Education, patient care, and a collegial work environment are core characteristics of our training program. We prepare our residents for their desired career as a consultant anesthesiologist. We invite you to learn more about our program with strong networking opportunities and a community feel.

Curriculum

Clinical Base Year

All four years of training in our categorical program are here at the University of Vermont Medical Center. Residents in the PGY1/intern year are integrated within the Internal Medicine and Surgery departments. Residents will also rotate in Emergency Medicine, Critical Care Medicine, and Anesthesiology. A wellness curriculum during this first year brings the entire class together on a regular basis.

Clinical Anesthesia - 1 (CA-1) Year

As a foundation for subsequent acquisition of clinical skills and medical knowledge, the CA-1 Year emphasizes the fundamental aspects of anesthesia in order to provide a well-rounded experience in basic anesthesia training. This includes being exposed to preoperative assessment of a wide range of patients presenting for surgery, becoming familiar with the anesthetic implications of common diseases, and understanding the basic pharmacologic and physiologic considerations involved in anesthetic practice. The first month of the CA-1 year is spent in the general operating rooms working one-on-one with faculty mentors who will guide you through your first anesthetic cases. A daily, two-month intensive introductory lecture series has been designed to complement your initial experience in the general operating rooms. As a CA-1 resident, you will be preferentially be assigned to straightforward cases, providing you with an opportunity to master the basics. Call duties are gradually phased in as residents gain sufficient skill and experience needed during on-call duties.

Additional time will be spent in the CA1 year in the clinical practice of four week subspecialtydisciplines, including obstetric anesthesia, regional anesthesia and acute pain management, surgical intensive care unit, pediatric anesthesia, neuroanesthesia and/or cardiothoracic anesthesia.

Clinical Anesthesia - 2 (CA-2) Year

The CA-2 Year provides more detailed clinical exposure to anesthesia subspecialties and greater independence in case management. Each subspecialty rotation anesthetic has specific goals for study and designated learning objectives. As a CA-2 resident, you will spend 1 month in critical care medicine, neuroanesthesia, pediatric anesthesia, cardiothoracic anesthesia, obstetric anesthesia, anesthesia in remote locations and chronic pain. While POCUS didactic sessions start in the intern year and continue through the CA3 year, a dedicated two-week POCUS rotation is scheduled in the CA2 year.

Clinical Anesthesia - 3 (CA-3) Year

In general, CA-3 residents spend the majority of their year carrying out more advanced cases in patients with significant co-existing disease. Residents have an opportunity to choose from several elective rotations including TEE, research, and blood bank. All residents will complete an OR management rotation where they learn how to supervise and run a busy OR board.

Clinical Rotations

Focus: Cardiothoracic Anesthesia

About 400 cardiopulmonary bypass cases are performed annually, providing an outstanding  clinical experience for our residents. Cardiac cases include coronary artery bypass grafting,  valvular repair and replacement, as well as complex aortic reconstructive surgery. Thoracic cases  include video assisted thoracoscopic procedures, open thoracotomy for lung resection, as well as  open and endoscopic esophageal surgeries. Intraoperative transesophageal echocardiography  (TEE) is used in the majority of cardiac procedures and this hands-on TEE experience is  supplemented with education from our TEE certified faculty. During this rotation, residents also  become proficient in placement and interpretation of arterial and central venous catheters and  become expert in management of perioperative cardiac dysfunction. We also offer a TEE  elective for CA-3 residents.

Focus: Critical Care

The primary goal of the Critical Care experience is to provide physicians with an opportunity to  acquire the knowledge, skills, experience, judgment and for optimal care of severely injured and  critically ill patients. Residents are supervised by Critical Care Medicine faculty from the  Departments of Anesthesiology and Surgery. Daily teaching from ICU faculty complements  patient care in the SICU. We view familiarity with critically ill patients as being instrumental in  the care anesthesiologists provide in the operating room and essential for creating a foundation of  clinical practice in becoming a perioperative physician. Anesthesiology trainees rotate for 1  month in the PGY1/intern year, 2 months in the SICU during the CA-1 and CA-2 years, and 1  month in the CA-3 year acting as a fellow-like consultant.

Focus: Obstetric Anesthesia

UVM Medical Center serves as the regional referral center for high-risk perinatal patients as well  as the community birthing center for low-risk deliveries. Currently, there are 2300 deliveries and  we provide approximately 1900 neuraxial anesthetics per year. Anesthetic care is individualized  for patients with a wide range of medical and obstetric co-morbidities. Through the provision of  cutting-edge Enhanced Recovery After Cesarean Delivery (ERAC), we provide cesarean delivery patients current, best evidence-based perioperative care, anesthesia and post-cesarean  analgesia. Residents typically spend one month on the obstetrical anesthesia service in each of  their CA-1 and CA-2 years and receive continued exposure to obstetrics throughout their  training.

Focus: Pain Medicine

The multidisciplinary Pain Management Center has six full-time anesthesiologist with  subspecialty certification in pain medicine, as well as a physical medicine and rehabilitation  specialist, a psychologist, and a full support staff. The pain service offers a full range of inpatient  and outpatient consultation services, including care of patients with postoperative pain, chronic  non-cancer pain, and cancer-related pain. Rotating residents participate in all aspects of the pain  service while on this subspecialty rotation. The CA-2 rotation is designed to give residents a firm  foundation in the assessment and treatment of a variety acute and chronic pain conditions. An  advanced elective rotation including opportunities for participating in ongoing or investigator  initiated clinical research is available for interested CA-3 residents.

