Residency education in anesthesiology consists of 4 years of postgraduate experience: a clinical base year (CBY) followed by 36 months of clinical anesthesiology. Although historically the CBY was completed as a distinct internship, often in an unrelated institution, Columbia University instituted an integrated 4 year program beginning in 2008. This change followed the 2006 modification of the anesthesiology training requirements by the Anesthesiology Residency Review Committee; this afforded residency programs the opportunity to take responsibility for the CBY experience, giving them an unprecedented degree of oversight and control to optimally integrate the entire training continuum.
Following the 2006 training modifications, the options for entry into an anesthesiology program became limited to:
- Participation in a CBY integrated with a three year anesthesiology program;
- Transfer (e.g. from Surgery or Internal Medicine) after 1 + years of GME training.
Importantly, the degree of integration of the CBY is left open-ended. For three year anesthesiology programs which lack resources or interest in offering their own on-site PGY-1 year, the major impact of the change has been to require quarterly performance assessments from external PGY-1 program directors to the anesthesiology program directors where training is to be completed. Programs which choose to offer an on-site program, in contrast, have continual contact with their residents and the ultimate authority over the constitution and content of the required rotations within the ACGME guidelines.
What is required in the CBY?
Regardless of where residents take their PGY-1 year they must have:
- 6 months of inpatient care: Internal Medicine, Surgery, Pediatrics, Surgical Specialties, OB/GYN, Neurology, Family Medicine or a combination of the above
- 1-2 months each of Emergency Room Medicine and Critical Care Medicine
- May have up to 1 month of Anesthesiology
- Any missing elements can be made up during CA1 – 3 years.
What have we done at Columbia?
In response to the new requirements, the Department of Anesthesiology at Columbia applied for and received approval for a 4-year curriculum with 26 residents per year. By embracing the opportunity to offer a 48-month program, we believe we have been able to optimize the educational and training experience of our residents. A uniform training experience, providing for direct care of acutely ill hospitalized patients in a first-tier academic medical center that is consistently ranked on the U.S. New & World Report Honor Roll, offers a consistency and training breadth which was prohibitive within the prior curriculum format.
It is our goal to provide the "ideal" residency and we believe that we have created an outstanding training experience. Moreover, we look forward to continuing to grow and refine the residency as needed.
The Assistant Program Directors for the CBY resident year are Drs. Brian Egan and Brigid Flynn.
Dr. Brian Egan
After graduating from Dartmouth College with a BA in Psychology in 1995, I went on to study medicine at Yale University and graduated with an MD, MPH in 2000. I then completed a transitional year internship at St. Vincent's Medical Center in Bridgeport, Connecticut, and anesthesiology residency at Brigham and Women's Hospital in Boston, MA. Following my residency I was pleased to join the staff of Columbia University Medical Center in the fall of 2004.
Since my arrival I have been heavily involved in resident education and resident advocacy. My teaching activities are many and include participation in the core curriculum lecture series as well as individualized formal lectures in the operating room. In addition, I assist in the medical student education process both during their required one week rotation and during the sub-internship program. Finally, I am also responsible for overseeing the education of the oral-maxillofacial residents as they rotate through anesthesia.
I am a diplomate of the American Board of Anesthesiology (ABA), a member of the American Society of Anesthesiologists (ASA), and a member of the Society for Education in Anesthesia (SEA). I am very pleased to be involved in implementing and overseeing the evolving residency curriculum as CBY program director. Along with Drs. Wood, Pang, Whittington, Hastie and Flynn, I am working to make the PGY-1 year a superior, integrated experience which will provide a solid medical foundation and lead seamlessly into the completion of the education process.
Dr. Brigid Flynn
After graduating from Kansas State University with a BA in Pre-Medicine, I attended the University of Kansas School of Medicine. I completed my anesthesia residency at the University of Virginia in 2006 and was excited to come to Columbia University Medical Center and complete a critical care fellowship. Since completion of my fellowship, I have enjoyed practicing both general and transplantation anesthesia in the OR’s and cardiothoracic intensive care in the ICU’s.
The focus of my practice is two-fold. Firstly, in the ICU, I enjoy the challenges of caring for cardiothoracic patients in a large volume and tertiary environment such as Columbia. The devices, including LVAD’s and ECMO’s, require one to be continually learning as the technology is changing rapidly. It is also fulfilling to work as a productive team member with all of the various specialists that compose our multidisciplinary team. In the OR’s, I enjoy working with residents in providing an optimal anesthetic experience for patients. Secondly, as I continue to learn throughout my career, I enjoy teaching residents and fellows. I routinely give formal lectures to residents, but also enjoy the informal day-to-day teaching that occurs both on ICU rounds and in the ORs. I also participate in training residents and fellows in the practical application of ultrasound use for operative and ICU patients.
I am a member of the American Board of Anesthesiology and the New York State Society of Anesthesiologists. It is an honor to work with Drs. Wood, Pang, Whittington, Hastie and Egan on educational initiatives for residents with my emphasis being on the PGY-1 Clinical Base Year (CBY). Our hope is to provide a CBY year that offers an array of rotations and educational opportunities that will set the groundwork for a superior anesthesia residency experience.