Residency Training

The Department of Anesthesiology, Critical Care & Pain Management provides training opportunities for residents enrolled in an affiliated program. Our faculty teach residents in all three years of clinical anesthesia residency training. We have long-standing partnerships with the anesthesiology residency programs at NewYork-Presbyterian Weill Cornell, Johns Hopkins, Georgetown, UCSF, and we have formed affiliations more recently with NewYork-Presbyterian Columbia, UTSW, Mount Sinai, and Medical College of Wisconsin. Residents who rotate with us learn the fundamentals of regional anesthesia if they come during their CA-1 year, and have graduated responsibilities and exposure to more complex cases as CA-3s.

Weill Cornell Medical College

Georgetown University

Johns Hopkins University

University of California - San Francisco

Columbia University Medical Center

University of Texas - Southwestern Medical Center

Mount Sinai Hospital

Medical College of Wisconsin

1. Clinical Experience
   The goal of this rotation is to provide residents with an advanced experience in regional anesthesiology and acute pain medicine. The rotation at our high-volume orthopedic center offers residents extensive hands-on experience with neuraxial techniques and ultrasound-guided peripheral nerve blocks for major joint, sports, hand/foot, and trauma surgery. Residents work closely with regional anesthesia faculty to develop procedural proficiency, refine ultrasound anatomy interpretation, and manage perioperative analgesia. Emphasis is placed on patient selection, informed consent, block safety, and multimodal pain management, preparing residents to integrate regional anesthesia into a broad range of fast-paced surgical settings.
2. Didactic Curriculum
   1. During the rotation, we bring residents to the Skills Acquisition and Innovation Laboratory (SAIL) in NYP-Cornell for a simulation session we have designed to focus on potential complications of regional anesthetics. The state-of-the-art simulation center is equipped with a simulation control room, simulation operating room, 28 high-definition cameras, multiple advanced simulation manikins, and allows us to expose trainees to realistic and unpredictable scenarios that put heightened demand on providers in regional anesthesiology. The aim of these sessions is to give residents practical experience in a safe and controlled environment by simulating rare, high-stakes perioperative complications with high fidelity. By incorporating training sessions at SAIL, this course helps residents prepare for emergent clinical situations they might have not yet encountered during their training, while also building effective interpersonal and communication strategies, leadership, and professionalism.
   2. We host residents each month in our Bioskills Lab for a cadaver workshop focusing on challenging neuraxial procedures in the lateral decubitus position. Senior residents are typically approaching expertise in spinal/epidural placement in the OB population but can often encounter challenges with orthopedic patients who are morbidly obese, elderly/cachectic, patients with scoliosis or other spinal pathology/hardware, and patients in the lateral decubitus position. It can be difficult for residents to fine-tune this skillset because the time-sensitive nature of the OR can limit opportunities to troubleshoot the challenging procedures. To close this gap, we created a challenging neuraxial lab which gives guidance for patient positioning, when to consider alternative needles, utilizing the paramedian approach, and how to perform neuraxial ultrasound for preprocedural mapping. The residents practice these skills in a low-stakes environment with a thawed cadaveric torso that confers realistic tactile feedback.
   3. We organize 2 oral boards preparation sessions each month. These sessions focus on learning common “do’s and don’ts” of the exam, and how to use a structured framework to help organize your thoughts after reading the clinical prompts.
3. Learning Objectives — By the end of this rotation, residents will be able to:
   • Assess patients preoperatively and identify which patients are strong candidates for a regional anesthetic.
   • Distinguish between regional techniques that are used for a surgical anesthetic versus techniques used to manage post-operative pain.
   • Optimize fundamental neuraxial block and peripheral nerve block technique and patient positioning in order to maximize efficiency and safety.
   • Perform full range of neuraxial and peripheral nerve blocks for orthopedic surgeries with confidence.
   • Determine which patients will be at higher risk for challenging neuraxial block and/or procedural complications based on age, body habitus, and medical comorbidities.
   • Develop a procedural framework and have a systematic approach to troubleshooting neuraxial procedures in challenging circumstances (eg. lateral positioning, morbid obesity, scoliosis or other spinal pathology, spinal hardware).
   • Perform neuraxial ultrasound for preprocedural mapping of valuable anatomic landmarks

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