Anesthesia Fellowships

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

• Annual Caseload
• Meet our Faculty
• Rotations
• Clinical Expectations
• Educational Opportunities

Annual Caseload

Our 2019 case count included 967 open heart surgeries, 5 minimally invasive mitral valve repairs and aortic valve repairs, 46 aortic surgeries, 31 LVAD/ECMO/RVADs, 4 OFF PUMP CABGs, and 325 structural heart diseases. Structural Heart Disease procedures include TAVR, MITRAclips, TMVR, VIVTAVR and MVR, ASD Closures, Watchman Devices, and VSD/Paravavular leak closure. (All procedures except TAVRs are done with Real Time Echo Guidance performed by cardiac anesthesiologists.)

Meet Our Faculty

Rotations

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

Clinical Expectations

The fellow will do the following:

• Perform preoperative assessment on all in-house cardiothoracic patients assigned to them
• 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
• Develop competency in advanced echocardiographic skills 2D, 3D and real time echocardiographic guidance for structural heart procedures
• Develop basic skills in performing and interpreting transthoracic echocardiography

The fellow will always be supervised by an attending but have appropriate independence to make management decisions. The fellow will learn proper communication techniques and a team-based approach to patient care.

Later in the fellowship, fellows will have an opportunity to supervise residents.

Educational Opportunities

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

Other Opportunities and Ongoing Research

The Adult Structural Heart Anesthesia (ASHA) Fellowship

The only one of its kind in the country,this fellowship is a six-month focused fellowship aimed at developing expertise in all aspects SHD. It includes participating in preoperative triaging of patients, preoperative planning and work up, learning cardiac imaging (CT, Cardiac MRI, fusion imaging) in addition to Real time three dimensional echocardiography and procedural guidance. Learn more about the ASHA Fellowship here.

Valve Research Group

The fellow will join a multi-specialty group of clinical collaborators from anesthesia, cardiology and cardiac surgery, brought together by Cardiac Division Director, Dr. Feroze Mahmood, to design and conduct clinical research and develop innovative therapies for cardiovascular disease. View our current and past work including all Echo Lab happenings. The Echo Lab has a robust basic science research program focused on diabetic cardiomyopathy and microvascular coronary artery disease. Currently there are multiple projects underway relating to nanoparticle based remote delivery of angiogenic molecules for microvascular growth, pathophysiology of post-cardiac surgical atrial fibrillation, and gender-based differences in diabetic cardiomyopathy.

Multiple research fellows participate on these projects and split their time between the Echo Lab and the CLS lab.  They have access to national databases for their studies and participate in outcome-related statistical projects that are regularly published. We have multiple international collaborations with world-class medical centers from Canada, China, India and Netherlands.  Our fellows come from a list of prestigious educational and research institutions that continues to grow with long-term clinical and research collaborations.

Valve Analysis: We are investigating the differences that exist between normal and abnormal cardiac valves, specifically by using echocardiographic data to describe valvular morphology and dynamism over the cardiac cycle both qualitatively and quantitatively

One of our current focuses is a tricuspid annular analysis. We are examining the structural changes of the tricuspid annulus over the cardiac cycle. Our current methodology is being applied to both normal and abnormal annuli. We have also demonstrated the ability to prototype patient-specific annuli using CAD software and 3D printing.

Valve Modeling: Our current work consists in isolating structures of interest (e.g. mitral valve) from 3-dimensional transesophageal echocardiographic data to create computerized 3-D models that can be 3D printed with commercially available printers. Potential short-term uses for this technology include in vitro simulation of specific hemodynamic conditions, as well as planning and training for surgical or interventional procedures.

Simulation-based training:  We have studied the use of simulation training in medical education. Our research has centered on the value of simulation as a component of multi-modal training.

We have performed motion analysis for transesophageal echocardiography during training and have been able to see the changes in automaticity and motion efficiency that occur during psychomotor learning.

