Vanderbilt Anesthesiololgy

Overview

The Pediatric Anesthesiology Residency Program at Vanderbilt University Medical Center provides 12 months of subspeciality education and training in all aspects of pediatric anesthesiology. This program is accredited by the Accreditation Council for Graduate Medical Education. Subspeciality training is at the CA-IV level and begins after satisfactory completion of an ACGME-accredited residency in anesthesiology. Education and training concentrate on all phases of perioperative anesthesia care for patients undergoing both inpatient and outpatient surgical procedures, as well as for patients undergoing diagnostic and non-operative procedures outside of the operating room. The didactic program and clinical curriculum also include pediatric pain management, advanced life support and critical care of neonates, infants, children and adolescents. Trainees actively participate in division and departmental educational activities relevant to their training. Under faculty supervision, trainees assume graduated responsibility for instruction and supervision of medical students and junior residents assigned to the service. In addition, trainees are encouraged to participate in clinical and/or basic science research relevant to the discipline of pediatric anesthesiology.

Faculty

The Director of the Pediatric Anesthesiology Residency Program is responsible for oversight of all aspects of education and training. This includes applicant evaluation and selection; development and coordination of clinical experience and didactics; supervision of the teaching staff and, in turn, residents; review of resident, faculty and program evaluations.

Pediatric anesthesiology faculty in the Division of Pediatric Critical Care and Anesthesia actively supervise trainees during their clinical assignments in pediatric anesthesia. In addition, faculty members participate in the didactic curriculum, as well as in other educational and clinical conferences. Other faculty within the Department of Anesthesiology, e.g., anesthesiology faculty in the Division of Cardiovascular Anesthesia and critical care faculty in the Division of Pediatric Critical Care and Anesthesia, actively supervise trainees assigned to subspeciality clinical rotations.

Facilities

Clinical training programs are conducted on the campus of Vanderbilt University Medical Center. Vanderbilt Children’s Hospital serves as both a primary care facility for local residents and a regional referral center. Consequently, experience in pediatric anesthesia ranges from brief outpatient procedures to complex neonatal, cardiovascular, orthopedic and neurosurgical procedures.

Curriculum

The clinical anesthesia program provides a broad experience, beginning with routine case assignments and progressing to increasingly complex surgical procedures and patient problems. Residents can expect to easily exceed the minimum requirements for clinical case experience recommended by the ACGME (250 pediatric patients, including 35 neonates, 60 infants, 10-15 “open heart” cases, and 5 craniotomies). Residents gain experience in the management of sedation and anesthesia outside the operating room by participating in the care of patients undergoing cardiac catheterization, MRI and other diagnostic and therapeutic procedures. Residents also participate in the activities of the Pediatric Pain Service, providing inpatient consultations for postoperative pain management and other acute medical conditions. Experience in chronic pain management is gained through involvement in the management of both outpatients and inpatients with chronic pain problems. Critical care experience is provided during the one-month assignment in the Pediatric Critical Care Unit. The clinical curriculum is flexible and can be modified to address the training requirements and clinical and academic goals of the individual resident.

Outline of Clinical Curriculum:

Didactics: The basic lecture series, “Fundamentals of Pediatric Anesthesia, provides a foundation in the principles of pediatric anesthesiology and an opportunity for trainees to develop skills in lecture preparation and presentation, as well as in discussion facilitation. The core lecture series, “Pediatric Anesthesia Practice,” provides in-depth lectures and discussions of the major topics in pediatric anesthesia practice (see attachment).

Division and Departmental Conferences: Routine attendance and participation is also required at the Division Continuous Quality Improvement and Morbidity/Mortality Conference; Division Research Conference and Journal Club; Departmental Grand Rounds; and relevant Pediatric Critical Care Conferences.

Research: Trainees are encouraged to participate in clinical and/or basic science research. An introduction to the foundations of research is available through the “Experimental Medicine Course” offered annually by the School of Medicine and by participation in the research conferences of the Division of Pediatric Critical Care and Anesthesia. Experience in clinical or basic science research is most easily obtained by participation in ongoing research projects of faculty within the Division of Pediatric Critical Care and Anesthesia.

Education and Training Objectives

Resident Duties and Responsibilities

In accordance with clinical assignments, pediatric anesthesia residents participate in the continuum of perioperative anesthesia care under the supervision of attending faculty members. Residents are assigned to provide direct patient care for routine then increasingly complex cases. As residents gain experience, they also participate in the supervision of junior anesthesia residents and medical students. Attending faculty remain responsible for approving the anesthesia plan and personally supervising all critical aspects of anesthesia care, consistent with departmental and HCFA policies.

The standard workweek is Monday – Friday, with weekends off except when on call. On call responsibilities may vary but generally entail call from home on an average frequency of one in five nights or weekend days. When assigned to non-anesthesia rotations, e.g., and PICU rotation, trainees are expected to take in-house call on a frequency similar to that of other trainees. All rotations comply with ACGME minimum guidelines for average hours worked per week (<80), frequency of call (< one in four nights) and days off (one in seven). Clinical anesthesia duty is limited to a maximum of 24 hours of “in-house” service.

Evaluation Process

Faculty members review the performance and progress of residents at the monthly meeting of the Pediatric Anesthesia Service and complete written evaluations quarterly. Written evaluations are requested more frequently if substandard performance is observed. The program director subsequently reviews all evaluations with residents and completes a summary evaluation at six-month intervals. Unsatisfactory resident performance shall be reviewed immediately by the Program Director and, if indicated, Division faculty. Persistent unsatisfactory performance shall prompt review and action by the departmental Clinical Competence Committee.

Residents are requested to complete on-line evaluations of faculty members and written evaluations of the training program every six months. The Program Director shall review evaluations and meet at least annually with faculty to discuss the training program and plan indicated modifications.

Application Process

Applicants must be eligible for licensure in the state of Tennessee and must anticipate completion of clinical anesthesia training in a program accredited by the Accreditation Counsel for Graduate Medical Education prior to entering the Pediatric Anesthesiology Residency Program. Applicants must submit the following: a completed application form; a current curriculum vitae; a personal statement; copy of the medical school diploma; Dean’s letter; a reference letter from the Program Director of the Anesthesiology Program; two reference letters from colleagues; USMLE scores; ABA in training exam scores. The Program Director reviews all completed applications and invites eligible candidates for an interview with faculty in the Division of Pediatric Critical Care and Anesthesia. The Program Director shall select from eligible applicants based upon the sum of the information provided by applicants, reference letters, and evaluations of interviewing faculty members.

Contact Information