Anesthesia Fellowships

To go to a specific section on this page, please use the links below:

• Rotations
• Clinical Expectations
• Non-clinical Educational Opportunities

Rotations

The Cardiothoracic Anesthesia fellow will typically complete the following rotations during the one-year fellowship:

Clinical Expectations

The fellow will be expected to do the following:

• Whenever feasible, perform preoperative assessment on all in-house cardiothoracic patients that he/she is assigned to care for intraoperatively
• Develop a comprehensive anesthetic plan based on the preoperative assessment
• Discuss the preoperative assessment and anesthetic plan with a supervising member of the Cardiac Anesthesia Division
• During the intraoperative period, put the anesthetic plan into effect and modify the plan in real time as indicated or necessary

The fellow will always be supervised by an attending but given appropriate independence to make management decisions. During the intraoperative period, the fellow will receive teaching from faculty on an informal, one-on-one basis that will cover a broad range of topics related to cardiothoracic anesthesia, cardiothoracic surgery, cardiopulmonary bypass and perfusion management. The fellow will learn proper communication techniques in a team-based approach to patient care.

Non-clinical Educational Opportunities

 Outside of the clinical setting, the cardiothoracic fellow will be expected to participate in the following educational opportunities:

• Didactic series: A comprehensive didactic series related to all aspects of cardiothoracic anesthesia has been developed for our fellowship. These lectures are given by Division members, fellows, senior residents during their cardiac anesthesia electives and invited speakers.
• TEE: The fellow will attend daily TEE reading sessions and weekly TEE chapter reviews.
• Resident interaction: The cardiothoracic fellow will have significant interaction with anesthesia residents. The fellow will:
  • Attend any session of the resident didactic series
  • Give formal presentations to residents at Morbidity and Mortality conferences and at two Cardiac Division conferences
  • Lead informal discussions with residents at weekly TEE review sessions
  • Be given the opportunity to teach our residents both within and outside the operating rooms and to supervise residents
• Conferences: The fellow will attend clinical conferences affiliated with the department. In addition, he/she can attend a quarterly combined TEE conference amongst all the three Harvard teaching hospitals where the fellows present and discuss interesting cases.

Rotations

The Critical Care fellow will complete the following rotations during the one-year fellowship:

*Details about each ICU unit are below:

1. Trauma Surgical Intensive Care Unit (TSICU): A 10 bed unit caring from trauma and acute care surgery patients admitted largely through the emergency room. Coverage of this unit is shared 50% with the Division of Surgical Critical Care.
2. Surgical Intensive Care Unit (SICU): A 15 bed unit for both surgical and neurosciences patients. Coverage of this unit is shared 50% with the Division of Surgical Critical Care.
3. Cardiovascular Intensive Care Unit (CVICU): A 16 bed until caring for patients undergoing cardiac and vascular surgery. Added to the clinical coverage in 2006, this unit is covered 100% of the time by Anesthesia Critical Care.

Clinical Expectations

In the clinical setting, the Critical Care fellow will:

• Provide complete care of critically ill patients
• Perform bedside ultrasonography and echocardiography
• Function as a leader of a multidisciplinary health care team providing such care
• Have a working knowledge of the administration and management of a critical care unit

The fellow will always be supervised by an attending but given appropriate independence to make management decisions. In the clinical setting, the fellow will receive teaching from faculty on an informal, one-on-one basis and will learn proper communication techniques in a team-based approach to patient care.

Non-clinical Educational Opportunities

Outside of the clinical setting, the fellow will participate in the following didactics:

• Weekly Journal Clubs
• Weekly multidisciplinary didactic lectures (with contributions from the Departments of Renal, Respiratory, Neurosurgery, Nutrition and Cardiology)
• Bi-weekly echocardiography conferences
• Bi-weekly Morbidity & Mortality conferences
• Echocardiography courses

In addition, the fellow is encouraged to participate in:

• Bedside teaching rounds
• Line lab sessions
• Education courses offered through the Harvard Medical School Catalyst Education Program

The fellow will spend dedicated time teaching and supervising residents during their ICU rotations. He/she will also facilitate lectures and Journal Clubs in the resident didactic series

These educational opportunities will provide the fellow with knowledge in critical care medicine that not only will be applied in the clinical setting but also will enable him/her to critically appraise the literature as it pertains to critical care medicine.

