Anesthesia Fellowships

Overview and Fellowship Goals

The cardiothoracic anesthesia fellowship at BILH is designed to produce experts and leaders in the field of cardiothoracic anesthesia.

The fellowship in Cardiothoracic Anesthesia at the Beth Israel Lahey Health provides the academic and clinical foundation for a career as a cardiothoracic anesthesiologist. The emphasis is on an in-depth understanding of cardiopulmonary pathophysiology, pharmacology, and therapy, in addition to learning all aspects of clinical management of patients undergoing cardiothoracic procedures. Our fellows are also provided with the knowledge and skills necessary to become certified in perioperative transesophageal echocardiography as outlined by the National Board of Echocardiography.

Current Fellows

Objectives

1. To develop clinical and content expertise in cardiac anesthesia and perioperative transesophageal echocardiography guided by a multidimensional curriculum. In addition, a structural heart curriculum is designed to develop competence in structural heart echocardiography, multimodal imaging and real time three dimensional imaging for structural heart interventions.
2. To encourage innovation and scholarship by participation in various research initiatives in the department, including the Valve Research Group and a dedicated Echo Lab.
3. To provide a holistic knowledge of related subspecialties via a shared curriculum and case conferences, presentations by invited faculty and rotations with structural heart group, electrophysiology lab and cardiac surgery.
4. To provide an opportunity for the fellows to develop the skills required to succeed as an independent practitioner and an educator by supervision of residents.

Eligibility/How To Apply/Contact Information

The Adult Cardiothoracic Fellowship participates in the Match with the Society of Cardiac Anesthesiologists (SCA) using the San Francisco Match.

For applicants applying for the 2-year Dual Adult Cardiothoracic and Critical Care Medicine Fellowship:

• Complete an application for both Adult Cardiothoracic Fellowship and Critical Care Medicine through the San Francisco Match.
• Complete this supplementary form and email it to Kimberley Brown.

Program Director
Ruma Bose, MD
Email Ruma

Fellowship Coordinator
Kimberley Brown
Email Kimberley

Rotations and Schedules

The clinical rotations are designed to provide a comprehensive clinical and educational experience in all aspects of cardiothoracic anesthesia.

Our clinical rotations are as follows:

• Cardiac Anesthesia (open heart, minimally invasive, hybrid aortic surgeries ) - 6.5 months
• Pediatric cardiac anesthesia at Boston Children's Hospital - 1 month
• Heart transplantation and MCS at Tufts Medical Center - 1 Month
• Cardiac Intensive care unit - 1 Month
• TEE - 1 month
• Perfusion and MCS - 2 weeks
• Structural Heart Disease - 1 month

Curriculum and Didactics

The underlying principle guiding the fellowship curriculum is to provide a foundation of knowledge related to cardiac anesthesia and perioperative echocardiography along with a wider understanding of related subspecialties. This is achieved by shared lectures, case conferences and journal clubs between Critical Care, Cardiology, Cardiac Surgery and Cardiac Anesthesia.

Didactics include:

• Dedicated academic time every Wednesday that allows for protected didactics, research and other scholarly projects
• Lectures given by invited speakers and division faculty
• Online learning via the Anesthesia Toolbox and Moodle flipped classroom
• Shared ICU curriculum, including relevant lectures and journal clubs
• Fellows present at Department Morbidity and Mortality Conferences for the Departments of Anesthesia, and Cardiology, as well as at ICU M&Ms
• Dedicated ECHO lab with TTE and TEE simulators for training

Curriculum Highlights include:

• ECHO Basics Course and 3D echocardiography taught by Dr. Feroze Mahmood
• Weekly ECHO rounds facilitated by Cardiac Anesthesia Faculty
• Simulation based training in 3D echocardiography, multiplanar reformatting, valve motion analysis and 3D printing in the state of the art ECHO lab
• Fellow as Teachers allows the fellows to teach and mentor residents in the Cardiac Operating room and education lab
• Transthoracic echocardiography (TTE) instruction at the bedside and ICU
• Regional anesthesia for cardiac and thoracic procedures including parasternal and ESP blocks
• Participation in Root Cause Analysis Projects

Regional and National Scholarly opportunities:

• Fellows are given the opportunity to participate in the Quarterly combined ECHO conference held jointly with other Harvard affiliated hospitals (Mass General, Brigham and Women's Hospital and Tufts Medical Center)
• Every year each fellow attends the SCA sponsored ECHO Week
• Opportunity to the attend the SCA annual conference and present cases and research

Research and Other Opportunities

All fellows are expected to participate in research during their time in our fellowship. Division faculty are engaged in a variety of research projects spanning many areas related to anesthesia, critical care and perioperative care and outcomes.

