The CA-1 year starts with a mix of intense didactic lectures and a daily exposure to the operating rooms. During the month of July, you will have two lectures each day and spend the rest of your time in the operating rooms learning where things are and getting comfortable being in the environment. During this time you will be working one-on-one with attendings. You will also be involved in preoperative and postoperative visits with guidance from the other residents. A dedicated weekly simulator curriculum will also be part of your orientation month. By the end of July, you will be ready to start your rotations.

Basic Rotations
Starting in August, CA-1 residents rotate through multiple basic anesthesia areas in the operating room including:

• General surgery
• Surgical oncology
• Gynecology
• Gynecologic oncology
• ENT
• ENT oncology
• Plastic surgery
• Urology
• Orthopaedic surgery

OPAC Rotation
Each CA-1 also does a one-month rotation through The Ohio State University Preoperative Assessment Center (OPAC). They will receive instruction on performing preoperative evaluations and ordering patient workups according to evidence-based guidelines.

Critical Care Medicine
Our residents rotate through our 42-bed surgical intensive care unit (SICU), which is co-managed by the Department of Anesthesiology and the Department of Surgery. This ICU is the primary landing site for our Level 1 trauma and Level 1 burn patients. During this rotation, residents learn how to manage the critically ill, post-surgical, burn, and trauma patient. Teaching occurs at the bedside, during rounds, with in-situ simulation, and during didactic sessions. Critical care ultrasonography and placement of arterial and central venous catheters is also expected.

Additional CA-1 Information
In addition, the resident gains experience providing anesthesia outside the operating rooms (eg, interventional radiology, CT, MRI, ECT). CA-1 residents also complete one month on the obstetric floor and a two-week rotation in the PACU. Near the end of the CA-1 year, the resident will begin subspecialty rotations as a prelude to the CA-2 year.

The CA-2 year is dedicated to various subspecialty rotations. These include obstetrics, neuroanesthesia, cardiovascular, thoracic, regional, pediatric anesthesia, critical care medicine and pain management.

Obstetrics (OB)
The OB rotation takes place in the maternity suites at the main University Hospital. Residents learn about maternal and fetal physiology and pathophysiology as it applies to maternal pain control for labor pain and anesthetic management of the peritoneum for multiple procedures, including cesarean births, postpartum tubal ligations or cerclages. Anesthetic techniques include utero neuraxis blocks (spinal, epidural and combined spinal-epidural anesthesia), general anesthetics, as well as local anesthetics. Residents are involved in the care of high-risk patients. Residents will attend daily lectures and weekly multidisciplinary conferences.

Neuroanesthesia
The neuroanesthesia rotation takes place at University Hospital and The James Cancer Hospital. Cases include both vascular and non-vascular craniotomies as well as various spinal procedures. Residents learn neuroanesthesia and monitoring techniques, such as evoked potential and ICP monitoring. During the rotation, residents attend additional neuro didactic sessions.

Cardiovascular
The cardiovascular rotation is completed at the Ross Heart Hospital, which is connected to the general operating rooms. Clinical experience ranges from on- and off-pump CABG surgery, valvular surgery, ventricular assist devices to aortic surgery (including ascending, arch, descending and abdominal aortic surgery and stent placement). Didactics expand from physiology and pathophysiology to advanced monitoring, including transesophogeal echocardiography, cerebral oximetry and spinal drain monitoring. Teaching occurs pre- and intraoperatively, as well as during additional weekly cardiovascular didactic sessions.

Thoracic
The thoracic rotation takes place at The James Cancer Hospital or the Ross Heart Hospital. Procedures include thoracotomies and thoracoscopies, mediastinoscopies, bronchoscopies and esophagoscopy with laser Rx, as well as lung volume reductions and lung transplants. Residents learn about physiology, pathophysiology and pharmacology as it applies to thoracic surgery. They will become proficient in methods of lung isolation and bronchial blockers, as well as options for postoperative pain management (thoracic epidural and paravertebral blocks).

Regional
The initial rotation of regional anesthesia takes place away from the main campus at University Hospital East with a large percentage of upper and lower extremity orthopedic and podiatric surgery. Residents will learn anatomy of the upper and lower extremity as it applies to performing upper and lower extremity blocks. The placement of blocks or in-dwelling catheters is facilitated using nerve stimulators or ultrasound. Residents will spend a day in the cadaver lab in order to reinforce concepts learned on their rotation.

Pediatric Anesthesia
The pediatric anesthesia rotation takes place at Nationwide Children’s Hospital away from the main OSU campus. The resident learns about pediatric physiology and pathophysiology as it applies to the anesthetic management of a child. Residents are exposed to a wide variety of surgical procedures in the inpatient as well as ambulatory surgery setting. The teaching that occurs in the operating room is supplemented with daily didactic teaching conferences.

Critical Care Medicine
Our residents rotate through our 28-bed cardiothoracic surgical intensive care unit (SICU), which is staffed 24/7 by intensivists from the Department of Anesthesiology. During this advanced rotation, residents will improve upon procedures learned in the surgical ICU but also have the opportunity for the placement of pulmonary artery catheters, hemodynamic monitoring using disposable transesophageal echocardiography, as well as critical care ultrasonography. Residents will expand upon their knowledge of cardiac and pulmonary physiology will caring for patients post lung and heart transplant patients, as well as patients with mechanical circulatory support (ventricular assist devices) and extracorporeal life support (ECLS.ECMO). Teaching occurs during bedside rounds as well as scheduled didactics.

