Residency Program

Program Overview

The Residency Training Program at Yale-New Haven Hospital consists of a four-year continuum of education in Anesthesiology as approved by the American Board of Anesthesiology. This includes one year of non-anesthesia clinical training (Clinical Base Year) and three years of clinical anesthesia training (CA-1, CA-2, and CA-3 years).

The twelve-month clinical base year (internship) must be completed in a program accredited by the Accreditation Council for Graduate Medical Education (ACGME); or in Canada, in an institution approved by the Royal College of Physicians and Surgeons. This experience in clinical medicine will form the foundation upon which subsequent training in anesthesiology can occur. The Department of Anesthesiology at Yale-New Haven Hospital has associations with several of the hospitals in the vicinity which have a limited number of positions available at the PGY-1 level. We encourage applicants to investigate the PGY-1 position on their own, as many of them may require the application to be processed through the ERAS System. The CA-1 positions are processed through the National Residency Matching Program (NRMP) via this Department's office. If any positions remain after the Match has been completed by the NRMP, candidates are eligible to apply for any unfilled CA-1 positions. Candidates who already possess an MD or DO degree may also apply for an unfilled CA-1 position; however, all slots will be filled through the Match first.

The three years of clinical anesthesia, (CA-1 through CA-3 years), will consist of experience in 1) basic anesthesia training, 2) sub-specialty anesthesia training, and 3) advanced anesthesia training. Experience in basic anesthesia training is intended to emphasize basic and fundamental aspects of patient management in the perioperative period. At least twelve months of the CA-1 and CA-2 years are spent in basic anesthesia training. Also, during the CA-1 and CA-2 years, subspecialty training is included. During the CA-3 year, the resident receives additional exposure to the various subspecialties and has greatly increased responsibilities. During the course of their training our residents have the opportunity to experience the full spectrum of surgical procedures, and each resident will be involved in approximately 400 anesthetics per year. Subspecialty rotations at Yale-New Haven Hospital include Obstetric Anesthesia, Pediatric Anesthesia, Cardiac Anesthesia, Anesthesia for Thoracic and Vascular Surgery, Neuroanesthesia, Ambulatory Anesthesia, Critical Care Medicine, Liver Transplantation, Acute Pain Management, Chronic Pain Management and Post Anesthesia Care.
Regional anesthesia is taught during all clinical rotations, especially neuraxial anesthesia. The resident receives a focused experience in regional anesthesia during the Block Rotation. During the Block Rotation, the resident reviews the entire OR schedule to find patients who might benefit from a peripheral nerve block. In association with the Block Attending, the resident approaches the patient and, when appropriate, performs the block in the preoperative area. Interscalene, axillary, femoral, sciatic, popliteal, and continuous femoral nerve block are commonly used for orthopedic procedures.

Although Yale-New Haven Hospital serves as the focal point for residency training, a portion of the educational experience is acquired in our affiliated institutions. Every resident spends a minimum of one or two months of their residency at the West Haven Veterans Affairs Healthcare Center (3 miles away), providing the resident an opportunity to work in a different venue and with our medically complex veteran population. Each resident spends a month in the offices and procedure rooms of Dr. Lawrence Kirschenbaum, a specialist in the management of chronic pain during their chronic pain rotation.

Specialty workshops are scheduled throughout the year. Will Rosenblatt uses the AirMan™ Simulator to teach residents advanced airway techniques such as the Fastrach LMA, fiberoptic bronchoscopy and retrograde intubation as well as critical decision making in airway management. In cooperation with the Department of Anatomy, residents participate in the "Anatomic Basis of Regional Anesthesia" workshop that uses cadaver dissection and multimedia presentation to correlate clinical procedures with the underlying anatomy. The "Pacemaker" workshop teaches residents how to use modern pacemaker boxes and to place transvenous pacemakers.

Ample opportunity for research exists at all levels of training. Residents are encouraged to participate in one of the many ongoing research projects as well as to design their own and to present their work at scientific meetings. One to two residents have the opportunity to devote a 6-month portion of their CA-3 year to the Clinical Scientist Track. (hyperlink to http://anesthesiology.yale.edu/residency/residency/cst.html)

Residents are invited to participate in our Grand Rounds program. A recurring program, "The Myths of Anesthesia" is very popular. Recent presentations have included "Succinylcholine is Contraindicated in Burn Patients", "Phenylephrine is Contraindicated in Obstetrical Anesthesia", "Anesthetic Technique Can Reduce Perioperative Cost", "All Patients Should Receive Anti-emetics" and "Hypothyroid Patients Should Not Be Corrected Before Coronary Surgery".

The department was one of the first in the country to require residents to complete the twice-yearly American Society of Anesthesiologists Self-Evaluation Exam. Each resident is required to take the Annual American Board of Anesthesiology In-Training Examination to help prepare them for the ABA Written Board Certification Exam. Residents are required to research questions that are frequently answered incorrectly, and then write a synposis on the "Key Word Phrases." At the end of the academic year, a manual of Key Words is distributed to the residents as an aid in preparation for the upcoming examination. Each resident is also required to take the standardized Anesthesia Knowledge Test at 0 months, 1 month, 6 months and 18 months to help track their didactic progress.

Residents are invited to participate in Departmental Committees. Residents on the Morbidity and Mortality Committee help review complications, present cases for discussion and develop plans for quality improvement. Residents on the Medical Student Education Committee help develop curricula and programs for our expanding medical student education program. Residents on the Education Council help improve and assure the quality of the resident education program.

The residents are the cornerstone of our medical student education program. Residents provide clinical teaching in the OR and also provide didactic lectures in small-group settings. The students award the department's annual "Resident Award For Excellence In Medical Student Education".

For a number of years, various members of our attending staff have been very active in charitable organizations such as Interplast and Healing the Children. These organizations provide free medical and surgical care to people in the developing nations of the world. It has been the practice of the attendings who provide anesthesia services during these missions to select a resident to accompany them. This is an unique opportunity and experience for the resident, as the working conditions and equipment are distinctly different from those to which clinicians are accustomed.