Overview and Fellowship Goals

The current education and training model for Point of Care (POC) ultrasound skills is often not sufficient to allow trainees to reach a level of proficiency to practice these skills confidently and independently. In order to develop the complete set of clinical skills (e.g., regional anesthesia, invasive monitoring, POC ultrasound, echocardiography, management of ECMO and ventricular assist devices) to rise to the challenge as perioperative physicians, additional training beyond residency is highly beneficial.

In addition to leading the integration of advanced technologies into the care of complex patients, future leaders must be able to teach and disseminate their knowledge and approaches to patient care. Multimodal approaches to education including online, live lecture, and simulation require training in order to learn to adapt these approaches to adult learning. Development and incorporation of assessment tools are likewise critical to ensure the successful uptake of new approaches to care. This fellowship will develop an Advanced Perioperative Clinical Anesthesiologist who will be able to provide the highest level of clinical care and also train the next generation.

Our fellowship goals include:

• The graduating fellow will be highly skilled in the use of point of care ultrasound and echocardiography for high-risk patients undergoing non-cardiac procedures.
• The graduating fellow will have expertise in preoperative, intraoperative and postoperative management of high-risk patients undergoing non-cardiac procedures.
• The graduating fellow will become an innovative academic leader who can apply multimodal, competency-based educational programs, and interactive teaching tools to the training of residents and faculty.
• The graduating fellow will gain expertise in advanced monitoring and management devices, e.g. ventricular assist devices, spinal drains, pacemakers, hybrid OR with stand-by pump through participation in high risk surgeries.
• The graduating fellow will master the fund of knowledge to participate as a consultant in a multi-disciplinary team caring for high-risk patients undergoing non-cardiac procedures.

Eligibility/How To Apply/Contact Information

• Completion of residency training in Anesthesiology in an Accreditation Council for Graduate Medical Education (ACGME), ACGME-International (ACGME-I) or Royal College of Physicians and Surgeons of Canada (RCPSC) accredited training program; or
• Equivalent non-ACGME residency to include:
• Completed a residency program in the core specialty outside the continental United States that was not accredited by the ACGME, AOA, ACGME-I, RCPSC or CFPC.
• Demonstrated clinical excellence in comparison to peers throughout training. Additional evidence of exceptional qualifications is required, which may include one of the following:
• Participation in additional clinical or research training in the specialty or subspecialty;
• Demonstrated scholarship in the specialty or subspecialty;
• Demonstrated leadership during or after residency. Applicants being considered for these positions must be informed of the fact that their training may not lead to certification by ABMS member boards or AOA certifying boards.
• In recognition of the diversity of medical education and training around the world, this early evaluation of clinical competence required for these applicants ensures they can provide quality and safe patient care. Any gaps in competence should be addressed as per policies for fellows already established by the program in partnership with the Sponsoring Institution.
• If needed, have a valid ECFMG certification either with no expiration date or if the certificate has an expiration date an extension letter from the ECFMG will need to be submitted also.
• Be eligible for a Massachusetts Limited Medical License and J1 visa (if needed).

To apply for the fellowship, visit the Anesthesia Education website.

Program Director
Robina Matyal, MD

Fellowship Coordinator
Kimberley Brown
Email us with questions about the fellowship.

Rotations and Schedules

• Point of Care (POC) ultrasound for two months. Training in echocardiography, regional anesthesia and focused ultrasound use in perioperative arena.
• Intensive Care Unit: Cardiovascular Intensive Care Unit/Surgical Intensive Care Unit (CVICU/SICU) for one month. Training in the management of patients with high-acuity illness.
• Advanced Clinical for three months. Providing exposure to complex thoracic, vascular and transplant patients.
• Cardiology anesthesia for two months. Providing exposure to patients undergoing cardiac catheterization and electrophysiology procedures.
• Academic rotation for four months. Providing training and experiential training in educational practice and training.

