Clinical Curriculum

At Henry Ford, we care for some of the most complex and critically ill patients in the region. Our clinical volume and complexity offer a very high level of training for our residents and fellows in both the general surgical and subspecialty surgical populations as well as the ICUs, Pain Clinics and beyond. Residents are exposed to higher level cases at an early stage in their training. We have adjusted our curriculum to meet this demand and we are finding that our residents are prepared to face a very high level of complexity as expert consultants and trusted anesthesiologists upon graduation.

Below you will find a general overview of each year of your residency training at Henry Ford Hospital.

PGY-1 Longitudinal Curriculum:

As of July 2018, we have recreated our PGY-1 experience to allow for active clinical training in anesthesiology for FOUR months of the PGY-1 year. Four- five interns spend three months of their internship in a row within our department and experience a graded training process beginning with a month of clinical observation with Senior residents. PGY1’s are assigned a self-directed reading curriculum with weekly quizzes. During these months, PGY1’s are given free time to read. They are then allowed more autonomy with case management as the three-month period progresses by being assigned their own cases with supervision from a Senior resident and a faculty member. For one to two weeks of the three-month period, the PGY-1 will spend a week working one to one with an attending physician on daily cases. Finally, all 14 PGY1 residents return in June for an intensive, more advanced clinical training and didactic program. By the second week of June, PGY1 residents are assigned their own rooms with indirect faculty supervision and are ready to fly as of July 1.

The other eight months of the PGY1 are spent on the following rotations:

• Inpatient Internal Medicine
• Inpatient Cardiology
• Emergency Medicine including Point of Care Ultrasound Curriculum
• ENT with heavy focus on fiberoptic laryngoscopy
• Blood Bank/Transfusion Medicine
• Medical ICU
• Perioperative Medicine Clinic

Of note, all PGY-1 residents have a dedicated week plus additional training in Point of Care Ultrasound directed by fellowship trained Emergency Medicine Ultrasound experts. This allows our Interns to have exceptional POCUS experience before even starting their Anesthesiology Residency. They also undergo skills training in early PGY 1 year that helps them prepare well for arterial line and central line placements. In June, they have full day Sim session to prepare for crisis management in OR. This dedicated hands-on training session prepares them for most common emergency scenarios that they will encounter during their early CA-1 year. Having a structured and robust anesthesiology experience in PGY1 year helps to create a solid foundation for the CA-1-3 years.

PGY2/CA1:

The PGY2 year is spent learning the basic of clinical anesthesiology practice. Much of the time is spent rotating in General Anesthesia with months in Obstetric Anesthesia, Vascular Anesthesia, Neuro Anesthesia, Regional Anesthesia, Pain Medicine and SICU.

In addition, to complete the requirements of the PGY1 year given the four months spent within the Anesthesia department, residents complete a two-week rotation in Advance Heart Failure and another two-week rotation in Transplant Hepatology. At Henry Ford we care for a high volume and complexity of end-stage liver disease and heart failure with one of the most robust liver transplant programs in the region. We also have a very robust LVAD program and heart transplant program. We feel experience in management of these patients directly before their transplants is essential in understanding the pathophysiological processes affecting anesthesia care during transplant and directly post-transplant.

PGY3/CA2:

The PGY3 year is commonly the year where residents begin their subspecialty rotations. Our residents do one more month of Obstetric Anesthesiology at Henry Ford Main, two months of Cardiac Anesthesiology, two months of Pediatric Anesthesiology at Children’s Hospital of Michigan, one month of SICU and Pain Medicine.

PGY4/CA3:

During the PGY4/CA3 year, residents are elevated to leaders in the operating room. This year residents rotate in multiple months of Advanced Clinical Tract Anesthesiology (ACT) which gives them exposure to all of the most complex cases Henry Ford has to offer, one month SICU, one additional month of Regional Anesthesia, two week of Perioperative Surgical Home rotation, two weeks of Ambulatory Anesthesiology where residents act as Junior attendings at one of our ambulatory centers, two weeks of Non-Operating Room Anesthesiology, plus multiple elective months including TEE, Pediatric Anesthesiology, Pain Medicine, SICU, CTSICU, Noninvasive and Structural Cardiology, Research, Supervision track or any other areas a resident has interest in. We are always happy to accommodate resident interests.

Residents also spend around a month throughout their residency in our Perioperative Care Clinic.

CALL STRUCTURE:

Residents take overnight call in a night float system which is usually arranged in two-week blocks, Sunday to Thursday from 7pm to 7am. After the second week, the resident enjoys Friday, Saturday and Sunday off before returning to daytime schedule to ensure adequate rest and ease in cycling back to days. Resident take around 6 total weeks of night float per year. We also cover some of the weekend call shifts, however that burden has been significantly reduced due to CRNA support. All call shifts except Friday calls are 12 hours, giving ample time for rest and recovery.