Rotations

The Neuroanesthesia fellowship is a one-year fellowship. The fellow will function as a junior attending in the operating rooms for approximately two weeks per month. He/she will participate in the anesthesia call schedule in proportion to his/her clinical time.

During the remaining two weeks of each month, the fellow will complete the following rotations:

Clinical Expectations

As a Level 1 Trauma Center, there is a significant volume of patients with severe central nervous system injury to both the brain and spinal cord. The fellow will:

• Perform preoperative assessments of patients with neurological and neurosurgical diseases
• Develop and execute anesthesia plans
• Learn basic interpretation of neuroradiological imaging

Non-clinical Educational Opportunities

The fellow will be given the opportunity to develop his/her skills as a teacher of residents both in the OR and in the resident didactic series . The fellow will also participate in:

• Fellow-level Journal Clubs, lectures and case presentations
• Clinical conferences affiliated with the department

The Department of Anesthesia, Critical Care and Pain Medicine at Beth Israel Deaconess Medical Center seeks candidates interested in pursuing advanced fellowship training in neurocritical care. We offer a 12-month Neurocritical Care Fellowship that leads to board certification in Neurocritical Care by the United Council for Neurological Subspecialties (UCNS). To be board-eligible in Neurocritical Care, candidates must have completed an ABA-approved fellowship in critical care medicine. In addition, a 24-month track that leads to dual certification in critical care medicine and neurocritical care is an option. We are particularly excited for candidates who are interested in developing their expertise in critical care ultrasonography and neurocritical care research.

The Division of Critical Care Medicine is internationally recognized for its innovative research, point-of-care ultrasonography, didactic teaching and patient care. Beth Israel Deaconess Medical Center is a large, tertiary care teaching hospital of Harvard Medical School. BIDMC is known for its collegial atmosphere that embraces a multi-disciplinary approach to patient care.

An example 12-month Neurocritical Care Fellowship would include:

• 8 months in our dedicated Neuroscience Intensive Care Unit (required by the UCNS)
• One-month elective in Neurocritical Care at the Western Infirmary, Edinburgh, Scotland
• One-month elective in Neuroanesthesia
• One-month elective in Clinical Research in our department-sponsored research division, Center for Anesthesia Research Excellence (CARE)
• One-month elective in ICU ultrasonography

Rotations

The Obstetric Anesthesia fellow will typically complete the following rotations during the one-year fellowship:

Clinical Expectations

In the clinical setting, the fellow will be expected to:

• Instill competence and refine decision making in management of the high risk parturient
• Develop critical judgment and proficiency in managing a parturient with comorbidities
• Conduct research applicable to obstetric anesthesia and publish their results
• Manage complex cases in obstetric anesthesia
• Develop consultant-level mastery of the physiological and pharmacologic consequences of obstetric anesthesia
• Serve as a consultant and a teacher for other anesthesiologists interested in obstetric anesthesia

Non-clinical Educational Opportunities

Besides attending clinical conferences affiliated with the department, the fellow will be given the opportunity to teach and supervise our residents. He/she is expected to:

• Give two resident lectures as part of the resident didactic series
• Conduct a monthly Journal Club for attendings and interested residents covering pertinent obstetric anesthesia topics

This

twelve-month fellowship

with intensive training in evaluation and treatment of pain, instruction in the technique of somatic and sympathetic blocks, intra-spinal catheters and pumps, neurolytic blocks, cryoanalgesia, and spinal cord stimulation. Fellows spend time on both the Chronic Pain Service and Acute Pain Service, with ample time allotted for didactic sessions and multidisciplinary meetings at BIDMC and other Harvard teaching hospitals. Successful completion leads to certification eligibility by the American Board of Anesthesiology.

Perioperative Medicine (POM) Fellowship

The Perioperative Medicine Fellowship is a one-year, non-ACGME accredited program combining six months of perioperative medicine training and six months as a junior faculty member in the Department of Anesthesia, Critical Care and Pain Medicine. Working within the well-established BIDMC perioperative surgical home, the fellow will develop the skills and knowledge needed to lead multidisciplinary teams in improving the care of the surgical patient.

