The Anesthesia Residency Program at St. Elizabeth's Medical Center provides an excellent educational and clinical environment to facilitate the learning, critical thinking, clinical knowledge and procedural skills expected of a consultant in anesthesia that translate to the operating room, critical care unit, pain management center, medical subspecialty procedural unit and emergency room. The teaching faculty cultivates the sense of responsibility, professionalism, commitment and inquisitiveness that are so essential to the practice of anesthesia. By the completion of the residency, our graduates uniformly become masterful anesthesiologists capable of pursuing either academic or community-based practice careers.
Structure of the Residency
We accept residents into the PGY1 Fundamental Clinical Skills Year as interns and also into the first year of anesthesia training. Residents spend most of their CA1 year of training at St. Elizabeth’s Medical Center learning the basics of clinical anesthesiology. In the CA2 year, residents will rotate to several affiliated hospitals in eastern Massachusetts for several months. The CA3 year of residency is more flexible, and every effort is made to tailor it to the needs and desires of individual residents. In order to provide the most comprehensive training, we have created affiliations with Boston Children’s Hospital for pediatric anesthesia, the Massachusetts Eye and Ear Infirmary, Massachusetts General Hospital and Holy Family Hospital for neuroanesthesia, and the Lahey Clinic for supplemental experiences in critical care, thoracic anesthesia, and liver transplantation.
PGY1, Fundamental Clinical Skills Year
The PGY1 year interns will rotate to St. Elizabeth’s Medical Center and Carney Hospital in Dorchester, Massachusetts. The year will be structured as a transitional internship and will focus on the basics of acquiring histories and physical exams. Rotations include Internal Medicine, Surgery, Emergency Department, Intensive Care Units, Cardiology, Pulmonology and Anesthesiology. Those wishing to do this internship should apply to the categorical program.
The fundamentals of anesthesia are emphasized during the first year with an introduction to a variety of surgical patients from the orthopedic, gynecologic, urologic, ENT, podiatric, vascular and general surgery services. Residents will be taught to complete comprehensive histories and physical examinations in ambulatory surgical and in-patient settings, as well as in the Pre-anesthesia Testing (PAT) clinic, so that they can develop the rational thinking and problem identification skills required to provide for a safe and comfortable anesthetic. Residents become acquainted with obstetric anesthesia early in their training, supervised by specific obstetric staff anesthesiologists, to gain insight into the anesthetic management of peripartum and postpartum patients.
Our program is unique in that almost all residents rotate through cardiac anesthesia in their first year, giving them early exposure to complex patients, as well as experience with insertion and interpretation of invasive monitors (arterial, pulmonary arterial catheters, and transesophageal echocardiography). In addition, our first-year residents get experience in regional anesthesia techniques by performing facial plane anesthetics on their patients who undergo laparoscopic and robotic abdominal surgeries.
In the second year of training, residents are given increasing responsibility and independence as well as more challenging cases. Our second-year residents are assigned to care for patients having major vascular and thoracic surgeries and receive at least two months of critical care training. CA-2 residents also rotate to affiliated hospitals including Boston Children’s Hospital for pediatric anesthesia and the Lahey Clinic for neuroanesthesia and liver transplantation. Finally, second-year residents will spend two months in the pain clinic, one month focusing on patients with acute pain syndromes and one focusing on the care of patients with chronic pain.
Third-year residents will spend one month caring for post-anesthetic patients in the PACU, ICU and day surgery units. In addition, third-year residents will spend one month on a dedicated regional anesthesia team and will serve exclusively as the “block resident.” Additional neuroanesthesia experience is available at Massachusetts General Hospital and Holy Family Hospital. Finally, one month at the Massachusetts Eye and Ear Infirmary is provided to each resident. The remainder of this year allows residents to specialize in specific skills and interests. Many request and are provided with extra months of pediatric, critical care, cardiothoracic, chronic pain, and regional anesthesia. Opportunities for research electives and quality improvement initiatives are also available. By the completion of the third year, our graduates are uniformly competent anesthesiologists capable of pursuing either academic or community-based, practices.
The educational program of the anesthesia residency is designed to meet the criteria of the American Board of Anesthesiology (ABA) as well as our department's own educational goals: to provide each resident with a comprehensive background in all areas of modern anesthetic practice.
Specialized one-month rotations include cardiac anesthesia, obstetric anesthesia, pain management, critical care, major vascular, thoracic, vascular, ENT, orthopedic and neuroanesthesia, offsite anesthesia, pediatric anesthesia and post-anesthetic care.
There are multiple avenues for residents to receive feedback on their performance, as well as to evaluate and help shape the educational program.
Salary & Benefits
The salaries of the resident staff at St. Elizabeth's Medical Center are comparable to those provided at other hospitals in the Boston area. The Department of Anesthesiology also provides residents with multiple educational resources and other benefits.
Residents begin taking call one month after starting the program. Five residents are on call every evening. The first-call resident is usually the most senior; second- and third-call residents are generally more junior. First- and second-call residents remain in-house to cover surgical and obstetrical cases and for hospital-wide emergencies. The third-call resident helps with late cases and leaves the hospital as soon as the first- and second-call residents can manage the workload. The third call resident is also available to return to the hospital if needed. Two additional residents stay to finish late cases, but do not have overnight pager responsibilities. There is always an in-house staff anesthesiologist to assist and supervise the on-call residents, 24 hours a day, seven days a week and a second staff is available to return to the hospital if needed. Call rooms are adjacent to the obstetrical suite and are comfortably furnished. Televisions, computer workstations and showers are available.
Electronic Medical Record System
The Department of Anesthesiology uses AnesthesiaTouch, an iPad based Electronic Medical Record (EMR). Vital signs stream into the EMR which allows the resident to focus exclusively on the patient. Patient data is available in real-time to remote locations. The final record produced by this EMR is perfectly legible and available on the hospital-wide Meditech EMR.
The departmental library and conference room are well furnished, conveniently located, and offer online access. Journals are accessed through the Tufts University School of Medicine digital library.
A team of technicians help maintain and update the anesthesia equipment. Monitors and other machines are regularly serviced. Anesthesia carts are appropriately stocked in a timely fashion, and used materials are promptly disposed of or disinfected. They also set up monitors and are of great help in starting major cases and emergencies.
Application to the program is through the ERAS system. The requirements for application are:
• Three letters of recommendation
• Personal statement
• Curriculum vitae
• Medical school transcript
• Dean's letter
• USMLE transcripts I, II (CA-1 applicants are expected to have passed Step III prior to starting the CA-1 year)
• ECFMG (if applicable. If you have any questions, please see www.ecfmg.org)
Learn the answers to frequently asked questions about applying to the Anesthesiology Residency Program at St. Elizabeth’s Medical Center.
Other questions regarding the anesthesia residency program can be directed to:
Residency Program Coordinator
St. Elizabeth’s Medical Center
Department of Anesthesiology, Critical Care & Pain Medicine
736 Cambridge Street
Brighton, MA 02135