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Department of Anesthesiology

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Residency Program
 Residency Application Procedures
 Frequently Asked Questions

Introduction

The New York Medical College (NYMC) Residency Training Program is organized to provide education, training and experience in total patient care necessary for the development of consultant anesthesiologists. The program is integrated and uses the facilities of Westchester Medical Center (WMC), an 800 bed tertiary/quaternary care hospital in suburban Westchester, Danbury Hospital, in Danbury, Connecticut, the Metropolitan Hospital, a large municipal hospital on the upper east side of Manhattan, as well as Sound Shore Medical Center, located in New Rochelle.

There are more than 70 staff members on the full time faculty at these hospitals that contribute significant effort to undergraduate and graduate medical education. Approximately 90% of the faculty are certified by the American Board of Anesthesiology. Additionally, several faculty members completed fellowships in pediatric anesthesia as well as in cardiothoracic anesthesia and critical care. A handful of faculty are double- or triple-boarded.

The Department of Anesthesia of New York Medical College serves in hospitals that meet the needs of a diverse ethnic and socioeconomic community. In addition, the Medical College is a member of the Touro College and University System and is an equal opportunity employer.

Clinical Base Year

The Department of Anesthesia does not offer a Clinical Base (CB) year. However, some CB positions may be made available through NYMC affiliates, or in other clinical departments at WMC. Entry into the program is at the CA-1 level. For those who are applying while still in medical school, positions are secured through the National Resident Matching Program Advanced Anesthesia Match. Applications are considered from graduates of medical schools at any time.

Clinical Anesthesia (CA1-2)

The first twenty-four months of clinical anesthesia training (CA-1, CA-2) are divided into three major components. The first, Clinical Care, involves patient care in the operating room and obstetrical suite, including experience in general surgery, cardiac surgery, (both adult and pediatric), neurosurgery, orthopedic surgery, major vascular surgery, ophthalmologic and ENT surgery, neonatal and pediatric surgery, and gynecological procedures. A staff anesthesiologist is assigned to each anesthetic administered by a resident. Maximum supervision ratio is one attending physician to two residents. Difficult cases mandate one-on-one supervision, and supervision ratios at WMC are one-on-one. A minimum of two attending anesthesiologists are available in house 24 hours a day 7 days a week at WMC. At the other hospitals in our integrated program, a minimum of one attending anesthesiologist is present 24/7.

The first year of clinical anesthesia (CA-1) is designed to teach new residents the basics of uncomplicated anesthetic management, to encourage and stimulate reading, and to provide a formal didactic program. At the end of twelve months, the resident is expected to be able to participate in the full clinical and academic life of the department and assume a major role in the care of more seriously ill patients or those requiring more complicated anesthetic management. By the completion of the CA-1 year, the resident should no longer require continuous one-on-one supervision for uncomplicated cases.

In the second year (CA-2), emphasis is placed on the subspecialties of anesthesia and the resident has more responsibility for the conduct of anesthesia. The resident's experience includes major cardiovascular, thoracic and neurosurgical anesthesia, diagnostic and therapeutic nerve blocks, geriatric anesthesia, intensive and respiratory care of surgical and medical patients, radical cancer surgery, obstetrical anesthesia, pediatric anesthesia, and anesthesia for emergency surgery, as well as outpatient surgery. By the end of the CA-2 year, it is expected that the resident can safely anesthetize most patients without continuous supervision.

The second major component of the Clinical Anesthesia Continuum is academic. New residents receive a core introductory lecture series upon entering the program. Advanced cardiac life support (ACLS) certification is required and Conferences are held five days a week. These sessions include basic science topics and case reviews. In addition, every Monday, there is a formal academic session during which staff physicians in anesthesia and from other departments focus on selected topics. Guest speakers present, both from other departments within the New York Medical College family and from other institutions.

The resident is expected to participate in presenting conferences; preparation involving research into current literature, as well as textbook sources, is expected. Resident presentations should reflect familiarity with the topics. Evidence-based medicine is emphasized. By the end of the training period, it is expected that the resident will have established a reading schedule enabling him or her to review previously learned material and to continuously expand his or her knowledge daily. Graduates are expected to be committed to lifelong learning.

The third component of the Clinical Anesthesia Continuum involves acquiring competence managing patients in the post anesthetic care unit and intensive care units. It includes the diagnosis and treatment of respiratory emergencies, respiratory support techniques, interpretation of cardiovascular monitoring parameters, and resuscitation, as well as the treatment of patients with metabolic disease, cardiac or renal failure, and those in coma.

All residents must pass the third part of the National Board Exam or USMLE Step 3 by the end of 6 months of CA-1 year training. Continuance in the program is based in part on the resident's performance at conferences, staff evaluations, and performance on the In-Training examination given to all anesthesia residents annually. It is mandatory that this national exam be taken each year as it allows the resident to judge his or her performance individually and against the peer group nationally. It also allows the Program Chairman to reorient didactic and clinical teaching toward those areas where departmental deficiencies have been identified.

Specialized Year (CA-3)

Residents in their CA-3 Year should expect to be assigned to the more difficult or complex anesthetic procedures or to the most seriously ill patients. Areas of emphasis that may be chosen for a subspecialty clinical track include:

  1. Cardiac Anesthesia
  2. Pediatric Anesthesia
  3. Neurosurgical Anesthesia
  4. Obstetric Anesthesia
  5. Regional Anesthesia
  6. Critical Care
  7. Difficult Airway Management

At the completion of the CA-3 year, the resident should be skilled in all areas of anesthesia, including adult and pediatric cardiac anesthesia, high risk obstetrics, and neonatal surgery. In summary, the candidate must be both clinically sage and able to function independently as a valued consultant.

