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Residency Training in Anesthesiology at the University Of Washington
The Department of Anesthesia at the University of Washington serves the educational needs for the five "WWAMI" states: Washington, Wyoming, Alaska, Montana and Idaho. We offer both 3 and 4 year residency training programs in anesthesiology with an opportunity for final year residents to undertake a 6 month research track. We also offer a combined 5-year program in Anesthesiology and Critical Care Medicine. Training is conducted at our 4 main affiliated teaching hospitals all with national and international reputations. We provide a high volume of complex and interesting cases and residents have the opportunity to be taught by experienced faculty members, many of who are national and international leaders in their fields of expertise.
Mission Statement
The goal of the UW Anesthesiology Residency Program is the education of resident physicians in all areas of knowledge, clinical & technical skills, and professional attitudes related to anesthesiology; in order graduate accomplished anesthesiologists who meet the requirements to become certified by the ABA and who are proficient to practice anesthesiology independently in either an academic institution or in private clinical practice.
The UW Anesthesiology Residency Program offers a diverse range of training opportunities
- Categorical “4 year program” -- 12 positions available for 2010 (all 4 years of training carried out within the UW system)
- Advanced “3 year program” -- 8 positions available for 2011 (3 years of clinical anesthesia training at UW and the internship year is matched separately)
- Combined Anesthesiology and Critical Care Medicine fellowship "5 year program" -- 2 positions available for 2010
- Bonica Scholars program "6 year program" (including 4 years of anesthesia and 2 years of research)
- Opportunities in Global Health
View the UW SOM GME Policy for Eligibility and Selection, and the
Anesthesiology Residency Essential Requirements for Training
Brief History of UW
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Dr. John Bonica |
The University of Washington was founded in 1861 and is located in Seattle on the shores of Lake Washington. The UW School of Medicine has an outstanding national reputation for teaching, clinical service and research. Likewise, our department is ranked among the leading academic departments in the country. The Department of Anesthesiology was founded in 1960 by Dr. John Bonica, a world leader in regional anesthesia and pain management.
We pride ourselves on the depth and breadth of the training we offer. When a physician completes our program, he or she is equipped to handle any clinical situation in the perioperative period. The University of Washington Medical Center is located on the university campus and our residents and faculty have ready access to scientists in all disciplines so that collaborative efforts are facilitated. The Department has extensive grant-supported basic and clinical research programs and many externally funded grants.
Overview of Anesthesiology Residency Training at UW
A Top Notch Program
In April 2006, the UW anesthesiology residency training program was reaccredited by the ACGME for a period of 5 years, placing us in the top 20% of residency training programs nationally.
We are accredited for 72 residents in the clinical anesthesia years 1 though 3, (24 residents per year). We also offer 16 “categorical” positions for PGY1 residents who rotate through linked medicine and surgery rotations. The categorical positions (Clinical Base Year) are a popular choice as they allow residents to remain in the same program for all 4 years of their training and to take advantage of excellent training opportunities. By offering the majority of our positions as four year training we compete with the top programs nationally. We have developed a well balanced internship year providing outstanding experience in general internal medicine. As well as this strong grounding in medicine, our interns also experience a variety of other specialties which provide a strong base to their clinical anesthesiology training. This includes months of intensive care, pain, anesthesiology, otolaryngology, general surgery, internal medicine, and emergency room care.
A top choice for Medical Students
Anesthesiology is an increasingly popular subspecialty for graduating medical students. The Department of Anesthesiology has close links to the University of Washington Medical School, offering 2 and 4 week clerkships for medical students from both the local medical school and from schools across the country. Anesthesiology is one of the top choices for graduating medical students and has consistently been in the top 5 choices of specialties which UW medical students match to after graduating, attracting between 7 and 11% of UW graduates since 2002. Of these upwards of 40% join our own residency program.
We welcome applications from external medical students to join our program for a clerkship - come and work with our residents and attendings and experience our training program first hand! - many current and former residents joined our training program after being favorably impressed as medical students.