The fellow will be expected to take OR call 1 weekend per month (Saturday and Sunday, 7am-5pm) and one late OR call per week, including non-OR rotations. The division of Clinical: Non-clinical days will be 3:2 during the initial phase of training and will change to Clinical: Non-clinical days of 2:3 during the education focused part of the training.

Curriculum and Didactics

The training during this fellowship will be based on a comprehensive and multi-faceted model spread over 1 year. The training model is envisioned to be a combination of didactic, simulation and advanced clinical learning. Initial training will focus on acquiring a variety of skills in perioperative clinical anesthesia to manage high-risk patients undergoing non-cardiac surgery. Subsequently, additional training will include:

• Approaching current knowledge deficits through research.
• Devising innovate educational curricula and educational tools.
• Applying these curricula and tools to reduce knowledge deficits.

Research and Other Opportunities

Fellows will be expected to complete a mentored scholarly/Quality Assurance/process improvement project during their fellowship, focusing on utilization of perioperative ultrasound in training. The research time will provide dedicated time whereby the fellows can develop and initiate an ultrasound/Echo research project from start to finish. The fellows will be responsible for trainee/patient recruitment, enrollment and data collection. Finally, the fellows will then analyze the data for presentation to the research group with the ultimate goal of publication.

Examples of projects may include:

• Develop a process improvement project for enhanced recovery from the postoperative anesthesia care units by introducing point of care ultrasound, and pain management strategies.
• Identification of training deficits in current educational curricula and proposed strategies to improve the current and standard training models.
• Develop “Standard of Practice” pathways for vascular surgery and advance non-cardiac surgical cases.
• Develop and update preoperative evaluation program especially for vascular and high-risk non-cardiac surgeries.

Overview and Fellowship Goals

The mission of the ACGME-accredited Anesthesia Critical Care Fellowship at Beth Israel Deaconess Medical Center is to train physicians in the art and science of critical care medicine, allowing them to become compassionate and thoughtful leaders who can contribute to academic, clinical and educational achievements in our field. Our program seeks to build a strong clinical core in our trainees through broad exposure to different facets of intensive care and a comprehensive didactic program. We pride ourselves on constantly evolving our program to expand training and opportunities for our fellows, including in research, quality improvement and education.

Current Fellows

Our fellowship goals include:

• Clinical training focused on the management of a broad and complex critically ill patient population in a quaternary care medical center
• Enhanced fellow education by exposure to a wide range of multidisciplinary faculty specialists, both in and outside of the ICUs
• Early career development for our trainees, including mentoring in the areas of academic investigation, administration, quality improvement and education
• Development of an inclusive program that contributes to a representative and balanced critical care workforce by training a diverse group of fellows

Eligibility/How To Apply/Contact Information

The Anesthesia Critical Care Medicine Fellowship is an ACGME-accredited fellowship. All qualified applicants must be enrolled in or have completed an ACGME certified residency program or its equivalent.

We participate in the San Francisco Match that is sponsored by the Society of Critical Care Anesthesiologists (SOCCA). We also welcome applicants pursuing an Emergency Medicine/Critical Care Pathway and those applicants interested in pursuing a dual fellowship in Critical Care Medicine and Adult Cardiothoracic Anesthesia.

For applicants applying for the 2 year Dual Adult Cardiothoracic and Critical Care Medicine Fellowship:

• Complete an application for both Adult Cardiothoracic Fellowship and Critical Care Medicine through the San Francisco Match.
• Complete this supplementary form and email it to Kimberley Brown.

Program Director
Ameeka Pannu MD
Email Ameeka

Fellowship Coordinator
Kimberley Brown
Email Kimberley

Rotations and Schedules

Our fellows rotate through our core intensive care units (ICUs) for 9 months of the year. This includes our Trauma-Surgical ICU, Surgical ICU, Cardiovascular ICU and Neurosciences ICU. They also complete rotations in a combined med-surg unit, the Finard ICU and on night float. These rotations offer an exposure to a wide range of pathology, ranging from trauma and intracerebral pathology to the critically ill postoperative patient and the patient on mechanical circulatory support. In the units, the fellows, along with the attendings, lead a multidisciplinary team including dedicated housestaff and advanced practice providers.