Pain Management
Residents learn about acute and chronic pain in the hospital and office setting. There they will be exposed to patient evaluations, multi-modal measures of treating chronic and cancer pain, as well as managing acute pain using spinal epidural or systemic analgesic techniques. They will observe and perform numerous pain procedures.

The CA-3 year provides the resident with a 12-month experience in advanced and complex anesthesia assignments. Clinical assignments in the CA-3 year include difficult or complex anesthesia procedures and the care of seriously ill patients. Subspecialty rotations are encouraged but may not be longer than six months.

Rotations
Ambulatory rotation: Senior residents will spend one month at the new Eye and Ear Institute where they will learn to develop strategies for outpatient anesthetic management. In addition to performing regional blocks, the resident will become proficient at the anesthetic management for ENT, plastics and eye procedures.

TEE rotation: Residents have the option of spending one month at the Ross Heart Hospital where they will learn the basics of performing and interpreting TEE exams. The month includes one-on-one teaching and a dedicated lecture schedule.

Cardiac critical care rotation: Residents interested in pursuing further training in cardiac or critical care anesthesiology can elect to do a an additional one month elective in the cardiothoracic surgical ICU where they will expand upon their knowledge of post-cardiac surgery, ventricular assist device (VAD), intra-aortic balloon pump, and ECMO patients.

Regional anesthesiology: This one month elective, which takes place at the main campus allows senior residents to hone the skills they have learned during their regional rotation during their CA-2 year. Regional exposure includes upper and lower extremity blocks, perineural catheters, paravertebral blocks and epidurals. The block resident also acts as the go-to resident for difficult airways, codes, ultrasound IV or other advanced procedures that may be needed throughout the day.

Research Track
The program offers resources to provide a research track of up to six months devoted to a laboratory or clinical investigation. For the resident who elects this track, it is expected that the result of the investigations will be suitable for presentation at a local, regional or national scientific meeting. The research track generally occurs in the CA-3 year, but at the program director's discretion, may be taken earlier.

Scholarly Activity
The resident is expected to do an academic project, which may include special training assignments, grand rounds presentations, preparation and publication of a review article, book chapters, manuals for teaching or clinical practice or similar academic activities. A faculty supervisor is in charge of each project. At the discretion of the program director, the project may occur prior to the CA-3 year. In addition, each will be assigned to a team departmental quality improvement project. Each resident is also required (and provided funding) to present at the Midwest Anesthesia Residents' Conference.

Clinical base year available

This program meets the ABA requirement of one year of non-anesthesia clinical training prior to starting three years of clinical anesthesia training. Within the institution, we partner with program directors from other specialties to provide an enhanced learning experience for our PGY-1 trainees in various medical and surgical disciplines.

The clinical spectrum that our academic medical center offers is wide-reaching and allows our PGY-1 residents to rotate in longstanding and successful training programs in internal medicine, neurology, critical care, emergency medicine, general surgery, otolaryngology, obstetrics and pain medicine. PGY-1 residents will also do a month of anesthesiology where they will interact with upper level residents and start to develop some of the skills they will need in the coming years.

We believe the addition of the clinical base year to our three-year advanced program solidifies the general medical knowledge base of our anesthesia residents and improves their understanding of how their future colleagues in other specialities think and practice.

For those resident graduates who wish to go on to post-graduate physician training, Ohio State's Wexner Medical Center offers ACGME-approved fellowships in critical care medicine, pain medicine, cardiothoracic anesthesiology and obstetric anesthesiology, as well as non-ACGME approved fellowships in regional anesthesiology, neuroanesthesia and ambulatory anesthesiology business and leadership.

In order to be considered for our training program, we require the following:

• Completion and submission of the ERAS common application form
• Dean's letter
• An official copy of your medical school transcript
• USMLE or COMLEX test scores (we have not set a minimum score)
• A personal statement
• Three additional letters of recommendation from physicians who are acquainted with your work or capabilities
• A personal interview in Columbus, Ohio

Interviews will be conducted on The Ohio State University campus from October to January. All applicants selected for an interview will be notified via e-mail as soon as possible. Early (or late) selection for an interview does not imply additional desirability of the candidate. ALL candidates invited for an interview are considered exceptional by the residency selection committee.

There will be 10 to 12 applicants scheduled per day and the groups are typically divided in half. One group will interview in the morning and the other group will interview in the afternoon. At the time of your interview invitation we will ask your preference, if any, for a morning or afternoon session. Our residents will host a dinner for applicants the night before your interview and we strongly encourage you to make every effort to arrive in Columbus in time to join the group at a local restaurant.

We are happy to pay for one night lodging and will make your overnight reservations at either The Blackwell or Hyatt Place, depending upon availability. Please be sure to inform us if you will require hotel reservations and if you have any special needs.

Foreign medical graduates are welcome to apply through ERAS following the requirements listed above. J-1 is the only visa accepted into this program.