and placement of double lumen tubes as well as experience managing patients requiring deliberate hypotension, hemodilution, deliberate hypothermia, intra-aortic balloon pumps and cardiopulmonary bypass. Residents also become more familiar with techniques and physics of monitoring i.e. transducer set-up and use, cardiac output determination and interpretation of arterial blood gases.
The CA-3 year is designed to allow the resident to gain experience in advanced and complex clinical anesthesia assignments while also meeting the requirements of the ACGME Residency Review Committee.
Required CA-3 rotations include:
OB Anesthesia - 1 month Memorial Campus
Neuroanesthesia - 1 month University Campus
Pediatric Anesthesia – 1 month University Campus
SICU – 1 month University Campus. Two weeks as advanced resident in L2ICU (neuro/trauma) and 2 weeks as junior fellow in L3ICU (trauma). The advanced resident will be responsible for individual patients, but will not take call; the junior fellow will not have responsibility for individual patients but rather will be responsible for care for all patients in the ICU. Junior fellows will not take call.
Residents may elect to pursue specific rotations in the resident’s areas of interest including multiple various opportunities at the UMMHC campuses (Critical Care, cardiovascular, pain management, transplant, ambulatory etc.) as well as additional elective rotations outside the UMass system. Outside electives are limited to two months, and are often used to “audition” for fellowship positions or employment positions.
The residency program currently has the following electives through affiliation agreements:
Pediatric Anesthesia at Rhode Island Hospital, Providence RI
Pediatric Anesthesia at Children’s Hospital, Boston – 2 month requirement
ENT at Mass. Eye and Ear Infirmary, Boston
Pain Management at Brigham and Women’s Hospital, Boston (BWH)
OB Anesthesia at Brigham and Women’s Hospital, Boston
Cardiothoracic Anesthesia at Rhode Island Hospital, Providence RI
Thoracic Anesthesia at Brigham and Women’s Hospital, Boston
Other clinical interests at different sites may also be pursued with the approval of the Program Director. Residents may also choose to pursue a 6 month Clinical Scientist Track. Applicants are required to submit a research proposal to the Academic Vice-Chair, Dr. Mark Dershwitz. Dr. Dershwitz and/or Dr. Heard are available to offer information about ongoing Departmental and Institutional research projects, as well as suggestions or advice. The Clinical Competence Committee will make the final decision, with input from the Program Director, as to the resident’s suitability for the Scientist track. The decision will be based upon academic and clinical performances.
CA-3 residents may also take PALS and ATLS courses.