The balance of the year consists of elective time. The fellows rotate with our colleagues in other departments to enhance their understanding of specialty practice, including a total of four weeks on a transthoracic echocardiography (TTE) rotation. Popular electives include Blood Bank, Infectious Diseases, Nephrology and Interventional Pulmonology. Fellows also use elective time to complete research and education projects.

Curriculum and Didactics

Our didactic program is designed to both give our fellows a strong foundation in core critical care medicine concepts and provide a deeper understanding of organ-specific disease. Our standing didactics include:

• Weekly ultrasound/echo conference, including lecture, case review and hands-on learning
• Weekly lecture, taught by faculty from various departments at BIDMC
• Weekly journal club, with fellow and faculty participation
• Biweekly Morbidity and Mortality Conference
• Combined didactics with the Cardiothoracic Anesthesia fellowship, including echocardiography teaching
• Dedicated neurocritical care didactics

Curriculum highlights include:

• Dedicated teaching around mechanical circulatory support (MCS) and extracorporeal life support
• Year-long ultrasound curriculum
• Lectures and workshops led by both core critical care faculty and faculty from other departments
• Robust weekly journal club covering both landmark and contemporary literature
• Continuous evaluation and expansion of the fellowship didactic program

Research and Other Opportunities

The faculty of the Division of Critical Care is involved in Research that runs the gamut from basic science to clinical outcomes. Our fellows are encouraged to participate in clinical research that interests them, and this work is regularly published and presented at national conferences. Fellows are also involved in other scholarly projects like case reports and book chapters.

We also focus on the role of the fellow as educator, and as such, our fellows teach medical students and residents at bedside, at our weekly resident conferences, and during our structured courses.

All fellows are active participants on interdisciplinary committees that seek to improve the quality of care in our ICUs. In addition, our fellows have the opportunity to learn about the administration and management of a critical care unit through both observation and participation on administrative and executive committees.

Overview and Fellowship Goals

The Neuroanesthesia fellowship is designed to provide advanced clinical training in the provision of anesthesia for both the surgical and endovascular management of complex intracranial disease and the surgical treatment of complex acute and chronic spine disorders.

Current Fellows

Goals:

• To gain mastery in the practical, perioperative management of patients presenting with a broad range of neurologic conditions that require a complex neuroanesthetic
• To appropriately utilize advanced monitoring modalities in the care of neurosurgical patients, including neurophysiologic intraoperative monitoring (NIOM), electroencephalography (EEG), near infrared spectroscopy (NIRS), and transcranial ultrasonography
• To advance the practice of neuroanesthesia through clinical research, quality improvement initiatives, and pedagogy

Eligibility/How To Apply/Contact Information

This is a non-ACGME accredited fellowship that welcomes applications from candidates who have completed or are completing training in anesthesia residency programs.

All applicants with training outside of the United States must be able to obtain an ECFMG certificate and have completed USMLE step 1, step 2CK and step 2 CS.

To apply for this fellowship please complete the Department of Anesthesia's online application. 

Program Director
Richard Pollard, MD, FASA
Email Richard

Fellowship Coordinator
Kimberley Brown
Email Kimberley

Rotations and Schedules

Our rotations are designed to provide a comprehensive clinical and educational experience in all aspects of neuroanesthesia. During this year the fellow will spend time on the following rotations:

• Clinical Neuroanesthesia (6-7 months)
• Pediatric Neuroanesthesia (1 month)
• Neuroradiology/Endovascular care (1 month)
• Intraoperative Neuromonitoring (1 month)
• Neuro Intensive Care (1 month)
• Clinical Neuroscience Research (Optional; 1 month)

Curriculum and Didactics

Our curriculum is designed to allow the fellow to care for surgical patients through the perioperative continuum from preoperative assessment through surgery, and post-surgical care in the Neuro ICU. This allows the fellow to start their life-long learning about both surgical and non-surgical management of these patients. Our curriculum teaches the optimization of medical care of the neurosurgical patient and provides insight into the multidisciplinary approach to the care and management of these patients.

