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Curriculum Summary

CLINICAL BASE YEAR (INTERN)

Anesthesia residents at MMC complete a medicine preliminary internship prior to their anesthesia training. Residents must have a solid base of medical knowledge to build upon in the following years.

The intern year is spent rotating with the internal medicine residency teaching services. The intern year is split into 26 two week blocks. Blocks include: Medicine Wards, ICU, Emergency Medicine, Neurology, Cardiac Intensive Care, Cardiac Consultation, Pulmonary Consultation, Oncology, Obstetrics, Clinical Anesthesia and Anesthesia Systems. Seven of these blocks will be on service and the remainder of this time will be spent in subspecialties of the medical services.

CLINICAL ANESTHESIA YEAR 1 (CA1)

The CA1 year is designed to ease the resident into the clinical practice of Anesthesiology. Beginning July 1st, each new CA1 will participate in an intensive 1-week orientation “Boot Camp” curriculum designed to introduce the resident to the policies and procedures of the department, as well as simulation of basic principles in the practice of anesthesiology.

Upon completion of the orientation curriculum, each resident will be paired with an attending anesthesiologist for the month of July. The attending anesthesiologist will have no additional resident or CRNA oversight responsibility during this time to ensure exceptional one-to-one training during the resident’s first month. Additionally, the CA1 resident will participate in daily didactic lectures presented by an attending anesthesiologist that will encompass airway management and anesthetic delivery systems as well as basic physiology and pharmacology as it pertains to the anesthetized patient.

Beginning in August, each CA1 will be assigned to general OR cases on a daily basis for the first 6-months of training. Thereafter, each CA1 will rotate through four-week long subspecialty assignments.

Subspecialty rotations include:

  • Pediatric Anesthesiology
  • Vascular/ Thoracic Anesthesiology
  • Neuro Anesthesiology
  • Obstetrical Anesthesiology
  • Surgical Critical Care (1 month in second half of CA1 year)

CLINICAL ANESTHESIA YEAR 2 (CA2)

The CA2 year consists of 2 blocks of Advanced Clinical Track (ACT) anesthesiology encompassing advanced general OR cases as well as 9 subspecialty training blocks including:

  • Cardiovascular Anesthesiology (2-months)
  • Pediatric Anesthesiology
  • Surgical Critical Care (2-months)
  • Regional Block/ Post-Operative Pain Management
  • Outpatient Pain Management
  • Outpatient Surgery Center
  • Vascular Thoracic Anesthesiology

CLINICAL ANESTHESIA YEAR 3 (CA3)

The CA3 year allows more flexibility in training, offering 4 elective blocks. Elective rotations include, but are not limited to:

  • Additional general subspecialty blocks
  • Medical simulation
  • TEE
  • Medical Direction/ Supervision of CRNA’s at Southern Maine Medical Center

To accommodate each CA3’s individual educational goals, the department is extremely proactive in facilitating elective rotations that have not necessarily been created for previous residents, as long as they meet educational requirements set forth by the ACGME.

Required subspecialty blocks during the CA3 year include:

  • Pre-Admission Unit (outpatient preoperative evaluation)
  • Pediatric Anesthesiology
  • Vascular/Thoracic Anesthesiology
  • Regional Block/ Post-Operative Pain Management
  • Obstetrical Anesthesiology
  • Post-Anesthesia Care Unit (PACU)
  • Neuro Anesthesiology
  • Research

Didactics

Equally important to the resident of anesthesiology is a rigorous didactic program. The fundamentals of the practice of anesthesiology are presented in a curriculum entitled "Seminars in Anesthesiology." Residents learn most of this material in the problem-based learning format wherein a faculty member presents and facilitates the discussion of a case and reviews the pertinent current literature. Each Tuesday afternoon, residents have protected time for the Seminars program and are relieved from all clinical duties from 1:30 - 4:30 for participation.

Simulation Training

Residents have the opportunity to take advantage of MMC's state-of-the-art simulation center, which opened in 2010. The Hannaford Center for Safety, Innovation and Simulation at MMC offers high-tech and realistic simulation and provides an environment for learning new techniques. Residents are able to enhance their skills through repeated practice and review. Trips to the simulation center are planned nearly every month to provide exposure to difficult OR scenarios and allowing the residents to develop plans to quickly and effectively address a wide variety of issues. Simulation training continues through all years of MMC's anesthesiology residency.

Grand Rounds

Each Thursday morning, the department hosts Anesthesiology Grand Rounds at MMC's Dana Auditorium. The surgery schedule is delayed by one hour to accommodate the program, ensuring the participation of all department members. Presentations include staff lectures, resident lectures, interactive case conferences, visiting lecturers, departmental and subspecialty updates, as well as Mortality and Morbidity (M&M) conferences. Grand Round sessions are open to the Anesthesia Department.

The department hosts a Journal Club quarterly at a staff member’s home. The articles are presented by residents who then lead the discussions.

Mock oral boards are provided to all residents twice a year to assist in preparation for the ABA Certification process. The department pays particular attention to detail in organizing and facilitating this process to ensure that the resident becomes comfortable with the process. There are several ABA Oral Board Examiners within the department who ensure continuity with the ABA’s procedures.

A departmental library is in close proximity to the operating rooms, and the Maine Medical Center Health Sciences Library provides state of the art resources for reference and research. Computers for resident use are provided in several locations, including operating rooms.

Cardiac anesthesia and TEE conference takes place with residents and attendings frequently. Participation is required for residents rotating through the cardiovascular subspecialty, but all residents and staff are invited to attend.

Duty Hours

Duty hours are closely monitored for ACGME compliance. While the actual number of hours worked by residents may vary, residents average 55-70 hours per week. Residents have sufficient off-duty time to avoid undue fatigue and stress. The program monitors on-duty schedules to ensure that these assignments do not interfere with education, performance, or clinical care and judgment. Duty hours are limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities and moonlighting.

On Call Shifts

The on-call schedule is prepared by the Chief Resident and printed in four week blocks. Given the recent change in the examination structure of the American Board of Anesthesiologists (ABA), we have moved to having each resident take 4 calls per 4-week block, or 1 call per week on average. Residents are relieved the morning after call at 0700 (except for Thursdays when residents are expected to stay and attend Grand Rounds until 0800).

Maine Medical Center is a member of the MaineHealth System