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Education

3-year Advanced Program


 

CA-1 Year

The CA-1 year starts with a mix of intense didactic lectures and a daily exposure to the operating rooms. During the month of July, you will have two lectures each day and spend the rest of your time in the operating rooms, learning where things are and getting comfortable being in the environment. During this time you will be working one-on-one with attendings. You will also be involved in preoperative and postoperative visits with guidance from the other residents. A dedicated weekly simulator curriculum will also be part of your orientation month. By the end of July, you will be ready to start your rotations.

Starting in August, CA-1 residents rotate through multiple basic anesthesia areas in the operating room including:

  • General surgery.
  • Surgical oncology.
  • Gynecology.
  • Gynecologic oncology.
  • ENT.
  • ENT oncology.
  • Plastic surgery.
  • Urology.
  • Orthopaedic surgery.

Each CA-1 also does a one-month rotation through The Ohio State University Preoperative Assessment Center (OPAC). They will receive instruction on performing preop evaluations and ordering patient workups according to evidence-based guidelines.

In addition, the resident gains experience providing anesthesia outside the operating rooms (eg, interventional radiology, CT, MRI, ECT). CA-1 residents also complete one-month on the obstetric floor and a two-week rotation in the PACU.

Near the end of the CA-1 year, the resident will begin subspecialty rotations as a prelude to the CA-2 year.
 

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CA-2 Year

The CA-2 year is dedicated to various subspecialty rotations. These include OB, neuro, cardiovascular, thoracic, regional, pediatric anesthesia, critical care medicine, and pain management.

Cardiovascular RotationRoss Heart Hospital

The CV rotation is completed at the Ross Heart Hospital, which is connected to the general operating rooms.

Clinical experience ranges from on- and off-pump CABG surgery, valvular surgery, ventricular assist devices to aortic surgery (including ascending, arch, descending and abdominal aortic surgery and stent placement).

Didactics expand from physiology and pathophysiology to advanced monitoring, including transesophogeal echocardiography, cerebral oximetry and spinal drain monitoring. Teaching occurs pre- and intraoperatively, as well as during additional weekly cardiovascular didactic sessions.

Neuroanesthesia Rotation

The neuroanesthesia rotation takes place at University Hospital and The James Cancer Hospital. Cases include both vascular and non-vascular craniotomies as well as various spinal procedures.

Residents learn neuroanesthesia and monitoring techniques, such as evoked potential and ICP monitoring. During the rotation, residents attend additional neuro didactic sessions.

James Cancer HospitalThoracic Rotation

The thoracic rotation takes place at the James Cancer Hospital or Ross Heart Hospital.

Procedures include thoracotomies and thoracoscopies, mediastinoscopies, bronchoscopies and esophagoscopy with laser Rx, as well as lung volume reductions and lung transplants.

Residents learn about physiology, pathophysiology and pharmacology as it applies to thoracic surgery. They will become proficient in methods of lung isolation and bronchial blockers, as well as options for postoperative pain management (thoracic epidural and paravertebral blocks).

OB Rotation

The OB rotation takes place in the maternity suites at the main University Hospital. Residents learn about maternal and fetal physiology and pathophysiology as it applies to maternal pain control for labor pain and anesthetic management of the peritoneum for multiple procedures, including cesarean births, postpartum tubal ligations or cerclages. Anesthetic techniques include utero neuraxis blocks (spinal, epidural and combined spinal-epidural anesthesia), general anesthetics, as well as local anesthetics. Residents are involved in the care of high-risk OB patients. Residents will attend daily lectures and weekly multidisciplinary conferences.

Regional Rotation

The initial rotation of regional anesthesia takes place away from the main campus at University Hospital East with a large percentage of upper and lower extremity orthopedic and podiatric surgery.

Residents will learn anatomy of the upper and lower extremity as it applies to performing upper and lower extremity blocks. The placement of blocks or in-dwelling catheters is facilitated using nerve stimulators or ultrasound.

Residents will spend a day in the cadaver lab in order to reinforce concepts learned on their rotation.

Pain Management Rotation

Residents learn about acute and chronic pain in the hospital and office setting. There they will be exposed to patient evaluations, multi-modal measures of treating chronic and cancer pain, as well as managing acute pain using spinal epidural or systemic analgesic techniques. They will observe and perform numerous pain procedures.

Critical Care Rotation

Our residents rotate through our 42-bed Surgical Intensive Care Unit (SICU), which is co-managed by the Departments of Surgery and Anesthesiology.

During this rotation residents learn how to manage the critically ill post-surgical, burn and trauma patient. The teaching occurs at the bedside, during rounds and didactic sessions.

Nationwide Children's HospitalPediatric Rotation

The pediatric anesthesia rotation takes place at Nationwide Children’s Hospital away from the main OSU campus.

The resident learns about pediatric physiology and pathophysiology as it applies to the anesthetic management of a child. Residents are exposed to a wide variety of surgical procedures in the inpatient as well as ambulatory surgery setting.

The teaching that occurs in the operating room is supplemented with daily didactic teaching conferences.

 

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CA-3 Year

The CA-3 year provides the resident with a 12-month experience in advanced and complex anesthesia assignments. Clinical assignments in the CA-3 year include difficult or complex anesthesia procedures and the care of seriously ill patients.

Subspecialty rotations are encouraged but may not be longer than six months.

Ambulatory Rotation

Senior residents will spend one month at the new Eye and Ear Institute where they will learn to develop strategies for outpatient anesthetic management. In addition to performing regional blocks, the resident will become proficient at the anesthetic management for ENT, plastics, and eye procedures.

TEE Rotation

Residents have the option of spending one month at the Ross Heart Hospital where they will learn the basics of performing and interpreting TEE exams. The month includes 1 on 1 teaching and a dedicated lecture schedule.

Cardiac Critical Care Rotation

For those residents interested in pursuing further training in cardiac or critical care anesthesiology, they can elect to do a one month elective in the cardiac ICU where they will learn to manage post-cardiac surgery, ventricular assist device (VAD), intra-aortic balloon pump, and ECMO patients.

Regional Anesthesiology

This one month elective which takes place at the main campus allows the senior resident to hone the skills they have learned during their regional rotation during their CA-2 year. Regional exposure includes upper and lower extremity blocks, perineural catheters, paravertebral blocks, and epidurals. The block resident also acts as the go-to resident for difficult airways, codes, ultrasound IV, or other advanced procedures that may be needed throughout the day.

Research

The program offers resources to provide a research track of up to six months devoted to a laboratory or clinical investigation. For the resident who elects this track, it is expected that the result of the investigations will be suitable for presentation at a local, regional or national scientific meeting. The research track generally occurs in the CA-3 year, but at the program director's discretion, may be taken earlier.

Scholarly Activity

The resident is expected to do an academic project, which may include special training assignments, grand round presentations, preparation and publication of a review article, book chapters, manuals for teaching or clinical practice or similar academic activities. A faculty supervisor is in charge of each project. At the discretion of the program director, the project may occur prior to the CA-3 year. In addition, the resident is expected to complete a quality improvement project. Each resident is encouraged to present at the Midwest Anesthesia Residents' Conference.


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