Contact Kim Mabee kmabee@u.washington.edu 206 543 2474 for details about our clerkship opportunities.
Successful Graduating Residents
Residents enrolled in our training program are enthusiastic, dedicated, hard working physicians who have to deal with some of the toughest cases referred to our hospitals across the 5 “WWAMI” states. Consequently our graduating residents are highly sought after by private practice and academic institutions across the country.
| Activities of Graduating Residents 2008 and 2009 (Total 40) | ||||
|---|---|---|---|---|
| Year | 2008 | 2009 | ||
| Activities | Number | % | Number | % |
| Fellowship / Academic Institution | 6 | 33 | 8 | 37 |
| Washington state Private Practice | 7 | 39 | 4 | 18 |
| Rest of the “WWAMI” states (WY, AK, MT, ID) |
0 | 0 | 4 | 18 |
| Other States, mainly West and Mid-west | 5 | 28 | 6 | 27 |
| Total | 18 | 22 | ||
Graduating Residency Class of 2009
After three years of hard work and dedication, the class of 2009 celebrate at their graduation banquet!. This outstanding group of newly qualified anesthesiologies look forward to the next step of their careers in fellowship positions at the University of Washington, Seattle Children's Hospital and in private practice in areas including Seattle, Wyoming, Montana, and California
Success in the American Board of Anesthesiology Examinations
Our graduating residents who took the written ABA examination in 2005 had a 100% (19/19) first time pass rate and in 2006 the pass rate was 94% (17/18). Full certification by the ABA is granted after passing the oral boards examination usually within the first few years of graduating. Our pass rates over the last 5 years have well exceeded the national average:
| Year of Graduation | Total Graduated | ABA Primary Certification |
National rates |
|---|---|---|---|
| 2004 | 19 | 19 (100%) |
87% |
| 2005 | 20 | 19 (95%) |
85% |
| 2006 | 17 | 17 (100%) |
71% |
| Total | 56 | 55 (98%) |
81% |
Training Hospitals
Residency training at the University of Washington is conducted at the four major affiliated hospitals, University of Washington Medical Center (UWMC), Harborview Medical Center (HMC), Seattle Children's and Veteran’s Affairs Puget Sound Health Care System (VA). Residents may also undertake subspecialty rotations at local private hospitals including Virginia Mason (regional anesthesia and ambulatory surgery), Evergreen (obstetric anesthesia) and Northwest (cardiac anesthesia).
Clinical Case Load
Our training program adheres strictly to the program requirements defined by the ACGME http://www.acgme.org/acWebsite/RRC_040/040_prIndex.asp
Resident training in anesthesiology is in many ways an apprenticeship, with an emphasis on teaching and learning “on the job” in the operating rooms, intensive care units and pain clinics. The UW anesthesiology program provides ample clinical cases and training opportunities in all areas of clinical anesthesia, pain medicine and intensive care. A summary of the case logs from the graduating class of 2008 and 2009 confirm that our residents are well above the minimum ADGME requirements (see brackets). This data does not reflect the large number of high acuity patients taken care of by our residents.
| Cardiac bypass | 41 (20) | Cesarian section | 96 (20) |
|---|---|---|---|
| Major vascular | 33 (20) | Vaginal delivery | 117 (40) |
| Intracranial procedures | 83 (20) | Epidurals | 179 (50) |
Major trauma |
199 (10) | Spinals | 119 (50) |
Pediatric cases < 1yr |
42 (15) | Nerve blocks | 144 (40) |
Pediatric cases 1-12 yrs |
235 (100) | Acute / chronic pain patients | 135 (25) |
| Patients > 65 yrs | 265 | Ambulatory surgery cases | 527 |
Faculty Supervision and Teaching
The teaching faculty at UW represent a diverse group of highly trained anesthesiologies. There are currently (Sept 09) 129 clinical faculty the majority of whom trained at the best institutions in the US and Canada (75%). In addition the department has recruited widely internationally to add depth to both the clinical and research expertise in the department. This provides residents with a rich educational environment and exposure to many "right ways" of doing thngs!
