Anesthesiology

The program is fully accredited by the Accreditation Council for Graduate Medical Education and consists of three years of Clinical Anesthesiology with subspecialty and/or research rotations.

The Clinical Base Year or Transitional Year (PGY-1) may take place at UPMC Mercy or at another accredited health care institution.

The training continuum provides comprehensive experience in the management of patients in all surgical subspecialties. Involvement in Critical Care Medicine, Pain Management, Post-Anesthesia Care and Ambulatory Anesthesia prepares the resident for a broad range of practice opportunities in Anesthesiology.

ANESTHESIA CONTINUUM

The anesthesiology training program is fully accredited for three years of training by the Accreditation Council for Graduate Medical Education. The three year Continuum consists of training in Clinical Anesthesia (CA-1, CA-2 and CA-3). The Department participates in the National Resident Matching Program (NRMP) for entrance at the CA-1 year of training.

Clinical Base Year

The Resident in Anesthesiology must complete twelve months of accredited preliminary training in a clinical discipline other than anesthesiology. Acceptable training includes a transitional year, internal or emergency medicine, pediatrics, surgery or any of the surgical specialties, obstetrics and gynecology, neurology, family medicine or any combination of these as approved for the individual resident by the Program Director.

The Clinical Base Year must be spent in residency programs in the United States which are accredited by the Accreditation Council for Graduate Medical Education (ACGME) or approved by the American Osteopathic Association. It also may be spent in Canadian institutions which are approved by the Royal College of Physicians and Surgeons of Canada and are affiliated with medical schools approved by the Liaison Committee on Medical Education.

UPMC Mercy offers a transitional year program, as well as preliminary years in medicine and surgery, which are highly acceptable to this department for fulfilling the Clinical Base Year requirement.

It is a requirement of the Commonwealth of Pennsylvania that, prior to beginning the CA-1 year, the resident must complete a qualifying examination (NBME/USMLE or FLEX) that would serve as a basis for securing an unrestricted license to practice medicine in the Commonwealth of Pennsylvania.

Clinical Anesthesia

Each new CA-1 resident is paired with a higher level resident who serves as their mentor during the first month of training.

The first three months of the CA-1 year emphasize basic concepts and are devoted to fundamental aspects of anesthetic management. In July of each year the Department conducts a series of intraoperative tutorial sessions for residents beginning their first year of Clinical Anesthesia.

During the remainder of the CA-1 and CA-2 years, the Program provides rotations in anesthesia for general surgery, pediatric surgery, obstetrics and gynecologic surgery, neurosurgery, cardiovascular and thoracic surgery, orthopedic surgery and surgery of the ear, nose and throat. Experience in caring for Level I trauma patients undergoing emergency surgery and/or airway management occurs on an ongoing basis. A dedicated obstetrical anesthesia rotation takes place at Magee-Women’s Hospital in Pittsburgh, and dedicated pediatric anesthesia training occurs at Children’s Hospital of Pittsburgh. In addition, residents enhance their experience and care of both obstetric and pediatric patients at UPMC Mercy. The CA-1 & CA-2 years also include training in the management of acute and chronic pain, anesthesia for ambulatory surgery, and post-anesthesia care. A regional anesthesia experience at Jefferson Regional Medical Center in Pittsburgh provides a dedicated rotation to regional anesthetic techniques. Resients perform three to five blocks per day during this rotation, more than adequately fulfilling this residency requirement.

The American Board of Anesthesiology requires a two month experience in Critical Care Medicine. The Trauma/Life Support Center of Mercy Hospital is a mixed medical/surgical unit in which Attending Physicians with Critical Care Certification from the Departments of Anesthesiology, Medicine and Surgery direct residents from those three departments in providing total management of patients in the Unit.

ADVANCED ANESTHESIA TRAINING

The CA-3 year consists of one of three distinct tracks which may be selected by the resident in collaboration with the Director or Associate Director of the Program. These tracks are designated the Advanced Clinical Track, the Subspecialty Clinical Track and the Clinical Scientist Track.

Advanced Clinical Track:

Residents who select this track will complete a minimum of six months of assignments in advanced and complex anesthetic management. The remaining six months may be spent in one to three selected subspecialty rotations or an additional period of time caring for patients with complex medical/surgical problems who require anesthesia care.

Subspecialty Clinical Track:

Residents may elect to complete six months in a single subspecialty rotation along with advanced experience in complex clinical anesthesia assignments. Alternatively, the resident may select six months of experience in each of two subspecialty rotations. The subspecialty experiences at Mercy Hospital include cardiovascular and thoracic anesthesia, neuroanesthesia, pain management, and critical care medicine.

Clinical Scientist Track:

Residents who elect this option must devote six months to clinical and/or laboratory investigation. The remaining six months must be in advanced or subspecialty clinical training. During the six months of clinical or laboratory investigation the resident will receive instruction in research methodology and statistics and will participate in protocol development. Departmental investigations in the use of ultrasound, clinical pharmacology, blood conservation, echocardiography and novel drug therapy have been ongoing.

Specific departmental research efforts have concentrated on outcome parameters in cardiac anesthesia, post cardiopulmonary bypass coagulopathy, clinical applications of ultrasound (transesophageal echocardiography and facilitation of vascular access), pharmacologic studies of critically ill patients, blood pressure control during cardiopulmonary bypass, and value-based anesthesia care. The Department utilizes computer generated anesthesia records that provide opportunities for automated prospective data acquisition.

