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Department of Anesthesiology

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Residency Program

Introduction

Continuously accredited by ACGME since 1969, the New York Medical College (NYMC) Residency Training Program is organized to provide the education, training, and experience in total patient care necessary for the development of consultant anesthesiologists. The program is integrated and uses the facilities of Maria Fareri Children’s Hospital and Westchester Medical Center (WMC), an 800 bed tertiary/quaternary care hospital in suburban Westchester 25 miles north of midtown Manhattan, Danbury Hospital, in Danbury, Connecticut, and the Metropolitan Hospital, a large municipal hospital on the upper east side of Manhattan. There are more than 70 staff members on the full-time faculty at these hospitals who contribute significant effort to undergraduate and graduate medical education. Approximately 99% of the faculty completed certification by the American Board of Anesthesiology within two years of graduating from residency. Additionally, several faculty members completed fellowships in pediatric anesthesia as well as in cardiothoracic anesthesia and critical care. A handful of faculty is double- or triple-boarded. Residents spend the majority of their time (approximately 20 months) at WMC, with their other assignments divided between Danbury and Metropolitan Hospitals.

The Department of Anesthesia of New York Medical College serves in hospitals that meet the needs of a diverse ethnic and socioeconomic community. The Medical College is a member of the Touro College and University System.

Clinical Base Year

The Department of Anesthesia does not offer a Clinical Base (CB) year. However, some CB positions may be made available through NYMC affiliates, or in other clinical departments at WMC. Entry into the program is at the CA-1 level and positions are secured through the National Resident Matching Program Advanced Anesthesia Match.

Clinical Anesthesia (CA1-2)

The first twenty-four months of clinical anesthesia training (CA-1, CA-2) are divided into a series of mandatory rotations that cover a broad spectrum of clinical challenges. Residents learn to provide excellent patient care in the operating room and obstetrical suite, including experience in general surgery, cardiac surgery, (both adult and pediatric), neurosurgery, orthopedic surgery, major vascular surgery, ophthalmologic and ENT surgery, neonatal and pediatric surgery, transplant surgery, and gynecological procedures. Residents also gain proficiency in pain management in a variety of settings. In addition, they are assigned to one-month rotations in the preoperative assessment clinic and in the post-anesthesia care unit. A staff anesthesiologist is assigned to each anesthetic administered by a resident. Maximum supervision ratio is one attending physician to two residents. Difficult cases mandate one-on-one supervision, and supervision ratios at WMC are one-on-one. A minimum of two attending anesthesiologists are available in house 24 hours a day 7 days a week at WMC. At the other hospitals in our integrated program, a minimum of one attending anesthesiologist is present 24/7.

The first year of clinical anesthesia (CA-1) is designed to teach new residents the basics of uncomplicated anesthetic management, to encourage and stimulate reading, and to provide a formal didactic program. At the end of twelve months, the resident is expected to be able to participate in the full clinical and academic life of the department and assume a major role in the care of more seriously ill patients or those requiring more complicated anesthetic management. By the completion of the CA-1 year, the resident should no longer require continuous one-on-one supervision for uncomplicated cases.

In the second year (CA-2), emphasis is placed on the subspecialties of anesthesia and the resident has more responsibility for the conduct of anesthesia. The resident's experience includes major cardiovascular, thoracic, and neurosurgical anesthesia, diagnostic and therapeutic nerve blocks, transplantation anesthesia, geriatric anesthesia, intensive and respiratory care of surgical and medical patients, radical cancer surgery, obstetrical anesthesia, pediatric anesthesia, and anesthesia for emergency surgery, as well as outpatient surgery. By the end of the CA-2 year, it is expected that the resident can safely anesthetize most patients without continuous supervision.

Specialized Year (CA-3)

Residents in their CA-3 Year should expect to be assigned to the more difficult or complex anesthetic procedures or to the most seriously ill patients. Areas of emphasis that may be chosen for a subspecialty clinical track include:

  1. Cardiac Anesthesia
  2. Pediatric Anesthesia
  3. Neurosurgical Anesthesia
  4. Obstetric Anesthesia
  5. Regional Anesthesia
  6. Transplantation Anesthesia
  7. Critical Care
  8. Difficult Airway Management
  9. Pain Management

At the completion of the CA-3 year, the resident is expected to be competent in all areas of anesthesia, including adult and pediatric cardiac anesthesia, critical care, high risk obstetrics, and neonatal surgery. In summary, the candidate must be both clinically sage and able to function independently as a valued consultant.

Graduates of our program have pursued fellowship training in a variety of subspecialties at extremely distinguished institutions, which have included Brigham and Women’s Hospital, Children’s National Medical Center, Columbia Presbyterian Medical Center, Johns Hopkins, Mount Sinai, New York University, Ochsner Clinic, University of Iowa, University of Pittsburgh Medical Center, Virginia Mason Medical Center, and Yale.

Academics

New residents receive a core introductory lecture series upon entering the program that extends daily throughout the month of July.  Conferences are held five days a week for all residents. These sessions include basic science topics and case reviews. In addition, every Monday, there is a formal academic session during which staff physicians in anesthesia and from other departments focus on selected topics. Guest speakers present, both from other departments within the New York Medical College family and from other institutions.

The resident, in conjunction with faculty members, is expected to participate in presenting conferences; preparation involving research into current literature, as well as textbook sources, is expected. Evidence-based medicine is emphasized. By the end of the training period, it is expected that the resident will have established a reading schedule enabling him or her to review previously learned material and to continuously expand his or her knowledge daily. Graduates are expected to be committed to lifelong learning.