Faculty work closely with residents at all times providing supervision and clinical teaching in the operating rooms. In many cases residents are supervised 1:1 by faculty particularly in areas such as cardiac, obstetric and pediatric anesthesia. 2:1 supervision (2 residents with 1 attending) is provided in the first 4 weeks of a resident's training after which residents are gradually exposed to more independence as their clinical experience grows. At all times the minimum supervision residents can expect is their faculty member supervising one other operating room with a CRNA or another resident.
Dr Janet Pavlin MD demonstrates ultrasound-guided popliteal nerve blockade to Dr Jasper Chen. |
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Dr Alex Vitin assists DrDiane Goebel placing a swan ganz catheter in a patient for liver transplantation. With upwards of 120 OLT cases per year our residents all get ample experience of these most challenging cases. If you can handle a liver transplant you can handle just about anything! |
Didactic Curriculum
The didactic curriculum has been developed over several years to provide graded education that runs in tandem with residents’ clinical experience in the operating rooms. Four hours of protected time are set aside for resident lectures every Wednesday morning, followed by protected time in the simulator on Wednesday afternoons. In the first 2 months of the academic year the CA1 residents undergo an intensive course of lectures covering basic physiology, pharmacology, equipment and the practice of general anesthesia. For the remained of the year the lectures follow a three weekly cycle for the CA1, CA2 and CA3 residents. The CA1 residents continue with fundamental knowledge, for the CA2 residents, lectures focus on the subspecialty areas such as cardiothoracic, neuro and regional anesthesia to reflect the subspecialty rotations. In the CA3 year the didactic curriculum offers a number of interactive seminars with an in depth discussion of pertinent topics. Residents also receive didactic lectures during their subspecialty rotations in obstetric anesthesia, pediatric anesthesia, intensive care and pain medicine.
In addition there are weekly resident conferences at each hospital, departmental grand rounds, morbidity and mortality conferences, journal clubs, oral boards review and special evening seminars. Resident attendance is expected at all educational events and CRNAs and faculty provide coverage in the ORs to facilitate resident attendance at educational events.
- All full list of weekly conferences is provided.
Dr Sanjay Bhananker demonstrates the anatomy of the femoral nerve during a ‘resident special” workshop on regional anesthesia. We hold a variety “resident special” workshops with faculty and CRNAs providing cover in the ORs to allow all residents to attend.. |
Duty Hours
At UW we pay strict attention to the ACGME defined work hours and closely monitor our resident duty hours. The average hours worked by residents per week for 2006 - 07 academic years were: CA1s 55.11: CA2s 57.58: CA3s 51.58.
The average hours worked by residents per week for 2008-09 academic years were
- 56 hours per week
Simulation Training in Anesthesiology
We have a fully operational anesthesia simulator and a well defined program of simulation sessions for residents covering a wide curriculum of critical incident management, team work and communication skills. Our simulation center has recently received recognition from the American Board of Anesthesiology (ABA) as a training site for maintenance of certification for practicing anesthesiologists. Click here to go to the UW's Institute for Simulation and Interprofessional Studies (ISIS).
In our innovative disclosure training program residents practice breaking bad news to simulated patients after a high fidelity simulation exercise.
Research Opportunities
There are many opportunities for residents to become involved in research projects. We have many, well funded faculty actively engaged in all manner of research including laboratory based work, clinical research, and analysis of closed claims data from the Closed Claims Data base. Many of our residents present abstracts and posters at local and national meetings such at the Western Anesthesia Resident Conference (WARC), ASA, SNAAC, PGA. Each resident is provided with an academic fund of $1000 per year to facilitate scholarly activities and there is additional departmental funding for residents who are selected to present work at national meetings. In the CA3 year all residents have an elective month which allows an opportunity to undertake more detailed research projects. In the CA3 year residents with a definite academic interest may participate in the 6 month resident research track (RRT). This track is an alternative to clinical anesthesia devoted to developing the skills necessary for a career in academic anesthesia and research. With appropriate approval and mentoring residents work on clinical or laboratory based research projects.