Our standing didactics include:

• Anesthesia Department Grand Rounds and Morbidity and Mortality Conference
• Neurosurgery Morbidity and Mortality Conference
• Neurovascular Surgery Case Conference
• Neurosurgery Tumor Board
• Neuroradiology Case Conference
• Stroke Neurology Case Conference

Curriculum Highlights:

• The fellow will participate in interventional neuroradiology cases including intracranial vascular coiling, embolization, and thrombectomy following stroke.
• The fellow will work alongside with neurosurgeons and neurologists in the operating room, the neurointerventional suite, and the Neurosciences ICU.
• The fellow will gain experience in pediatric neuroanesthesia, including intra-operative MRI, at Boston Children’s Hospital.
• The fellow will learn advanced NIOM techniques, including pediatric cases, at Massachusetts General Hospital.
• The fellow will gain experience reading EEGs with neurologists on the epilepsy service.
• The fellow will have both local and external opportunities to learn advanced monitoring methods, including NIRS and transcranial ultrasound.

Regional and National Scholarly opportunities:

• The fellow will have the opportunity to attend the annual SNACC meeting.
• The fellow with have opportunities to participate in clinical and education research projects and quality improvement initiatives in our department.

Research and Other Opportunities

Our fellows have the opportunity to participate in research projects during their year with us. Departmental faculty lead projects in fields ranging from basic science to education to perioperative outcomes.

Overview and Fellowship Goals

The core philosophy of the Obstetric Anesthesiology Fellowship is to offer balanced training to the future OB anesthesiologist and provide the clinical, educational and research foundation required to provide the highest level of care to parturients. We seek to train physicians who can educate their colleagues across disciplines and participate in the scientific evolution of obstetric anesthesia.  To create experts, we expose our trainees to a wide variety of educational materials, clinical experiences, instruction, and opportunity for independent learning.  Fellows will participate in each of these four domains to evolve as comprehensive clinicians and leaders in the field.

• Clinical
• Administrative
• Education
• Research

Current Fellows 

Eligibility/How To Apply/Contact Information

The Obstetric Anesthesiology Fellowship is an ACGME-accredited fellowship. All qualified applicants must be enrolled in or have completed an ACGME certified residency program or its equivalent.

Our fellowship participates in the San Francisco Match along with the Society of Obstetric Anesthesia and Perinatology (SOAP).

The process of applying to our fellowship is a two-step process:

1. Register for the SF Match
2. Submit a completed application using the online application for the Department of Anesthesia

Application requirements are as follows:

• SOAP Application
• Current CV
• Three letters of Recommendation
• USMLE step 1, step 2, step 2 CK
• ECFMG certificate
• Completed BIDMC Application

Program Director:
Philip Hess, MD, FASA
Email Philip

Fellowship Coordinator
Kimberley Brown
Email Kimberley

Rotations and Schedules

Our rotations are designed to provide a comprehensive clinical and educational experience in all aspects of obstetric anesthesia. During this year the fellow will spend time on the following rotations:

• Clinical Care of the Parturient: 7 months
• Research: 3 months
• Maternal-Fetal Medicine: 2 weeks
• Neonatal Intensive Care Unit (NICU): 2 weeks
• Transthoracic Echocardiography (TTE): 2 weeks
• Blood Bank: 1 week

Curriculum and Didactics

Our standing fellowship-specific didactics include: 

• Weekly lectures presented by the faculty and allied services
• Monthly journal club/case based discussion
• Point of care ultrasound training

A fellow learns through mentoring by all the attending anesthesiologists on the service. This is a process that is experientially-based and patient-centered. The fellow learns through active watching, listening, discerning, and doing in an apprenticeship model. We have deliberately cultivated a fellowship culture where faculty serve as role models to the future obstetric anesthesiologists, demonstrating not just optimal patient care but also critical review of the literature and a structured approach to interdisciplinary care of the parturient. We pride ourselves on a model where our faculty is present for questions, discussion and consultation at all times.

Research and Other Opportunities

Research is an essential tool for advancing the knowledge base of OB anesthesia and also keeps the researcher on the cutting edge of their field. We strongly believe research is a vital part of evolving into a complete clinician, and our faculty leads a number of different studies on various aspects of obstetric care.

The fellow will have at least one dedicated research project throughout the year. This includes navigating the IRB, subject enrollment, data collection, statistical analysis and write-up. The fellow will receive basic and/or advanced training in statistics and research design and will submit at least one abstract to a national meeting, such as the ASA or SOAP meetings.