Basic Research

Our basic research projects are spearheaded by The Vice Chair or Research, Dr. Simon C. Robson, Vice Chair of Neuroscience Research, Dr. Rami Burstein, Dr. Robina Matyal, Head of the Vascular Anesthesia Division and others.

Dr. Simon Robson's major area of basic science and translational research provides the central theme of Center for Inflammation Research, which also includes laboratories of Dr. Serena Maria Longhi and Dr. Shahzad Shaefi. Dr. Robson's research is focused on vascular biology, immunity, immunometabolism and purinergic signaling. Over the past two decades he has been involved in the discovery, characterization and investigations of mammalian ectonucleotidases, which are vascular, myeloid and regulatory lymphoid cell-expressed ectoenzymes that hydrolyze extracellular nucleotides, such as ATP and ADP, to immunosuppressive adenosine and derivatives.

Dr. Rami Burstein is a world leader in migraine and photophobia research. His research group is focused on migraines and has made significant progress in understanding how migraines alter the nervous system. They investigate the neurobiology behind migraine triggers and have examined the physiological basis of light and touch sensitivity in some migraine sufferers.

Dr. Dan Levy's research group is interested in addressing the function of the nociceptive sensory system that innervates the cerebral meninges as well as mechanisms that contribute to its activation, which is considered paramount for the genesis of headaches, such as migraine.

Dr. Robina Matyal’s research interests lie in diabetes-associated cardiovascular disease. She has significant experience in exploring the genetic and cellular mechanisms of disease processes leading to perioperative myocardial dysfunction, especially in diabetes. As an academic anesthesiologist with a significant research background, Dr. Matyal tends to approach her research projects with a translational focus. She is very active in collaborative projects and is currently working on a cutting edge research project about a novel drug delivery system for patients suffering from ischemic cardiomyopathy with Dr. Peter Kang from Cardiology Research.

All Investigators in the Department who conduct bench and translational research have been recipients of numerous awards and research grants from Foundations, Federal government as well as Pharmaceutical industry.

Clinical Research

Our department has a thriving research program that offers many opportunities in which our fellows may collaborate, and also to launch their own projects with the mentorship of experienced investigators and the support of our Center for Anesthesia Research Excellence.

Dr. Daniel Talmor, Chair of Anesthesia, Critical Care and Pain Medicine, leads a group of clinician-scientists focused on improving outcomes for patients with critical illnesses. The investigations conducted by this group range from mechanistic work at the bench that extends into translational research, to interventional clinical trials, supported and informed by epidemiologic surveys. Dr. Talmor's research program is focused on the following areas: 1) Optimal delivery of mechanical ventilation, 2) Prevention of Acute Respiratory Distress Syndrome, 3) Early identification of patients at risk for organ failure, and 4) Prevention and Early Treatment of Acute Lung Injury

Dr. Balachundhar Subramaniam's research program is focused on perioperative outcomes and includes Postoperative neurocognitive function, perioperative hemodynamics as well as wellness resilience research. Dr. Subramaniam was recently awarded an NIH grant to conduct a multi-center, prospective clinical trial (PANDORA) that will investigate the effectiveness of prophylactic intervention of IV Acetaminophen in prevention of postoperative delirium in older cardiac patients.

Dr. Shahzad Shaefi's clinical research is focused on the administration of low-dose carbon monoxide, which may exert anti-inflammatory, anti-apoptotic as well antimicrobial effects in various surgical and critical illness settings. Dr. Shaefi's lab is currently performing exploratory studies in healthy human volunteers.

