Residency education in anesthesiology consists of 4 years of postgraduate experience: a clinical base year (CBY) followed by 36 months of clinical anesthesiology. Following the 2006 modification of the anesthesiology training requirements by the Anesthesiology Residency Review Committee, Columbia University instituted an integrated 4-year program beginning in 2008. This has allowed us to take responsibility for the CBY experience. This unprecedented degree of oversight and control has allowed us 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 level of integration as required by the RRC is broadly defined. Many three year anesthesiology programs that lack the resources or interest in offering their own on-site PGY-1 year have accommodated the 2006 training modifications by soliciting quarterly performance assessments from external PGY-1 program directors. Although this technically satisfies the RRC’s definition of integration, programs such as ours, which choose to offer an on-site program, 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 – 2 years.
What have we done at Columbia?
The Department of Anesthesiology at Columbia University embraced the above changes and applied for and received approval for a 4-year curriculum with 26 residents per year. By offering a 48-month program, we believe we have been able to optimize the educational and training experience of our residents by providing experience in direct care of acutely ill hospitalized patients in a first-tier academic medical center that is consistently ranked on the U.S. News & World Report Honor Roll, and offering a consistency and training breadth which was prohibitive within the prior curriculum format. The experience is unmatched by programs which fulfilled training requirements only through enhanced communication with PGY1 PDs.
It has been our goal to provide the "ideal" residency and we believe that we have created an outstanding training experience. Moreover, we have continued to grow and refine the residency over time, incorporating unique experiences into the PGY1 year such as dedicated transfusion medicine and patient safety rotations. Having our residents on-site has also allowed us to incorporate training elements early into the program representing skill requirements of a cutting-edge anesthesiologist of the 21st century, such as the longitudinal bed-side ultrasound curriculum which begins in the PGY1 year and continues throughout the 4-year curriculum as well as our brand-new simulation curriculum.
The Assistant Program Directors for the CBY resident year are Drs. Brian Egan and Julia Sobol.
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 overseeing the evolving residency curriculum as CBY program director. Along with Drs. Brambrink, Pang, Whittington, Hastie and Sobol, 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. Julia B. Sobol
After receiving a BA in Biology from Harvard University, I attended medical school at Washington University in St. Louis. I completed one year of General Surgery residency at Cornell and then switched to Anesthesiology residency at Columbia University Medical Center. I completed a critical care fellowship at Columbia in 2010. Since that time, I have enjoyed being an attending at Columbia, splitting time between working in the OR and ICU and doing clinical research.
The complexity of patients at Columbia and the cutting-edge therapies offered allow a wide breadth of educational opportunities for residents and fellows. I enjoy teaching trainees in both formal and informal sessions how to manage these challenging patients in the OR and in the ICU. I am involved in the core curriculum lecture series, as well as in airway lectures given monthly to residents taking the airway course. I also participate in training residents and fellows in using ultrasound technology in the perioperative period.
I am a diplomate of the American Board of Anesthesiology with subspecialty certification in critical care medicine. I am a member of the American Society of Anesthesiologists, the Society of Critical Care Anesthesiologists, the Society of Critical Care Medicine, and the International Anesthesia Research Society. It is an honor to work with Drs. Brambrink, Pang, Whittington, Hastie, and Egan on resident education initiatives. Our goal is to provide a clinical base year that offers a wide range of educational opportunities that will lay the groundwork for an exceptional anesthesia residency experience.