Overview and Fellowship Goals

The Pain Medicine Fellowship at the Beth Israel Deaconess Medical Center is a multidisciplinary program dedicated to patient care, teaching, and research using cutting edge knowledge and technology. Our fellows train in the outpatient Arnold-Warfield Pain Management Center, the inpatient Acute/Chronic Pain Services, and satellite pain clinics in the greater Boston area. Members of our faculty specialize in diagnosing and treating patients who have not responded to conventional therapies and our fellows are trained to offer comprehensive care to patients with complex pain syndromes. The multidisciplinary team includes specialists in anesthesiology, neurology, physiatry, internal medicine, psychology, nursing, physical therapy and complementary medicine. The fellowship provides trainees with a focused year of training with an emphasis on developing clinical expertise, leadership, research and clinical care through multidisciplinary training.

Current Fellows

Through the course of their training, our fellows:

1. Develop an in depth understanding of basic science concepts, clinical skills, evidence- based medicine, and emerging research within the field of pain medicine.
2. Learn interventional techniques and advanced surgical skills used in the treatment of Pain Disorders.
3. Develop the skills needed to implement care across multiple determinants of patient health and welfare.
4. Work with stakeholders in our community to provide a multidisciplinary approach to care for patients in a variety of clinical settings, and vulnerable patient populations (including LGBTQ and non-native English Speakers).

Eligibility/How To Apply/Contact Information

The Pain Medicine Fellowship is an ACGME-accredited fellowship. All qualified applicants must be enrolled in or have completed an ACGME certified residency program or its equivalent in the following disciplines:

• Anesthesia
• Physical Medicine and Rehabilitation
• Neurology
• Emergency Medicine

The Pain Medicine Fellowship participates in the NRMP match. All applications must be submitted through the ERAS system.

Program Director
Jyotsna Nagda, MD
Email Jyotsna

Fellowship Coordinator
Kimberley Brown
Email Kimberley

Rotations and Schedules

The Pain Fellowship is a comprehensive 12 month program. Fellows will spend the majority of their clinical time at the Arnold Warfield Pain Management Center providing outpatient consultations and participating in interventional pain procedures that are both landmark and imaging guided.

Other rotations, including electives include:

• Headache Neurology
• Pain Psychology
• Pediatric Pain – Boston Children’s Hospital
• Palliative Care
• Advanced Surgical Procedures – BIDMC Boston and BIDMC Needham
• Chronic Pain Service – Inpatient Consult Service

Curriculum and Didactics

Our fellowship has a comprehensive didactic program encompassing topics in pain medicine, practice management, and medical-legal standards. Our standing didactics include:

• Lectures by the core clinical faculty as well as invited guest speakers and partners in industry
• Multidisciplinary Spine conference with Neurosurgery and Orthopedic Spine Surgery
• Weekly Department of Anesthesia Grand Rounds
• Weekly Department of Anesthesia Morbidity and Mortality Conference
• Biweekly Journal Club
• Practice Based Learning Discussion
• Pain Simulation Program hosted in the Shapiro Simulation and Skills Center

Curriculum Highlights:

• Pain medicine simulation program
• Four onsite fluoroscopy suites
• Hands on ultrasound training
• Robust and comprehensive didactic program

Regional and National Scholarly opportunities:

• Department supported memberships to ASA and MSA
• Opportunities to present at national and regional conferences

Research and Other Opportunities

The Clinical Interventional Pain Research Program continues to develop new research protocols for the advancement of interventional pain techniques. In addition, the Basic Science Pain Research program is continually working on research. Basic Science research projects are being accomplished in the areas of neuropathic pain and headaches among other areas.

Our Division’s dedication to research allows our fellows multiple opportunities to be involved in Pain Medicine research. In addition, each fellow selects and works on a QA/QI project that is presented at the end of the fellowship.

Every year we have multiple fellows presenting at National Conferences including ASIPP, NANS, ASRA and other conferences.

