beth israel deaconess medical center a harvard medical school teaching hospital

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Didactic Teaching

The program has generous dedicated educational time, including a comprehensive didactic conference schedule to provide a solid foundation of anesthesia knowledge and skills. Residents are routinely relieved from clinical duty so that they can attend these afternoon sessions.

 The general pattern of didactic courses includes lectures, problem-based discussions, or journal club on Mondays and Tuesdays, Grand Rounds and Morbidity and Mortality conference on Wednesday, and simulation or skills sessions on Thursday. Some Wednesday afternoons are also allocated for further interactive learning opportunities or specialty conferences, such as fiber-optic airway workshops, ACLS and neonatal resuscitation courses, and subspecialty fellowship lectures.

 Resident didactic courses are predominantly provided by faculty or guest speakers with expertise in that area.  In some instances, residents are invited to teach with faculty mentorship as part of our “Resident as Teacher” experience.  Formal mock orals exams are held at least twice per year, with ample opportunity for further practice with the three ABA examiners on faculty.

Monday    

4:30 PM    Resident Didactic Series, Problem-based Discussions, or Journal Club

Tuesday               

6:45 AM    Resident-led Keywords Review

4:30 PM    Resident Didactic Series, Problem-based Discussions, or Journal Club                

Wednesday           

7:00 AM    Department Grand Rounds              

7:45 AM    Clinical Conference (M&M)            

2:00 PM    Optional Obstetric Anesthesia Conference

4:30 PM    Optional Cardiac or TEE conference

Thursday        

4:30 PM    Simulation / Skills Workshop

 Following CA-1 orientation in July, the curriculum is divided into three sections, each with a different emphasis. An effort is made to coordinate subspecialty blocks with grand rounds blocks as much as possible to make for a more coherent learning experience.

Section 1- Core Topics:

The first quarter of the year is committed to providing essential information on the fundamentals of anesthesia and perioperative management. 

Perioperative Care: This portion of the curriculum is focused on sharpening the understanding of the role of the Anesthesiologist as a perioperative physician. Topics focus on anesthetic management of co-existing diseases. Preoperative assessment and optimization and postoperative management issues are also highlighted.

Anesthesia Practice Management:  Diverse topics pertaining to anesthesia such as billing, medicolegal issues, and careers in anesthesia are covered.

Pharmacology: More in-depth pharmacology of anesthetic and related agents is explored.  Pharmacokinetics and dynamics are covered more comprehensively.

Section 2- Subspecialty Blocks:

Each subspecialty discipline is allocated 1 to 4 weeks of didactic sessions based on input from division chiefs and the didactic workgroup. The blocks are designed to rotate over a 15-month period.  Some of these didactic courses are augmented by on-service lectures (e.g. ICU, pain, obstetric anesthesia, and pediatric anesthesia at Boston Children’s Hospital). All are enhanced by teaching in the OR relevant to rotations.

Section 3- Board Preparation: 

The final section of the curriculum focuses on board review and test taking strategies. The concept of this block is to unfetter the lectures during the remainder of the year from “teaching to the boards,” while at the same time acknowledging that this is an important component of a resident’s training experience. We are proud of the exceptional board pass rate by our graduates. Questions are grouped by topic area and discussion is facilitated by faculty expert in that area.  High yield topics such as statistics and Ph/Alpha Stat management and test taking strategies are also covered. Beginning in 2014, there will be separate board review series for junior and senior residents to reflect the changes in the ABA board certification examinations.

Other Components:

Subspecialty Conferences:  On Wednesdays there are Obstetric, Cardiac and Transesophageal Echocardiography conferences. These conferences are designed to complement teaching for residents and fellows on the subspecialty services, but are open to any interested residents.

Airway Management:  Fiber-optic bronchoscopy and double lumen tube placement skills labs are on Wednesday afternoons in the fall and are small groups led by faculty. Tracheostomy and cricothyroidotomy workshops as well as multiple departmental airway and equipment workshops are also held during the year.  

Simulation:  We have incorporated increasing numbers of simulation based activities into the didactic curriculum to take advantage of BIDMC’s state-of-the-art Carl J. Shapiro Skills and Simulation Center. In addition to the CA-1 orientation series, we offer a variety of simulation experiences ranging from an orientation to cardiac anesthesia to office based anesthesia. Crisis management is included so residents can gain experience managing rare anesthetic complications in a safe and supportive environment. Resident participation in development of scenarios is encouraged as well.  Interested CA-3 residents can elect a one-month simulation rotation, during which they learn about the application of technology in education and develop their teaching skills by leading simulation-based sessions for medical students, peer residents, and other healthcare professionals in the BIDMC community. In addition to the intraoperative TEE experience, there is also classroom TEE and TTE training for interested residents with our renowned cardiac anesthesia faculty using our advanced echocardiography simulator.

 Recent Announcements & Highlights

  • Several residents have been awarded a one month internship at the Harvard Medical School of Public Health as part of the Global Health Initiative.
  • Three of our residents have been selected to attend a focused 2 week research course.
  • Our didactic sessions are undergoing continuous improvement and are focused on interactive learning.
  • Robust keywords sessions are now led by residents.
  • Lectures are now available online the next day.
  • Lectures are conference telecast on both campuses to facilitate interactive learning opportunities.
  • Simulation and web-based teaching is available for an integrated TEE course in CA-2 year.
  • TTE simulation/web course is now available for interested residents.
  • Six residents passed the Basic Echo exam in 2013 (100% pass rate).
  • Faculty members advocate for residents in a competitive job and fellowship market; our graduates get top picks in both areas.
  • Our program provides ample research opportunities and support. The Elective Research Program is a longitudinal program designed to introduce motivated residents to the principles and practice of clinical and translational research.
  • Elective rotation at the Veteran’s Administration Hospital (PGY-4) is available to provide institutional variety and exposure to more cases.
  • Electives are available for heart transplantation and private practice environments at affiliated hospitals
  • Ample teaching opportunities are provided at BIDMC and HMS. A Certificate for Teaching Excellence is awarded to deserving residents upon graduation.