Curriculum – Anesthesiology Residency

Mount Sinai West and Mount Sinai Morningside Hospitals offers 13 categorical positions through the Department of Anesthesiology at The Icahn School of Medicine at Mount Sinai.

This four-year program uses multiple educational formats, both formal and informal. As a resident, you gain personalized training and mentorship from leaders in anesthesiology known worldwide in a friendly and comfortable learning environment.

Clinical Base Year

The clinical base year provides a strong foundation in medicine and surgery with a variety of electives to provide you with a well-rounded experience that helps you grow as a perioperative physician and future anesthesiologist. Our year-long program includes three months of inpatient internal medicine and general surgery, one month of emergency medicine, and one month of critical care. In addition, you experience a month-long perioperative medicine rotation with an emphasis on acute pain management (peri-surgical home), and a one-month rotation in clinical anesthesiology, where you work one-on-one with a clinical mentor. You maintain this mentoring relationship throughout your training. Our clinical base program also includes two elective months where you can  enhance your experience in ultrasound, cardiology, echocardiograms, cardiac intensive care unit, or in the blood bank. 

Our clinical base year familiarizes you with the close knit surgical and medicine communities of Mount Sinai West and Mount Sinai Morningside and smooths your  transition to anesthesia practice. You become a part of the Department of Anesthesiology through your anesthesia and perioperative medicine rotations as well as regular meetings with the program leadership and an Intern Year Improvement Committee composed of clinical anesthesia (CA) residents.

View a clinical base year sample schedule.

Clinical Anesthesia – Year 1

The first year of CA training focuses on the administration of general anesthetic care coupled with a robust didactic program with an eye toward The American Board of Anesthesiology (ABA) BASIC examination.

Our first year residents receive an intensive, one-month-long introduction to the anesthesiology curriculum, which includes one-on-one clinical mentoring, twice daily didactics, and simulation-based training. During the first month of your residency, you are excused from clinical duties so that you can attend weeklysimulation labs. After this intensive introduction, we offer ongoing training every week with rotating small groups of students. You continue to work with your clinical mentor from the internship year. Didactics include basic anesthesia knowledge along with sessions on well-being, study skills, and professionalism. Simulation training takes place in small groups and covers general topics including anesthesia induction, emergence, hypoxia, hypotension, and Advanced Cardiovascular Life Support (ACLS).

For the remainder of the year, the primary focus of our CA-1s is on general anesthesia, though most also rotate through our pre-admission testing clinic, non-operating room anesthesia, the post-operative care unit, and the medical intensive care unit. You also begin subspecialty exposure with rotations in obstetric anesthesia, chronic pain, neuroanesthesia, and cardiac, among others.

Our first year residents participate in an ABA BASIC exam review course near the end of the year. To help you get ready, we provide a study guide prepared by the program director as well as a course series that reviews the ABA content outline.

Clinical Anesthesia – Year 2

As a CA-2 resident, you find yourself immersed in subspecialty just as you have hit your stride in the general practice of anesthesia. This year will prove to be one of dynamic growth and challenge, as you gain exposure across many hospital locations. You rotate through cardiac, pediatric, obstetric, regional, thoracic, neuroanesthesia, chronic pain management, acute pain management, the surgical intensive care unit, and New York-Presbyterian Morgan Stanley Children’s Hospital.

During this year, you participate in our ABA ADVANCED didactic curriculum. We encourage our senior residents to present medically challenging cases or original research nationally as part of their professional development (every year multiple CA-2 residents present at the American Society of Anesthesiologists, New York State Society of Anesthesiologists, Post Graduate Assembly in Anesthesiology, Society for Education in Anesthesia, or subspecialty conferences). Over the last few years, CA-2 residents have joined our faculty on international service trips to locations including Bolivia, China, Burma, Tanzania, Vietnam, and the Dominican Republic.

Clinical Anesthesia – Year 3

While our CA-3 residents continue with subspecialty rotations, our program emphasizes a qualitative shift toward the higher level practice of incorporating principles such as oversight, leadership, resource management, and junior resident mentorship.

During this year, you spend one month at The Mount Sinai Hospital where you experience challenging and complex cardiac cases, pediatric cardiothoracic cases, and transplants. A month-long vascular rotation exposes you to major vascular and complex aortic endovascular cases. You also devote an additional month to practicing thoracic anesthesia at Memorial Sloan Kettering Cancer Center. This last training year is rounded out with additional echo/cardiac and advanced airway/ear, nose, and throat experiences. Unlike earlier years, this year in the general anesthesia rotations, you assume new leadership roles at both of our hospitals as team captain, coordinating the operating room alongside the on-call attending, and you take on more of a supervisory role with junior residents.

The following is an example of the training schedule for our residents categorized by clinical anesthesia (CA) years. 

