Education - Overview
With its roots buried in the second decade of the 20th century, the UB Department of Anesthesiology has expanded into a dynamic program of comprehensive education for residents in anesthesiology. Physicians accepted into the residency program will become an integral component of a department which aspires to achieve excellence in teaching, clinical care and research. Unique and diverse training opportunities abound.
Training in anesthesiology at UB is designed to provide resident physicians with a broad range of experiences which will enable them to function as competent consultants in a private or academic setting. Focused in this fashion, the department combines broad clinical experience with a comprehensive didactic schedule.
To complement the residency, the Department of Anesthesiology offers three one-year fellowship programs. The Pain Management, Cardiac Anesthesia, and Pediatric Anesthesiology fellowships are accredited by the American Board of Anesthesiology.
The educational program is committed to stimulating the intellectual capabilities of each resident. During lectures, basic science material is presented and then applied in selected case management discussions. Faculty members believe that problem-solving ability is central to the practice of anesthesiology.
Throughout each of the three years of training, there are required didactic lectures each month that are based primarily on the American Board of Anesthesiology (ABA) Content Outline. Residents convene at UB’s Farber Hall for the lectures. In addition, each hospital's department of anesthesiology sponsors various weekly educational conferences designed to enhance core lecture information.
Faculty members, community physicians, and anesthesiology residents gather for the Visiting Professor lecture series which hosts six nationally recognized professors per year. In addition, University Professor Rounds, Core Master Sessions, Journal Club, and Mortality/Morbidity Conferences are held monthly. The Can Am Anaesthesia Conference is held every May at historic Niagara Falls, Ontario, Canada, and is sponsored by the University at Buffalo, Western Ontario, and McMaster Universities.
Each Spring, UB Anesthesiology sponsors a regional anesthesia workshop. Residents in the CA-2 and CA-3 years learn block techniques using simulations, cadavers and ultrasound equipment.
**Simulation in Anesthesia**
The anesthesia simulator and Mock OR at UB has been designed to teach all levels of anesthesiology residents how to manage rare, but critical, events that transpire during the preoperative, perioperative, and postoperative period. Rare critical event scenarios are presented in a simulated environment in order to give residents the unique opportunity to respond to crisis situations and develop the appropriate skills to manage them.
Human errors are a leading cause of adverse anesthesia events that lead to poor patient outcomes 1 and may play an important role in surgical errors as well 2. Fortunately in anesthesia, critical, life-threatening events do not present themselves often. This, however, leads to the problem that even the most experienced anesthesiologists have often not managed these rare critical events during their careers. In following the adage that "practice makes perfect", it is difficult to practice to perfection when events happen on rare occasion. Simulation can fill a gap in educational training which will allow residents to practice and perfect their crisis management skills.
Crisis management training utilizing computer driven simulators has been employed for many years in the aviation, nuclear power industry and various other industries 3. Anesthesiology has often emulated the airline industry in its development of safety regulations and is now developing anesthesia simulators for crisis management and other basic skills. These simulators are finding their way into various anesthesia residencies across the country 4, and the University at Buffalo is proud to have added one to their arsenal of training modalities.
Having completed one clinical base year to include Ward Medicine, Cardiology, Pulmonology, MICU, Emergency Medicine, and Anesthesiology (Pre-op/PACU), the successful UB applicant embarks upon the first months of the CA-1 anesthesiology year. The first two months of the CA-1 year are spent in a one-on-one tutorial relationship with a faculty member learning the essentials of safe anesthesia. This tutorial training is complemented by an intensive didactic series which covers the basics of anesthesia at an introductory level.
For the balance of the first twelve months, the resident progresses through increasing levels of challenge in patient care, gaining expertise in the fundamentals of preoperative medical evaluation, intraoperative management and post-anesthetic care.
The next 24 months are designed on a continuum. The resident is exposed to more complex cases, as well as specialty areas of anesthesiology. During this period, the resident completes rotations outside of the operating room, providing an opportunity to function as a consultant for pain management and critical care.
As an adjunct to the resident's education, each physician is given one week per year to attend a regional or national conference in anesthesiology. Conference expenses are reimbursed in the CA-2 and CA-3 years up to $1,850 and $2,000 respectively, of which $600 may be used for the purchase of books. A $600 stipend for the USMLE Step 3 is provided for CB residents training in our program; CA-1 residents receive an $850 stipend to use for educational materials. Many books are provided to CA-1s as well.
Residents are encouraged to become active members of the medical community in general, and of the anesthesia community specifically. The department pays each resident's professional dues to the AMA, MSSNY, MSCE, ASA, and NYSSA as a demonstration of the importance of joining and participating early in issues that will affect one’s clinical practice.
- Cooper, J.B., Newbower, R.S., Long, D.D., McPeek, B. Preventable Anesthesia Mishaps: A Study of Human Factors. Anesthesiology, 1978;49:300-406.
- Spencer, R.C. Human Error in Hospitals and Industrial Accidents: Current Concepts. Journal of American College of Surgery, 2000;191:410-418.
- Rolfe, J.M., Staples, K.J. Flight Simulation. Cambridge, Cambridge University Press, 1986, 232-249.
- Anesthesia Simulator Sites and Users; University of Rochester Medical Center, Department of Anesthesiology, 2005. http://web.anes.rochester.edu/Public/content/Education-sim_simusers.php