The Department of Anesthesiology Curriculum | The University of Tennessee Graduate School of Medicine, Knoxville

The Department of Anesthesiology

Curriculum

The Anesthesiology residency training program is a 4 year, categorical program, beginning with a Clinical Base Year. This year is structured with rotations in the following specialties:

Internal Medicine
Medicine Critical Care
Pulmonary
Cardiology
Surgery
Surgical Critical Care
Emergency Medicine
Anesthesiology

Residents begin basic rotations in clinical anesthesia after a month-long orientation. The typical CA-1 year consists of several months of clinical anesthesia in combination with a few subspecialty rotations:

Clinical Anesthesia (approximately 7 months)
Neurocritical Care (1 month)
OB (1 month)
Preop (1 month)
Recovery (2 weeks)
Vascular (1 month)
Other (approximately 1 month)

Training in the CA-2 year is rigorous, with rotations in various subspecialties and is structured as follows:

Vascular/Perfusion (1 month)
Cardiothoracic Anesthesia (2 months)
Pain Medicine (2 months)
Neuroanesthesia (2 months)
OB (1 month)
Neurocritical Care (1 month)
Regional Anesthesia (1 month)
Pediatric Anesthesia (3 months, with 2 months being completed at Monroe Carell Jr. Hospital at Vanderbilt University, Nashville, TN)

The CA-3 year is a distinctly different experience than the CA-1 and CA-2 years, providing progressively more complex training along with increased independence and responsibility. The CA-3 year is structured as follows:

Advanced Clinical Anesthesia (approximately 6 months)
Neurocritical Care (1 month)
Preop (2 weeks)
Recovery (2 weeks)
Regional (2 weeks)
Transition to Practice (1 month)
Echocardiography (1 month)
Airway (1 month)
Out of OR Experience (2 weeks)

Didactic Program

Resident education in anesthesia is supplemented by the expansive and rigorous reading and didactic program. Our program has had a great measure of academic success as evidenced by resident performance on in-training exams and American Board of Anesthesiology board pass rates. We strive to continually improve resident education by implementing changes to our didactic program based directly on resident feedback.

During the Clinical Base Year, residents are provided with textbook, Basics of Anesthesia, and are provided with an outline of recommended readings that correspond with various specialties through which they rotate.

During the initial portion of the CA-1 year, residents read the introductory text Basics of Anesthesia. The objective is to establish good reading habits and to gain a foundation early in residency on which to build. CA-1 residents will meet with an assigned faculty mentor, the purpose of which is to ensure that this introductory reading program is being followed. Residents are questioned to assure that the material has been read there is ample opportunity for questions to be answered. During each session, residents are evaluated on his/her preparedness for these sessions.

Lectures are also delivered by faculty members to CA-1 residents during this time, separate from the advanced content that will be delivered to the CA-2-CA-3 residents.
In addition to the reading and lecture program, residents have the responsibility for making several different types of presentations throughout their training.

Presentation Topic Areas
Mock Orals
Each resident in anesthesiology must complete a Mock Oral Examination in each of the Clinical Anesthesia years. At the beginning of each academic year, a case scenario and a faculty examiner are assigned to each resident. The resident uses information technology to locate and evaluate scientific studies, clinical recommendations and guidelines to incorporate into his preparation. On the assigned date, the examination proceeds according to a truncated version of the ABA Oral Board examination format, with the remaining members of the Department of Anesthesiology in attendance. At the conclusion of the examination period, a brief review of the resident’s responses ensues.
Problem-based Learning
Each resident in anesthesiology must present a difficult clinical scenario to the Department of Anesthesiology in each of the Clinical Anesthesia years. A difficult clinical scenario will be assigned to the resident, who will be paired with a fellow resident and assigned a faculty mentor. The resident will use information technology to locate and evaluate scientific studies, clinical recommendations and guidelines to incorporate into his presentation. The resident will then utilize skills developed in part through the on-line educational module, The Resident as a Teacher, to educate the members of the Department of Anesthesiology (faculty and fellow residents) during this presentation at our monthly Problem-Based Learning Conference. This presentation will be led by the paired residents, and will include both a question-and-answer and lecture format.
Case Conference
To aid residents in developing skills needed for the scholarship of dissemination, each resident is required to present a case conference during the CA-1 and CA-2 years. The resident, in conjunction with the faculty mentor, decides upon an interesting or difficult clinical case and presents challenges associated with the anesthetic management. As a requirement of the presentation, the resident is expected to use information technology to find, evaluate and incorporate data from the scientific studies for these presentations.
Morbidity & Mortality
Residents are required to select and present a case for M&M during their CA-2 and CA-3 years. Each resident is expected to select a case in which they have not been involved and then identify what happened, present an analysis of the case with supporting literature and participate in an interactive discussion with the audience.
Root Cause Analysis
Each resident must present one Root Cause Analysis (RCA), after having completed rotations in post-anesthetic recovery and pre-anesthetic assessment. Each resident is required to identify a problem, determine the basic underlying cause as opposed to merely 'treating the obvious symptoms.' During this exercise with the aid of a faculty mentor, the resident is expected to use the Six Sigma approach of repeatedly asking 'why' a problem occurs. By applying this type of methodology, the resident learns how to identify system errors and to suggest solutions.
Journal Club
Journal Club occurs throughout the year with a goal of stimulating research hypotheses and updating clinical knowledge. These sessions take place during regular morning sessions, as well as special research-oriented evening sessions throughout the year. Residents work alongside faculty mentors to find articles from current general and subspecialty anesthesia journals that are relevant to the session's topic. Articles should be of research in nature. Residents choose one article for discussion and prepare slides to answer the questions via a PowerPoint presentation.
Grand Rounds
Each CA-3 resident must present an hour-long Grand Rounds presentation about a clinically relevant topic of interest to the entire department. After discussion with the resident’s faculty mentor, a topic or interesting clinical case is selected. The resident uses information technology to locate and evaluate scientific studies to incorporate into his presentation. The resident then utilizes skills developed in part through the on-line educational module, The Resident as a Teacher, to educate the members of the Department of Anesthesiology (faculty, fellow residents, nurse anesthetists and student nurse anesthetists) during this presentation at our weekly Grand Rounds Conference.