Curriculum

Anesthesiology Residency Curriculum 

Dignity Health St. Joseph’s Medical Center Anesthesiology Residency program offers a robust and comprehensive training experience with opportunities at affiliated institutions such as Shriners Hospitals for Children in Northern California, Valley Children's Hospital, San Joaquin General Hospital, and UC Davis Medical Center.

The core curriculum for anesthesiology residents comprises a series of learning modules. The modules focus on basic and advanced topics outlined in the American Board of Anesthesiology (ABA) examination content outline, ABA certification requirements, leadership and healthcare systems fundamentals, and essential clinical skills. Residents protected didactic lectures once a week along with bi-monthly education days for simulation sessions, case based scenarios, and procedural workshops. 

Clinical Base Year (CBY)

The categorical positions begin with an integrated internship at Saint Joseph Medical Center. The internship is designed to provide the intern with a foundation in medical and surgical specialties, as well as an introduction to anesthesiology. The curriculum of the year is divided into four-week block rotations.

Clinical Base Year (CBY) Rotation Schedule
Rotation - Length

• General Internal Medicine - 3 months
• Pulmonology - 1 month
• Critical Care Medicine - 2 months
• General Surgery - 1 month
• Infectious Disease - 1 month
• Emergency Medicine - 1 month
• Cardiology - 1 month
• Research & Procedures - 1 month
• General Operating Room - 1 month
• Elective - 1 month (Cardiology, Pulmonology, ID, Nephrology)

Clinical Anesthesia Year 1 (CA-1)

The curriculum will be intensive and progressive, designed to facilitate skill-building and knowledge consolidation. It will focus on the fundamental principles of general anesthesiology necessary for anesthesiologists to function effectively. CA-1 residents participate in lectures tailored to prepare them for both their In Training Exams and the BASIC exam. The first clinical anesthesia year is focused primarily on general operating room cases while the second half of the year introduces residents to subspecialties such as obstetrics, acute pain, neuroanesthesia, critical care, and cardiac anesthesia. 

Clinical Anesthesia Year 1 (CA-1) Rotation Schedule
Rotation - Length

• General Operating Room - 7 months
• Critical Care Medicine - 1 month
• Obstetric Anesthesia - 1 month
• Neuroanesthesia - 1 month
• Acute Perioperative Pain Management - 1 month
• Cardiothoracic Anesthesia - 1 month
• Pre-operative Clinic - 0.5 month
• Post Anesthesia Care Unit - 0.5 month

Clinical Anesthesia Year 2 (CA-2)

During the CA-2 year, residents will continue to hone their skills and knowledge with more detailed clinical exposure to anesthesia subspecialties. In addition, the CA-2 year gradually gives residents increasing levels of responsibility and autonomy in patient care, especially in tasks already mastered during the CA-1 year.

Clinical Anesthesia Year 2 (CA-2) Rotation Schedule
Rotation - Length

• General Operating Room - 1 month
• Critical Care Medicine - 1 month
• Neuroanesthesia - 1 month
• Regional Anesthesia - 1 month
• Ambulatory Anesthesia - 1 month
• Acute Perioperative Pain Management - 1 month
• Cardiothoracic Anesthesia - 1 month
• Thoracic Anesthesia - 1 month
• Pediatric Anesthesia - 2 months
• Chronic Pain - 1 month
• Obstetric Anesthesia - 1 month
• Elective - 1 month

Clinical Anesthesia Year 3 (CA-3)

Senior residents have the opportunity to tailor their training to align with their personal and professional goals with additional subspecialty training in pediatrics and elective rotations. In addition to having the opportunity to engage in research projects, residents will meet all the requirements to sit for the Basic Perioperative Transesophageal Echocardiography Examination.

Clinical Anesthesia Year 3 (CA-3) Rotation Schedule
Rotation - Length

• General Operating Room (Advanced Clinicals) - 4 months
• Pediatric Anesthesia - 2 months
• Research - 1 month
• Cardiothoracic Anesthesia - 1 month
• Obstetric Anesthesia - 1 month
• Regional Anesthesia - 1 month
• POCUS/TEE - 1 month
• Non-Operating Room Anesthesia (NORA) - 1 month
• Elective - 1 month

Didactic Series

Weekly Didactics are held every Wednesday afternoon and are split between Basic and Advanced curricula. CA-1 residents focus on fundamental principles of anesthesiology to prepare them for the Basic exam at the end of their academic year. CA-2’s and CA-3’s are given lectures on advanced topics that will expand their understanding of subspecialty topics and prepare them for the Advanced exam.

Expectation of Residents
Residents should review the learning objectives before each session and complete all required pre-reading assignments assigned before each session. All residents are expected to participate in the discussions during the session. Additionally, residents are expected to review the relevant medical literature on pertinent clinical subjects.

Educational Activities
The core curriculum for anesthesiology residents includes the following educational activities:

Self-Directed Learning Plans (SDLP)
We implement a curriculum using self-directed learning plans (SDLPs) based on clinical questions arising from the resident’s practice. The primary goal of this activity is to foster the development of residents as adult, self-directed, lifelong learners and enable them to recognize and fill knowledge gaps.

