Description of the Program
Clinical Anesthesia Years (CA-1, CA-2, CA-3)
Resident Reading List
Anesthesiology Residents
Welcome Future Residents
Comments From a Former Chief Resident

The Program

The MetroHealth Department of Anesthesiology offers a four-year anesthesiology residency training program, including one year of rotating internship, primarily in medicine and pediatrics, and three years of clinical anesthesia training. In addition to extensive anesthetic experiences gained in the operating rooms and the lecture halls, residents rotate through specialty fields including:

Cardiothoracic Anesthesia
Neuro Anesthesia
Obstetrical Anesthesia
Pain Management
Critical Care
Pediatric Anesthesia
Burn and Trauma Anesthesia
Recovery Room Care Management

Most importantly, MetroHealth residents possess the ability and confidence to deal with extremely ill and complicated patients.

Back to top

Clinical Anesthesia Years (CA-1, CA-2, CA-3)

CA-1: The first Clinical Anesthesia year is designed to introduce the resident to a wide variety of routine cases with controlled exposure to more difficult cases. During the first few months, CA-1 residents are eased into an exclusive team in which they work along side and are supervised and trained by staff physicians and senior residents. In the second half of the CA-1 year, the resident usually rotates at least once through the major areas of Cardiac, Pediatric, Obstetrical and Neuroanesthesia as well as Critical Care. The CA-1 resident rapidly gains independence from "tight" supervision as his/her skills and abilities increase.

CA-2: During the second clinical anesthesia year, the resident gradually gains freedom to formulate anesthetic plans, and when appropriate, he/she is permitted to embark upon a wide variety of anesthetic techniques. The CA-2 resident manages cases of increasing difficulty and is introduced to pain management.

CA-3: The senior resident may choose among elective rotations including advanced clinical subspecialty and research tracks and will often supervise junior residents. A high level of independence is granted to the CA-3 resident and he/she frequently manages anesthetic inductions under the watchful eye of the staff anesthesiologists. During the final year, the senior resident will develop his or her role as a consultant anesthesiologist and will become comfortable dealing with patients at all levels of complexity.

Back to top

Resident Reading List

The listed texts may be ordered at a discount through Wendy Lister, Department of Anesthesia, extension 4801. The earlier you start reading the texts, the better!

Key texts in Anesthesia

• Miller RD, et al. Anesthesia, 4th Edition (2 volumes), Churchill Livingstone.
  If you read one book during your residency, this is the one.
  
  
• Stoelting and Dierdorf. Anesthesia and Coexisting Disease, 3rd Edition.
  Almost one-half of the ABA exam deals with pathophysiology of disease states or altered physiology. This is a very valuable text for all residents.
  
  
• Clinical Anesthesia Procedures of the Massachusetts General Hospital.
  This is a pocket quick reference for day-to-day use.
  
  
• Rogers MC et al. Principles and Practice of Anesthesiology, 1st Edition (2 volumes), Mosby.
  This text makes the enormous effort of highlighting the information that will truly make you a consultant in anesthesia.

Other Texts

• Gaba. Crisis Management in Anesthesiology. Churchill Livingstone.
  
  
• Berry F. Management of Routine and Uncommon Problems in Pediatric Anesthesia, 2nd Edition.
  Eminently readable.
  
  
• Dorsch JA and Dorsch SE. Understanding Anesthesia Equipment, 3rd Edition.
  Don't miss this one.
  
  
• Barasch PG. Clinical Anesthesia, 3rd Edition (and companion).
  Distributed by Burroughs Wellcome.
  
  
• Stoelting RK and Miller RD. Basics of Anesthesia.
  AKA "Baby Miller." Good start for medical students. You will likely fail boards if this is the only book you read.
  
  
• Schnider and Levinson.Obstetrics, 3rd Edition.
  
  
• Stehling LC. Common Problems in Pediatric Anesthesia.
  The experts describe exactly how they would handle specific pediatric problems.
  
  
• Smith's Anesthesia for Infants and Children.
  
  
• Gregory GA. Pediatric Anesthesia.
  
  
• Newfield P and Cottrell JE. Handbook of Neuroanesthesia.
  
  
• Yao and Artusio. Anesthesiology, Problem-Oriented Patient Management.
  
  
• Faust RJ. Anesthesiology Review.
  
  
• Kaplan JA. Cardiac Anesthesia, 3rd Edition.
  
  
• Benumof. Thoracic Anesthesia.
  
  
• Winnie AP. Plexus Anesthesia: Perivascular Techniques of Brachial Plexus Block.
  
  
• Martin JT. Positioning in Anesthesia and Surgery.
  
  
• Stene JK and Grande CM. Trauma Anesthesia.
  
  
• Cousins MJ and Bridenbaugh PO. Neural Blockade in Clinical Anesthesia and Management of Pain.
  
  
• ASA Annual Refresher Course Lectures

Anesthesia Journals

• Anesthesiology.
  Official journal of the ASA. A must.
  
  
• Anesthesia and Analgesia.
  Official journal of the IARS. Another must.
  
