Program Structure

Basic Clinical Training (PGY1 or BCT)

The sequence of training begins with a PGY1 resident seconded to a broad based clinical year. Residents rotating on Anesthesia during the base year receive a four week orientation period during which they are exposed to the Pre-Admission Clinic, Pediatric Pain Service and the operating room which includes a two week communications course.


Rotation

Duration

Cardiology 4 weeks
Emergency Medicine 4 weeks
General Surgery 4 weeks
Otolaryngology 4 weeks
Medicine 8 weeks
Obstetrics 4 weeks
Pediatrics 4 weeks
Anesthesia 8 weeks
Communications 4 weeks
Electives 4 weeks
Vacation 4 weeks

PGY2

This year begins at either the Royal Alexandra or University Hospitals where the rotation will be designed to allow the beginning resident to develop basic skills in Anesthesia. Residents in this year concentrate their experience in the OR in general, regional, obstetrical and difficult airway rotations. During this time period residents are closely supervised on a one-to-one basis by a staff person.


PGY3 & PGY4

Residents concentrate their experience in the subspecialty rotations which include cardiac, thoracic, neurosurgical, pediatric and obstetric anesthesia, in a variety of intensive care settings and 6 months in internal medicine rotations such as cardiology and pulmonary medicine.


PGY5

This year is a more flexible year and options available to residents include up to 6 months of elective time.


Mandatory Content of Training

Each year is comprised of 12 months divided into 13 blocks.


Rotation

Duration

Anesthesia for General Surgery & Subspecialties
18 months
Pediatric Anesthesia
4 months
Obstetric Anesthesia 4 months
Neuroanesthesia
2 months
Cardiovascular Anesthesia
2 months
Regional Anesthesia
2 months
Chronic Pain Medicine
1 month
Pediatric ICU
2 months
ICU Elective
1 month
Adult Intensive Care
3 months
Internal Medicine

         Pulmonary
2 months
         Cardiology 2 months
         Transfusion Medicine 1 month
         Selectives 2 months

Classroom Instruction

Instruction in the basic sciences relevant to anesthesia forms the core of the two year series of resident seminars. These occur during the mandatory academic half-day each week from July through June (ie. all year).

This is considered protected time from all clinical duties for all anesthesia residents. The core program includes general and subspecialty case-based seminars, morbidity and mortality rounds, journal clubs and visiting speaking lectures. Both residents and staff are involved in presentations.

An introductory Summer Lecture Series is provided for PGY2 and Family Practice Anesthesia residents. The series consists of 11, one hour sessions each summer.

Anesthesia residents have access to a patient simulator. A Crisis Resource Management Course is conducted annually for all residents in the program except those in the PGY1. Simulation has also been expanded into areas such as anesthetic management of major disease states and intraoperative issues. Residents are booked in small groups over a number of sessions to ensure full participation.


Evaluation and Exams

Evaluation of trainees is comprehensive and has several components, including daily evaluations, logbooks, end of rotation evaluations and 6-monthly reviews with the program director.

An on-line logbook exists for each resident and is considered a mandatory component. This logbook is a national initiative and is utilized by every university anesthesia program in Canada.

The summer introductory lecture series finishes with a written examination in August. An exam based on academic half days will be given in December and June.

Residents write the Anesthesia Knowledge Test (AKT) (6) in the fall of the PGY2 year and the Anesthesia Knowledge Test (24) in the first month of the PGY5 year. All residents sit the American Board of Anesthesia - American Society of Anesthesiology (ABA-ASA) board examination at least once during their residency, typically in the spring of the PGY3 year.