The CBY program is completely administrated by the Residency Program Director and Associate Program Director. This year’s rotations were chosen because they satisfy ACGME Anesthesiology requirements and because of the high quality teaching offered to our residents by faculty across the University of Pittsburgh Medical Center (UPMC). A tradition of careful collaboration between our residency leadership and the hosting departments’ faculty ensures quality training and seamless transitions as the CBY residents rotate through the year. Benefits of integrating this year into the residency are numerous. Early exposure to quaternary care patients in multiple clinical settings strengthens our residents’ ability to care for these same patients later in the perioperative setting as anesthesiology residents. CBY residents are supported as members of the Department of Anesthesiology and have easy access to the anesthesiology faculty and residents.
The 13 four-week blocks of training during the CBY are as follows:
- Acute Pain Medicine – 1 block
- Anesthesiology – 1 block
- Anesthesiology Professional Practice – 1 block
- Cardiology – 1 block
- Critical Care Medicine – 2 blocks
- Emergency Medicine – 1 block
- Hemostasis & Hemotherapy – 1 block
- Internal Medicine – 2 blocks
- Otolaryngology – 1 block
- Pediatrics – 1 block
- Surgery – 1 block
CBY residents in our department are afforded the same benefits that the CA-1, CA-2, and CA-3 residents enjoy. These include a competitive salary, four weeks of paid vacation, one week of paid meeting time, comprehensive health insurance, a travel and education discretionary account, and free parking. As all of our educational programs are in the University of Pittsburgh Department of Anesthesiology, the CBY is in full compliance with ACGME graduate medical trainee duty hours regulations.
- Acute Pain Medicine: This rotation is designed to be an introduction to acute pain medicine for CBY residents. They spend one block working with the Acute Interventional Perioperative Pain Service at UPMC Presbyterian. The CBYs learn safe and effective opiate management, the indications and contraindications for regional anesthesia, and management of in-dwelling peripheral nerve block catheters. While it is not the emphasis of this rotation, the CBYs often complete ACGME’s required minimum for peripheral nerve blocks during this introductory rotation.
- Anesthesiology: During this rotation, CBYs are paired with senior anesthesiology residents for a personalized graduate medical education level introduction to anesthesiology at UPMC Presbyterian. The CBYs perform cases side by side with the senior resident. Readings focus on anesthesiology practice standards and guidelines. The rotation also fosters camaraderie among the residents and introduces the CBYs to a large number of faculty members.
- Anesthesiology Professional Practice: This unique and innovative non-clinical rotation is designed to introduce CBY residents to a variety of aspects of professional anesthesiology practice including: research basics, data management and statistical analysis, policy and advocacy, professionalism, leadership, legal issues, business management, ASA registries, international anesthesia, and other related topics. All CBY residents complete this rotation together in a four-week block that concludes with attendance at the ASA annual meeting (funded by the department).
- Cardiology: CBYs join the cardiology consult service at UPMC Presbyterian for this rotation. They field consults ranging from chest pain to perioperative optimization. This active and academic service provides important teaching regarding cardiovascular medicine in an acute care setting directly applicable to the practice of anesthesiology.
- Critical Care Medicine: CBYs work in two different high acuity intensive care units during these blocks. The rotations serve to provide the necessary firm foundation in critical care medicine required for successful training in anesthesiology.
- Emergency Medicine: The CBYs work in the busy UPMC Presbyterian Emergency Department during this rotation. This ED sees a wide spectrum of illness ranging from exacerbations of chronic illnesses to early complications arising from organ transplantation. UPMC Presbyterian is a Level I trauma referral center.
- Hemostasis & Hemotherapy: This unique rotation serves to address the very important issues of transfusion medicine and coagulation, which are integral to the practice of anesthesiology, but sometimes not adequately addressed in anesthesiology training. The CBYs attend transfusion rounds and review complications from transfusions with UPMC’s transfusion medicine experts. The rotation also includes coagulation rounds during which the residents learn clinical coagulation management.
- Internal Medicine: CBYs spend two months working on an Internal Medicine Inpatient Team at UPMC Presbyterian. These important rotations serve to hone the residents history taking, physical examination, and diagnostic skills in a highly supportive but acute environment. Skills furthered here serve to bolster the often very critical medical decision making required of anesthesiologists.
- Otolaryngology: This rotation was chosen because of the high level of collaboration necessary between anesthesiologists and surgeons in caring for otolaryngology patients. The CBYs spend one month on the UPMC Presbyterian Head and Neck Cancer service. This very active service provides state of the art care for patients with often advanced malignancies of the head and neck, including the airway. The CBYs learn important basic surgical management principles, as well as tracheostomy management.
- Pediatrics: This rotation serves as an introduction to the medical care of children before residents undertake the awesome responsibility of caring for children in the perioperative setting. In order to expose the residents to a wide breadth of patient ages and presentations, this rotation takes place in the busy Emergency Department at Children’s Hospital of Pittsburgh of UPMC. The collaborative and academic setting fosters keen instincts in caring for children.
- Surgery: CBYs spend one month working with the Thoracic Surgery service at UPMC Presbyterian. Thoracic surgery was chosen to host the CBYs because of the many medical issues in thoracic surgery with which anesthesiologist must be intimately familiar. The CBYs learn basic bronchoscopy skills, radiographic assessment of the chest using different imaging modalities, and chest tube management.