Clinical Anesthesia Training Years

The following are descriptions of each of these rotations:

  • Mentor: General anesthesia rotations in the beginning of the CA1 year. You  work one-on-one with a faculty member to transition into your clinical anesthesia years.
  • NORA: The non-operating room anesthesia rotation exposes you to the challenges of anesthesiology outside of the operating room in settings such as endoscopy, interventional radiology, neurointerventional, and transesophageal echocardiography/cardioversions.
  • PAT: The pre-admission testing rotation covers perioperative medicine. With supervision, you are the anesthesiologist in charge at the pre-admission testing clinic screening patients for surgery. Through patient encounters and didactic sessions, you gain proficiency in preoperative testing.
  • Neuro: The neuroanesthesia rotation gives you experience with craniotomies for supratentorial and infratentorial tumors, decompressive craniectomies, epilepsy surgeries, transphenoidal pituitary adenoma resections, functional deep brain stimulators, minimally invasive intracerebral hemorrhage  surgery, a large variety of spine surgeries, strokes, and coiling of cerebral aneurysms.
  • PACU: The post-anesthesia care unit rotation consists of managing perioperative complications and responding to hospital emergencies under the supervision of a faculty member. In addition, you begin to become proficient with peripheral nerve blocks as we see a large volume of patients that require post-operative regional blocks.
  • MICU: During your rotation in the medical intensive care unit, you become an integral part of the medical intensive care team for four weeks.
  • Cardiac: The four-week rotation at Mount Sinai Morningside consists of a high volume of on and off pump coronary artery bypass grafting (CABGs), robotic CABGs, mitral valves, aortic valves, aortic aneurysms, and electrophysiology.
  • Pediatric: This four-week rotation introduces you to pediatric anesthesia and consists of everyday pediatric cases such as dental care, ear, nose, and throat and magnetic resonance imaging. This experience prepares you for the more complex cases and children you will encounter at the Children’s Hospital of New York.
  • CHONY: After acquiring a basic understanding of pediatric anesthesia at your home institution, you experience eight weeks of pediatric anesthesia at the New York-Presbyterian Morgan Stanley Children’s Hospital. The hospital  provides services for the major pediatric surgical specialties, including pediatric general surgery, neurosurgery, orthopedics, otolaryngology, ophthalmology, plastic surgery, urology, cardiac, and solid organ transplant. You take care of patients ranging from neonates to adolescents.
  • OB: The introductory rotation in obstetric anesthesiology as a CA1 exposes you to one of the highest volume labor and delivery units in Manhattan. You gain experience in the anesthetic management of vaginal and cesarean deliveries, various obstetric procedures, and obstetric emergencies, and become proficient in neuraxial anesthesia techniques. In the CA2 and CA3 years, you take on a more active role in managing the labor and delivery unit, being a consultant, and handling more challenging cases.
  • SICU: This four-week experience in the surgical intensive care unit allows you to learn perioperative management of surgical patients in the critical care setting alongside surgical and anesthesia faculty.
  • Chronic Pain: As part of the pain management team, you manage inpatient and outpatient chronic pain consults. You learn about  pain management procedures such as steroid injections, medial branch blocks, radiofrequency ablation, joint injections, trigger point, peripheral nerve blocks, sympathetic blocks, spinal cord stimulators, and ketamine infusions.
  • Thoracic: This four week thoracic experience introduces you to intrathoracic cases such as VATS, open thoracotomies, and esophagectomies, where you develop the skills for managing lung isolation.
  • Sloan: At the cancer center at Memorial Sloan Kettering Cancer Center you are exposed to a high volume of challenging thoracic cases in cancer patients. The skills you learned in the introductory thoracic rotation sharpen as you gain proficiency in managing complex video-assisted thoracic surgery, pneumonectomies, esophagectomies, anterior mediastinal mass resections, and endobronchial ultrasounds.
  • Acute Pain: In this rotation, you become an integral part of the acute pain management team, performing inpatient acute pain consults, managing post-operative pain, postpartum pain, and taking responsibility for all the post-operative pain catheters.
  • Sinai: This four-week rotation at The Mount Sinai Hospital gives you exposure to solid organ transplants (including liver), pediatric cardiothoracic cases, and complex cardiac surgeries.
  • Echo/Cardiac: This rotation hones your skills in transesophageal echocardiograms by allowing you to join the cardiology service and interpret transesophageal echocardiogram examinations alongside them.
  • Regional: In this rotation, you gain proficiency in upper extremity blocks and catheters, lower extremity blocks and catheters, truncal blocks, neuraxial blocks, and thoracic blocks. Even though this is the official regional rotation, you receive robust training in regional anesthesia performing a wide variety of blocks and catheters for varying procedures in many other areas of your training.
  • Vascular: You are exposed to major vascular cases such as carotid endarterectomies, bypasess, aortic repairs, and complex endovascular aortic and thoracoabdominal aneurysms in a dedicated vascular hybrid operating room.
  • Advanced Airway/Ear, Nose, and Throat: This four-week experience lets  you manage the most difficult airways in patients with head and neck cancer undergoing major airway reconstructive surgeries or airway therapies. You build on your skills in fiberoptic intubations, video laryngoscopy, jet ventilation, and management of tracheostomies.
  • Ortho: In four weeks of orthopedic procedures,  you gain experience in  a variety of orthopedic cases including knee replacements, hip replacements, joint revisions, spine surgeries, shoulder replacements, hand surgeries, and robotic orthopedic procedures. This rotation also provides another opportunity to build on you regional anesthesia skills

Didactics     

In addition to the introductory curriculum that the CA1s receive at the beginning of their training, you also attend  daily educational activities in the mornings. Journal club occurs once a month with the visiting professor the evening before the Wednesday morning conference.

Monday:

  • CA1:  Basic Lecture Series

Tuesday:

  • CA2 & CA3: Advanced Lecture Series

Wednesday:

  • All residents and faculty: Grand Rounds/Workshops/Simulation/Visiting Professors

Thursday:

  • All residents: Specialty Specific Didactics/Journal Clubs/Trouble Rounds/ Wellness Sessions/ Chief Resident Forums