  
• Journal of Clinical Anesthesia.
  
  
• Journal of Cardiothoracic and Vascular Anesthesia.
  
  
• Canadian Journal of Anesthesia.
  
  
• American Journal of Anesthesiology.
  
  
• British Journal of Anesthesia.
  
  
• Anaesthesia.
  
  
• Journal of Clinical Monitoring.
  
  
• Critical Care Medicine.
  
  
• Progress in Anesthesiology.
  
  
• Current Reviews in Anesthesiology.
  
  
• Seminars in Anesthesia.
  
  
• Problems in Anesthesia.
  
  
• Audiodigest Anesthesiology. (cassettes)

Back to top

Anesthesiology Residents

Clinical Anesthesia - Year Three
Feda Almallouhi, M.D.
Ovidiu Brescan, M.D.
Romulo Paz, M.D.
Zakir Qureshi, M.D.

Clinical nesthesia - Year Two
Emil Choi, M.D.
Satish Joshi, M.D.

Clinical Anesthesia - Year One
Charanjit Bahniwal, M.D.
Katrina DeSantos, M.D.
Mohan Kareti, M.D.
Maria Jocelyn Loy, M.D.
Chandra Tokala, M.D.
Roderick A. Yamat, M.D.

Back to top

Welcome Future Residents

Greg Gordon, M.D., Vice Chair and Residency Coordinator

As a MetroHealth Anesthesiology resident, you will enjoy an informal, collegial atmosphere while developing confidence in your ability to handle any anesthetic problem. Major advantages will be our active trauma service, our group of wonderful people, dedicated to teaching and providing state-of-the-art, cost-effective care to all, and the major role that you will play controlling your own destiny by driving your own residency program.

Of the more than 13,000 cases done annually by you and your 12 to 15 resident colleagues and the other anesthesia care team members, you will especially remember many of the trauma-related problems as powerful facilitators in acquiring knowledge and skill in efficient prioritizing, resuscitation, managing badly deranged airways and keeping cool under pressure. MetroHealth is the most active trauma center in our part of the country. An active ground transport system plus four helicopters are needed, especially during the summer months. You may elect to spend time on the Metro Life Flight helicopter transport service and take care of on-the-scene resuscitation. Your Certification in Advanced Trauma Life Support will, of course, be encouraged and supported.

The MetroHealth anesthesiology attending staff, of which there are more than one per resident, are dedicated to inspiring you and your fellow residents to learn and gradually assume independence in delivering anesthesia care. At first, you will be eased into your role in the operating room by working as part of an exclusive team with one Senior Resident and/or Attending Anesthesiologist. Daily introductory didactic lecture and discussion sessions with all first year residents will provide educational direction and foster camaraderie. During your first months with us, you may elect to take advantage of our Mentor/Protege Program by selecting a Mentor from among your attendings. During your residency, you will develop a special positive relationship with this individual who will take personal responsibility to help assure your success in anesthesiology. Starting after the first few months at MetroHealth, you will begin a series of subspecialty rotations for 1 or 2 months with our various Clinical Teaching Units, each headed by a talented expert anesthesiologist who will guide you in achieving the specific written objectives of that subspecialty unit. You will receive expert training and have ample experience in flexible fiberoptic intubation and management of acute and chronic pain problems. Two or three written exams with questions taken from past American Board of Anesthesiology written board exams, and mock oral exams with individualized post exam analysis will help prepare you for the boards. You may elect to participate in our active clinical present a poster or paper or publish an abstract or paper with our attendings.

Your input will be a major factor in designing your experience as a MetroHealth anesthesiology resident. The Chief Resident is a mandatory member of each of the three residency program committees. Informal feedback sessions with the program director, residency coordinators, and residency committee chairpersons provide ample opportunity for communication, discussion and decision for change.

MetroHealth welcomes you to a fun, exciting anesthesiology resident experience that will facilitate your development into a mature, multi-talented, consultant-level, board-ready anesthesiologist.

Back to top

Comments from Former Chief Resident

Daniel Meenan, D.M.D.

As I look back at the time spent at MetroHealth Medical Center, I realize that it has trained me to handle virtually any challenging case that I will encounter as an anesthesiologist when I leave the program for private practice in three months. The extensive hands -n experience provides the skills necessary to deliver safe and effective anesthesia as well as giving one confidence in one's abilities. The atmosphere and the Staff-Resident relationship is relaxed. The trauma and emergency anesthesia patient management is often under the direct supervision of the Senior Resident on call. This added responsibility is an excellent learning experience. The pain service resident has the unique experience at our program of learning the surgical techniques of implantation of nerve stimulators and infusion pumps. Senior residents actually perform the operative procedure.

The first two years of the program encompass eight months of general anesthesia training in cardiac, pediatrics, neurosurgery, obstetrics, ICU, recovery room, ambulatory and pain rotations. The program deliberately integrates the on-call duties so that expertise in all specialties is enhanced as the resident progresses and the skills in any one area are not lost.

Back to top