All residents must pass USMLE Step 3 by the end of 6 months of CA-1 year training. Advancement in the program is contingent upon the resident's performance at conferences, attainment of appropriate milestones, staff evaluations of clinical care, passing the Basic Examination of the American Board of Anesthesiology, and satisfactory Anesthesia Knowledge Tests and In-Training Examination (ITE) scores. It is mandatory that the ITE be taken each year as it allows the resident to judge his or her performance individually and against the peer group nationally. It also allows the Chairman/Program Director to reorient didactic and clinical teaching toward those areas where departmental deficiencies have been identified.

Research

A focused intramural clinical research program is supported within the Department. Members of the department annually present papers at national and international meetings, as well as publish papers in peer-reviewed journals. A Department research committee meets regularly under the direction of Mario Inchiosa, Ph.D. This committee reviews research proposals of both staff and residents and promotes active participation of all staff and residents in research. CA-3 residents especially are encouraged to develop research projects and to publish or present their findings in national forums. It is expected that all residents graduating from the program will complete at least one academic project, and/or publish one paper.

To specifically aid the resident and junior staff in developing research, the Department employs a senior pharmacologist, Mario Inchiosa, Ph.D., whose responsibility is to help in designing and executing research protocols. Dr. Inchiosa is an extremely valuable research resource who is conducting important investigations in a range of areas, including reflex sympathetic dystrophy syndromes, predictive analytics with linear modeling, and coagulation abnormalities in patients undergoing cardiopulmonary bypass.

Residency Application Procedures

This program participates in ERAS, the Electronic Residency Application Service. All application materials come through the ERAS system. Interested applicants should contact the Student Affairs office at their medical school for information on submitting application information. A complete description of this procedure may also be found on the ERAS web site.

To be considered complete, an application must have the ERAS Common Application Form, medical school transcript, official USMLE transcript, Dean's letter (MSPE), Step I and II Exam scores (with an average score of at least 220 [most successful applicants score considerably above this]), letter of recommendation from Program Director of any previous medical or surgical residency training (if applicable), and at least three letters of recommendation from faculty who have worked recently with the candidate.

All correspondence should be directed to:

Melissa Gayle, MBA, Residency Coordinator
Department of Anesthesiology
Macy Pavilion Room #2391
Westchester Medical Center
Valhalla, New York 10595

Email: gaylem@wcmc.com
Tel: 914-493-7692
Fax: 914-493-7927

All ECFMG certification data are verified.

Eligible applicants will be invited for an interview. All attempts will be made to schedule the interview on a date that is convenient for the candidate. Candidates will be interviewed by the Resident Selection Committee, which is comprised of Attending Staff from all integrated institutions and several residents.
We participate in the NRMP. Off-cycle applicants are considered based on vacancies.

Frequently Asked Questions

The department looks for those candidates who show the greatest promise of developing into excellent clinicians and who can function at the consultant level. We are especially interested in academic accomplishment, clinical and interpersonal skills, and professionalism. It is anticipated that every resident who starts the program will finish; it is a non-pyramidal residency program.

Who will interview me and what is involved?
Members of the Resident Selection Committee, which is comprised of faculty members and residents, conduct interviews. The interview day will begin with a 45-minute presentation by the Chairman/Program Director offering an overview of our program, followed by a tour of Westchester Medical Center and Maria Fareri Children’s Hospital. Additional information on the two other integrated training sites will be presented. Lunch will be provided.

What is included in duty hours?
Duty hours are compliant with regulations established by both the ACGME and New York State, the latter being more stringent. In additional to daily clinical assignments, duty hours include in-house 24-hour assignments. The frequency of in-house call may vary among the three integrated training sites. At WMC, in-house call typically varies between every fifth or sixth night, and may occasionally be even less frequent.
At some sites, the night call may be considerably less than this.  Call in house does not exceed 24 hours and the resident is off the next day.

Is housing available?
Limited housing is available on the Westchester campus and is determined by a competitive process. An apartment is also available gratis near Danbury Hospital for Danbury rotators.

What fringe benefits are provided?
Residents are salaried according to WMC policies. Salaries and benefits are available on the WMC website.

How much vacation time is allowed?
The department policy must follow that of the American Board of Anesthesiology. Any and all absences from training, including vacation and sick leave, may not exceed a total of 60 days over the entire 3 years. Attendance at scientific meetings may not exceed five (5) working days per year and shall be considered part of the training program. Absences in excess of those specified will require lengthening of the resident's total training time to the extent of the additional absence.

What are the rotations?
In the CA-1 and CA-2 years the resident will rotate among the three teaching hospitals to gain exposure in the various subspecialties required by the ACGME (cardiac, neurosurgery, pediatrics, pain management, obstetrics, critical care, and regional anesthesia). In the CA-3 year, residents will complete 5 months of Advanced Clinical Track, 1 month of Difficult Airway Management, and 6 months of electives. Electives are chosen by the resident with the guidance of the program director, who considers such factors as case log data, subspecialty areas requiring additional attention as reflected by examination scores or clinical evaluations, and resident preference.

What conferences are held?
While the schedule varies slightly between hospitals the conferences are as follows:
Journal Club (monthly), Didactic Sessions (Tuesday, Wednesday, and Friday), Weekly Grand Rounds (Monday), Monthly Morbidity & Mortality Conferences, and Oral Board Reviews (Thursday).



 

 


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