Fellow Research from the last academic year:

Brachioradial pruritus in a 52-year-old woman: A case report
AA Berger, I Urits, V Orhurhu, O Viswanath, J Hasoon

Caudal epidural blood patch for the treatment of intractable CSF leak after placement of a permanent intrathecal pump
I Urits, AA Berger, J Hasoon, L Law, T Simopoulos, M Aner, J Gill, C Yazdi

Erector Spinae Plane Block for Relief of Chronic Intercostal Neuralgia After Chest Tube Placement
J Hasoon, AA Berger, I Urits, S Jang

High Frequency Spinal Cord Stimulator Implantation for Combined Alleviation of Chronic Back and Abdominal Pain
AA Berger, J Hasoon, I Urits, T Simopoulos, J Gill

Successful use of erector spinae plane block for perioperative pain control in patient undergoing coronary artery bypass graft surgery
I Urits, RH Schwartz, J Hasoon, S Shipon, O Viswanath, AD Kaye, J Eskander

Treatment of Low Back Pain in a Patient with Paget Disease of the Bone
C Bruno, M Chinn, P Rana

Overview and Fellowship Goals

This unique 2-year clinical non-ACGME post-graduate fellowship program in Perioperative Quality and Safety combines formal training through Harvard Medical School, deep immersion in organizational operations at BIDMC, and a highly productive research program.

Successful candidates will be enrolled in a fully funded 2-year integrated program, culminating in a Master of Healthcare Quality and Safety (MHQS) degree from Harvard University.

The program is designed to help clinicians improve patient safety and health care quality in an increasingly complex and evolving health care environment.

Current Fellows

On completion of the fellowship program, graduates will be able to:

• Drive strategic change and foster a culture of quality and safety
• Generate data-driven solutions to address operational challenges
• Measure, interpret and communicate meaningful health care outcomes
• Identify quality and safety gaps and develop strategies to address them
• Use data to support rational and evidence-based improvements
• Develop and implement quality improvement initiatives within a tight budget
• Assess and improve health care processes through evidence-based best practices
• Identify, design, and implement malpractice prevention and intervention strategies

Eligibility/How To Apply/Contact Information

The fellowship program accepts up to two fellows a year, including physicians trained both in the US and overseas. Additionally, we also welcome attending (consultant) anesthesiologists who wish to pursue the MHQS program while employed as faculty at BIDMC.

All prospective candidates are strongly encouraged to directly contact the Program Director Dr. Satya Krishna Ramachandran for more information.

Essential criteria for all applicants:

• Successful completion of postgraduate training in Anesthesiology, including evidence of successful board eligibility or certification
• Full registration on the State or National Medical Register (including entry on the specialist register or eligibility for state medical licensure)
• Confirmation of current and ongoing employment
• At least 5 years of post-MD anesthesia training or higher
• ECFMG certification: The Step 1, Step 2 CK&CS must be mandatorily completed for limited licensing
• Submit your initial application here for July start. International applicants are instructed to send in their applications as early as possible

Desirable criteria:

• All three USMLE steps completed
• A track record of excellent clinical care attributes and organizational citizenship
• Evidence of interest in quality and safety
• Higher academic degrees that indicate intent and ability to excel in academically rigorous environments

Candidates from England who wish to apply through the Royal College of Anaesthetists, please visit the SALG-BIDMC page to learn more about the Scholar program.

Rotations and Schedules

The clinical rotations are fully coordinated with the academic schedule of the 2-year MHQS program:

• On average, fellows can expect to work 20-25 clinical hours a week during the ‘term time' of their MHQS program.
• Fellows will resume a complete clinical workload when the MHQS course is in recess
• Clinical responsibilities for the fellow include late call once a week and weekend day call six to twelve times a year.
• The appointment does not stipulate specific anesthesia or surgical specialty case-mix, and it is anticipated that the successful applicants will be exposed to a wide variety of anesthetic care within BIDMC.

Curriculum and Didactics

The curriculum for the fellowship follows the two-year MHQS program from Harvard University. Successful candidates will have protected time to participate in didactics at Harvard Medical School, which is walking distance from BIDMC.

The key benefits of this program are:

• The curriculum is designed to accelerate your ascent to a leadership role focused on health care quality and safety
• Distinguished faculty who are recognized leaders in some of the nation's most prestigious health care systems
• A learning model that combines concrete theory with applied learning
• An accomplished community of professional peers that you can call upon long after the program ends
• A capstone project that is aligned with your goals and interests plus one-on-one mentoring
• The carefully designed curriculum that focuses on all operational aspects of health care quality and safety
• Exposure to best practices within the Harvard network of hospitals, including Massachusetts General Hospital, Brigham and Women's Hospital, Boston Children's Hospital, Beth Israel Deaconess Medical Center and Dana-Farber Cancer Institute.