Dr. Brian P. O'Gara is interested in finding innovative solutions to common perioperative problems through clinical effectiveness research. His current research focus includes the following areas of interest: 1) Lung protective properties of the inhaled anesthetics. Preliminary data from both preclinical models and human trials suggests that the volatile anesthetics may possess organ protective properties. Dr. O'Gara is interested in determining whether we can extend this potential benefit to patients in the operating room and ICU who are at risk for lung injury. 2) Cognitive prehabilitation to prevent postoperative delirium and POCD. As the population ages, more and more of our older patients will undergo surgery. Many within this vulnerable group are prone to postoperative cognitive disorders, namely delirium and postoperative cognitive dysfunction (POCD). Dr. O'Gara's research team is committed to investigating whether an innovative preventative approach, cognitive prehabilitation, can be effective in preventing these serious and impactful conditions. 3) Intraoperative virtual reality. Dr. O'Gara is conducting an innovative clinical trial investigating whether the use of virtual reality immersion can reduce intraoperative anesthetic requirements during upper extremity surgery and whether it can prevent anesthesia related complications.

Dr. Feroze Mahmood and Dr. Robina Matyal’s group is investigating the role of three-dimensional echocardiography in context of cardiac valvular surgery. Over the years, they applied advanced analytical techniques to ascertain and describe valvular geometry and its role in pathophysiological circumstances. They also explored associations between gender, body surface area, choice of analgesia and outcomes in patients undergoing abdominal aortic aneurysm surgery. Currently, their research group is engaged in investigating the role of rapid prototyping in innovating future practices for valve surgery and endovascular aneurysmal repair.

Anesthesia Research at BIDMC:

• The Department of Anesthesia
• Valve Research Group
• Shaefi Laboratory

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 unit 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 Departments of Anesthesia, Critical Care and Pain Medicine and Neurology at Beth Israel Deaconess Medical Center seek candidates interested in pursuing advanced fellowship training in neurocritical care. 

1. For candidates who have completed a GME-approved fellowship in critical care medicine, we offer a 12-month Neurocritical Care Fellowship that leads to board certification in Neurocritical Care by the United Council for Neurological Subspecialties (UCNS).
2. In addition, a two-year UCNS Accredited Fellowship Training Program is available to graduates of ACGME accredited neurology, anesthesiology, emergency medicine and neurosurgery residency programs. For graduates of an ABA-accredited anesthesia residency program a 24-month track that leads to dual certification in critical care medicine and neurocritical care is also an option. 

We foster exceptional clinical training in neurocritical care with supported research opportunities in related clinical and basic neurosciences. We are particularly excited for candidates who are interested in developing their expertise in critical care ultrasonography and neurocritical care research. What sets the Harvard/BIDMC program apart? With a fully integrated critical care training faculty and a close relationship between the departments of Neurology and Anesthesia, Critical Care and Pain Medicine, we provide our neurocritical care fellows with exposure to all aspects of the clinical practice and neurosciences with increasing autonomy and attainment of the positive characteristics and core competencies necessary to become outstanding independent practitioners, investigators, and future leaders in the field.

Irrespective of your specialty training, you will be a key participant in the BIDMC Critical Care Fellowship, which allows you to acquire advanced critical care expertise and procedural training in airway management, vascular access, bedside ultrasonography and echocardiography. The BIDMC 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.

Program Leadership

Harvard/BIDMC Neurocritical Care Fellowship Director (Anesthesia):
Shahzad Shaefi, MD, MPH
Department of Anesthesia, Critical Care and Pain Medicine
1 Deaconess Road, RB-470
Boston, MA 02215
sschaefi@bidmc.harvard.edu

Harvard/BIDMC Neurocritical Care Associate Fellowship Director (Neurology):
Corey R. Fehnel, MD, MPH
Department of Neurology
330 Brookline Avenue, KS-471
Boston, MA 02215
cfehnel@bidmc.harvard.edu 

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.

The Perioperative Quality and Safety Fellowship is a 2-year fellowship aimed at developing future international academic leaders in perioperative quality and safety. The program will equip fellows with the theoretical, practical and leadership skills to implement world-class quality and safety techniques and processes within their organizations. 

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 Mary Jane Cahill mcahill2@bidmc.harvard.edu).

*This program participates in the NRMP Match.