Research

A focused intramural clinical research program is supported within the Department. Members of the department annually present papers at national and international meetings, as well as publish papers in peer-reviewed journals. A Department research committee meets regularly under the direction of Mario Inchiosa, Ph.D. This committee reviews research proposals of both staff and residents and promotes active participation of all staff and residents in research. CA-3 residents are encouraged to develop research projects and to publish or present their findings in national forums. It is expected that all residents graduating from the program will complete at least one study, and/or publish one paper.

To specifically aid the resident and junior staff in developing research, the Department employs a senior pharmacologist whose responsibility is to help in designing and executing research protocols. Dr. Inchiosa is an extremely valuable research resource who is conducting important investigations in a range of areas, including reflex sympathetic dystrophy syndromes and coagulation abnormalities in patients undergoing cardiopulmonary bypass.

Residency Application Procedures

This program participates in ERAS, the Electronic Residency Application Service. All application materials come through the ERAS system. Interested applicants should contact the Student Affairs office at their medical school for information on submitting application information. A complete description of this procedure may also be found on the ERAS web site.

To be considered complete, an application must have the ERAS Common Application Form, medical school transcript, official USMLE transcript, Dean's letter, Step I and II Exam scores (with an average score of at least 220 [most successful applicants score considerably above this]), letter of recommendation from Program Director of any previous medical or surgical residency training (if applicable), and at least two letters of recommendation.
All correspondence should be directed to:

Resident Coordinator
Department of Anesthesiology
Macy Pavilion Room #2391
Westchester Medical Center
Valhalla, New York 10595

Tel: 914-493-7692
Fax: 914-493-7927

Please be advised that the program verifies the ECFMG test-taking attempts of all foreign medical graduates being considered for employment as residents in the hospital's postgraduate training programs. This is done by written communication with the Educational Commission for Foreign Medical Graduates, located in Philadelphia, PA.

An interview is required. All attempts will be made to schedule the interview on a date that is convenient for the candidate. With rare exception, all candidates will be interviewed by the Resident Admissions Committee, which is comprised of Attending Staff from all institutions and Chief Residents.

The National Resident Matching Program will be used for PGY 2 CA-1 positions that start in July of each year. In addition there occasionally are a few positions outside of the MATCH, with start dates in January and other times of the year.

Frequently Asked Questions

What qualities is New York Medical College looking for in residents?
The department looks for those candidates who show the greatest promise of developing into excellent clinicians and who can function at the consultant level. We are especially interested in academic accomplishment, clinical and interpersonal skills, and professionalism. It is anticipated that every resident who starts the program will finish; it is a non-pyramidal residency program.

Who will interview me and what is involved?
Members of the Resident Admission Committee, which is comprised of faculty members and the chief residents, conduct interviews. Every attempt is made to make the interview process stress-free and informal. You will not be quizzed on medical information, nor will any test be administered. You will be taken on a tour of the hospital. Lunch will be provided. For those applying through the MATCH, interviews will take place after November 1st. Non-MATCH candidates are interviewed at any time.

How much night call is expected?
Night call varies between every fifth or sixth night, depending on the clinical service. At some sites, the night call may be considerably less than this maximum. Call in house does not exceed 24 hours and the resident is off the next day.

Is housing available?
Limited housing and single rooms are available on the Westchester campus and at the Metropolitan Hospital Center in Manhattan. An apartment is also available gratis near Danbury Hospital.

What fringe benefits are provided?
While the residency is a fully integrated program between four hospitals, residents are each contracted with Westchester Medical Center for payroll purposes. All contracts contain and reference:

Financial Support
Vacation policies
Professional Liability Insurance
Disability Insurance and other hospital and health insurance benefits
Professional, parental, and sick leave benefits
Conditions under which living quarters, meals and laundry services or their equivalents are to be provided
Counseling, medical, psychological and other support services
Institutional policies covering sexual and other forms of harassment.

How much vacation time is allowed?
The department policy must follow that of the American Board of Anesthesiology. Any and all absences from training, including vacation and sick leave, may not exceed a total of 60 days over the entire 3 years. Attendance at scientific meeting may not exceed five (5) working days per year and shall be considered part of the training program. Absences in excess of those specified will require lengthening of the resident's total training time to the extent of the additional absence.

Are there positions that begin other than in July?
Yes. In general, the program year begins on the first of July and concludes on the 30th of June. From time to time, however, positions do become available in January and other times of the year.

Do you accept people who have already trained in other specialties?
Yes. Previous training does not count against acceptance and may to some degree enhance admission chances.

What are the rotations?
In the CA-1 and CA-2 years the resident will rotate between the four teaching hospitals to gain exposure in the various subspecialties required by the ACGME (cardiac, neurosurgery, pediatrics, etc). In the CA-3 year, residents will complete 6 months of Advanced Clinical Track, along with 6 months of electives. Electives are chosen by the resident with the guidance of the program director.

What conferences are held?
While the schedule varies slightly between hospitals the conferences are as follows:

Journal Club, Teaching Sessions (Tuesday-Friday), Weekly Grand Rounds (Monday), Monthly Morbidity & Mortality, and Oral Board Reviews (Thursday).

 

 


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