Curriculum

Rotations

Much of the clinical teaching at Mass General takes place in or around the operating room or at the bedside. Emphasis is placed on case-related teaching in individual and small-group settings. Residents rotate to join clinical teams for one or two months at a time, in more than 12 specialty areas. Teams generally include two to six residents, occasionally a fellow, and four or five specialist attending staff. This deployment provides team members with the kind of small-group intimacy that would otherwise be difficult to foster in institutions as large as Mass General.

Specialty Rotations include: Critical care, Pain management, Cardiac anesthesia,Pediatric anesthesia, Neuroanesthesia, Thoracic anesthesia, Vascular anesthesia, and Obstetric anesthesia.

To provide more robust training opportunities, the department draws upon the resources of other Mass General departments, other Harvard-affiliated hospitals and the Massachusetts Institute of Technology to arrange non-traditional or research fellowships for residents with special interests. Additional rotations are available at area medical centers, including Children’s Hospital Boston, West Roxbury VA, Massachusetts Eye and Ear Institute and the Shriner’s Burn Institute. Finally, a multitude of electives and international rotation opportunities exist for interested trainees (see Extracurricular Opportunities, above).

CA1 Didactic Session

Didactics

The Program offers a number of formal didactics.

Grand Rounds and Case Conference

Grand Rounds are an integral component of resident education in the Department of Anesthesia, Critical Care and Pain Medicine (DACCPM). Grand Rounds feature faculty from Mass General, other Harvard-affiliated hospitals, the Massachusetts Institute of Technology, as well as national and international guest lecturers who are leading scientists and experts in their field.

Designed for residents to explore actual or theoretical cases based on information taken from a number of medical disciplines, Case Conference is held on Thursday mornings from 8:00 am to 9:00 am. The hour is typically led by a staff member with resident involvement. The goal is to engage in an interactive discussion with the audience regarding preoperative, intraoperative and postoperative anesthesia care. It provides an opportunity for residents to make key decisions based on the cases that are presented, and to defend their medical reasoning with evidence.

The Morbidity and Mortality Conference is held every two months in place of a Case Conference. This conference provides residents with the opportunity to take part in the department’s continuous efforts to improve quality and safety. Theoretical and actual cases are discussed where near-misses could have resulted in less than optimal clinical outcomes. The discussions are bolstered by literature-based evidence, are non-punitive and are aimed at reinforcing the department’s adherence and commitment to safety and safe medical procedures.

Journal Club
The Journal Club occurs bi-monthly, providing a format for the residents and faculty to review current literature pertaining to anesthesia practice. The sessions are led by residents and involve extensive review of the evidence prior to discussing the designated article. The goal of the club is to foster evidence-based practice with critical appraisal of the literature.
CA1 Core Lecture Series

An integrated lecture series of approximately 40 weekly lectures specifically targeted to the CA-1 resident (September – June). Basic topics of anesthetic management are presented by DACCPM faculty and include airway anatomy, pharmacology, physiology and physiologic derangements, as well as introduction to subspecialty anesthesia. These topics are presented in sequence with the goal of building upon a gradually deepening understanding of fundamental concepts.

CA2/3 Advanced Lecture Series
These weekly lectures by faculty are on topics that are central to becoming a consultant in the field of anesthesia, including vascular access, neuropathic pain, regional anesthesia and coagulation, endocrine diseases, and anesthesia as it is used in transplant surgeries. These are presented at the level of continuing medical education (CME) courses.
Subspecialty Didactics
The Intensive Care Unit (ICU), pediatric, obstetric, neuro, acute pain, chronic pain, preoperative clinic, orthopedic, thoracic and cardiac anesthesia clinical subspecialty rotations conduct weekly didactics, which are in addition to the departmental lectures. This “micro” level of didactic training facilitates case-related teaching. Teams can follow specific cases from the outset, and team members benefit and learn from discussing clinical care decisions with colleagues.
Exam Prep

Though studies for the exams is not central to our educational philosophy, we do want to make sure that our trainees feel adequately prepared and comfortable going into the exams.

To make sure our residents feel comfortable going into the exams, we provide our residents with the following resources:

  • Board Review lecture series, on Thursday mornings
  • The most recent ACE exam for each resident, purchased from the ABA for high quality practice
  • Mock Oral Exams, yearly
  • “As requested” Mock Oral exams (from one of our oral board examiners)
  • Mock OSCEs, yearly