For more details about the RRT see the RRT goals and objectives.
Anesthesiology and Critical Care Medicine Program Description
This innovative program offers a 5-year continuum of education beginning with the Clinical Base (“internship”) year and culminating in eligibility for certification in both Anesthesiology and Critical Care Medicine through the American Board of Anesthesiology. The first three years of training parallel those of trainees in the “conventional” residency track, and include a total of 5 months of intensive care unit rotations. The last two years of training integrate 12 months of Advanced Critical Care Medicine at the fellow level with conventional Anesthesia rotations and electives. This blending of training over the final two years allows trainees to enhance their operative skills while mastering the field of Critical Care Medicine. Critical Care fellowship rotations are jointly administered between the UW Department of Anesthesiology and the Department of Medicine, Division of Pulmonary and Critical Care Medicine; please see the fellowship description for further details.
Bonica Scholars Program
A new initiative offering residents the opportunity to complete an extra 2 years of research after completing their clinical training. The medical students who match to this program are pariedpaired with a research mentor early in his/her training in order to faciliatefacilitate research relationships early. This position does carry an additional financial incentive!
-- see Applying for residency for details and appliction forms
Global Health
A new initiative offering residents the opportunity to complete an extra 2 years of research after completing their clinical training. The medical students who match to this program are pariedpaired with a research mentor early in his/her training in order to faciliatefacilitate research relationships early. This position does carry an additional financial incentive!
The Department of Anesthesiology and Pain Medicine at UW enthusiastically supports resident involvement in global health. A number of our faculty are active in overseas medicine in the developing world and provide mentorship and opportunities for many residents to gain overseas experience during their training.
In the CA3 year the Department funds a month’s ‘elective’ time for residents to explore various training opportunities and many residents use this time to travel overseas.
Examples of resident global health experiences in recent years include:
Four senior residents in consecutive years from 2006 to 2009 were recipients of the prestigious SEA/HVO fellowship to travel to Tanzania and participate in training of local anesthesia providers.
Other countries our residents have visited include South Africa, Honduras, Nepal, and Columbia
In the CA3 year, the Department funds a month's "elective" time for residents to explore various training opportunities and many residents use this time to travel overseas.
Four senior residents in consectutive years from 2006 to 2009 were recipients of the prestigious SEA/HVO fellowship to travel to Tanzania and participate in training of local anesthesia providers.
Other countries our residents have visited include South Africa, Honduras, Nepal, and Columbia.
Examples of anesthesia apparatus used by anesthesiology residents on overseas expeditions.
An example of one of many places in South America visited by Dr. Jo Davies on overseas missions.
Dr. Davies is one of several faculty members who provide strong mentorship and support for many residents wishing to travel overseas during their residency training and beyond.
New Directions and Program Growth in the Future
In recent years the increased interest in anesthesiology trainng from medical students and the national shortage of well trained physician anesthesiologist has prompted our program to look to expanding our training program. We have a particular interest in developing connections with private practice groups in other parts of Washington State to introduce residents to more rural and community based practice. In an exciting development the program is currently exploring opportunities to further expand the training programs ffrom the point of view of resident numbers and allow us to offer a more diverse spectrum of training opportunities for our residents.
In addition our long term goal is to further expand our Clinical Base Year t match our Clinical Anesthesia (CA) numbers. These expansion plans are currently (Oct 09) being negotiated and we anticipate they will be finalized before the 2010 match deadline.
Residency Program Director and Staff
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Residency Program Director
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Associate Program Director & Director for the Internship Year Allen N. Gustin, Jr., MD, FCCP Assistant Professor |
Residency Program Coordinator Assistant Program Coordinators |
Questions?
Please call, email or write if you need additional information or assistance. Contact Louena Goodwin (206-543-2773; fax 206-543-2958; anesuwa@u.washington.edu).
Our program is indexed on the AMA's Fellowship and Residency Electronic Interactive Database (FREIDA). Click here to go to FREIDA and search for our program using our 10-digit identifier: 0405421161
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