Problem-Based Learning Discussions (PBLD)
Problem-based discussion or multiple problem-based interactive talks on various topics are incorporated into the core didactic series and bi-monthly educational days. The PBLD sessions are based entirely on the ABA advanced examination content outline..

Grand Rounds
Monthly anesthesia Grand Rounds are held at 07:00 AM on Wednesday mornings. The mission of this series is to deliver exceptional lectures by distinguished speakers on cutting-edge topics in the field of medicine. Additionally, present important, interesting, and unusual anesthesia problems, along with an analysis of pathophysiological and therapeutic interventions in selected cases. Both department members and visiting faculty present topics at this conference. Each resident is required to give a Grand Rounds presentation at the end of their residency training. Senior residents select a topic related to a noteworthy issue raised during their patient care and conduct a thorough literature search, finding information that both supports and disputes the findings. Residents are guided and helped by a self-selected faculty mentor.

Journal Clubs
Journal Club is held monthly and is moderated by CA-2 residents under the guidance of an assigned faculty mentor. Residents discuss recent literature and provide an opportunity to understand how research conclusions inform the development of evidence-based medicine and best practices guidelines, as well as critique articles for their scientific merit and relevance. All residents are expected to attend, and each session features two article presentations. The primary goal of these sessions is to encourage residents to follow peer-reviewed journals and develop the skills necessary to read such material critically.

Morbidity & Mortality
Monthly Morbidity and Mortality Conferences focus on discussing complications, their etiology, and relevant anesthesia decision-making. Residents are required to select and present a case for M&M during their CA-2 and CA-3 years. A faculty member guides these discussions. Presentations include a review of relevant literature, guidelines, and current practices both within the department and throughout the country. Time is allotted for questions and collegial exchange between faculty and residents. The primary mission of these conferences is to discuss cases of unexpected morbidity or mortality, identifying opportunities to improve performance and clinical outcomes.

Ultrasound Workshops
These hands-on workshops, incorporated into our bimonthly education days, are designed to review the anatomy of peripheral nerves and blood vessels, as well as the ergonomics and physics associated with ultrasound. Furthermore, residents learn how to optimize image quality for standard applications, identify artifacts, recognize targets, understand scanning techniques, and comprehend needle approach techniques, including in-plane and out-of-plane needle guidance. These sessions are conducted through hands-on practice, including scanning on a live model, as well as peripheral nerve blocks and vessel cannulation using cadavers and phantoms.

Problem-Based Simulation Scenarios
These sessions include high-fidelity simulated problem-based scenarios that promote a safe learning environment and provide specialized training for incoming residents. The training focuses on the basics of induction, emergence, and troubleshooting, as well as developing and enhancing procedural knowledge and efficiency. Additionally, it teaches crisis management and provides training to address complex, catastrophic anesthesia complications. Besides, residents have the opportunity to develop management strategies to identify and predict difficult airways and learn alternate approaches to airway management. Additionally, residents have the chance to practice in challenging patient scenarios, including delivering bad news, obtaining informed consent, and discussing perioperative complications.

Transthoracic and Transesophageal Echocardiography Simulation Scenarios
Residents are provided with a basic understanding of ultrasound, including the machines, types of probes, obtaining views, and fundamental physics related to ultrasound, followed by instruction on echocardiography through high-fidelity simulation. The primary goal of these sessions is to facilitate the acquisition of essential knowledge and basic psychomotor and technical skills required for transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE), and to reinforce didactic learning. Echo is incorporated into the curriculum, and residents are expected to have enough exposure to meet requirements for Basic TEE certification.

Root Cause Analysis/ Quality Improvement
Each resident is required to complete one Quality Improvement (QI) project during their residency. Each resident must identify a relevant clinical or systems problem, determine the underlying cause, and develop strategies to improve it.

Mock Oral Board Examination
The purpose of the mock oral board examination is to prepare residents for the ABA standardized oral examination and elevate their level of critical thinking, patient care, and professional interactions to a consultant level during residency. Residents will participate in several Mock Oral Board sessions during their residency, with an emphasis on senior residents.

Each mock oral session is followed by incisive feedback on examinee style and response content. A written evaluation will be provided to each resident. These sessions may be individual sessions or group sessions, which also involve discussing high-yield content and allow junior/senior residents to ask questions and engage in live discussions.

Objective Structured Clinical Examination (OSCE) Sessions
Our residents participate in mock Objective Structured Clinical Examination (OSCE) sessions. The mock OSCEs are based on the ABA Content Outline and include standardized patients, ultrasound models, simulated exam rooms, and monitors. Standardized checklists are used to evaluate residents on communication and professionalism, as well as understanding and application of medical knowledge.

Medical Ethics and Professionalism
The goal of these lectures is to introduce residents to fundamental concepts in education, business, law, and communication that impact the delivery of effective healthcare. These lectures focus on healthcare management, organizational structure, clinical instruction, ethics, healthcare economics, risk management, professionalism, research, educational skills, physician leadership, and excellence in patient care.

Research/ Scholarly Activity
We encourage and support resident scholarly activity, and our program requires residents to participate in some type of scholarly activity during their residency training. These scholarly activities may include research studies, case reports, etc. that are supervised by a faculty mentor. Residents regularly participate in abstract presentations at national conferences, education-related service on national committees, research, or publication of a book chapter.