INTRAOPERATIVE ECHOCARDIOGRAPHY

The department has a very strong focus on intraoperative echocardiography (IOE). All faculty who perform IOE at Mercy are testamurs of the Perioperative Transesophageal Echocardiography Examination by the National Board of Echocardiography. The IOE service is provided exclusively by anesthesiologists on the faculty. Faculty members have participated in preparing the national written examination for perioperative transesophageal echocardiography and speak regularly at national meetings on IOE.

The department sponsors a biannual conference on intraoperative echocardiography that features Mercy faculty members and distinguished speakers from other universities. The conference attracts anesthesiologists, cardiologists, and cardiac surgeons from across the country and Canada.

Residents have ample opportunity to learn IOE from faculty members during their cardiac and dedicated TEE rotations.

THE DIDACTIC PROGRAM

The didactic program begins in September of each year and runs through the first part of June. Scheduled conferences are held regularly.

Grand Rounds are presented by residents and attending faculty members on an assigned basis. Problem Based Learning Discussions are patterned after the successful format from recent meetings of the American Society of Anesthesiologists, emphasizing participation of the entire group. The sessions provide in-depth reviews of factors surrounding common and uncommon clinical problems; the format reinforces communication skills vital to a consultant in anesthesiology.

A Didactic Lecture Series based on the Current Content Outline of the In-Training Council of the American Board of Anesthesiology and the American Society of Anesthesiologists is structured to provide a systematic approach to the basic sciences and anesthetic management. The course is presented over a three year period and each senior resident is required to give one lecture.

A Written Examination Workshop is based on ASA¹s Self-Evaluation Examination, and members of the faculty with experience as Associate Examiners for the American Board of Anesthesiology conduct practice oral examinations in group and individual settings throughout the continuum of training.

An important and unusual feature of Mercy¹s didactic program is scheduled library time; each resident is assigned one library day per month, during which he/she can pursue reading assignments or prepare journal club or grand rounds presentations.

Journal Club meetings occur throughout the year and are hosted by members of the attending faculty. Residents present timely articles from recent publications to stimulate discussion centered on selected topics.

ANESTHESIA LIBRARY

A comprehensive departmental library acquires current textbooks and subscribes to the major anesthesia journals and other pertinent literature. Each resident receives, at departmental expense, three textbooks, the Journal of Anesthesiology and Refresher Courses in Anesthesiology.

VISITING PROFESSORSHIP PROGRAM

The Department invites distinguished teachers and investigators during the year to present lectures and to participate in clinical instruction in the operating rooms as an integral part of the educational program.

EDUCATIONAL ALLOWANCE

Each house officer may attend one major educational meeting during each of the CA1-CA3 years. The yearly educational allowance will cover expenses to most meetings in the United States. Alternatively, residents may use this educational allowance to purchase reading or computer educational material.

NIGHT SCHEDULE

Residents in anesthesiology begin taking night and weekend call with a more senior resident during their second month of clinical anesthesia and assume additional clinical responsibility that is commensurate with their experience and progress. A member of the faculty attends all night, weekend and holiday emergency procedures. Residents begin their call day at 11:00 a.m. and are off the day after night call; the frequency of call averages one night in seven.

FACULTY ADVISORS

Each resident is assigned to a member of the faculty who will act as advisor/counselor during the course of the resident’s training.

GRADUATES

Graduates of Mercy Hospital’s Residency Training Program are highly successful in securing competitive fellowship training positions, university faculty appointments, and jobs in private practice. Numerous graduates of the program are Anesthesia Department Chairpersons, Division Chiefs, and Oral Board Examiners. Several have authored well-respected textbooks and book chapters in important anesthesia textbooks. Two graduates of our residency program became presidents of the American Society of Anesthesiologists and one became president of the American Board of Anesthesiologists.

LIVING IN PITTSBURGH

Pittsburgh is a city on the move. No longer a center for heavy industry; the city has earned an international reputation for its successful shift into advanced technology and biomedical enterprises. The extensive physical redevelopment of the metropolitan area has been paralleled by a rise in quality of life indicators, as demonstrated by the selection of Pittsburgh as among the most livable cities in the United States.

Building on a base of stable neighborhoods, low housing costs, moderate climate, and low crime rates, Pittsburgh also boasts a diversified economy and strong cultural, educational, and medical communities.

Leisure Activities Abound

Regular performances by the Pittsburgh Symphony, Ballet Theater, and the Opera will satisfy the most demanding performance-goers. Museum lovers will appreciate The Carnegie, with its outstanding art collection and museum of natural history. Sports enthusiasts will enjoy the Pittsburgh Pirates, Penguins, and Steelers, as well as Division I college sports.

For More Information…

See the Graduate Medical Education overview booklet for:

A concise description of medical education activities at Mercy
A brief introduction to each of the Hospital’s residencies
More information about living in Pittsburgh
See individual residency program brochures for details about educational opportunities in each specialty.

A HEALTHY LEARNING ENVIRONMENT

UPMC Mercy fosters an environment of interaction that is conducive for training young physicians. As part of this effort, a personal interview is required of an anesthesiology applicant. The visit gives the applicant an opportunity to meet our faculty and to interact with residents currently in the program.

Contact:	Denise Picciafoco
Title:	Anesthesiology Residency Coordinator
Address:	Department of Anesthesiology UPMC Mercy 1400 Locust Street Pittsburgh, PA 15219
Phone Number:	(412) 232-8009
Fax Number:	(412) 232-7384
E-mail Address:	anesthesiology.residency@mercy.pmhs.org