Focus: Pediatric Anesthesia

Our faculty includes multiple anesthesiologists with subspeciality training in pediatric anesthesia. This rotation provides our residents with knowledge and experience in providing general and regional anesthesia for a broad spectrum of pediatric surgeries. We also perform a significant number of anesthetics for patients undergoing procedures outside of the operating room. Our emphasis in pediatrics is on the successful use of regional anesthesia whenever feasible. Dr. Chris Abajian pioneered spinal anesthesia for infants at the University of Vermont, and maintains the largest database in the world on outcomes associated with the use of this technique. We continue to utilize infant spinal anesthesia when appropriate for patient care.

Focus: Regional Anesthesia and Acute Pain Medicine

The use of regional anesthesia for surgery and postoperative analgesia is emphasized throughout training at the UVM Medical Center/University of Vermont. A large percentage of lower extremity surgery is performed under regional anesthesia, including spinal, epidural, and peripheral neural blockade. Regional anesthesia is utilized in a significant portion of anesthetics for upper extremity surgeries as well. Trainees gain exposure to a variety of techniques including continuous catheter techniques for both regional and neuraxial analgesia. Ultrasound is an integral part of the experience. Unique to our institution is the extensive use of spinal anesthesia for neonatal abdominal and lower extremity surgery in infants.

Education and Conferences

CA-1 Lecture Series

Weekly three-hour education sessions provide a comprehensive exposure to clinical anesthesiology and professional development. During the first half of the session, residents are led through a lecture/discussion by a faculty member with expertise in the topic area. Through the course of the year, the residents will cover the entire suggested ABA content outline for the Basic Examination in Anesthesiology. The second half of the weekly sessions focuses on interactive sessions and professional development. Topics covered in the second session include wellness, effective presentation skills, financial literacy, teaching skills, simulation sessions, written and oral board preparation and echocardiography. 

These regularly scheduled sessions will contribute to the resident’s professional development both during and after residency. Topics include wellness, effective presentation skills, financial literacy, and teaching skills. This time will also include active learning through simulation sessions, written board preparation and introduction to transthoracic echocardiography concepts. Presentations are provided by faculty and visiting speakers.

CA-2/3 Lecture Series

Weekly three-hour education sessions are based on detailed texts in physiology, pharmacology, and the anesthetic implications of co-existing disease. During the first half of the lecture session, didactic and active learning lectures guides trainees through in-depth discussions of the entire range of knowledge expected of a consultant in anesthesiology and the ABA content outline for the Advanced Examination in Anesthesiology.

The second half of the session will focus on professional development. The professional development sessions build on topics learned during the first year and expand to include topics such as interviewing techniques and evaluating contracts. The second half of the lecture sessions will also include simulation, written and oral board preparation, wellness topics, transthoracic and transesophageal echocardiography concepts and provide an opportunity to facilitate a problem-based learning discussion.

Anesthesia Grand Rounds and Morbidity and Mortality Conferences

Department Grand rounds are held on a weekly basis, bringing together all of the members of the department. Grand Rounds presentations feature visiting professors, non-departmental UVM/UVM Medical Center faculty, and Departmental faculty. Residents will prepare a grand rounds presentation during their training. Morbidity and mortality conferences are case-based and are aimed at learning more from problems and challenges that have arisen in the course of delivering clinical care. Residents will be asked to participate when appropriate with faculty oversight, direction and support.

Journal Club

This monthly conference (Sept-Oct, Feb-June) is held on a weekday evening at the home of a faculty member or on campus at the hospital. CA-1 residents are assigned articles and asked to present a brief synopsis of the published findings in an informal discussion style with backup support from a CA-2/3 resident. Critical elements of our Journal Club include highlighting research design and statistical considerations with a goal toward developing skills in critical analysis of scientific literature.

Key Words Written Board Review

This monthly conference is intended for all residents and is a review of the American Board of Anesthesiology key work phrases. With faculty supervision, assigned reading material is reviewed in the context of ABA in-training examination-style questions through an active learning process.

Simulation

Department faculty is intricately involved in the College of Medicine's Clinical Simulation Center. About six times a year, each clinical anesthesia class participates in a simulation experience taught by faculty within the center. Each CA3 resident participates in separate mock Objective Structured Clinical Examination (OSCE) to prepare them for the ABA applied exam.

Oral Board Simulation

All residents will undergo a simulated oral board examination session on a bi-annual basis with department faculty. Evaluation and feedback help prepare residents for the ABA advanced exam. In addition to these formal sessions, oral board review also occurs during the professional development lecture series.

Regional and National Meetings

Our residents are encouraged to attend and present at regional and national meetings. 

Mission Statement

The Department of Anesthesiology at The University of Vermont Medical Center seeks to educate and train residents who are well rounded, professional, intelligent, empathetic, and flexible leaders. Graduates of our program will be ready to pursue opportunities in the diverse and ever changing practice of anesthesiology and perioperative medicine. We collaborate with our graduates to help them reach their personal and academic practice goals for fellowship opportunities, research careers, and private or academic practice. We prepare them to succeed as leaders within their work environments, whether in rural or urban locations. Our program is unique in that its small size allows us to have intimate knowledge of residents’ skills through first hand, frequent observations.  The small class size allows early and frequent access for residents to all subspecialties. We are responsive to resident feedback and have created a supportive atmosphere with strong networking opportunities and a community feel.