Fellows will be trained as a Simulation Instructor through the world-renowned Center for Medical Simulation. Fellows are also coached and mentored to apply these skills operationally and engage in various implementation projects. Our aim is to maximize your ability to execute change in healthcare quality and safety from the day you complete your fellowship training.

Examples of projects and programs are:

• M&M review: fellows help guide faculty and residents in delivering their presentations
• Resident RCA faculty: help guide residents in learning and performing an RCA
• Implementation of a debriefing framework after major adverse events in the OR
• OR efficiency
• In-situ team training for emergency manual implementation
• Running large multidisciplinary team training events
• Greening the OR

Research and Other Opportunities

Fellows are fully integrated into the Quality & Safety and Outcomes Research Labs that leverage the rich data resources in an academic environment that sets them up for success. Under the mentorship of Dr. Krish Ramachandran, you will be engaged in operationally relevant investigations using high-end research methodology. See more information about our Department's Research at their website.

Publications in 2020 (fellows names bolded)

Li Y, Ciampa EJ, Zucco L, Levy N, et al. Adaptation of an obstetric anesthesia service for the SARS-CoV-2 pandemic: description of checklists, workflows, and development tools. Anesth Analg. 2020 Epub ahead of print

Levy N, Zucco L, Ehrlichman RJ, et al. Development of Rapid Response Capabilities in a Large COVID-19 Alternate Care Site Using Failure Modes and Effect Analysis with In-Situ Simulation. Anesthesiology. 2020 Epub ahead of print

Zucco L, Santer P, Levy N, et al. A comparison of postoperative respiratory complications associated with the use of desflurane and sevoflurane: a single centre cohort study. Anaesthesia. 2020 Epub ahead of print

Feuerstein JD, Levy N, Zucco L, et al. Management of a COVID-19 patient in the endoscopy suite. VideoGIE. 2020 May 8;5:327-330

Zucco L, Levy N, Ketchandji D, Aziz M, Ramachandran SK. Perioperative Considerations for COVID-19 Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Anesthesia Patient Safety Foundation Online Article

Education materials

Our fellows developed and published the training materials our hospital uses for COVID preparedness, including the simulated videos. These are available for free-online-access.

Awards in 2020

• Oral and ePoster Presentation: SALG Patient Safety Conference, UK 2020, Joint 1st prize
• "Concise Out of operating room Interprofessional in-Situ Exercises (CONcISE)": Implementation of a Novel Program and Impact of Drill Frequency on Critical Measures of Patient Safety. CRICO RMF Grant $200,000

Overview and Fellowship Goals

Regional fellows will spend 2 weeks every month on Regional Anesthesia and the Acute Pain Medicine service to develop the technical skills to gain proficiency in basic and advanced regional blocks in the perioperative period. Upon completion of the fellowship, the fellow will be able to serve as a consultant for other physicians interested in regional anesthesia and provide optimal perioperative pain control for their patients.

Current Fellows

Eligibility/How To Apply/Contact Information

The program accepts applications on a rolling basis and does not currently participate in a match system.

In order to apply, please complete the common application and create an account.

You will be able to upload your application, letters of recommendation, test scores and other required documentation after creating your account.

Rotations and Schedules

Fellows alternate 2 weeks at a time on adult regional anesthesia and the acute pain service along with practicing as an attending anesthesiologist within the Department of Anesthesia, Critical Care and Pain Medicine at the Beth Israel Deaconess Center. We have opportunities for fellows to rotate through the community hospitals in the Beth Israel Lahey Health system for a private practice experience in regional anesthesia. There is a short rotation available at Boston Children's Hospital.

Curriculum and Didactics

One of the big advantages of our program is that we can tailor it for your individual success. As a fellow you will be expected to attend weekly departmental grand rounds, give didactic lectures to residents, and conduct a monthly Journal Club covering pertinent acute pain medicine and regional anesthesia topics.

Research and Other Opportunities

Every fellow is expected to complete at least one Quality and Safety or one Research project during the year. Fellows are encouraged to come up with a project congruent with their interests, but usually a choice of at least 3 different projects is provided as well. For more information on our Departments' Research, please see their website.

Please see the application requirements for each fellowship below. No exceptions or considerations will be given to materials received by email or mail. Questions about applications can be emailed to Kimberley Brown.

*This program participates in the NRMP Match.