Requirements

• Completion of an ACGME Anesthesiology residency
• Anesthesiology Board certification or eligibility
• Eligibility for full Massachusetts medical license

Goals of the fellowship

1. To create leaders in the field of Perioperative Medicine
2. To improve patient outcomes along the continuum of surgical care
3. To collaborate with specialties outside of anesthesiology
4. To advance the field of perioperative medicine through scholarly publications and presentations

Structure of the fellowship

1. Perioperative surgical home
   1. The fellow will develop expertise in the management of the surgical home.
   2. The fellow will have a working knowledge of various PSH models, including regulatory and financial implications.
2. Preoperative evaluation and risk assessment
   1. Understand the relationship between perioperative medicine and patient centered outcomes
   2. Learn how to manage a state-of-the-art pre-admission testing unit
   3. Understand the concept of risk assessment and risk management
3. Leadership skills and communication
   1. The fellow will develop and lead multidisciplinary case conferences, presenting the patient’s history and risk assessment. The fellow will provide data to drive evidence-based decision-making for providers.
   2. The fellow will participate in a hospital based longitudinal leadership curriculum, consisting of a series of events such as negotiation, change management, elevator pitches, etc.
4. Quality Expertise: Assessment and reporting
   1. The fellow will work with the department and hospital to create and populate a perioperative dashboard with meaningful outcomes (for example, reoperation rates and readmission in vulnerable patient groups).
   2. The fellow will assist in root cause analysis of adverse events involving preoperative evaluation.
5. Education
   1. The fellow will lead bi-monthly Journal Clubs.
   2. The fellow will participate in the development and teaching of the resident curriculum in perioperative medicine.
6. Research/Scholarship
   1. The fellow will be expected to develop expertise in the perioperative surgical home and regularly update the PSH portal on the BIDMC portal with relevant data.
   2. Fellows participate in research, outcomes and writing for journals and publications as well as in-service training to nursing staff, etc.
   3. Fellows will participate in Journal Clubs, M&M’s, roundtable discussions, grand rounds and lectures.
   4. There are opportunities for the fellow to become involved in research already in progress or to develop an original project. Activities considered as academic projects include a research paper or case report submitted to a peer-reviewed journal and presentation of a clinical chart review or a review article submitted to and accepted by a peer-reviewed journal, a book chapter or other endeavor

Rotations

The Regional Anesthesia fellow will typically complete the following rotations during the one-year fellowship in addition to completing the research requirement for fellows:

Clinical Expectations

In the clinical setting, the fellow will be expected to:

• Develop the technical skills to proficiently perform basic, intermediate, and advanced regional blocks in the preoperative, intraoperative and postoperative period
• Perform a variety of peripheral (single injection and continuous) nerve blocks using ultrasound, paresthesia and nerve stimulation techniques
• Manage complex cases in regional anesthesia and acute pain medicine
• Develop consultant-level mastery of the physiological and pharmacologic consequences of regional and acute pain anesthesia
• Serve as a consultant and a teacher for other anesthesiologists interested in regional anesthesia and acute pain medicine

Non-clinical Educational Opportunities

Besides attending clinical conferences affiliated with the department, the fellow will be given the opportunity to teach and supervise our residents. He/she is expected to:

• Give two resident lectures as part of the resident didactic series
• Conduct a monthly Journal Club for attendings and interested residents covering pertinent acute pain medicine and regional anesthesia topics

All fellows are expected to complete a research project during their fellowship year. Fellows may participate in original research by starting up a project or joining an

existing division project

leading to an article, abstract, or poster at the end of the fellowship. Fellows may also develop an enduring educational tool or a quality assurance/quality improvement project. At the end of their fellowships, we expect fellows to have a basic understanding of the principles of research in their division.

Please see the application requirements for each fellowship below. No exceptions or considerations will be given to materials received by e-mail or mail. Questions about applications can be sent to Lynnette Cheseborough (lchesebo@bidmc.harvard.edu).

*This program participates in the NRMP Match.